Glucosamine, which occurs naturally in the body, plays a key role in the
construction of cartilage -- the tough connective tissue that cushions the
joints. Glucosamine stimulates the production of glycosaminoglycans (the key
structural components of cartilage) as well as the incorporation of sulfur into
cartilage. Sulfur is necessary for making and repairing cartilage.
Glucosamine may be effective in treating and possibly slowing the progression
of osteoarthritis. This is a type of arthritis caused by continuous wear and
tear on the joints leading to inflammation, breakdown, and eventual loss of
cartilage. The tissues most affected by osteoarthritis are the weight bearing
joints, such as the knees and hips, as well as the joints in the hands.
Studies suggest that glucosamine may be at least as effective as some of the
medications frequently used to treat this joint condition, but with fewer
gastrointestinal side effects. The medications used to treat osteoarthritis are
known as nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and
piroxicam. NSAIDs may cause stomach upset, cramps, constipation, diarrhea, and
in some cases, stomach ulcers.
Glucosamine is often taken with chondroitin, another supplement thought to be
effective in treating arthritis. These substances are often combined with
manganese as well, a trace metal that is also needed for building cartilage.
Arthritis Although not every single study agrees, strong
evidence from many well-designed trials, indicate that glucosamine sulfate
supplements may be an effective treatment for osteoarthritis -- particularly
osteoarthritis of the knee. In general, findings from these studies suggest that
glucosamine provides several benefits for people with osteoarthritis including
pain reduction (as effective as ibuprofen and other NSAIDs), improved function
and mobility, and slowed progression or even prevention of joint destruction
when taken for 3 or more years.
In comparison to NSAIDs, glucosamine takes longer to begin working. However,
pain control lasts longer with glucosamine and the supplements cause fewer side
Although glucosamine and chondroitin are often administered together for the
treatment of osteoarthritis, it is not clear that the combination works better
than either supplement alone. Nor is it clear if glucosamine is better than
chondroitin or vice versa. Perhaps the most definitive results regarding the
effectiveness of glucosamine and chondroitin for osteoarthritis will be achieved
with the ongoing Glucosamine/Chondroitin Arthritis Intervention Trial sponsored
by the National Institutes of Health. This large-scale study involving over
1,600 people is investigating the effects of glucosamine alone, chondroitin
alone, and a combination of both for the treatment of knee osteoarthritis.
Results are expected in 2005.
Inflammatory Bowel Disease (IBD) Crohn's disease and
ulcerative colitis are two inflammatory bowel diseases that are marked by
chronic, recurrent bloody diarrhea. Preliminary evidence suggests that N-acetyl
glucosamine oral supplements or enemas may improve symptoms of IBD in children
who do not improve from standard medical treatments. Further research is needed,
however, to determine whether the substance is safe and effective for the
treatment of IBD.
There are no food sources of glucosamine. Supplements are derived from either
bovine cartilage or chitin, the hard outer shells of shrimp, lobsters, and
Glucosamine is available as an oral supplement in the following
Glucosamine sulfate: 500, 750, and 1,000 mg capsules and
N-acetyl glucosamine: 500 and 750 mg capsules and tablets
Glucosamine hydrochloride (HCL): 500, 750, and 1,000 mg capsules and
Glucosamine/chondroitin sulfate combination products (often contain
manganese as well)
Glucosamine sulfate is the form used in most research studies. It is believed
to be the best source because it provides the sulfur necessary for making and
Glucosamine is also available as an injectable form that your physician can
insert directly into the arthritic joint. N-acetyl glucosamine is also available
as an enema.
How to Take It
There are no known scientific reports on the pediatric use of glucosamine.
Therefore, it is not currently recommended for children.
1,500 mg per day (500 mg three times a day) for one to two
Ongoing supplementation (roughly 1,000 mg per day) may be required to prevent
the progression of osteoarthritis or to reduce pain and inflammation associated
with the condition.
Because of the potential for side effects and interactions with medications,
dietary supplements should be taken only under the supervision of a
knowledgeable healthcare provider.
The majority of studies indicate that glucosamine is safe, nontoxic, and
causes only minor side effects such as stomach upset, heartburn, indigestion,
gas, bloating, and diarrhea. If these symptoms occur, glucosamine should be
taken with food.
People with peptic ulcers should take glucosamine sulfate with food.
Glucosamine sulfate may contain high amounts of sodium or potassium, so
individuals on a restricted diet or taking potassium-sparing diuretics should
carefully check the label before taking glucosamine supplements.
People with diabetes should have their blood sugar checked regularly as
glucosamine may cause insulin to work less effectively. Some glucosamine
supplements are derived from shellfish, so individuals with shellfish allergies
should check with a health care professional before taking these
People who are allergic to sulfur are usually allergic to sulfa drugs or
sulfite-containing food additives. Sulfur is an essential nutrient that is
naturally present in the body of all individuals. "Sulfur-sensitive" people can
safely use glucosamine sulfate.
If you are currently being treated with any of the following medications, you
should not use glucosamine or make any adjustments to your medications without
first talking to your healthcare provider.
Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Glucosamine may
increase the anti-inflammatory activity of NSAIDs such as ibuprofen. This
interaction may result in the need for lower doses of these medications.
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Review Date: April 2002
Reviewed By: Participants in the review process include: Jacqueline A. Hart, MD,
Department of Internal Medicine, Newton-Wellesley Hospital, Harvard University
and Senior Medical Editor Integrative Medicine, Boston, MA; Gary Kracoff, RPh
(Pediatric Dosing section February 2001), Johnson Drugs, Natick, Ma; Steven
Ottariono, RPh (Pediatric Dosing section February 2001), Veteran's
Administrative Hospital, Londonderry, NH; Margie Ullmann-Weil, MS, RD,
specializing in combination of complementary and traditional nutritional
therapy, Boston, MA. All interaction sections have also been reviewed by a team
of experts including Joseph Lamb, MD (July 2000), The Integrative Medicine
Works, Alexandria, VA;Enrico Liva, ND, RPh (August 2000), Vital Nutrients,
Middletown, CT; Brian T Sanderoff, PD, BS in Pharmacy (March 2000), Clinical
Assistant Professor, University of Maryland School of Pharmacy; President, Your
Prescription for Health, Owings Mills, MD; Ira Zunin, MD, MPH, MBA (July 2000),
President and Chairman, Hawaii State Consortium for Integrative Medicine,
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