What is glucosamine?

Joint disorders | November 28, 2016 | Author: Naturopath

age related

What is glucosamine?

Many Australians are taking glucosamine as a supplement for joint pain and osteoarthritis. Osteoarthritis is the most common form of arthritis which causes degeneration of the articular cartilage and the underlying subchondral bone leading to low-grade synovial inflammation. Unfortunately the use of pharmaceutical anti-inflammatories (although providing much needed pain relief in individuals) doesn’t help in cartilage repair and reducing disease progression.  Multiple scientific studies have supported the use of glucosamine to reduce the symptoms of osteoarthritis and to slow its progression when used long-term. It can safely be used in conjunction with non-steroidal and anti-inflammatory drugs, with most people taking glucosamine finding they require anti-inflammatories less often.

What is it?

Glucosamine is a naturally occurring substance that is a component of proteoglycans, mucopolysaccharides and hyaluronic acid. These are constituents of joint tissue, such as articular cartilage, synovial fluid and tendons. Glucosamine is also a component of mucous secretions, heart valves and blood vessels.

Glucosamine is mostly derived from the shells of prawns and other crustaceans or can be produced synthetically. Its most common forms include glucosamine sulfate and glucosamine hydrochloride. Studies have shown the sulfate form to be superior, although the hydrochloride form has shown results in some studies.

There are also forms that aren’t derived from shellfish which are better suited to vegetarians and those with allergies.

The recommended amount of glucosamine is 1500mg per day, or even more in people who are overweight or obese. It is also more effective when taken in divided doses throughout the day.

Main Actions

Increase cartilage production: Glucosamine helps in increasing the synthesis of cartilage and prevents its breakdown. It also helps in the production of synovial fluid which lubricates the joint and acts as a shock-absorber.

Decrease inflammation: Glucosamine has been shown to prevent the production of many inflammatory mediators that contribute to the damage of cartilage.

Gastrointestinal protection: It may help to protect the mucous membrane lining in the bowel from damage.

Conditions it can be used for

Osteoarthritis

There is very good evidence to suggest that glucosamine sulfate is effective for the treatment of osteoarthritis by slowing disease progression. It was shown to be most effective for moderate severity osteoarthritis, particularly of the knee. Glucosamine sulfate also provides pain relief and is superior to the hydrochloride form. A review of the clinical trials of the hydrochloride form showed inconsistent results. Several clinical studies have also found that glucosamine is as effective as non-steroidal anti-inflammatories in treating the symptoms of osteoarthritis but can take a little longer for results (approximately 2-6 weeks). To gain a joint protective effect from glucosamine it needs to be taken long-term for at least 6 months to several years.

Inflammatory bowel disease

Studies have suggested that glucosamine may also be helpful in treating inflammatory bowel diseases (IBD) by reducing inflammation and tissue injury. In people with IBD such as Crohn’s disease and ulcerative colitis the synthesis of the protective glycoprotein cover that protects the lining of the bowels is impaired.

Rheumatoid Arthritis

A study conducted on 51 patients with rheumatoid arthritis found that glucosamine treatment produced noticeable improvement in symptoms when compared to placebo.

The participants in the study consumed 1500mg a day of glucosamine hydrochloride.

 

Combination therapy

With chondroitin sulfate

Glucosamine and chondroitin sulfate are commonly found together in supplements for arthritis. Numerous studies have shown that when taken in combination it is effective in treating the symptoms of osteoarthritis and reducing joint narrowing space. The GAIT trial found that the combination of glucosamine hydrochloride with chondroitin was more effective than celecoxib (a prescription non-steroidal anti-inflammatory drug) in treating moderate to severe osteoarthritis.

With MSM

In one particular study, methylsulfonylmethane (MSM) when combined with glucosamine was found to produce a greater and faster reduction in pain, swelling and loss of function than either agent used alone.

With Omega-3

A study involving 177 patients with moderate to severe hip or knee osteoarthritis found that glucosamine when combined with omega-3 was more far superior to glucosamine sulfate taken individually.

With chondroitin and camphor

Glucosamine can also be used topically to the affected areas for joint relief. A cream containing chondroitin and camphor was found to relieve the pain of osteoarthritis of the knee within 4 weeks.

Cautions

Glucosamine is a safe supplement to take with relatively little side-effects. However the following cautions are advised. People with diabetes should monitor their blood sugar levels while taking glucosamine, although no significant change should be anticipated. People with severe shellfish allergy should source a form not derived from crustaceans. Caution is advised in people taking warfarin.

Although the data can somewhat be conflicting, there is evidence to suggest that glucosamine does in fact reduce the symptoms of osteoarthritis and slow disease progression if taken long-term. It has also proven beneficial in rheumatoid arthritis and inflammatory bowel disease. The sulfate form has more evidence supporting its efficacy, so is therefore considered superior to the hydrochloride from. Glucosamine has also been shown to be more effective when taken in combination with chondroitin, MSM or omega-3 essential fatty acids.

References

Braun L, Cohen M. Herbs and natural supplements: An evidence based guide vol. 2. Churchill Livingstone, Australia

Roman-Blas J et al. Glucosamine sulfate for knee osteoarthritis: science and evidence-based use. Therapy 7.6 2010:591-604

http://www.openaccessjournals.com/articles/glucosamine-sulfate-for-knee-osteoarthritis-science-and-evidencebased-use.pdf

Nakamura H et al. Effects of glucosamine administration on patients with rheumatoid arthritis. Rheumatol Int. 2007 Jan;27(3):213-8

https://www.ncbi.nlm.nih.gov/pubmed/16953394

Clegg DO et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 2006 Feb 23;354(8):795-808

https://www.ncbi.nlm.nih.gov/pubmed/16495392

Usher PR, Naidu MUR. Randomised, double-blind, parallel, placebo-controlled study of oral glucosamine, methylsulfonylmethane and other combination in osteoarthritis. Clin Drug Invest April 2004:353-363

http://link.springer.com/article/10.2165/00044011-200424060-00005

Cohen M et al. A randomized, double-blind, placebo controlled trial of a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor for osteoarthritis of the knee. J Rheumatol. 2003 Mar;30(3):523-8

https://www.ncbi.nlm.nih.gov/pubmed/12610812

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