What are the potential benefits of glucosamine for osteoarthritis. How effective is glucosamine in treating knee pain and joint deterioration. What are the safety considerations and possible side effects of taking glucosamine supplements. When should doctors recommend glucosamine to patients with osteoarthritis.

Understanding Glucosamine: Structure, Function, and Bioavailability

Glucosamine is an aminomonosaccharide that plays a crucial role in the human body, particularly in connective tissues. Its chemical structure (2-amino-2-deoxy-β-d-glucopyranose) allows it to be a key component in the biosynthesis of glycoproteins and glycosaminoglycans. But what makes glucosamine so important for joint health?

Glucosamine is highly concentrated in cartilage, the flexible connective tissue that cushions joints. When taken orally as a supplement, about 90% of glucosamine sulfate is absorbed and rapidly incorporated into articular cartilage. This high bioavailability suggests that supplementation could potentially influence cartilage health and function.

There are several forms of glucosamine available as supplements, including:

• Glucosamine sulfate
• Glucosamine hydrochloride
• N-acetyl-glucosamine
• Glucosamine chlorohydrate salt

While some studies suggest that glucosamine sulfate may be more effective, particularly a specific commercial product called Dona, research from China indicates that glucosamine hydrochloride and sulfate forms may be equally beneficial. This variability in formulations adds complexity to evaluating glucosamine’s overall effectiveness.

The Role of Glucosamine in Osteoarthritis Treatment

Osteoarthritis is a degenerative joint disease characterized by the breakdown of cartilage and underlying bone. How might glucosamine help in managing this condition? Researchers have proposed several potential mechanisms:

1. Direct stimulation of chondrocytes (cartilage cells)
2. Incorporation into glycosaminoglycans to support cartilage structure
3. Anti-inflammatory effects
4. Inhibition of cartilage-degrading enzymes

One key component affected in osteoarthritis is keratan sulfate, which decreases as the disease progresses. Glucosamine sulfate forms half of the disaccharide subunit of keratan sulfate, suggesting a potential role in maintaining or restoring this important cartilage component.

Additionally, hyaluronic acid, found in both articular cartilage and synovial fluid, contains N-acetylglucosamine as part of its structure. By providing building blocks for these crucial joint components, glucosamine supplementation may support overall joint health and function.

Clinical Evidence: Does Glucosamine Work for Osteoarthritis?

The effectiveness of glucosamine in treating osteoarthritis has been the subject of numerous clinical trials, with mixed results. What does the current evidence suggest?

Two long-term clinical trials initially showed promising results, demonstrating that glucosamine sulfate could slow the progression of joint structure changes in knee osteoarthritis and control symptom progression. These findings sparked significant interest in glucosamine as a potential treatment option.

However, subsequent trials have produced conflicting results. The largest study to date, the Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) funded by the National Institutes of Health, has not definitively confirmed whether glucosamine is effective in treating osteoarthritis.

Despite these inconsistencies, there is currently no clear evidence to recommend against the use of glucosamine. Many patients report subjective improvements in pain and function, even if these benefits are not consistently demonstrated in clinical trials.

Safety Profile and Potential Side Effects of Glucosamine

One of the advantages of glucosamine as a potential treatment for osteoarthritis is its relatively benign safety profile. But what do we know about its potential side effects and interactions?

Reported adverse effects from glucosamine supplementation are generally uncommon and minor. This favorable safety profile makes it an attractive option for patients who may be at risk of side effects from other osteoarthritis treatments, such as nonsteroidal anti-inflammatory drugs (NSAIDs).

However, there are some important safety considerations to keep in mind:

• Shellfish allergies: Most glucosamine is derived from shellfish, so caution is advised in patients with shellfish allergies.
• Asthma: Some studies have suggested a potential link between glucosamine use and exacerbation of asthma symptoms.
• Diabetes: Glucosamine may affect blood sugar levels, so patients taking diabetes medications should monitor their glucose levels closely.
• Warfarin: There have been reports of potential interactions between glucosamine and warfarin, a blood-thinning medication.

