Glucosamine capsule
Glucosamine is made from the combination of a sugar - hence the first part
of the name glucos(e) - and an amine, which is a derivative of ammonia containing nitrogen
(N) and hydrogen (H) atoms.
Glucosamine is found largely in cartilage and
plays an important role in its health and resiliency. As we age, we lose some of the
glucosamine and other substances in cartilage. This can lead to thinning of cartilage and
the onset and progression of
osteoarthritis. It is important to note that there are a
variety of important substances within cartilage and glucosamine ingestion, by itself,
should not be viewed as the complete answer.
Glucoamine and Osteoarthritis
Glucosamine has hardly been evaluated in conditions other than osteoarthritis. Hence it is not clear whether glucosamine is helpful in those with damage
to cartilage or joints due to musculoskeletal injuries. Glucosamine does help rebuild
cartilage in osteoarthritis patients, but it is unlikely that it would help joints where
the cartilage has been surgically removed.
Similarly, glucosamine has not been
tested in autoimmune diseases involving joints such as lupus and rheumatoid arthritis. Those with artificial joints are not likely to be helped by glucosamine
since they have no cartilage.
Combining Glucosamine with Drugs
Glucosamine may be taken together with acetaminophen or NSAIDs such
as ibuprofen and naproxen. After glucosamine starts working in a few weeks, hopefully the
dose of the drugs can be reduced or eliminated. I am not aware of glucosamine interacting
with other medicines.
Glucosamine and allergies
Those who are allergic to sulfates may take glucosamine hydrochloride and not glucosamine
sulfate, and they should avoid chondroitin sulfate. Glucosamine is derived from shrimp,
oyster and crab shells and chondroitin is derived from cartilage of cows, pigs, and
sharks. There is no synthetically made glucosamine on the market.
Additional
glucosamine
information.
A good Joint formula contains many nutrients found to
have a role in arthritis.
Boswellia serrata
Chondroitin-Sulfate
Glucosamine
Lipoic acid
MSM
Turmeric root extract,
Curcumin
Glucosamine sulfate of
hydrochloride?
Glucosamine is available as glucosamine sulfate or glucosamine hydrochloride. A review of
the scientific literature shows glucosamine is likely to be helpful for many
patients with osteoarthritis. Almost all of
the studies done with glucosamine have used the sulfate form since a company in Europe
funded the studies, and we know that it works. However, the hydrochloride form has
been used by doctors for many years and it seems to work just as well. The hydrochloride
form is cheaper. The positive effects of glucosamine
reducing joint pain are often noticed within a few weeks.
Long term safety
Based on our current understanding, glucosamine can be taken for
extended periods, months and years. Thus far, after being on the market for quite a number
of years, there have not been any reports in the medical literature of any significant
side effects resulting from the use of glucosamine. However, as with most nutrients
and medicines, long term effects are not clearly known. It is best
pregnant women not take glucosamine until more is known about this interaction.
Glucosamine and Diabetes
I am not aware of any significant changes to blood sugar resulting from glucosamine
ingestion. The dose of glucosamine, one or two grams a day, is minimal as a sugar source
compared to the amounts of carbohydrates found in the foods we consume. One study indicates that glucosamine is safe in diabetes.
In a study published in Archives of Internal Medicine, 38 elderly patients
with type 2 diabetes were divided into two groups. The first group took 1500 mg
of glucosamine a day combined with 1200 mg of chondroitin sulfate. Chondroitin
is another supplement often used in combination with glucosamine to treat
osteoarthritis. The other group took placebo pills. Two-thirds of the dose was
taken in the morning and one-third in the evening. The study lasted for 90 days.
Blood studies were done to evaluate blood sugar levels, and also levels of
hemoglobin A1c, a specific blood marker than can tell us average blood sugar
levels over long periods of time. There was no statistically significant rise in
hemoglobin A1c levels in those who took glucosamine.
