Does Glucosamine Help Treat Arthritis?
Let’s quickly talk about the supplement glucosamine. This is a very commonly consumed supplement, often taken in combination with chondroitin sulfate to help prevent or treat the symptoms of osteoarthritis.
Osteoarthritis is the most common form of arthritis, affecting an estimated 12.1 percent of Americans 25 years and older. Therapeutic options includes nonpharmacologic interventions such as weight loss, physical and occupational therapy, and surgery. Medication options include acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), intra-articular injections, opiates, and glucosamine sulfate. (source: AAFP)
Glucosamine Supplement Options: http://amzn.to/2pcF5PG
Glucosamine is a molecule classified as an amino sugar, which you can derive from the name ‘glucos’ = sugar and ‘amine’ = amino group (or a nitrogenous group). In humans, it acts as a precursor to a cluster of molecules called glycosaminoglycans. Glycosaminoglycans are polysaccharides essentially composed of chains of different types of repeating sugars with proteins and uronic acids attached. (It is more complicated than that, but that simplified version is easy to remember). The purpose of glycosaminoglycans is to act as the bodies natural lubricant and shock absorber for joints. It is an essential component of the structural integrity of the cells in your body, especially in cartilage.
Because of our biological understanding of glucosamine, it is often supplemented for the purposes of treating and preventing diseases of the joints, known as arthritis. Most often, this is in the form of osteoarthritis. Researchers had hoped that this supplement would benefit cartilage and joints, although the evidence to date is somewhat mixed and underwhelming.
The most substantive and definitive evidence is a 2010 meta analysis published in the british medical journal (Wandel, et al.) that sought to assess all of the prior clinical trials together. These authors concluded “ Compared with placebo, glucosamine, chondroitin, and their combination do not reduce joint pain or have an impact on narrowing of joint space.”
The GAIT trial or Glucosamine/chondroitin Arthritis Intervention Trial published in 2006 (New England Journal of Medicine, Clegg, et al.) concluded “Glucosamine and chondroitin sulfate alone or in combination did not reduce pain effectively in the overall group of patients with osteoarthritis of the knee. Exploratory analyses suggest that the combination of glucosamine and chondroitin sulfate may be effective in the subgroup of patients with moderate-to-severe knee pain.”
A third study, published in 2010 (Annals of Rheum Dis, Sawitzke, et al) concluded “Over 2 years, no treatment achieved a clinically important difference in an osteoarthritis index known as WOMAC regarding pain or function as compared with placebo.
However, another study published in 2006 (Cochrane, Towheed et al.), completed a meta analysis of prior studies found “Pooled results from studies using a non-Rotta preparation or adequate allocation concealment failed to show benefit in pain and WOMAC function while those studies evaluating the Rotta preparation show that glucosamine was superior to placebo in the treatment of pain and functional impairment resulting from symptomatic OA”. For what it’s worth, the rotta prep is a glucosamine preperation prepared by rotta pharmaceuticals who funded the study.
It appears that glucosamine (along with chondroitin sulfate) may have have a limited role in the prevention and possibly treatment of arthritis. Researchers and physicians are not sure how much of a role it actually has because the evidence as a whole is underwhelming and much of the research is industry supported. I would add that any purported effects of of supplementation are best appreciated and most effective over years and less substantial in shorter time periods.
The most commonly used doses range from 900 to 1500 mg daily
The safety profile of glucosamine (as well as chondroitin sulfate) is similar to that of a placebo and superior to NSAIDS like ibuprofen or aspirin. The most common side effects are gastrointestinal.
It’s also worth noting that glucosamine (and many other supplements) are not regulated by the FDA and the quality of amount of glucosamine in any given package or tablet can vary widely.