What Are Glucosamine And Chondroitin Made Up Of
Glucosamine and chondroitin are cartilage components that the body naturally produces. By supplementing the cartilage tissue, discomfort and swelling in the joints that are most prone to be affected by osteoarthritis can be lessened. Also, this can prevent the breakdown of connective tissues.
Chondroitin is derived from the cartilage of cow tracheas, whereas glucosamine is derived from shellfish shells . Their chemical composition is similar to cartilage molecules, and their manufacturers claim that they help worn cartilage. However, medical experts and researchers are skeptical about their benefits.
A Study On The Effectiveness And Safety Of Glucosamine Chondroitin And Celebrex
The purpose of this new analysis of prior studies was to investigate the effectiveness and safety of glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of knee osteoarthritis . The study covered 54 previous studies and a total of 16,427 patients.
Researchers discovered that all the treatment options showed improvements in pain, but only glucosamine plus chondroitin showed improvement in function and reduction in the narrowing of the joint space seen in arthritis. In addition, gastrointestinal adverse effects were seen in those using the celecoxib. Researchers concluded that the combination of glucosamine and chondroitin was an effective treatment for osteoarthritis of the knee.
What About Skin Delivery
Maybe you’ve heard of topical or transdermal preparations of glucosamine and chondroitin. Are these good to use?Of note, you may see ‘topical’ and ‘transdermal’ used interchangeably, but there is a difference.Topical medications treat skin locally at site of application .Transdermal medications are actually absorbed through the skin and are intended to have an effect inside the body. Transdermal preparations are often used for anti-nausea drugs, pain relievers, and hormone replacement therapy.Glucosamine and chondroitin can also be used on the skin in a transdermal preparation.Research published in the Journal of Rheumatology demonstrated that topical application of glucosamine and chondroitin was more effective in relieving arthritic knee pain over placebo in as little as 4 weeks.
Use of topicals is a great option because you get the results you want without the nasty side effects of taking pills . Win/win situation, right?
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Can Diabetics Use Glucosamine Chondroitin
For those suffering from diabetes, there has been a lot of misinformation about how Glucosamine Chondroitin might affect them. Frankly speaking, the use of Glucosamine for diabetics will not have a negative impact on them. This fact is surprising to many.
From a technical standpoint, Glucosamine is a type of sugar. In spite of that fact, clinical studies have found that Glucosamine has no effect on either insulin sensitivity or blood sugar levels. That is true even though a few authors have stated that those who suffer from diabetes might be adversely affected by using Glucosamine. Those early opinions have since been found to be wrong.
Many years ago some researchers had suggested that Glucosamine may make insulin resistance worse. If that was true, Glucosamine had the potential to increase blood sugar in those who have Type-2 diabetes. However, all subsequent clinical trials found that there was no possibility of this happening. If you are diabetic, you can use Glucosamine.
Effects On Radiological Joint Space
Six trials reported changes in width of joint space.343537414243 The network meta-analysis of differences in changes in minimal joint space narrowing at the end of the treatment period showed minute effects for all preparations compared with placebo. The difference was 0.2 mm in favour of glucosamine, 0.1 mm in favour of chondroitin, and 0.0 mm for the combination, which corresponded to effect sizes of 0.16 , 0.08 , and 0.00 . Heterogeneity between trials was low , there was no evidence for inconsistency , and the goodness of fit of the model to the data was excellent.
Foods That Help Reduce Arthritis Pain
Vegetables, fruits and whole grains provide antioxidants that may ease the pain and swelling of arthritis, an inflammation of the joints. Also helpful are omega-3 fatty acids , which the body converts to anti-inflammatory compounds. Fat eight to 12 ounces weekly of fish rich in omega-3s, such as salmon, mackerel and sardines. Limit polyunsaturated fats, such as corn oil and safflower oil, which are high in omega-6 fatty acids, substances converted in the body into compounds that promote inflammation. Also limit your intake of saturated fat, found primarily in meat and dairy products, because these unhealthy fats may increase inflammation.
More Study Needed But A Positive Beginning
I think this is an interesting study, which will hopefully lead to a new interventional option for patients who havent had satisfactory results from conventional therapy alone. We know placebo effect is high with glucosamine, yet we can account for this with novel questionnaires to address individual patient beliefs. I will be interested to see additional longer-term studies showing sustained benefit and safety while accounting for the placebo effect. This study shows it is safe, effective, and may be a good option for patients in addition to therapy. Or maybe we can eventually try glucosamine sulfate prior to NSAIDs or acetaminophen, which have reported side effects, says Dr. Botto-van Bemden.
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Surrogate Endpoint/in Vitro Studies
In vitro studies investigating surrogate outcomes related to osteoarthritis treatment in dogs suggest that the use of glucosamine and chondroitin produces chondroprotective effects . Currently, good-quality evidence does not exist to suggest that in vitro studies using surrogate endpoints translate into clinically meaningful improvements in canine osteoarthritis symptoms. provides a brief summary of surrogate endpoint/in vitro trials for reader interest.