Timing of Glucosamine ingestion
It's difficult to say when the best time or frequency to take glucosamine, whether with or
without food, but a good option is to take glucosamine before meals. All 1,500 mg a day
can be taken at one time or split in two or three divided doses throughout the day.
Glucosamine and Chondroitin
If glucosamine itself is not helpful in relieving arthritic symptoms, it may be combined
with chondroitin and other
nutrients. Alternatively, glucosamine and chondroitin can be started together
with several other nutrients.
Can glucosamine pills be absorbed from the stomach
and end up in cartilage?
Yes. After oral administration of glucosamine sulfate, 90% is absorbed.
(Sulfate means that the glucosamine is attached to a sulfur and oxygen atoms.)
In a study done in Italy, two healthy male volunteers were given 250 mg of
oral GS, tagged with radioactive carbon 14 as a tracer, in the morning on an
empty stomach. The radioactive GS was found an hour later in blood and then
later in other tissues. The researchers state, "GS very rapidly diffuses in most
tissues and organs and that it has a special tropism (attraction) for articular
tissue (cartilage) and for bone." These volunteers were also given GS
intravenously (IV) and intramuscularly (IM). The amount of GS in blood after
oral administration was only a quarter of the amount available by IV and IM.
Therefore oral administration is effective, but not as good as IV or IV. When
oral GS is absorbed, it first goes to the liver where a large portion gets
broken down into smaller molecules such as carbon dioxide, urea and water.
Glucosmaine Research Update
The effect of glucosamine-chondroitin supplementation on glycosylated
hemoglobin levels in patients with type 2 diabetes mellitus: a
placebo-controlled, double-blinded, randomized clinical trial.
Scroggie DA, Albright A, Harris MD. Wilford Hall Medical Center, Lackland Air
Force Base, Lackland, TX 78236, USA.
Arch Intern Med. 2004 Apr 12;164(7):807.
With increasing use of glucosamine-containing supplements for the
treatment of osteoarthritis, there is increasing concern in the medical
community about possible toxic effects. The present study was undertaken to
determine whether glucosamine supplementation altered hemoglobin A1c
concentrations in patients with well-controlled diabetes mellitus. To
evaluate possible effects of glucosamine supplementation on glycemic control in
a selected population of patients with type 2 diabetes mellitus.
Placebo-controlled, double-blinded, randomized clinical trial. SETTING:
Outpatient, diabetes monitoring clinic. Patients were typically
elderly patients, evenly divided between men and women. Most of the patients
were being treated with 1 or 2 drugs for glycemic control. In
daily doses for 90 days, patients received either placebo or a combination of
1500 mg of glucosamine hydrochloride with 1200 mg of chondroitin sulfate (Cosamin
DS; Nutramax Laboratories Inc, Edgewood, Md).Main Outcome Measure Hemoglobin A1c
levels before and after 90 days of therapy. There were 4 withdrawals
from the glucosamine-treated group. Three were related to comorbidities
(myocardial infarction, congestive heart failure, and atrial fibrillation) and 1
to a possible adverse reaction (excessive flatus). No other patient reported any
adverse effects of glucosamine therapy, and no patient had any change in their
diabetes management. Mean hemoglobin A1c concentrations were not significantly
different between groups prior to glucosamine therapy. Posttreatment hemoglobin
A1c concentrations were not significantly different between groups, nor were
there any significant differences within groups before and after treatment.
This study demonstrates that oral glucosamine supplementation does
not result in clinically significant alterations in glucose metabolism in
patients with type 2 diabetes mellitus.
Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women
with knee osteoarthritis: evidence from two 3-year studies.
Bruyere O. WHO Collaborating Center for Public Health Aspect of Osteoarticular
Disorders, Liege, Belgium.
Menopause. 2004 Mar-Apr;11(2):138-43.
