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Glucosamine

(Known as Glucosamine sulfate, Glucosamine hydrochloride, N-acetyl glucosamine, Glucosamine)

Your joints are protected by cartilage. Think of cartilage as a shock-absorber for your joints such as the knee, shoulder and elbow. Over time, cartilage can wear away. This leaves your bones making painful contact with each other. Glucosamine is an important building block needed by the body to manufacture specialized molecules called glycosaminoglycans, found in cartilage. Glucosamine is almost exclusively researched and used for the treatment of joint pain and osteoarthritis.If you're involved in any kind of sport or regular exercise, your joints will experience a massive amount of stress. Some people have trouble just getting out of bed in the morning, simply because of the relentless pounding their joints suffered as part of sporting activity. Glucosamine is a safe and effective way to reduce joint pain. Many athletes also use it to protect their joints, making a future injury less likely.Glucosamine, which occurs naturally in the body, plays a key role in the construction of cartilage - the tough connective tissue that cushions the joints. Glucosamine stimulates the production of glycosaminoglycans (the key structural components of cartilage) as well as the incorporation of sulfur into cartilage. Sulfur is necessary for making and repairing cartilage.

Glucosamine may be effective in treating and possibly slowing the progression of osteoarthritis. This is a type of arthritis caused by continuous wear and tear on the joints leading to inflammation, breakdown, and eventual loss of cartilage. The tissues most affected by osteoarthritis are the weight bearing joints, such as the knees and hips, as well as the joints in the hands.

Glucosamine (alone or in combination with chrondroitin sulphate) has been shown to speed recovery from injury, significantly reduce joint pain, and improve mobility [5]. Of 68 athletes given glucosamine, 52 were completely pain free after just 20 weeks. One year later, researchers were unable to find any sign of cartilage damage in the athletes [2].

Glucosamine and chrondroitin sulphate can also reverse joint degeneration in osteoarthritis sufferers. The American Medical Association recently admitted that the majority of research demonstrated "moderate to large effects" of glucosamine and chrondroitin preparations [8].

The glucosamine/chrondroitin combination is so effective, it has even been used by the U.S Navy [7]. Following 16-weeks of supplementation, test subjects reported a large reduction in joint pain. Their average score in a physical examination also improved by an impressive 43%.

A number of well-controlled studies show that glucosamine can reduce pain without the side effects often seen with commonly prescribed medications [9]. Studies suggest that glucosamine is equally as effective as some of the medications frequently used to treat this joint condition, but with fewer gastrointestinal side effects. The medications used to treat osteoarthritis are known as nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and piroxicam. They tend to cause stomach upset, cramps, constipation, diarrhea, and in some cases, stomach ulcers.

Unlike these medications for joint pain (which only control the symptoms) glucosamine reduces joint pain and tenderness [4], while at the same time rebuilding damaged cartilage [4]. It will also reduce your reliance on anti-inflammatory drugs, and, in many cases, you'll find it superior to ibuprofen for controlling joint pain [6]. Glucosamine hydrochloride (known as Glucosamine HCL) is considered by most experts to be superior to glucosamine sulfate, and has been shown in clinical trials to reverse cartilage damage. [12, 13].
For injury prevention, 600-700 milligrams of glucosamine daily (preferably in combination with chondroitin) should be sufficient. To speed recovery from injury and promote healing, most research has used up to 1400 milligrams daily in 3 or 4 divided doses.Although not every single study agrees, strong evidence from many well-designed trials indicate that glucosamine is a highly effective treatment for joint pain and osteoarthritis, particularly osteoarthritis of the knee. In general, findings from these studies show that glucosamine provides several benefits for people with nagging joint pain, including pain reduction (as effective as ibuprofen and other forms of medication), improved function and mobility, and slowed progression (or even prevention) of joint damage when taken for three or more years. In comparison to medication for joint pain, glucosamine takes longer to begin working. However, pain control lasts longer and the supplements cause fewer side effects.Most experts believe that taking glucosamine (particularly the HCL form) and chondroitin sulfate in combination is a more effective treatment for joint pain than taking either one by itself. Some athletes add N-acetyl-L-cysteine to the glucosamine/chrondroitin combination in the belief this will reduce joint pain still further. Although no study has tested this combination of nutrients, anecdotal reports are very promising. At the time of writing, there are no well-known drug interactions with glucosamine.

1. Alcantara, J., McDaniel, J.W., Plaugher, G., & Alcantara, J. (1998). Management of a patient with calcium pyrophosphate deposition disease and meniscal tear of the knee: a case report. Journal of Manipulative and Physiological Therapy, 21, 197-204
2. Bohmer, D., Ambrus, P., & Szogy, A. Treatment of chrondopathia patellae in young athletes with glucosamine sulfate. (1984). In: Current Topics in Sports Medicine (edited by Bachl, N., Prokop, L., & Suckert, R.), pp. 799-800. Vienna, Austria: Urban and Schwarzenberg
3. Coyle, E.F. (1984). Time course loss of adaptations after stopping prolonged intense endurance exercise. Journal of Applied Physiology, 57, 1857-1862
4. da Camara C.C., Dowless, G.V. (1998). Glucosamine sulfate for osteoarthritis. Annals of Pharmacotherapy, 32, 580-587
5. Deal, C.L., & Moskowitz, R.W. (1999). Nutraceuticals as therapeutic agents in osteoarthritis, chrondroitrin sulfate, and collagen hydrolysate. Rheumatic Diseases Clinics of North America, 25, 379-395
6. Kelly, G.S. (1998). The role of glucosamine sulfate and chrondroitin sulfates in the treatment of degenerative joint disease. Alternative Medicine Reviews, 3, 27-39
7. Leffler, C.T., Philippi, A.F., Leffler, S.G., Mosure, J.C., & Kim, P.D. (1999). Glucosamine, chrondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Military Medicine, 164, 85-91
8. McAlindon, T.E., LaValley, M.P., Gulin, J.P., & Felson, D.T. (2000). Glucosamine and chrondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. Journal of the American Medical Association, 283, 1469-1475
9. McCarty, M.F. (1994). The neglect of glucosamine as a treatment for osteoarthritis-a personal perspective. Medical Hypotheses, 42, 323-327
10. McCarty, M.F. (1996). Glucosamine for wound healing. Medical Hypotheses, 47, 273-275
11. McCarty, M.F., Russell, A.L., & Seed, M.P. (2000). Sulfated glycosaminoglycans and glucosamine may synergize in promoting synovial hyaluronic acid synthesis. Medical Hypotheses, 54, 798-802
12. Houpt JB, McMillan R, Wein C, & Paget-Dellio SD. (1999). Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. Journal of Rheumatology, 26, 2423-2430
13. Das, A., & Hammad, T.A. (2000). Efficacy of a combination of FCHG49 glucosamine hydrochloride, TRH122 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis. Osteoarthritis and Cartilage, 8, 343-350
14. Leffler, C.T., Philippi, A.F., Leffler, S.G., Mosure, J.C., & Kim, P.D. (1999). Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Military Medicine, 164, 85-91

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