It’s important to note that no significant supplement-drug interactions involving glucosamine have been definitively established. However, patients taking any of the medications mentioned above should consult with their healthcare provider before starting glucosamine supplementation.

Clinical Recommendations: When and How to Use Glucosamine

Given the mixed evidence and generally favorable safety profile, how should healthcare providers approach the use of glucosamine in clinical practice?

For patients who express interest in trying glucosamine, especially those at high risk of secondary effects from other accepted treatments, it may be reasonable to support a 60-day trial of glucosamine sulfate. This approach allows patients to assess whether they experience any subjective benefits while minimizing the risk of long-term adverse effects.

After the trial period, the decision to continue therapy can be left to individual patients, with the physician monitoring for possible adverse effects. This personalized approach acknowledges the variability in patient responses to glucosamine while maintaining appropriate medical oversight.

It’s important to note that glucosamine should be used with caution in patients with shellfish allergies, asthma, diabetes, or those taking warfarin. In these cases, close monitoring and potentially alternative treatment options should be considered.

Glucosamine in Combination with Chondroitin: Added Benefits?

While most clinical studies have focused on glucosamine alone, many commercial products combine glucosamine with chondroitin sulfate. But does this combination offer any advantages over glucosamine alone?

The evidence for the glucosamine-chondroitin combination is currently inconclusive. Some animal studies suggest that the combination may be more effective than glucosamine alone, but human clinical trials have not consistently demonstrated superior outcomes.

The GAIT study, which included a glucosamine-chondroitin arm, did not find significant benefits for the combination over placebo in the overall study population. However, a subgroup analysis suggested potential benefits in patients with moderate to severe osteoarthritis pain.

Given the lack of clear evidence for superiority, the decision to use glucosamine alone or in combination with chondroitin may depend on individual patient factors, preferences, and responses to treatment.

Future Directions: Ongoing Research and Unanswered Questions

While glucosamine has been extensively studied, many questions remain unanswered. What areas of research are likely to shape our understanding of glucosamine’s role in osteoarthritis treatment in the coming years?

• Optimal formulation: Further research is needed to determine whether specific forms of glucosamine (e.g., sulfate vs. hydrochloride) are more effective.
• Personalized medicine: Identifying patient characteristics that predict response to glucosamine could help target its use more effectively.
• Combination therapies: Exploring glucosamine in combination with other supplements or conventional treatments may reveal synergistic effects.
• Long-term outcomes: Additional long-term studies are needed to assess glucosamine’s potential for slowing disease progression and improving quality of life over extended periods.
• Mechanism of action: Further elucidation of glucosamine’s effects at the cellular and molecular level could inform more targeted therapeutic approaches.

As research in these areas progresses, our understanding of glucosamine’s role in osteoarthritis management is likely to evolve, potentially leading to more refined and effective treatment strategies.

The Patient Perspective: Shared Decision-Making in Glucosamine Use

Given the uncertainties surrounding glucosamine’s effectiveness, how can healthcare providers engage patients in shared decision-making about its use? Consider the following approach:

1. Educate patients about the current evidence, including both potential benefits and limitations.
2. Discuss individual risk factors and potential interactions with other medications or conditions.
3. Explore patient preferences and values regarding traditional and complementary treatments.
4. Collaboratively develop a plan for trialing glucosamine, including specific goals and timelines.
5. Establish a follow-up schedule to assess response and address any concerns.

By involving patients in the decision-making process, healthcare providers can ensure that the use of glucosamine aligns with individual needs and preferences while maintaining appropriate medical oversight.

Economic Considerations: Cost-Effectiveness of Glucosamine Treatment

With the substantial consumer market for glucosamine supplements, it’s important to consider the economic implications of its use. How does the cost-effectiveness of glucosamine compare to other osteoarthritis treatments?