Clinical Trials: Glucosamine/chondroitin Versus Undenatured Collagen Type Ii Placebo Or Glucosamine/chondroitin/undenatured Collagen Type Ii
Gupta et al. conducted a prospective, randomized, double-blinded study that included approximately 31-37 client-owned dogs weighing > 40 lbs with moderate osteoarthritis. The trial consisted of four arms in which the subjects received either 1) glucosamine HCl, chondroitin sulfate, and undenatured collagen type II , 2) glucosamine HCl and chondroitin sulfate, 3) UCII, or 4) placebo. For complete dosing schedules, please see . Outcomes included therapeutic efficacy, tolerability, and safety. Efficacy was measured objectively through peak vertical force and impulse area measurements obtained with a piezoelectric sensor-based ground force plate and subjectively through observational pain assessments on a monthly basis for 150 days. Additionally, the physical, hepatic, and renal functions of the dogs were monitored each month via body weight, temperature, pulse, alkaline phosphatase , alanine transaminase , bilirubin, blood urea nitrogen , and creatinine measurements. The placebo arm showed no statistically significant changes in any of the outcome measures by trial end. The glucosamine and chondroitin arm exhibited a significant reduction in subjectively-assessed pain at 90 days with maximal effects observed at 150 days. The GFP-based parameters remained significantly unchanged by trial end. Supplementing glucosamine and chondroitin with UCII did not provide any additional benefit. None of the dogs receiving dietary supplements showed any signs of adverse effects.
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Inclusion Criteria For Articles
Only studies defined as presenting high quality of evidence were included :2323. Oxford Centre for Evidence-Based Medicine. Disponível em: http://www.cebm.net/index.aspx?o=5653. Disponível em: http://www.cebm.net/index…
Systematic reviews or meta-analyses on RCTs that evaluated the use of glucosamine/chondroitin in humans with knee and/or hip osteoarthrosis
Controlled RCTs that compared the use of glucosamine/ chondroitin with placebo or another medication, with a minimum of 24 weeks of follow-up
Adequately designed studies that included at least 100 patients in each intervention
Studies in which the primary outcome was assessment of pain intensity and the secondary outcome was assessment of the diminution of the joint space by means of radiographs on the knee
Australian Rheumatology Association And Arthritis Australia Statement Regarding The Use Of Glucosamine For The Treatment Of Osteoarthritis
Recent media reports have raised concern over the use of glucosamine in the treatment of osteoarthritis. These reports appear to be based on two unrelated recent events:
In October 2019 the ACR updated their guidelines for the management of osteoarthritis from a longstanding conditional recommendation against the use of glucosamine for osteoarthritis , to a strong recommendation against the use of glucosamine for osteoarthritis . They did not cite new safety concerns.
This paper reviewed 366 glucosamine related adverse drug reactions reported to the Therapeutic Goods Administration between 2000-2011, including 43 classified as severe, possibly related to the known risks of glucosamine in those with shellfish allergy. This highlights a valid concern but the number of adverse events needs to be considered in the context of the many hundreds of thousands of people who took glucosamine during that period. This suggests that severe adverse reactions are very uncommon.
Many other osteoarthritis treatment guidelines make conditional recommendations against the use of glucosamine on the basis that it probably does not help, including The Royal Australian College of General Practitioners guideline for the management knee and hip OA .
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Contraindications Adverse Effects And Interactions
The reported adverse effects have been generally uncommon and minor. Glucosamine is produced from the shells of lobster, crab, and shrimp. However, the antigen proteins associated with seafood allergies are not found in the shell, and there have been no reports of reactions in persons with shell-fish allergies who take glucosamine.33 There also have been no significant supplementdrug interactions involving glucosamine. In one case report, the addition of glucosamine sulfate to a stable-dose regimen of warfarin appeared to magnify the anticoagulant effects of warfarin in a 69-year-old man.34 Only one person has been reported to have had an allergic reaction to oral glucosamine.35
Glucosamine Warnings And Side Effects
Because glucosamine may be made from crustacean shells, those who have shellfish or seafood allergy should consult their doctor before taking it.
An analysis of 10 years of Australian adverse drug reaction data showed that almost three-quarters of the reactions to glucosamine and chondroitin products involved hypersensitivity reactions, some of which were severe. In Australia, under new medicine label rules, products must declare if they are derived from or contain crustacea or crustacean products and fish, among other allergens. However, as manufacturers have been given 4 years to comply with the new rules, it is wise to check with your doctor or pharmacist.
Glucosamine is an amino sugar therefore concerns have been raised that it may affect blood sugar levels and contribute to insulin resistance and that it should be taken with caution by people with diabetes. However, these concerns have not been borne out by recent studies.
People taking blood-thinning medicines, such as warfarin, should also talk to their doctor before taking glucosamine, as it may increase the risk of bleeding. Glucosamine may also cause side effects such as gastrointestinal upsets, sleepiness, headaches or skin reactions in some people.
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Which Brand Of Arthritis Supplement Should I Use
There are many different brands of glucosamine and chondroitin, which are usually sold together as one arthritis supplement. Again, there is no government monitoring to ensure the purity of these products.
