These studies suggest that glucosamine sulfate may inhibit the breakdown of cartilage associated with osteoarthritis and may have the potential to help build-up cartilage. Glucosamine hydrochloride, another form of glucosamine, is available as a nutritional supplement and is considered to be as effective as the sulfate form although there are fewer completed studies to review.
This hydrochloride form of glucosamine is more available for absorption into the body; therefore, a smaller dose delivers an equivalent amount in the system. Chondroitin sulfate is a larger molecule also found in cartilage. Chondroitin sulfate has been studied much less extensively, but early results show that it also seems to work as an anti-inflammatory and reduces pain. Some laboratory studies suggest that chondroitin sulfate may slow cartilage breakdown associated with osteoarthritis and even stimulate cartilage growth.
Many patients who suffer from osteoarthritis may benefit from the positive effects of taking this supplement. The painful symptoms of osteoarthritis may appear when cartilage becomes worn, and exposed bones begin to rub together. Conventional medicine does not yet have a proven treatment to stop or slow the progression of osteoarthritis. Traditional medical treatment includes drug therapy to control the pain associated with osteoarthritis. These treatments are sometimes disappointing for physicians and patients because medications may not provide complete relief and can have unwanted side effects.
Some of these patients may be candidates for nutritional supplements like glucosamine and chondroitin sulfate. Preliminary studies show glucosamine sulfate and chondroitin sulfate to be safe and well tolerated. Common side effects may include:. These side effects are reported in a small portion of patients. However, even substances that are found naturally in the body can have unpredictable results when taken in higher than normal quantities and in different formulations.
The epigenetic effect of glucosamine and a nuclear factor-kappa B NF-kB inhibitor on primary human chondrocytes--implications for osteoarthritis. Biochem Biophys Res Commun ; Glucosamine, a naturally occurring amino monosaccharide, suppresses dextran sulfate sodium-induced colitis in rats. Effect of glucosamine and related compounds on the degranulation of mast cells and ear swelling induced by dinitrofluorobenzene in mice.
Life Sci ;86 Glucosamine induces autophagic cell death through the stimulation of ER stress in human glioma cancer cells. D-glucosamine down-regulates HIF-1alpha through inhibition of protein translation in DU prostate cancer cells.
Cancer Cell Int ; J Cell Biochem ; Glucosamine is an effective chemo-sensitizer via transglutaminase 2 inhibition. Cancer Lett ; Evaluation of the effect of glucosamine on an experimental rat osteoarthritis model. Weiden S and Wood IJ. The fate of glucosamine hydrochloride injected intravenously in man.
J Clin Pathol ; Associations of herbal and specialty supplements with lung and colorectal cancer risk in the VITamins and Lifestyle study. Cancer Epidemiol Biomarkers Prev ; Audimoolam VK, Bhandari S. Acute interstitial nephritis induced by glucosamine.
Nephrol Dial Transplant ; Gastroenterol Clin Biol. Efficacies of different preparations of glucosamine for the treatment of osteoarthritis: a meta-analysis of randomised,double-blind, placebo-controlled trials. Int J Clin Pract ; Combined glucosamine and chondroitin sulfate, once or three times daily, provides clinically relevant analgesia in knee osteoarthritis.
Clin Rheumatol ; Effect of oral glucosamine on joint structure in individuals with chronic knee pain: a randomized, placebo-controlled clinical trial. Drug-induced acute liver injury mimicking autoimmune hepatitis after intake of dietary supplements containing glucosamine and chondroitin sulfate. Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib.
Hepatotoxicity associated with glucosamine and chondroitin sulfate in patients with chronic liver disease. World J Gastroenterol ; Glucosamine hydrochloride for the treatment of osteoarthritis symptoms.
Clin Interv Aging ; Vlad, S. Glucosamine for pain in osteoarthritis: why do trial results differ? Arthritis Rheum ; Reginster, J. The efficacy of glucosamine sulfate in osteoarthritis: financial and nonfinancial conflict of interest. Frestedt, J. A natural mineral supplement provides relief from knee osteoarthritis symptoms: a randomized controlled pilot trial. Yue, J. Kanzaki, N. Effect of a dietary supplement containing glucosamine hydrochloride, chondroitin sulfate and quercetin glycosides on symptomatic knee osteoarthritis: a randomized, double-blind, placebo-controlled study.
