GLUCOSAMINE - a patient's guide
- Many people take glucosamine to try reduce the symptoms of osteoarthritis and hopefully also slow the progression of joint damage
- It is licensed as a dietary supplement rather than a medication
- Although widely promoted and used, the scientific evidence supporting it’s use is not strong
- It is often sold in combination with other supplements such as chondtoitin sulphate
- Quality and strength of available formulations vary greatly
Structure and Function of Glucosamine
Glucosamine is a naturally occurring substance (an amino sugar).It is a normal constituent of glycosaminoglycans, which make up part of the structure of cartilage.
There is in vitro evidence (i.e. in the laboratory) whereby in cultured chondrocytes (cartilage cells),glucosamine may exert a protective effect on cartilage and have some anti-inflammatory effects.
Chondroitin sulphate is involved in the hydration of cartilage.
Evidence of benefits of Glucosamine
Although many people are happy to take it and some swear by its effectiveness, the evidence in its favour is not very strong. Many of the studies looking at its effect have been considered of poor quality and possible biased as most have been funded by makers of glucosamine.
Critics rightly point out that the same can be said of the conventional anti-inflammatories (NSAIDS) traditionally used to treat arthritis.
A recent comprehensive meta analysis of previous studies showed that one in 5 benefited in terms of symptomatic relief of hip and knee arthritis taking both glucosamine and chondroitin .(see link below)
Two large recent studies, The GAIT study, conducted in the
Although both have demonstrated some benefit from glucosamine, the effect was not particularly large compared to placebo. The period of follow up was also short (6 months in the GUIDE study).
It is also worth noting that the trials used pharmaceutical strength glucosamine which is not usually available through many commercial preparations.
Safety of Glucosamine
It appears that glucosamine is very safe with only minor side effects which seem to settle (eg nausea).There were some concerns it may predispose to diabetes ,but this has not been confirmed, although studies are ongoing in this area.
It certainly is much safer than other anti-inflammatories (NSAIDS) and this aspect has been promoted. However in many countries it is not licensed as a medication and is not subject to the same intensity of monitoring.
Do doctors recommend glucosamine ?
Rheumatologists are somewhat divided about it’s use .Because of its good safety profile, many doctors feel they cannot reasonably advise against it if the patient feels it is beneficial.
The link below shows different rheumatologists arguing for and against and will help your understanding of the issues.
In most cases the patient will be paying for it themselves and the doctors role is more one of guidance and informing .
If you are considering using glucosamine for arthritis,consider the following .
What are you treating? It is important to be sure you do have important osteoarthritis. Not every ache in or near a joint is arthritis. There may be other explanations eg- tendonitis, torn cartilage, or gout.
In fact osteoarthritis is not always an easy diagnosis as X-ray changes do not always correlate reliably with symptoms and function.
Lifestyle factors such as weight loss, increased activity, strength building and simple painkillers (eg paracetemol)are likely to make a bigger overall impact on the management of osteoarthritis symptoms.
If you do decide to take glucosamine, a period of careful monitoring (2to 3 months) will help you decide if the benefits make it worthwhile continuing.
The links below have been carefully selected to help you make an informed decision.