While glucosamine supplements are generally less expensive than prescription medications for osteoarthritis, their cost-effectiveness depends on their actual clinical efficacy. If glucosamine proves to be effective in slowing disease progression and reducing the need for more invasive interventions, it could potentially offer significant long-term cost savings.

However, given the current uncertainty about its effectiveness, patients should be advised to weigh the potential benefits against the ongoing cost of supplementation. For some patients, a trial period may help determine whether the subjective benefits justify the expense.

Regulatory Status and Quality Control of Glucosamine Supplements

As a dietary supplement, glucosamine is not subject to the same rigorous regulatory oversight as prescription medications. What implications does this have for patients and healthcare providers?

The lack of stringent regulation means that the quality and consistency of glucosamine products can vary significantly between manufacturers. This variability may contribute to the inconsistent results seen in clinical trials and individual patient experiences.

To mitigate these concerns, healthcare providers should recommend that patients choose glucosamine supplements from reputable manufacturers that adhere to Good Manufacturing Practices (GMP) and undergo third-party testing for quality and purity.

Additionally, patients should be encouraged to report any adverse effects to their healthcare provider and the FDA’s MedWatch program to help improve our understanding of glucosamine’s safety profile.

Integrating Glucosamine into a Comprehensive Osteoarthritis Management Plan

While glucosamine may offer potential benefits for some patients with osteoarthritis, it’s essential to view it as part of a comprehensive management strategy. What other interventions should be considered alongside glucosamine supplementation?

• Weight management: Maintaining a healthy weight can significantly reduce stress on weight-bearing joints.
• Exercise: Regular, low-impact exercise can improve joint function and reduce pain.
• Physical therapy: Targeted exercises and manual therapies can improve strength and flexibility.
• Assistive devices: Canes, braces, or orthotics can help reduce joint stress and improve mobility.
• Pain management: Over-the-counter or prescription pain relievers may be necessary for symptom control.
• Lifestyle modifications: Adapting daily activities to reduce joint stress can help manage symptoms.

By incorporating glucosamine into a multifaceted approach to osteoarthritis management, healthcare providers can offer patients a comprehensive strategy that addresses multiple aspects of the disease process and its impact on daily life.

Glucosamine | AAFP

STEPHEN DAHMER, MD, AND ROBERT M. SCHILLER, MD

Am Fam Physician. 2008;78(4):471-476

Patient information: See related handout on glucosamine, written by the authors of this article.

Author disclosure: Nothing to disclose.

Glucosamine is one of the most popular dietary supplements sold in the United States. Most clinical trials have focused on its use in osteoarthritis of the knee. The reported adverse effects have been relatively well studied and are generally uncommon and minor. No significant supplement–drug interactions involving glucosamine have been reported. The National Institutes of Health–sponsored Glucosamine/chondroitin Arthritis Intervention Trial, the largest randomized, double-blind, placebo-controlled study involving the supplement, still has not confirmed whether glucosamine is effective in the treatment of osteoarthritis. Despite conflicting results in studies, there is no clear evidence to recommend against its use. If physicians have patients who wish to try glucosamine, it would be reasonable to support a 60-day trial of glucosamine sulfate, especially in those at high risk of secondary effects from other accepted treatments. The decision to continue therapy can then be left to patients on an individual basis, while the physician monitors for possible adverse effects. Glucosamine should be used with caution in patients who have shellfish allergies or asthma, and in those taking diabetes medications or warfarin.

Glucosamine and chondroitin sulfate are among the most popular dietary supplements sold in the United States.¹ The U.S. consumer market for glucosamine and chondroitin was estimated at $810 million in 2005.² Glucosamine is also one of the most studied supplements, with more than 20 randomized controlled trials involving over 2,500 patients. ³ Glucosamine sulfate attracted the attention of the scientific community after two long-term clinical trials showed that it could slow the progression of anatomic joint structure changes in knee osteoarthritis and control the progression of symptoms.^4,5 Subsequent trials have had conflicting results, including the largest study, the National Institutes of Health–funded Glucosamine/chondroitin Arthritis Intervention Trial (GAIT).⁶ Although most studies are of glucosamine alone, it is often sold in combination with chondroitin. It is not known if this combination is better than glucosamine alone, but animal studies suggest that this may be the case.^7,8 This article focuses on a literature review of glucosamine and its use in osteoarthritis.

