Herbal Remedies & Vitamin Guide

01 May 2007

glucosamine

See also
Introduction
Glucosamine is an important building block needed by the body to manufacture specialized molecules called glycosaminoglycans, found in cartilage.
Where is it found?
Glucosamine is not present in significant amounts in most diets. Supplemental sources are derived from the shells of
shrimp, lobster, and crab, or may be synthesized.
Glucosamine has been used in connection with the following conditions (refer to the individual health concern for complete information):
Science Ratings - Health Concerns
*** - Osteoarthritis (glucosamine sulfate)
** - Autism
** - Knee pain (glucosamine HCI)
* - Minor injuries
* - Osteoarthritis (glucosamine HCl)
* - Sprains and strains
* - Wound healing (oral)
*** - Reliable and relatively consistent scientific data showing a substantial health benefit.
** - Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
* - For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support and/or minimal health benefit.
Who is likely to be deficient?
A glucosamine deficiency in humans has not been reported.

Which form is best?
Glucosamine is available in several forms. The glucosamine sulfate (GS) form (stabilized with a mineral salt) is the only form clearly shown in clinical trials to be effective for
osteoarthritis. For this reason, it is the preferred form.
GS is stabilized with one of two mineral salts: sodium chloride (NaCl) or potassium chloride (KCl).1 2 Although they both appear to effectively stabilize GS, the use of KCl as a stabilizer seems preferable since the average Western diet already provides far too much salt (NaCl) and not enough
potassium. However, most of the research has been done with the NaCl-stabilized form.
Concerns have been raised about the quality of GS products on the market. In one study, the amount of glucosamine contained in 14 commercially available glucosamine products varied from 41% to 108% of the amount stated on the label.3 Even when the weight of the sulfate molecule was included, 11 of the 14 products contained less than the amount of glucosamine stated on the label. Some manufacturers may include the weight of the stabilizing salts (NaCl or KCl) in the total weight of the product, without stating so on the label.
Glucosamine hydrochloride (GH) has been widely available as a dietary supplement for years, but only one trial has evaluated this form of glucosamine as a single remedy for OA.4 This trial found only minor significant benefits from 1,500 mg per day of GH for eight weeks, in people with osteoarthritis of the knee who were also taking up to 4,000 mg per day of
acetaminophen. To more fairly evaluate the effects of GH, future research should involve people not taking pain-relieving medication.
Another form of glucosamine,
N-acetyl-glucosamine (NAG), has not been studied in people with osteoarthritis.
How much is usually taken?
Healthy people do not need to routinely supplement with glucosamine. Most research with people who have
osteoarthritis, uses 500 mg three times per day of GS. Appropriate amounts for other conditions are not known.
Are there any side effects or interactions?
At the amount most frequently taken by adults—500 mg three times per day of GS—adverse effects have been limited to mild reversible gastrointestinal side effects. In one trial, people with
peptic ulcers and those taking diuretic drugs were more likely to experience side effects.5
Animal research has raised the possibility that glucosamine could contribute to
insulin resistance.6 7 This effect might theoretically result from the ability of glucosamine to interfere with an enzyme needed to regulate blood sugar levels.8 However, available evidence does not suggest that taking glucosamine supplements will trigger or aggravate insulin resistance or high blood sugar.9 Two large, 3-year controlled trials found that people taking GS had either slightly lower blood glucose levels or no change in blood sugar levels, compared with people taking placebo.10 11 Until more is known, people taking glucosamine supplements for long periods may wish to have their blood sugar levels checked; people with diabetes should consult with a doctor before taking glucosamine and should have blood sugar levels monitored if they are taking glucosamine.
In 1999 the first case of an
allergic reaction to oral GS was reported.12 Allergic reactions to this supplement appear to be rare.
Some GS is processed with sodium chloride (table salt), which is restricted in some diets (particularly for people with
high blood pressure).
The theory that GS and
chondroitin sulfate work synergistically in the treatment of osteoarthritis remains unproven.
At the time of writing, there were no well-known drug interactions with glucosamine.

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