What Is It?
Glucosamine, a sugar produced in the body and found in small amounts in foods, plays an important role in maintaining cartilage, the gel-like material that cushions joints. When taken as a dietary supplement, glucosamine may help to relieve the pain, stiffness, and swelling of osteoarthritis, a degenerative joint disorder that affects 12% of the population, in which cartilage has worn down. Rheumatoid arthritis sufferers report improvements with glucosamine supplements as well, as do individuals with other types of joint injuries. Some 70 countries around the world sanction glucosamine as a treatment for individuals with mild to moderately severe osteoarthritis.
While there is no readily available source of glucosamine in foods–the shells of crabs, shrimp and oysters contain it but aren’t typically consumed–several supplement forms have become widely available. These include glucosamine sulfate, glucosamine hydrochloride and N-acetyl-glucosamine (NAG). Glucosamine sulfate is the form best absorbed by the body and the one most commonly used to treat osteoarthritis. Interestingly, for years veterinarians have treated arthritis in certain animals with glucosamine hydrochloride.
The body draws on glucosamine, which contains the sugar glucose, to produce two molecules necessary for proper cartilage function. Whether glucosamine taken orally has the same cartilage-benefiting actions as the glucosamine naturally present in joints and connective tissue actually remains a subject of debate. Much of the glucosamine sulfate taken in pill form is apparently absorbed through the intestines and is available for the body to use, although precisely how much remains a subject of contention. Ultimately, many arthritis sufferers do report improvements, with about half of study participants experiencing significant relief from pain and inflammation. Research indicates possible benefits for other conditions as well.
Specifically, glucosamine may help to:
Relieve osteoarthritis-related pain, stiffness and swelling. The millions of Americans who suffer from osteoarthritis have cartilage that has dried out and gradually broken down over time, cracking and flaking off. When joints are deprived of this cushioning, painful stiffness and inflammation can develop. Glucosamine helps to prevent these symptoms by protecting and reinforcing cartilage. Studies indicate that some arthritis sufferers experience improved range of motion after taking glucosamine. Others report increased overall mobility. And several studies suggest that glucosamine may be as effective in easing arthritic pain and inflammation–and not nearly as irritating to the stomach–as the NSAIDs (nonsteroidal anti-inflammatory drugs) typically recommended for osteoarthritis.
A recent Chinese study of individuals with osteoarthritis of the knee found that while participants taking l,500 mg of glucosamine sulfate daily experienced a similar reduction in symptoms as those given l,200 mg daily of ibuprofen, the glucosamine group tolerated their medication much better.
Slow and possibly halt osteoarthritis-related damage to joints. Glucosamine appears to protect and strengthen the cartilage around joints, particularly in the knees, hips, spine, and hands. In so doing, it may help to prevent further joint damage. And while it can do little to actually restore cartilage that has completely worn away–or reverse joint damage that has already occurred–glucosamine appears to slow the development of mild to moderately severe osteoarthritis. Traditional NSAIDs prescribed for arthritis, in contrast, actually impair the body’s cartilage-building capacity.
In a 2001 study published in the esteemed medical journal The Lancet, Belgian investigators reported that glucosamine actually slowed the progression of osteoarthritis of the knee. Over the course of three years, scientists measured spaces between joints and tracked patients’ symptoms. Those on glucosamine showed no further joint narrowing in the knees. Put another way, the glucosamine appeared to protect the shock-absorbing cartilage that cushions the bones. In contrast, the condition of the patients taking the placebo steadily worsened.
Speed healing of strains and sprains. Because it helps to reinforce the cartilage around joints, glucosamine may hasten the healing of acute joint injuries, such as sprained ankles or fingers. The same is true of muscle injuries such as strains. In strengthening joints, glucosamine may also help to prevent future injury.
Control back pain. By helping to reinforce cartilage, glucosamine is believed to strengthen the tissue supporting the spinal disks that line the back. Back pain resulting from either muscle strain or arthritis may therefore improve with glucosamine. The supplement may also speed healing of strained back muscles in this way. Pain in the upper spine and neck may similarly respond to glucosamine.
Promote healthy aging. As the body ages, the cartilage supporting and cushioning all the joints tends to wear down. Glucosamine may help to postpone this process by giving cartilage a boost, protecting and strengthening it overall. The complications of osteoarthritis, a largely age-related disorder, are therefore also less likely to occur.
Note: Glucosamine has also been found to be useful for a number of other disorders. For information on these additional ailments, see our Dosage Recommendations Chart for Glucosamine.
