As some people get older they develop a degenerative condition known as osteoarthritis which is characterized by pain, stiffness, swelling of the joints and a general inability to move about easily. The condition, which is irreversible, is caused by the deterioration and eventual loss of bone cartilage, the soft connective tissue that protects joints and keeps bones from directly rubbing against each other. Some studies suggest that most people over 60 have osteoarthritis though the severity of the symptoms can vary greatly among individuals. Arthritis affects nearly 70 million Americans.
Relieving arthritis with glucosamine
Numerous allopathic and natural remedies are touted as treatments for the symptoms of osteoarthritis. Among them are nutritional supplements based on a substance called Glucosamine. Glucosamine is a naturally occurring amino sugar in the body that plays a vital role in keeping cartilage and other body tissues healthy. As people get older their bodies start producing less glucosamine. This gradual diminishing of glucosamine causes the bone cartilage to lose some of its elasticity and become stiff and inflexible, eventually resulting in osteoarthritis. Glucosamine supplements are designed to slow this process by compensating for the loss of the amino sugar that occurs with age. Glucosamine supplements are believed to help in the production of glycosaminoglycan, a molecule that helps repair and rebuild damaged cartilage.
Our bodies naturally make glucosamine as part of its way of keeping our joints lubricated and flexible for maximum mobility. Glucosamine is needed to react with hydrochloric acid in the stomach to eventually produce Hyaluronic Acid, which is a glycosaminoglycan. Hyaluronic acid is found naturally in cartilage, tendons, ligaments and synovial fluid around the joints. It helps with elasticity. Hyaluronic acid is unique among glycosaminoglycans in that it is nonsulfated, and can be very large, with its molecular weight often reaching the millions. It is one of the main components of the extracellular matrix. The extracellular matrix provides structural support to animal cells. The extracellular matrix is the most important feature of connective tissue in animals.
Since glucosamine is naturally occurring in the human body, many find it a viable alternative to over the counter or prescribed pills known to erode the digestive tract or cause internal bleeding or liver problems.
Glucosamine is also known as glucosamine sulfate, glucosamine sulphate, glucosamine hydrochloride, N-acetyl glucosamine, and chitosamine.
The Glucosamine Market
The common dosage for the supplement is 1,000 mgs. It is also available in 300, 500 or 750 mgs. as well. It can be taken in one of three ways; as an injection, in solid or pill form, or in liquid form.
In most cases, glucosamine supplements are taken along with supplements based on another naturally occurring substance in the body called chondroitin. Chondroitin is a complex carbohydrate that helps cartilage retain water. Supplements based on chondroitin are believed to slow down the production of certain enzymes that are known to destroy cartilage.
Glucosamine supplements are typically made from crab, lobster and shrimp shells, though some supplements are based on vegetables. Chondroitin supplements meanwhile are made from the cartilage of cows. Glucosamine is commercially available in either sulfate or in hydrochloride form each of which have very different chemical compositions.
Although it has only been tracked since the early 80’s, research shows that it is generally safe for most people.
Though glucosamine along with chondroitin supplements have been fairly widely used for some time now, there is still considerable discussion about the extent of their effectiveness in treating osteoarthiritis. Previous clinical studies have suggested for instance that the effectiveness of a glucosamine supplement is dependent on whether it is a Glucosamine hydrochloride or Glucosamine Sulfate.
Glucosamine hydrocholride vs glucosamine sulfate
Some research suggests that Glucosamine sulfate is more effective at alleviating osteoarthritis symptoms because it is more bio-available, or most easily absorbed by the body compared to hydrochloride supplements. Other studies however suggest that Glucosamine hydrochloride supplements are more concentrated, and are absorbed more rapidly in the gastrointestinal tract than other Glucosamine supplements. A third school of thought holds that Glucosamine supplements are most effective only when they are taken along with chondroitin supplements.
Glucosamine/chondroitin Arthritis Intervention Trial (GAIT)
Sufferers of osteoarthritis who are looking for some clarity on the subject unfortunately have little to go by. The most solid research to date on the effectiveness of Glucosamine was conducted by the University of Utah, School of Medicine on behalf of the National Institutes of Health (NIH). The study, which was called Glucosamine/chondroitin Arthritis Intervention Trial (GAIT), was designed to test the short-term effectiveness of Glucosamine and chondroitin sulfate in reducing pain associated with osteoarthritis.