In order to assure that you get a consistent dose of the supplements, stick with a reputable manufacturer choose products sold by large and well-established companies. If you don’t recognize a brand name, ask about the company’s reputation, how long it has been in business, and how long the store has stocked the brand.
Results Showed Glucosamine Sulfate To Improve Pain And Function
The research team didnt expect to see any changes until the six-month mark but were surprised to see results after just three months, reporting 18 percent difference in reduction of pain between the study and control group. The only side effects reported by the glucosamine sulfate group were some cases of mild and transient gastrointestinal upset.
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Where To Go From Here
These are only a few of the many supplements you can start taking that could be beneficial if you have arthritis. However, they are some of the best.
If you begin taking omega 3 fats in the form of fish oil, protein supplements such as whey and branched-chain amino acids, youll most likely see a big difference.
Test it yourself and keep your own records on what works for you. The answers are waiting for you to discover them!
Any specific supplement products & brands featured on this website are not necessarily endorsed by Donna.
Contents of this Article
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Glucosamine As A Preventative Measure
Studies into the use of glucosamine as a preventative complementary medicine tend to focus on those aged over 50. They have found some effectiveness for treatmenting knee osteoarthritis in older age groups.
They showed the degradation of type II collagen, the foundation of joint cartilage, was reduced in the groups that took a high dose of glucosamine compared with low dose and placebo groups. Regular supplementation with glucosamine sulfate has shown to have a small to moderate effect by slowing the rate of joint cartilage degeneration if taken regularly for three years.
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How Glucosamine Helps Osteoarthritis
Glucosamine sulfate functions as the primary building block for proteoglycans, large molecules in cartilage that give it viscoelastic properties. This molecule stimulates the formation and repair of articular cartilage. When taken orally, glucosamine sulfate is absorbed readily into the system and can be traced to cartilage as soon as four hours after consumption.
Similar to non-steroidal anti-inflammatory drugs , glucosamine sulfate has been shown to have unique anti-inflammatory effects. Additionally, in some laboratory tests, the glucosamine supplement demonstrated a protective effect on the cartilage. These studies suggest that glucosamine sulfate may inhibit the breakdown of cartilage associated with osteoarthritis and may have the potential to help build-up cartilage.1
Glucosamine hydrochloride, another form of glucosamine, is also available as a nutritional supplement, but is considered less effective for the treatment of osteoarthritis. This is because the sulfate moiety, not present in this formulation, is believed to play an important role in strengthening the cartilage and aiding in proteoglycan synthesis. This hypothesis has not yet been confirmed.
Using Glucosamine And Chondroitin For Fibromyalgia
Many fibromyalgia sufferers report that glucosamine and chondroitin supplements help to relieve some of their fibromyalgia symptoms. In particular, fibromyalgia patients find that these two nutritional supplements help to:
- relieve joint and muscle pain
- reduce the inflammation caused by related diseases, like osteoarthritis and rheumatoid arthritis
- increase joint strength and range of motion
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Study Selection And Characteristics
A flowchart of study search and selection was presented in Additional file : Figure S1. We identified 1407 references in our literature search and out of 97 potentially eligible studies, 26 articles describing 30 trials met our inclusion criteria and were included in the meta-analysis . All trials were published as full journal articles and all trials used a placebo control. Only two articles compared the effectiveness among glucosamine, chondroitin, and the two in combination with placebo at one time . Therefore, 14 RCTs were employed to assess the effectiveness of oral glucosamine, 12 studies were included in the analysis of oral chondroitin, and 4 trials were used to estimate the effectiveness in the subgroup of the combination of glucosamine and chondroitin. Characteristics of included studies were shown in Table . All of these included studies were published in English language. A total of 7172 participants were enrolled in this meta-analysis for the pain outcome. Most trials included patients with only knee OA, 1 trial included patients with knee or the hip OA, and 1 trial included patients with the only hip OA. The average age of the patients ranged between 42.65 and 67.09 years , and the percentage of women ranged from 28 to 93% . The average duration of symptoms was reported in 14 trials and ranged from 1.60 years to 12.98 years .
Table 1 Characteristics of the included studies for osteoarthritis of knee and/or hip
What Are The Possible Risks
- Shellfish allergy: most glucosamine supplements are made from shellfish, although some made from non-shellfish sources are now available.
- Bleeding: people taking the blood thinning medicine warfarin should talk to their doctor before starting, stopping or changing their dose of glucosamine or chondroitin. These supplements may interact with warfarin and make the blood less likely to clot or increase the risk of bleeding.
- Diabetes: glucosamine is a type of sugar so check with your doctor before taking glucosamine if you have diabetes.
- Pregnant or breastfeeding women: there have not been enough long-term studies to clearly say that glucosamine is safe for a developing baby. Pregnant women should talk to their doctor before taking glucosamine.
- Other side effects: upset stomach , headaches, and skin reactions.
Talk to your doctor or pharmacist about whether you should be trying these medications, whether they are safe for you and, if you decide to try them, make sure you get the right dose.
High-quality evidence shows little or no benefit from glucosamine or chondroitin for OA. If you want to try these supplements, talk to your doctor or pharmacist about whether they are safe for you.
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