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Glucosamine

Glucosamine (C₆H₁₄NO₅) is a dietary supplement distributed as a salt — usually as glucosamine HCl, glucosamine sulfate potassium, or glucosamine sulfate sodium. A typical dosage is 1,500 mg per day. The salt complexes, glucosamine sulfate _* KCl or glucosamine sulfate _* NaCl, or the hydrochloride, glucosamine sulfate _* HCl, are required for stabiliity. more...

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Glucosamine sulfate is a synthetic version of a compound the human body makes to stimulate the growth of cartilage. The idea is that such compounds help rebuild cartilage and reduce the symptoms of arthritis.

The supplement is an acceptable treatment in veterinary medicine, but the Arthritis Foundation and the American College of Rheumatology have not yet officially recommended it for humans, despite a large body of evidence supporting its use and the fact that it is considered a drug in several countries around the world. The United States Food and Drug Administration does not approve any dietary supplement, and, as such, at this time glucosamine is sold as a nutritional supplement and therefore does not need evidence of safety and efficacy. Glucosamine has been studied for over 20 years. As a natural substance that is already present inside the body, evidence bears out that glucosamine appears to be quite safe. One caveat - there is limited evidence that individuals with an allergy to shellfish should avoid glucosamine, as it is is usually derived from shellfish. There are vegetarian sources available.

Current research shows it may play a role in relieving pain associated with osteoarthritis. As used, it is often paired with MSM. The National Institutes of Health conducted a multi-arm, placebo-controlled study to see the effects of chondroitin and glucosamine on osteoporosis and osteoarthritis. Recent results of a 6-month clinical trial indicate that chondroitin sulfate (1.2 g) plus glucosamine (1.5 g) daily were as effective in relieving osteoarthritic knee pain as Celebrex, but more study would be helpful.

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Glucosamine: a review of its use in the management of osteoarthritis
From Alternative Medicine Review, 3/1/04 by A.J. Matheson

Matheson AJ, Perry CM. Drugs Aging 2003;20:1041-1060.

Glucosamine occurs naturally in all human tissues. It stimulates the synthesis of glycosaminoglycan, proteoglycan and hyaluronic acid, although the precise mechanism of action remains to be established. Formulated as glucosamine sulphate (Dona) and various others), glucosamine has been evaluated for its efficacy in relieving the symptoms of osteoarthritis and its disease-modifying potential. In two large randomised, double-blind, multicentre studies in patients with osteoarthritis, oral or intramuscular glucosamine for 4-6 weeks was associated with a greater decrease in symptom severity (as assessed by the Lequesne index) than placebo. In addition, there was a greater proportion of responders (defined as patients with a >or=3-point reduction in the Lequesne index, along with a positive overall assessment by the investigator) at the end of the treatment period with glucosamine than with placebo. In two large 4-week trials, oral glucosamine produced similar improvements to ibuprofen in the Lequesne index in one study and in articular pain scores in the other study. In a smaller g-week comparative trial, oral glucosamine therapy achieved a significantly greater improvement in articular pain score than ibuprofen, and the investigators rated treatment efficacy as 'good' in a significantly greater proportion of glucosamine than ibuprofen recipients. In comparison with piroxicam, glucosamine significantly improved arthritic symptoms after 12 weeks of therapy and remained effective 8 weeks after treatment was discontinued. Beneficial effects of long-term oral glucosamine therapy in preventing joint space narrowing and improving symptoms were shown in two 3-year placebo-controlled trials in a total of 414 patients with osteoarthritis. Statistically significant differences favouring glucosamine were noted in the per-protocol and intention-to-treat analyses for the primary endpoints for both ,joint structural changes and symptom modification. Glucosamine has a tolerability profile similar to that of placebo and is better tolerated than ibuprofen or piroxicam. In particular, glucosamine recipients had a markedly lower incidence of gastrointestinal disturbances than those receiving ibuprofen. Other adverse events reported in both glucosamine and ibuprofen recipients were pruritus or skin reactions, flushing and fatigue. In general, a lower incidence of withdrawal from clinical trials was reported for glucosamine recipients than either ibuprofen or piroxicam recipients. CONCLUSION: In short-term clinical trials, glucosamine provided effective symptomatic relief for patients with osteoarthritis of the knee. In addition, glucosamine has shown promising results in modifying the progression of arthritis over a 3-year period. Glucosamine may therefore prove to be a useful treatment option for osteoarthritis.

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