Glucosamine

Other Name(s):

chitosamine, 2-amino-2deoxy-D-glucose

General Description:

Glucosamine is a naturally occurring substance that alleviates symptoms associated with osteoarthritis. Most studies evaluating glucosamine in the treatment of arthritis typically show that glucosamine decreases symptoms and pain, and increases range of motion.

Glucosamine is found in chitin, the fibrous material that makes up the exoskeleton of crustaceans and insects. It is also found in mucoproteins and mucopolysaccharides produced by many animals.

Medically Valid Uses:

Both animal and human studies suggest that glucosamine sulfate can help control pain from osteoarthritis and slow the progression of the disease.

Other medications used to treat osteoarthritis (aspirin, acetaminophen, non-steroidal anti-inflammatory agents and cortisone) carry the risk for gastrointestinal disturbance, ulcers, gastrointestinal bleeding and, in the case of cortisone, calcium loss from bones. Glucosamine has been shown to be as effective as 400 mg of ibuprofen for pain relief, without the gastrointestinal side effects.

Unsubstantiated Claims:

Please note that this section reports on claims that have NOT yet been substantiated through scientific studies.

Glucosamine is claimed to possibly help prevent joint overuse symptoms. It also may slow or reverse joint damage associated with osteoarthritis and may reduce symptoms of temporal mandibular joint (TMJ) disease.

Dosing Format:

The recommended dose of glucosamine is 400 mg three times a day. Extremely high doses (1,200 mg three times a day) of glucosamine are thought to have anti-inflammatory and analgesic properties and are reported to rapidly relieve symptoms of osteoarthritis in some individuals.

Significant concentrations of glucosamine are not available through normal food sources and must be obtained as dietary supplements.

Glucosamine sulfate is often supplied in combination with other materials such as chondroitin sulfate or manganese ascorbate. The efficacy of these combinations is still being evaluated.

Women who are pregnant or breast-feeding should consult a physician before taking any dietary supplements.

Side Effects, Toxicity and Interactions:

Unlike other osteoarthritis medications, the side effects of glucosamine are minimal. Mild gastrointestinal problems, as well as drowsiness and skin reactions have been reported.

People with diabetes should consult a physician before taking high doses of glucosamine. Glucosamine has been shown to increase insulin resistance in several studies.

Additional Information:

Several theories suggest how glucosamine provides symptomatic relief for osteoarthritis.

Some studies suggest that glucosamine is an essential substrate for the biosynthesis of glycosaminoglycans and hyaluronic acid. Enhanced synovial production of hyaluronic acid may explain rapid clinical response to high-dose glucosamine in osteoarthritis. By supplying the body with large amounts of glucosamine, it is possible to increase the production of both glycosaminoglycans and hyaluronic acid. These materials are critical in maintaining the structure and integrity of the cartilage and synovium in the joint.

Another theory holds that glucosamine stimulates the synovial production of hyaluronic acid. Hyaluronic acid is the component that is thought to lubricate the joint cartilage and absorb shock.

Glucosamine is formed in the body by the transfer of the amido group from glutamine to the phosphated sugar fructose 6-phosphate. Glucosamine is a constituent of lipids, polysaccharides and glycoproteins. When given orally, glucosamine concentrates in the articular cartilage of the joints.

Click here for a list of reputable Web sites with general information on nutrition.

References:

  1. Kelly GS. The role of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease. Altern Med Rev. 1998;3(1):27-39.

  2. da Camara CC, Dowless GV. Glucosamine sulfate for osteoarthritis [see comments]. Ann Pharmacother. 1998;32(5):580-7.

  3. Qiu GX, Gao SN, Giacovelli G, Rovati L, Setnikar I. Efficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis. Arzneimittelforschung. 1998;48(5):469-74.

  4. {No Authors Listed] [Gonarthrosis--current aspects of therapy with glucosamine sulfate (dona200-S)]. Fortschr Med Suppl. 1998;183:1-12.

  5. Barclay TS, Tsourounis C, McCart GM. Glucosamine [see comments]. Ann Pharmacother. 1998;32(5):574-9.

  6. Leffler CT, Philippi AF, Leffler SG, Mosure JC, Kim PD. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Mil Med. 1999;164(2):85-91.

  7. Bassleer C, Rovati L, Franchimont P. Stimulation of proteoglycan production by glucosamine sulfate in chondrocytes isolated from human osteoarthritic articular cartilage in vitro. Osteoarthritis Cartilage. 1998;6(6):427-34.

  8. Kelly GS. The role of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease. Altern Med Rev. 1998;3(1):27-39.

  9. McCarty MF. Enhanced synovial production of hyaluronic acid may explain rapid clinical response to high-dose glucosamine in osteoarthritis. Med Hypotheses. 1998;50(6):507-10.

  10. Kelly GS. The role of glucosamine sulfate and chondroitin sulfates in the treatment of degenerative joint disease. Altern Med Rev. 1998;3(1):27-39.

  11. Barclay TS, Tsourounis C, McCart GM. Glucosamine. Ann Pharmacother. 1998;32(5):574-9.

  12. Virkamaki A, Yki-Jarvinen H. Allosteric regulation of glycogen synthase and hexokinase by glucosamine-6-phosphate during glucosamine-induced insulin resistance in skeletal muscle and heart. Diabetes. 1999;48(5):1101-7.

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