NMU 148 – Glucosamine and Osteoarthritis

Nutrition / Natural Medicine Update No 148 (October 24, 2019)

with Dr. James Meschino

Topic: Glucosamine Sulfate for Osteoarthritis. Does it Work – A Research Update

Source: Journal – Current Medical Research and Opinion (2016)

I mentioned in a previous update that 20% of adults between 40 and 69 years old regularly take a glucosamine supplement to help manage or prevent osteoarthritis. There has been some debate over the years as to how effective glucosamine is as a preventive and/or therapeutic agent for this condition. A 2016 review of the available studies, published in the journal Current Medical Research and Opinions, shed some important light on this subject. The paper highlights the research showing that glucosamine is a strong inhibitor of many inflammatory and degenerative agents that cause or worsen osteoarthritis, such as interleukin 1b, cyclo-oxygenase-2, nitric oxide, interleukin-6 and tumor necrosis factor-alpha, as well as cartilage destroying enzymes like metalloproteinases.

Glucosamine has been shown to directly or indirectly suppress the release of these inflammatory and cartilage-destroying substances in the body. They also provide evidence showing that long-term oral administration glucosamine sulfate reduces the destruction of cartilage in in-vitro models, as well as suppressing joint inflammation. Human clinical studies show that over the long-term glucosamine sulfate is moderately better than acetaminophen (paracetamol) in reducing osteoarthritic pain, is more cost-effective and is safer than acetaminophen as well as non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen or naproxen. Additionally, unlike acetaminophen and NSAIDs, glucosamine sulfate supplementation demonstrates actual disease-modifying properties, slowing or arresting the progression of osteoarthritis, improving mobility and functionality in arthritic patients, reducing inflammation, delaying structural changes and leading to a reduction in the need for knee replacement surgery, as an example.

With respect to glucosamine sulfate supplementation and osteoarthritis, the researchers conclude, “real-life pharmacoeconomic studies demonstrate a long-term reduction in the need for pain analgesia and NSAIDs with glucosamine sulfate therapy over 12 months, with a significant reduction in costs associated with medication, healthcare consultations and examinations”. Taken together, I think there is a growing argument to consider taking glucosamine sulfate once a person is 40 years of age to help prevent age-related changes that are linked to osteoarthritis development.  For individuals who have osteoarthritis, the effective daily dosage has been shown to be 1500 mg per day, taken once a day with food. For prevention of osteoarthritis after the age of 40 one might consider 500 -1,000 mg per day. Always check with your physician before changing your diet or supplementation program, as in certain instances supplements like glucosamine may be inadvisable. One final note, the form of glucosamine that has been shown to be the most effective form, from the studies we have to date with osteoarthritis patients is glucosamine sulfate, not other forms of glucosamine, such as glucosamine hydrochloride or N-acetylglucosamine.

I have included the reference for this information in the text below.

Reference:

Kucharz E, Kovalenko V, Szanto K, Bruyere O, Cooper C, Reginster JY. A review of glucosamine for knee osteoarthritis: why patented crystalline glucosamine sulfate should be differentiated from other glucosamines to maximize clinical outcomes. Current Medical Research and Opinions. 2016. A review of glucosamine for knee osteoarthritis.pdf

Eat Smart, Live Well, Look Great,

Dr. Meschino