Special tip: The dosage for glucosamine is calculated on body weight: about 900 mg per 100 pounds of body weight. If you weigh more than 200 pounds or take diuretics, consult your doctor about an appropriate dosage, as you may have to take a higher daily dose of the drug than is commonly recommended.
–Glucosamine is often sold in combination formulas for arthritis with the dietary supplement chondroitin sulfate.
For all types of arthritis and joint-related conditions: Take 500 mg of glucosamine sulfate three times a day.
For sprains, strains, and back pain: Take 500 mg of glucosamine sulfate three times a day.
To protect against aging-related ailments: Take 500 mg of glucosamine sulfate twice a day.
Be sure to check out our Dosage Recommendations Chart for Glucosamine, which has therapeutic dosages for specific ailments at a glance.
Guidelines for Use
Take glucosamine with food to minimize the risk of digestive upset.
Allow two to eight weeks for results.
When treating arthritis, consider boosting glucosamine’s effectiveness by taking it along with one of the following oral supplements: chondroitin sulfate (another compound that may affect cartilage), niacinamide (a form of the B vitamin niacin), or S-adenosylmethionine (SAMe), a form of the amino acid methionine. Glucosamine is also commonly combined with other anti-arthritis supplements such as boswellia (a tree extract), sea cucumber, and cayenne (or capsaicin) ointment.
Glucosamine supplements can safely be combined with conventional pain relievers such as acetaminophen and aspirin.
Glucosamine may interact with certain diuretics, necessitating higher doses of the diuretic. Ask your doctor for guidance.
There are no other known drug or nutrient interactions associated with glucosamine.
Note: For information on interactions with specific generic drugs, see our WholeHealth Chicago Drug/Nutrient Interactions Chart.
Possible Side Effects
No significant side effects have been reported, although long-term studies on glucosamine’s safety remain to be done.
In rare cases, heartburn, nausea or other minor gastrointestinal problems can develop.
If you’re pregnant or breast-feeding, check with your doctor before taking glucosamine.
Aging 750-1,000 mg glucosamine sulfate twice a day
Arthritis 500 mg glucosamine sulfate 3 times a day
Back Pain 500-1000 mg glucosamine sulfate 2 or 3 times a day; some nutritionally oriented physicians recommend starting at higher doses for 2-3 weeks, then reducing to 500 mg three times a day (or 750 mg twice a day).
Carpal Tunnel Syndrome 500 mg 3 times a day
Muscle Aches and Pains 500 mg glucosamine sulfate 3 times a day
Strains and Sprains 500 mg glucosamine sulfate 3 times a day
David Edelberg, M.D.
Glucosamine plays a crucial role in the manufacture of molecules called mucopolysaccharides, key building blocks within the body’s tendons, ligaments, cartilage, blood vessels, heart valves, and even the structures of the eye. It also stimulates chondrocytes, important cells within a joint that manufacture cartilage itself.
HOW IT HELPS BACK PAIN
Glucosamine sulfate (GS) helps to create the molecules needed to stabilize the disks in your spine and strengthen the complicated lacing of ligaments and tendons that holds everything in place. The studies on GS are strong, its side effects are few, and enthusiasm among WholeHealth Chicago patients for GS and its treatment for back pain and disk disease (as well as all forms of arthritis) is very high.
WHAT TO LOOK FOR
Glucosamine is available in a number of forms as well as in combination products. Only the sulfate form has been tested and found effective, although there are several types of glucosamine, including glucosamine hydrochloride and N-acetyl glucosamine. GS is synthetically manufactured and sold as a white powder, either in capsules or little packets that can be mixed into water. Combination products sometimes add GS to other joint support supplements, such as chondroitin and MSM. These combinations can be quite effective, although the evidence for glucosamine sulfate is stronger than that for chondroitin or MSM. My own opinion is that if you’ve read about chondroitin or MSM as well as GS, then one of the combination products may reduce your total cost, and it will certainly cut down on the number of pills you have to swallow.
Dosage is important. For joint and cartilage repair, you’ll need to get 1,500 mg a day to match dosages used in the studies. Spread this dose throughout the day for the best absorption. Take your GS with meals. Patience is a byword with GS. Remember, you’re not using a painkiller that has a rapid onset, but a substance that’s actually rebuilding your joints. Allow at least two to three months for the GS to show its full effect. Buyer beware: There’s also a topical form of GS, which you’re supposed to rub over your joints for relief. I’ve found this to be very ineffective and suggest you don’t waste your money on it
David Edelberg, MD