The study of 1583 patients suggested that patients with moderate to severe pain did indeed obtain statistically significant pain relief when they took Glucosamine combined with chondroitin sulfate. The results were somewhat less clear in the case of osteoarthritis suffers with only moderate pain. The NIH study however looked only at the effectiveness of Glucosamine hydrochloride supplements and not Glucosamine Sulfate based ones.
Meanwhile, a much earlier three-year clinical study conducted in the Prague Institute of Rheumatology, showed Glucosamine Sulfate to be effective in slowing the progression of knee osteoarthritis. The results of this study were very similar to those from a previous clinical study investigating the effectiveness of Glucosamine sulfate. What appears less clear though is the effectiveness of Glucosamine when it is taken by itself. The GAIT study for instance, showed that Glucosamine alone fared little better than a placebo in relieving osteoarthritis symptoms.
Glucosamine and TMJ
The pain of Temporomandibular Joint pain (TMJ) is termed an arthritic condition and sufferers can attest to the enormous amount of pain the condition causes. Glucosamine has been labeled as “possibly effective” for this condition.
The Mayo Clinic's Findings
In connection with glucosamine sulfate which is found in cartilage fluid, The Mayo Clinic's opinion is that available evidence does support the use of glucosamine sulfate to strengthen cartilage and that only this form of the supplement is helpful, not non-sulfated glucosamine.
The Mayo Clinic also reported that glucosamine is common in patients with osteoarthritis, and may be helpful in reducing the need for NSAID's. (non-steroidal anti-inflammatory agents) This is of course good news for those trying to reduce the number of such pills ingested on a daily basis.
As a final grade, the Clinic gave glucosamine an "A" for good evidence to support its benefit for mild to moderate knee osteoarthritis. A "B" grade was issued for glucosame's benefit when treating osteoarthritis in general. (The Mayo Clinic's report was last updated December 1, 2010)
The National Institute of Health’s Findings
Perhaps the final words about glucosamine should come from the United States National Institute of Health (NIH):
• Likely effective for osteoarthritis
• Takes 4-8 weeks to reduce pain compared to 2 weeks with standard treatment.
• Glucosamine slows break down of joints, if taken long term.
• Knee replacement surgery is less likely with glucosamine users.
Natural health enthusiasts advocate its use and its advantages over prescribed pills as being:
• Less costly
• More natural and therefore gentler on the stomach so less side effects.
• Proven effective for treating gout, joint pain, and rheumatoid arthritis
As is often the case with natural supplements and natural remedies the best advice might be to do your research, weigh the pros and cons, and consult your doctor for his or her opinion. The apparent fact that Glucosamine supplements have no side effects associated with their use has been one major factor driving growing adoption of the remedy. For the moment at least clinical studies have shown the use of Glucosamine to have no long term downsides. For many osteoarthritis sufferers, that alone may be benefit enough to choose Glucosamine.
Side Effects and Safety Concerns
Glucosamine can cause some mild side effects including nausea, heartburn, diarrhea, and constipation. Conflicting concerns arise over whether women who are pregnant or breast-feeding should take the supplement. Also whether or not people with asthma or who are diabetic should stay away from the supplement. Most importantly, those with a shellfish allergy are advised that certain glucosamine products can contain harmful particles that can cause an allergic reaction to occur.
Possible Drug Interactions (Clear the use of glucosamine with your primary care provider.)
Coumadin is used to slow blood clotting. Glucosamine may interact negatively with this medication preventing it from working properly.
Medications for cancer (Antimitotic chemotherapy). Some scientists think that glucosamine might increase how fast tumor cells copy themselves. Anyone receiving chemotherapy should remember to talk with their doctor about taking the supplement along with the chemotherapy drugs.
Acetaminophen (Tylenol). While there is some concern about taking glucosamine and acetaminophen, more information is needed before determining if this interaction is a big concern. For now, most experts say it is okay to use both together.
Medications for diabetes
Latest research now shows that glucosamine probably does not increase blood sugar in people with diabetes. Just to be on the safe side, however, a diabetic should discuss this with their health care provider and monitor your blood sugar closely.
Interactions with herbs and supplements. There are no known interactions between glucosamine and other herbs and supplements.
Food Interactions. There are no known interactions with foods except for those with shellfish allergies.