Clinical recommendation	Evidence Rating	References
Treatment with glucosamine sulfate is a reasonable option in patients who wish to try it or in those who cannot tolerate traditional therapies for knee pain in osteoarthritis.	A	4, 5, 17, 18, 25
Caution is advised when using glucosamine in patients with an allergy to shellfish, patients with asthma, and those taking diabetes medications or warfarin (Coumadin).	C	34, 35, 37, 38

Pharmacology

Glucosamine (2-amino-2-deoxy-β-d-glucopyranose) is an endogenous aminomonosaccharide synthesized from glucose and utilized for biosynthesis of glycoproteins and glycosaminoglycans.⁹ Glucosamine is present in almost all human tissues, highly concentrated in connective tissues of the human body, and found at highest concentrations in the cartilage. In humans, about 90 percent of glucosamine is absorbed when administered as an oral dose of glucosamine sulfate, and is rapidly incorporated into articular cartilage.¹⁰ Glucosamine can be found in many forms, including sulfate, hydrochloride, N-acetyl-glucosamine, or chlorohydrate salt, and as a dextrorotatory isomer. There is some dispute over which form is most effective. Pooled findings from studies using a specific commercial glucosamine sulfate product called Dona suggest that this formulation reduces osteoarthritis pain, whereas other formulations do not.¹¹ Another study performed in China provides some evidence that glucosamine hydrochloride and glucosamine sulfate are equally effective.¹²

The sulfate salt of glucosamine forms one half of the disaccharide subunit of keratan sulfate, which decreases in patients with osteoarthritis. Hyaluronic acid (found in articular cartilage and synovial fluid) is composed of repeating dimeric units of glucuronic acid and N-acetylglucosamine.¹³ Possible mechanisms of action for the chondroprotective effect of glucosamine include direct stimulation of chondrocytes, incorporation of sulfur into cartilage, and protection against degradative processes within the body through altered gene expression.^10,14,15 The exact mechanism of action for the possible effect of glucosamine is unknown.

Uses and Effectiveness

Glucosamine has been studied for many uses, including treatment of temporomandibular joint disorder and rheumatoid arthritis, but most trials have focused on its use in osteoarthritis. Clinical trials have yielded conflicting results. Double-blind studies enrolling more than 400 persons found glucosamine and ibuprofen (Motrin) to be equally effective in reducing symptoms of knee and temporomandibular joint osteoarthritis.^16–18 In four studies involving more than 500 persons, glucosamine failed to provide any meaningful improvement in symptoms.^19–23 A recent study concluded that most of the trials with positive outcomes were funded by manufacturers of glucosamine products, whereas most trials performed by neutral researchers failed to find benefit.²⁴

Two of the largest placebo-controlled trials conducted before 2007 were in Europe and used the glucosamine sulfate formulation.^4,5 In the 2001 Belgian study, 212 persons with osteoarthritis of the knee were followed for three years, received either placebo or oral glucosamine sulfate in a dosage of 1,500 mg daily, and were evaluated using the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. ⁴ The WOMAC index is the most commonly employed questionnaire in clinical research to assess degree of pain and stiffness, as well as functional impairment caused by osteoarthritis. The study showed that patients taking glucosamine sulfate had modest pain reduction (average of 11.7 percent relative reduction in the WOMAC index compared with baseline) and reduced joint-space narrowing compared with placebo, as measured by weight-bearing anteroposterior view radiography (0.06 mm versus 0.31 mm). Both differences were statistically significant; however, there was no correlation between improvement in symptoms and radiographic findings.⁴

In a similar 2002 trial conducted in Prague, Czech Republic, 202 patients with osteoarthritis of the knee were given placebo or 1,500 mg of Dona and were followed for three years.⁵ Those receiving Dona showed statistically significant improvement in symptoms of pain and stiffness compared with placebo (26 percent versus 16 percent mean reduction in the WOMAC index) and radiographic evidence of decreased narrowing in the medial joint compartment (mean gain of 0. 04 mm versus 0.19 mm of joint-space narrowing).