To investigate the effect of glucosamine sulfate on long-term
symptoms and structure progression in postmenopausal women with knee
osteoarthritis (OA). This study consisted of a preplanned combination of
two three-year, randomized, placebo-controlled, prospective, independent studies
evaluating the effect of glucosamine sulfate on symptoms and structure
modification in OA and post-hoc analysis of the results obtained in
postmenopausal women with knee OA. Minimal joint space width was assessed at
baseline and after 3 years from standing anteroposterior knee radiographs.
Symptoms were scored by the algo-functional WOMAC index at baseline and after 3
years. All primary statistical analyses were performed in intention-to-treat,
comparing joint space width and WOMAC changes between groups by ANOVA.
Of 414 participants randomized in the two studies, 319 were postmenopausal
women. At baseline, glucosamine sulfate and placebo groups were comparable for
demographic and disease characteristics, both in the general population and in
the postmenopausal women subset. After 3 years, postmenopausal participants in
the glucosamine sulfate group showed no joint space narrowing, whereas participants in the
placebo group experienced a narrowing of -0.33 mm. Percent changes after 3 years
in the WOMAC index showed an improvement in the glucosamine sulfate group and a
trend for worsening in the placebo group. This analysis, focusing on
a large cohort of postmenopausal women, demonstrated for the first time that a
pharmacological intervention with glucosamine for OA has a disease-modifying
effect in this particular population, the most frequently affected by knee OA.
The effect of glucosamine supplementation on people experiencing regular knee
pain.
Braham R. University of Western Australia, Crawley, Western Australia 6009. Br J
Sports Med. 2003 Feb;37(1):45-9; discussion 49.
The purpose of this study was to examine the effects of oral glucosamine supplementation on the functional ability and degree of pain felt by
individuals who had regular knee pain, most likely due to previous articular
cartilage damage, and possibly osteoarthritis. Subjects were randomly
supplemented with either glucosamine (n=24) or placebo (P) (lactose) (n=22) for
12 weeks at a dose of 2,000 mg per day. Over this period, four testing sessions
were conducted, with changes in knee pain and function assessed by clinical and
functional tests, (joint line palpation, a 3 metre "duck walk" and a repeated,
walking stair climb), two questionnaires (the Knee Injury and Osteoarthritis
Outcome Score (KOOS) and the Knee Pain Scale (KPS)) and participant subjective
evaluations. The clinical and functional test scores improved with time
but there were no significant differences between the two groups. The
questionnaire results also recorded a significant main effect for time, but the glucosamine group was found to have significantly better KOOS quality of life
scores at week eight and 12, and lower KPS scores at week eight than the placebo
group. On self report evaluations of changes across the 12 week supplementation
period, 88% (n=21) of the glucosamine group reported some degree of improvement
in their knee pain versus only 17% (n=3) in the placebo group.
These results suggest that glucosamine supplementation can provide some degree
of pain relief and improved function in persons who experience regular knee
pain, which may be caused by prior cartilage injury and/or osteoarthritis. The
trends in the results also suggest that, at a dosage of 2,000 mg per day, the
majority of improvements are present after eight weeks.
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Glucosamine Emails
I am a 37 year old male who has been active all my
life. Last year I started having major middle back pains that even wiped me out when I
washed dishes in my home. Mowing the yard really did me in. I was an avid runner, worked
out 4 to 5 times a week, have 2 jobs. One at a desk, the other waiting tables in an
Italian restaurant. I have consistently taken Bayer to relieve the pain yet I knew it
didn't repair the problem.
Recently, in a health food store I saw your product and thought I would give it
a try. Never having taken any vitamins or supplements, I purchased the Expensive Joint
Formula. I have been on it for 2 weeks now. On Sunday, I mowed the yard, dug a one foot
deep and 15 foot long drainage trench, cleared about a 4x20 area of weeds with a hoe, and
later that evening, I went to the gym and waited tables for 4 hours. I know I was pushing it. Seriously when I got back home I cried because I felt
I had a lot of my physical strength back.
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