Glucosamine occurs naturally in human tissues. Within joints, glucosamine stimulates the manufacture of key structural components of cartilage, which is essentially a layer of tissue that covers the surface of joints and acts as a shock-absorber.
As some people age they lose the ability to manufacture sufficient levels of glucosamine. This is particularly the case in postmenopausal women, but can affect either gender. The result is the onset of osteoarthritis which leads to pain and decreased motion in joints, particularly knees, hips and hands. Morning stiffness is often the first symptom of osteoarthritis.
Glucosamine can be taken as a supplement in the form of glucosamine sulphate.
Benefits of Taking Glucosamine Sulphate
- Reduced joint pain (Ref.1)
- Decreased symptom severity (2)
- Reduced joint space narrowing
- Fewer gastrointestinal disturbances than for ibuprofen
Research evidence
A study of 414 women, 319 of whom were postmenopausal, randomly assigned the women to either a group taking glucosamine sulphate or a placebo group. A three year follow-up showed that the postmenopausal women in the glucosamine sulphate group showed no joint space narrowing, whereas the placebo group experienced a narrowing of 0.33mm (Ref 3).
A literature review(4) found the following:
In two large randomised, double-blind, multicentre studies of patients with osteoarthritis, oral or intramuscular glucosamine sulphate taken for 4-6 weeks was associated with a greater decrease in symptom severity (as assessed by the Lequesne index) than for those taking a placebo. In addition, there was a greater proportion of positive outcomes in terms of symptoms and joint assessment at the end of the treatment period with glucosamine sulphate than with placebo.
In two large 4-week trials, oral glucosamine sulphate produced similar improvements to ibuprofen in symptom severity in one study and in articular pain scores in the other study.
In a smaller 8-week comparative trial, oral glucosamine sulphate therapy achieved a significantly greater improvement in articular pain score than ibuprofen, and the investigators rated treatment efficacy as 'good' in a significantly greater proportion of glucosamine sulphate than ibuprofen recipients.
In comparison with piroxicam, glucosamine sulphate significantly improved arthritic symptoms after 12 weeks of therapy and remained effective 8 weeks after treatment was discontinued.
Glucosamine sulphate recipients had a markedly lower incidence of gastrointestinal disturbances than those receiving ibuprofen. Other adverse events reported in both glucosamine sulphate and ibuprofen recipients were pruritus or skin reactions, flushing and fatigue. In general, a lower incidence of withdrawal from clinical trials was reported for glucosamine sulphate recipients than either ibuprofen or piroxicam recipients.
Glucosamine Sulphate Dose
Most of the above studies used 500mg glucosamine sulphate three times daily with positive outcomes. It can take 4-6 weeks before the full benefits of supplementation are experienced.
References
- Osteoarthritic patients with high cartilage turnover show increased responsiveness to the cartilage protecting effects of glucosamine sulphate. Christgau S et al, Clin Exp Rheumatol. 2004 Jan-Feb;22(1):36-42.
- The use of glucosamine therapy in osteoarthritis. Zerkak D, Dougados M. Curr, Rheumatol Rep. 2004 Feb;6(1):41-5.
- Glucosamine sulphate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies. Bruyere O et al, WHO Collaborating Center for Public Health Aspect of Osteoarticular Disorders, Liege, Belgium.
- Glucosamine: a review of its use in the management of osteoarthritis. Matheson AJ, Perry CM. Drugs Aging. 2003;20(14):1041-60.
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