The most recent meta-analysis of glucosamine was conducted in 2005 and included 20 randomized controlled trials with a total of 2,570 patients.¹¹ The investigators found that current evidence: (1) does not analyze the long-term effectiveness and toxicity of glucosamine; (2) does not differentiate which joints and which levels of severity of osteoarthritis warrant this therapy; (3) does not differentiate which dosage and route of administration are best; and (4) does not demonstrate whether glucosamine modifies the long-term progression of osteoarthritis. When restricting the analysis to eight studies with the highest-quality design, no overall improvement in pain or function was found.¹¹ The investigators concluded that there was high-quality evidence that glucosamine was not as useful for symptom improvement as had been previously thought.

The authors of the 2006 GAIT also were unable to conclude whether glucosamine is useful in the treatment of osteoarthritis. ⁶ GAIT was the first major clinical trial to directly compare glucosamine alone, chondroitin alone, combination glucosamine/chondroitin, a cyclooxygenase inhibitor, and placebo. It included more than 1,500 patients who were followed for six months. The WOMAC index was the primary outcome measure. Although radiographic data have yet to be published, the authors concluded that, compared with placebo, glucosamine alone or in combination with chondroitin did not reduce pain significantly after six months in patients with osteoarthritis of the knee. They did suggest that a combination of the two may be effective in a subgroup of patients with moderate to severe knee pain. An important finding in this study was a placebo effect of around 60 percent, suggesting that the sample size used was possibly inadequate.²⁵ Additional concerns about the study have been raised, including the attrition rate, limitations in data analysis, and the use of glucosamine hydrochloride preparation rather than the glucosamine sulfate preparation. ²⁶ A 2008 study of glucosamine sulfate in more than 200 patients with hip osteoarthritis showed no reduction in symptoms or progression of arthritis compared with placebo.²⁷

Glucosamine combined with chondroitin has been used in a topical form in a few small, randomized, double-blind, placebo-controlled trials with favorable results.^28,29 One study showed statistically significant improvement in pain reduction after eight weeks with a glucosamine/chondroitin preparation compared with placebo (visual analog scale measurements).²⁹ There have also been some initial studies suggesting that the addition of glucosamine to non-steroidal anti-inflammatory drugs (NSAIDs) could decrease NSAID use in those patients already taking them.³⁰ Because the anti-inflammatory ability of glucosamine is different from that of NSAIDs, it is possible the two might have a synergistic effect in alleviating some types of inflammation.³¹

Finally, a 2007 double-blind, placebocontrolled study of 51 Japanese patients with rheumatoid arthritis showed that glucosamine hydrochloride in a dosage of 1,500 mg daily significantly improved symptoms according to patients’ self-evaluation and physician global evaluation. ³² It did not, however, alter measures of inflammation as determined through blood tests.

Contraindications, Adverse Effects, and Interactions

The reported adverse effects have been generally uncommon and minor. Glucosamine is produced from the shells of lobster, crab, and shrimp. However, the antigen proteins associated with seafood allergies are not found in the shell, and there have been no reports of reactions in persons with shell-fish allergies who take glucosamine.³³ There also have been no significant supplement–drug interactions involving glucosamine. In one case report, the addition of glucosamine sulfate to a stable-dose regimen of warfarin (Coumadin) appeared to magnify the anticoagulant effects of warfarin in a 69-year-old man.³⁴ Only one person has been reported to have had an allergic reaction to oral glucosamine.³⁵

