What is Glucosamine?

by Sharon Crawford

Description

Glucosamine occurs naturally in the body. This one-molecule

substance consists of glucose and a hydrogen and nitrogen amine.
Because of its composition, it is classified as an amino sugar. Amino
sugars are different from other body sugars, as they form part of
carbohydrates. Their function is also different as they do not provide
an energy source, but rather are included in body tissue structure.
Therefore, glucosamine plays a role in several areas, for example,
constructing nails, skin, eyes, bones, ligaments, tendons, heart
valves, discharging mucous from the respiratory system, digestive
system, and urinary tract. Glucosamine helps blend sulfur into the
cartilage. When people grow older, their bodies may lose the capacity
to make enough glucosamine, so the cartilage in their weight-bearing
joints, such as the hips, knees, and hands is destroyed, then hardens
and forms bone spurs, causing pain, deformed joints, and limited joint
movement.

Glucosamine is not available from any primary food source, but

instead is commercially prepared from chitin, which is the shell part of
shellfish, such as lobster, crab, and shrimp, as well as animal
connective tissues, such as the marrow of chicken bones.
Commercially prepared glucosamine comes in three formats:
glucosamine sulfate, glucosamine hydrochloride, and N-acetyl-
glucosamine (NAG).

General use

Glucosamine works to stimulate joint function and repair. It is most

effective in treating osteoarthritis, the most prevalent type of arthritis.
A number of studies over the last 20 years have shown this. For
example, a 1982 clinical study compared usage of the NSAID
ibuprofen with glucosamine sulfate, for osteoarthritis of the knee.
During the first two weeks, ibuprofen decreased pain faster, but by
the fourth week the glucosamine group was well ahead in pain relief.
The overall results showed 44% of the glucosamine group had pain
relief compared to 15% for ibuprofen. Because glucosamine is not an

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anti-inflammatory drug, it takes longer to start working, but it works
equally well.

Another 1982 open trial study with 252 doctors and 1,506 patients
conducted in Portugal provided good clinical information on
appropriate dosage and usage of glucosamine sulfate for
osteoarthritis. For 50 days, patients took 500 mg of glucosamine
sulfate three times a day. The results showed 95% of the patients
benefited from the supplement, as it reduced their pain whether they
were resting, standing, or exercising. This study also showed the
effects of glucosamine on obese patients, however, they may require
higher dosages to offset the joints' reaction to the stress from obesity.
Those patients also taking diuretics or suffering from peptic ulcers
were also studied regarding the effect of, and their tolerance to,
glucosamine. The former might require higher dosages and the latter
need to take glucosamine with food.

In a more recent 2000 study at the Assaf Harofeh Medical Center, in

Ziffrin, 57 patients with osteoarthritis in the knee were treated
randomly for four weeks with glucosamine sulfate intravenously
combined with an 800 mg of chondroitin sulfate daily, or with a
placebo. As in the 1982 study, a record was kept of their knee pain
when at rest, standing, or moving. No reduction of symptoms
occurred with the placebo group, but the glucosamine/chondroitin
sulfate group showed much reduction of symptoms in all
activity/nonactivity functions. This latter group also showed no
negative reactions or any change in their blood tests. The study
concluded that glucosamine sulfate is safe for long-term osteoarthritis
treatment.

Another osteoarthritis study of the knee, in 1999 at the University of

Liege in Belgium, involved 212 patients worldwide. These patients
were randomly given either glucosamine or a placebo for three years.
The patients' pain was measured every four months and x rays were
taken of their knees. The placebo group had more pain and narrowed
joints, while the glucosamine group had no narrowing of joints and
their condition improved. This was one of the first studies to show
how glucosamine works by stopping the joints from narrowing. It was
also the first long-term study conducted.

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Since then, the University of Utah received a $6.6 million grant
(September 1999) from the National Institutes of Health for another
major ongoing glucosamine study.

Harvard Medical School conducted a somewhat unorthodox study

where patients scheduled for hip surgery were given ground chicken
bone supplements. After two weeks of taking these supplements,
their pain was reduced considerably.

Glucosamine supplements can also aid in treating sports injuries,

bursitis, food and respiratory allergies, asthma, osteoporosis,
tendinitis, vaginitis, some skin problems, and candidiasis.

Preparations

Although commercially prepared glucosamine comes in three

formats: glucosamine sulfate, glucosamine hydrochloride, and N-
acetyl-glucosamine (NAG), not all three work the same. There are
also differing opinions on which is better.

One claim states that glucosamine hydrochloride works 50% better

than glucosamine sulfate because hydrocholoride is the main
stomach acid helping the digestive system to put more active
ingredients into the body. Another prefers glucosamine sulfate
because of its high absorption rate of 98% documented in human
studies and its sulfur content. Studies as far back as the 1930s show
that people with arthritis usually have low levels of sulfur.

N-acetyl-glucosamine (NAG) can be beneficial to individuals with

Crohn's disease or ulcerative colitis. Individuals with these diseases
cannot change glucosamine to NAG as fast as those without the
diseases. In one study, cells from patients' intestines were soaked in
a solution with a 10:1 ratio of radioactive NAG to glucosamine. These
cells consolidated more NAG than did the cells from the intestines of
patients without Crohn's disease or ulcerative colitis.

Glucosamine is also sold mixed in formulas with devil's claw,

pregnenolone, methylsulfonylmethane (MSM), and chondroitin
sulfate. Chondroitin sulfate is one of the main glycosaminoglycans
(GAGs) that is contained in shark cartilage and sea cucumber.

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Although studies show that chondroitin sulfate has benefits, it is hard
to absorb because it contains large molecules.

Further confusion can arise because glucosamine is classified and

sold as a dietary supplement, meaning it has not gone through the
FDA approval process. As with any supplement, it is best to consult a
health practitioner. Glucosamine is sold at health food stores and
drug stores, and is available with or without salt.

The standard dosage is 500 mg three times daily. Obese people may
need to take higher dosages based on their weight.

Precautions

Individuals on potassium-reduced diets, with heart disease, renal

diseases, or high blood pressure related to salt intake should avoid
either the regular or salt-free glucosamine supplements.

Diabetics need to be aware that glucosamine is a glucose-containing

food, and can raise glucose (sugar) levels, and subsequently insulin
levels. A 2000 study of 15 nondiabetic patients at the Los Angeles
College of Chiropractic and MetaResponse Science showed that
those who took 1,500 mg of glucosamine a day for 12 weeks had
raised insulin levels. The conclusion was that the insulin rise would
probably be more in diabetics. However, researchers cautioned
diabetics there is no need to discard their glucosamine supplements
as more controlled studies are required.

Despite the concern regarding the use of glucosamine sulfate in

individuals with allergies to the sulfa drugs or the sulfite additives in
food, sulfur itself is a necessary mineral and human blood contains
large amounts of sulfur's sulfate form. Studies show that glucosamine
sulfate is safe for long term use to treat osteoarthritis, with the
exception of medical conditions listed above and below.

Side effects

High dosages of glucosamine may cause gastric problems, nausea,

diarrhea, indigestion, and heartburn. Glucosamine should be taken
with meals to help avoid these problems

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Interactions

Glucosamine should not be taken with heart medications or insulin.

Those taking diueretics may require higher amounts of glucosamine
on a daily basis.