Food Agric. Wandel, S. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ ;c Sawitzke, A. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT.
Jackson, C. The human pharmacokinetics of oral ingestion of glucosamine and chondroitin sulfate taken separately or in combination. Lee, Y. Effect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis. Theoharides, T. Can J Urol ; Dudics, V. Chondrogenic potential of mesenchymal stem cells from patients with rheumatoid arthritis and osteoarthritis: measurements in a microculture system.
Cells Tissues. Organs ; Cahlin, B. No effect of glucosamine sulfate on osteoarthritis in the temporomandibular joints--a randomized, controlled, short-term study. Shaygannejad, V. Effects of adjunct glucosamine sulfate on relapsing-remitting multiple sclerosis progression: preliminary findings of a randomized, placebo-controlled trial. Neurol Res ; Ostojic, S.
Glucosamine administration in athletes: effects on recovery of acute knee injury. Res Sports Med ; Rozendaal, R. Effect of glucosamine sulphate on joint space narrowing, pain and function in patients with hip osteoarthritis; subgroup analyses of a randomized controlled trial. Marti-Bonmati, L. Glucosamine sulfate effect on the degenerated patellar cartilage: preliminary findings by pharmacokinetic magnetic resonance modeling.
Eur Radiol ; A large, randomized, placebo-controlled, double-blind study of glucosamine sulfate vs piroxocam and vs their association on the kinetics of the symptomatic effect in knee osteoarthritis. Osteoarth Cartilage ;2 suppl 1 Nandhakumar J. Efficacy, tolerability, and safety of a multicomponent antiinflammatory with glucosamine hydrochloride vs glucosamine sulfate vs an NSAID in the treatment of knee osteoarthritis--a randomized, prospective, double-blind, comparative study.
Integr Med Clin J ; Muller-Fassbender, H. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Towheed, T. Glucosamine therapy for osteoarthritis. J Rheumatol ; Zhang, W. OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January Petersen, S.
Nonsteroidal anti-inflammatory drug or glucosamine reduced pain and improved muscle strength with resistance training in a randomized controlled trial of knee osteoarthritis patients. Arch Phys Med Rehabil ; Noack, W. Glucosamine sulfate in osteoarthritis of the knee. The efficacy and tolerability of glucosamine sulfate in the treatment of knee osteoarthritis: a randomized, double-blind, placebo-controlled trial.
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Diabetes ; Glucosamine induces insulin resistance in vivo by affecting GLUT 4 translocation in skeletal muscle. Implications for glucose toxicity. J Clin Invest ; No changes of cholesterol levels with a commercially available glucosamine product in patients treated with lipid lowering drugs: a controlled, randomised, open cross-over trial. BMCPharmacol Toxicol ; Kashin-Beck disease in Sichuan, China: report of a pilot open therapeutic trial.
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Theodosakis J. A randomized, double blind, placebo controlled trial of a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor for osteoarthritis of the knee. McAlindon T. Why are clinical trials of glucosamine no longer uniformly positive? Rheum Dis Clin North Am ; Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis.
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Am J Health Syst Pharm ; Towheed TE. Current status of glucosamine therapy in osteoarthritis. To date, there is no evidence that these supplements are effective for any other forms of arthritis. While the evidence for whether glucosamine and chondroitin will help your arthritis is low, these supplements are considered safe for most people to try.
If you want to try these supplements, talk to your doctor or pharmacist about whether they are safe for you. Different brands contain different amounts of glucosamine and chondroitin. Read the label carefully to see how many tablets you need to take to get the right dose, or ask your pharmacist for advice.
Talk to your doctor or pharmacist about whether you should be trying these medications, whether they are safe for you and, if you decide to try them, make sure you get the right dose. High-quality evidence shows little or no benefit from glucosamine or chondroitin for OA. Recent media reports have raised concern over the use of glucosamine in the treatment of osteoarthritis. These reports appear to be based on two unrelated recent events:. In October the ACR updated their guidelines for the management of osteoarthritis from a longstanding conditional recommendation against the use of glucosamine for osteoarthritis on the basis that it probably does not help , to a strong recommendation against the use of glucosamine for osteoarthritis on the basis that it convincingly does not help.