In a large open trial (n = 1,208), the most common adverse effects of oral glucosamine sulfate (1. 5 g daily) were epigastric pain or tenderness (3.5 percent), heartburn (2.7 percent), diarrhea (2.5 percent), and nausea (1 percent).³⁶ There was a single case report of a glucosamine-chondroitin sulfate compound triggering difficulty walking and climbing steps because of shortness of breath in a 52-year-old woman with longstanding intermittent asthma.³⁷ Finally, it has been hypothesized that glucosamine is associated with reducing the effectiveness of diabetes medications.³⁸ To date, this has been refuted, and the use of glucosamine in patients with diabetes has not been shown to affect insulin sensitivity or induce insulin resistance. Nonetheless, the Arthritis Foundation recommends that patients with diabetes monitor their blood glucose levels more often when taking glucosamine.³⁹ Scientific evidence for the safe use of glucosamine during pregnancy is not available.

Dosage

Glucosamine is supplied in tablets and capsules. The usual dosing schedule is 500 mg three times daily. In 2001, Consumer Reports evaluated 19 products and reported that most brands were reasonably well standardized, delivering at least 90 percent of the amount of glucosamine or chondroitin promised on the label. Only four products failed to meet that standard.⁴⁰ In 2001, one company recalled two products that were found to contain aristolochic acid, a substance that can cause kidney toxicity and cancer.⁴¹ Retail prices for a 30-day supply of glucosamine range from $9 to $35 (product quality may vary).³

Bottom Line

The use of glucosamine is widespread in the United States. Physicians should be encouraged to have open discussions with patients, as well as inform them about the controversy regarding the supplement’s effectiveness. Because of glucosamine’s potential for benefit, there is no reason to recommend against its use, especially in persons at high risk of secondary effects from other accepted treatments.

In trials that have found benefit with glucosamine, most focused on the glucosamine sulfate preparation, and most showed improvements after 30 to 90 days of therapy. Therefore, it would be reasonable to support a 60-day trial of glucosamine sulfate. The decision to continue therapy can then be left to patients on an individual basis, while the physician monitors for possible adverse effects. Caution is advised in patients with shellfish allergies or asthma, and in those taking diabetes medications or warfarin. If a patient chooses to try glucosamine therapy, the physician should recommend glucosamine sulfate (from a reputable source) in a dosage of 500 mg orally three times daily. Key points about glucosamine are summarized in Table 1.

Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews

Overview

Glucosamine is a chemical found in the body. Glucosamine supplements are sold as glucosamine sulfate, glucosamine hydrochloride, and N-acetyl glucosamine.

Glucosamine is used by the body to make other chemicals that build tendons, ligaments, cartilage, and the fluid that surrounds joints. Joints are cushioned by the fluid and cartilage around them. Taking glucosamine might increase the cartilage and fluid around joints and/or help prevent their breakdown.

People commonly use glucosamine sulfate and glucosamine hydrochloride for osteoarthritis. Glucosamine is also used for joint pain, rheumatoid arthritis, multiple sclerosis, and many other conditions, but there is no good scientific evidence to support these other uses.

Uses & Effectiveness ?

Likely Effective for

• Osteoarthritis. Taking glucosamine sulfate by mouth for at least 4 weeks can provide some pain relief and improve function for people with knee osteoarthritis. Products that contain glucosamine hydrochloride do not seem to work as well unless they are taken in combination with other ingredients. Taking glucosamine sulfate doesn’t seem to reduce the risk of getting osteoarthritis.

There is interest in using glucosamine for a number of other purposes, but there isn’t enough reliable information to say whether it might be helpful.

Side Effects

When taken by mouth: Glucosamine sulfate is likely safe in most adults when used for up to 3 years. Glucosamine hydrochloride is possibly safe for most adults when used for up to 2 years. N-acetyl glucosamine is also possibly safe when used for up to 6 months. Glucosamine can cause some mild side effects including bloating, nausea, diarrhea, and constipation.

When applied to the skin: N-acetyl glucosamine is possibly safe when used for up to 10 weeks.

When given as an enema (rectally): N-acetyl glucosamine is possibly safe when used in doses of 3-4 grams daily.

Special Precautions and Warnings

Pregnancy and breast-feeding: There isn’t enough reliable information to know if glucosamine sulfate, glucosamine hydrochloride, or N-acetyl glucosamine is safe to use when pregnant or breast-feeding. Stay on the safe side and avoid use.

Asthma: Glucosamine might make asthma worse. Until more is known, people with asthma should be cautious about taking products that contain glucosamine.

Diabetes: There used to be some concern that glucosamine might increase blood sugar levels. But most research shows that glucosamine doesn’t increase blood sugar levels in people with diabetes.

Glaucoma: Glucosamine might increase the pressure inside the eye and could worsen glaucoma. If you have glaucoma, talk to your healthcare provider before taking glucosamine.

High cholesterol: There used to be some concern that glucosamine might increase cholesterol levels. But most research shows that glucosamine doesn’t seem to increase cholesterol levels.

High blood pressure: There used to be some concern that glucosamine might increase blood pressure. But most research shows that glucosamine does not seem to increase blood pressure.

Shellfish allergy: Glucosamine is produced from the shells of shrimp, lobster, and crabs. If you have a shellfish allergy, talk to your healthcare provider before using glucosamine.

Interactions ?

Major Interaction

Do not take this combination

• Warfarin is used to slow blood clotting. Taking glucosamine with or without chondroitin increases the effects of warfarin. This can increase the risk for serious bruising and bleeding. Don’t take glucosamine if you are taking warfarin.

Moderate Interaction

Be cautious with this combination

• Some medications for cancer work by decreasing how fast cancer cells can copy themselves. Glucosamine might block these medications from working. Taking glucosamine along with some medications for cancer might decrease the effectiveness of these medications.

Minor Interaction

Be watchful with this combination

• Taking glucosamine SULFATE and acetaminophen together might affect how well each works. But more information is needed to know if this interaction is a big concern.

• Glucosamine might increase blood sugar levels. Taking glucosamine along with diabetes medications might reduce the effects of these medications. Monitor your blood sugar closely.

Dosing

Glucosamine sulfate and glucosamine hydrochloride have most often been used by adults in doses of 1500 mg by mouth daily for up to 3 years. Speak with a healthcare provider to find out what dose might be best for a specific condition.

Keep in mind that glucosamine used in supplements often comes from the shells of shellfish. Talk to your healthcare provider before taking these supplements if you have a shellfish allergy. Also, some glucosamine products aren’t labeled correctly. In some cases, the amount of glucosamine actually in the product has varied from none to over 100% of the amount stated on the product’s label. Some products have contained glucosamine hydrochloride when glucosamine sulfate was listed on the label.

View References

CONDITIONS OF USE AND IMPORTANT INFORMATION: This information is meant to supplement, not replace advice from your doctor or healthcare provider and is not meant to cover all possible uses, precautions, interactions or adverse effects. This information may not fit your specific health circumstances. Never delay or disregard seeking professional medical advice from your doctor or other qualified health care provider because of something you have read on WebMD. You should always speak with your doctor or health care professional before you start, stop, or change any prescribed part of your health care plan or treatment and to determine what course of therapy is right for you.

This copyrighted material is provided by Natural Medicines Comprehensive Database Consumer Version. Information from this source is evidence-based and objective, and without commercial influence. For professional medical information on natural medicines, see Natural Medicines Comprehensive Database Professional Version. © Therapeutic Research Faculty 2018.