They did not cite new safety concerns. This paper reviewed glucosamine related adverse drug reactions reported to the Therapeutic Goods Administration between , including 43 classified as severe, possibly related to the known risks of glucosamine in those with shellfish allergy.
This highlights a valid concern but the number of adverse events needs to be considered in the context of the many hundreds of thousands of people who took glucosamine during that period. This suggests that severe adverse reactions are very uncommon. Many other osteoarthritis treatment guidelines make conditional recommendations against the use of glucosamine on the basis that it probably does not help, including The Royal Australian College of General Practitioners guideline for the management knee and hip OA [3].
This information highlights growing evidence that glucosamine does not help people with osteoarthritis and is a reminder that people with shellfish allergy should not take glucosamine which is commonly derived from shellfish.
It does not identify any new safety concerns and should not cause undue alarm in people already taking glucosamine. If you have concerns about using glucosamine or treatment for osteoarthritis I recommend you have a chat with your local GP about the options available to you.
Australian Rheumatology Association — T: 02 E: [email protected]. Arthritis Australia — T: 02 E: [email protected]. Glucosamine and chondroitin - printable information sheet.
Glucosamine for the Treatment of Osteoarthritis Statement. Arthritis Australia advocates to government, business, industry and community leaders to improve care, management, support and quality of life for people with arthritis.
Arthritis Australia funds research and advocates to improve care, management, support and quality-of-life for people with arthritis. Home Managing arthritis Living with arthritis Complementary treatments and therapies Glucosamine and chondroitin.
Glucosamine and chondroitin This sheet has been written to provide general information about glucosamine and chondroitin for people with arthritis. Introduction Research is mixed on whether glucosamine and chondroitin are effective for arthritis. What is glucosamine? What is chondroitin? Why are these supplements supposed to help arthritis? What does the research say? Summary While the evidence for whether glucosamine and chondroitin will help your arthritis is low, these supplements are considered safe for most people to try.
What is the recommended dose? Glucosamine sulfate: mg per day Glucosamine hydrochloride: mg per day note, glucosamine sulfate is suggested to be more effective Chondroitin sulfate: — mg per day Different brands contain different amounts of glucosamine and chondroitin. What are the possible risks? Shellfish allergy: most glucosamine supplements are made from shellfish, although some made from non-shellfish sources are now available.
Bleeding: people taking the blood thinning medicine warfarin should talk to their doctor before starting, stopping or changing their dose of glucosamine or chondroitin. These supplements may interact with warfarin and make the blood less likely to clot or increase the risk of bleeding. Diabetes: glucosamine is a type of sugar so check with your doctor before taking glucosamine if you have diabetes. Pregnant or breastfeeding women: there have not been enough long-term studies to clearly say that glucosamine is safe for a developing baby.
Pregnant women should talk to their doctor before taking glucosamine. Other side effects: upset stomach for example, diarrhoea , headaches, and skin reactions. Australian Rheumatology Association and Arthritis Australia Statement regarding the use of glucosamine for the treatment of Osteoarthritis Recent media reports have raised concern over the use of glucosamine in the treatment of osteoarthritis.
These reports appear to be based on two unrelated recent events: A change in recommendation by the American College of Rheumatology ACR [1] In October the ACR updated their guidelines for the management of osteoarthritis from a longstanding conditional recommendation against the use of glucosamine for osteoarthritis on the basis that it probably does not help , to a strong recommendation against the use of glucosamine for osteoarthritis on the basis that it convincingly does not help.
A recent paper highlighting the known risks associated with glucosamine, particularly in people with shellfish allergy [2] This paper reviewed glucosamine related adverse drug reactions reported to the Therapeutic Goods Administration between , including 43 classified as severe, possibly related to the known risks of glucosamine in those with shellfish allergy.
Arthritis Australia and Australian Rheumatology Association comment: This information highlights growing evidence that glucosamine does not help people with osteoarthritis and is a reminder that people with shellfish allergy should not take glucosamine which is commonly derived from shellfish.
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