Glucosamine – ingredient description, instructions for use, indications and contraindications
ProWellness

Table of contents

• Description of glucosamine
• Food sources of glucosamine
• Pharmacological and useful properties
• Contraindications
• Regulations and regulations

9 0002 Disclaimer

Please note that all information posted on the site
Prowellness is provided for informational purposes only and is not a personal program, a direct recommendation for action, or medical advice. Do not use these materials for diagnosis, treatment, or any medical procedure. Consult your physician before using any technique or using any product. This site is not a specialized medical portal and does not replace the professional advice of a specialist. The Site Owner is not liable to any party who has suffered indirect or direct damage as a result of misuse of materials posted on this resource.

Description of glucosamine

Glucosamine is a chemical produced by humans, animals, and shellfish. It is a carbohydrate molecule bonded to a nitrogen atom. Contained in most tissues, in the smallest amount present in the cartilage of the joints.

In this regard, it is produced in the form of a dietary supplement. Glucosamine is one of the most commonly prescribed chondroprotective drugs. It is intended for the prevention and restoration of joint cartilage.

There are 2 main types of glucosamine – hydrochloride and sulfate:

• Glucosamine hydrochloride is made from plant material or crustacean chitin. Contains from 60% active substance. Well absorbed.
• Glucosamine sulfate is made from crustacean chitin. Contains 60-65% active substance. It is a compound consisting of glucosamine and a sulfuric acid salt residue. This is a rapidly oxidizing substance, and therefore it is stabilized with sodium or potassium chloride. As a result, taking this drug, a person receives about 400 mg of salt – the daily norm. In the presence of salt in food, its overdose is possible.

Food sources of glucosamine

Glucosamine can be obtained from meat. However, there is little of it in the meat itself and even in the skin. A decent amount of the substance is found in cartilage and bones. Therefore, to fully enrich the body with it, it is better to boil bone broth – this is one of the best sources of glucosamine, as well as chondroitin and collagen.

Pharmacological and beneficial properties

Glucosamine has a beneficial effect on the skin. It heals microtraumas, reduces the depth and number of wrinkles, moisturizes and eliminates pigmentation. In addition, this substance is a powerful antioxidant. It neutralizes free radicals that destroy healthy cells, causing premature aging and the formation of tumors. But this is far from its main value.

Glucosamine is a hepatoprotector recognized by official medicine. It compensates for the lack of glucosamine, stimulates the synthesis of collagen and hyaluronic acid, provides full-fledged calcium deposition in bone tissues, prevents joint destruction, eliminates pain, and relieves inflammation.

Contraindications

Glucosamine should not be taken in case of diabetes mellitus, with intolerance to the components, during pregnancy and breastfeeding, up to 12 years, as well as in the presence of an allergy to shellfish, if the drug is made on their basis.

When taking a chondroprotector, side effects may occur:

• bowel disorder;
• nausea;
• flatulence.

Attention! Side effects can be avoided if the drug is taken with meals.

Regulations and regulations

The optimal dosage of glucosamine for adults is 700 mg per day. In intensive training and in the first stages of the treatment of arthrosis, the doctor may prescribe 2500 mg of the active substance. The maximum dose is 3000 mg per day. The duration of the treatment course is from 3 months to 3 years.

If glucosamine sulfate is chosen for treatment, then table salt should be excluded from the diet. It is also necessary to give up alcohol and reduce sugar intake, since the chondroprotector violates tissue sensitivity to insulin.

Attention! Glucosamine should not be taken simultaneously with anticoagulants and penicillin antibiotics.

Disclaimer

Please note that all information posted on the site
Prowellness is provided for informational purposes only and is not a personal program, a direct recommendation for action, or medical advice. Do not use these materials for diagnosis, treatment, or any medical procedure. Consult your physician before using any technique or using any product. This site is not a specialized medical portal and does not replace the professional advice of a specialist. The Site Owner is not liable to any party who has suffered indirect or direct damage as a result of misuse of materials posted on this resource.

Glucosamine instructions for use: indications, contraindications, side effects – description Glucosamine tab., cover. film coated, 750 mg: 10, 20, 30, 40, 50, 60 or 100 pcs. (47775)