Glucosamine Sulphate

What is Glucosamine Sulphate?

Glucosamine is a combination of a protein and a sugar and is a substance that occurs naturally in the connective tissue and cartilage joints. It comes from the exoskeleton of shellfish (crab, lobster, shrimps etc), although it can be chemically synthesized by fermenting corn.

Why Take Glucosamine?

One study10 shows by taking Glucosamine Sulphate daily for over three months it can help alleviate the symptoms of osteoarthritis (OA). There have been a further fifteen studies that all show a similar outcome. Research carried out has indicated Glucosamine is particularly effective for patients with knee OA13. Many of the studies have illustrated the positive effects of Glucosamine for low back pain, although one study has shown little benefit beyond placebo, so clearly more research needs to be undertaken12  

The mechanism of OA is still not fully understood. It is thought to be the destruction of cartilage, possibly due to the loss of collagen and proteoglycans. It has been suggested that Glucosamine helps repair damaged cartilage as Glucosamine is needed to make proteins, which are the building blocks of cartilage. Glucosamine also pulls water into the cartilage producing a gel like sac providing cushioning and flexibility in the joint. Therefore, supplementation is thought to magnify the body’s natural level of Glucosamine.

How much should you take?

The recognised dosage for Glucosamine is 1,500mg per day.

This can be taken either in one dose  (1,500mg in one go) or split in to equal doses  (500mg three times a day). It is best taken with food.

Research suggests you need to take Glucosamine for three months in order to receive the full effects.

Are There Any Side Effects?

Glucosamine Sulphate appears to be safe for most people. We have to be careful here, as undoubtedly at some point some side effects will emerge. If you look at the long term side effects of NSAID’s (the medical way of treating OA)- 16,500 deaths and 103,000 hospitalizations in the US alone in one year, then glucosamine is looking pretty good!

People allergic to chitin in shellfish should avoid it, although most allergic reactions are to the shellfish meat. Pregnant women and children should probably avoid it until further research has been carried out. Some preliminary research suggests that Glucosamine Sulphate might raise blood sugar in people with diabetes. However, more reliable research indicates that Glucosamine Sulphate does not seem to significantly affect blood sugar control in people with type 2 diabetes. Glucosamine with routine blood sugar monitoring appears to be safe for most people with diabetes. If you have any concerns then you should consult your GP.

Allergic reactions to this supplement appear to be rare but may include mild nausea, vomiting, constipation, diarrhoea. In one trial, people with peptic ulcers and those taking diuretic drugs were more likely to experience side effects1.

If you have a reaction or one of the symptoms mentioned above, stop taking the supplement and consult your G.P.

References
1. Tapadinhas MJ, Rivera IC, Bignamini AA. Oral glucoseamine sulfate in the management of arthrosis: report on a multi-centre open investigation in Portugal. Pharmatherapeutica 1982;3:157-68.

2. Matheu V, Bracia Bara MT, Pelta R, et al. Immediate-hypersensitivity reaction to glucosamine sulfate. Allergy 1999;54:643-50.

3. Virkamaki A, Daniels MC, Hamalainen S, et al. Activation of the hexosamine pathway by glucosamine in vivo induces insulin resistance in multiple insulin sensitive tissues. Endocrinology 1997;138:2501-7.

4. Rossetti L, Hawkins M, Chen W, et al. In vivo glucosamine infusion induces insulin resistance in normoglycemic but not in hyperglycemic conscious rats. J Clin Invest
1995;96:132-40.

5. Houpt JB, McMillan R, Wein C, Paget-Dellio SD. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol 1999;26:2423-30.

6. Drovanti A, Bignamini AA, Rovati AL. Therapeutic activity of oral glucosamine sulfate in osteoarthritis: a placebo¬controlled double¬blind investigation. Clin Ther 1980;3:260-72.

7. Barzilai N, Hawkins M, Angelov I, et al. Glucosamine-induced inhibition of liver glucokinase impairs the ability of hyperglycemia to suppress endogenous glucose production. Diabetes 1996;45:1329-35.

8. Russell AI, McCarty MF. Glucosamine in osteoarthritis. Lancet 1999;354:1641; discussion 1641-2 [letters].

9. Rovati LC, Annefeld M, Giacovelli G, et al. Glucosamine in osteoarthritis. Lancet 1999;354:1640; discussion 1641-2.

10. Reginster JY, Deroisy R, Rovati L, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 2001;357:251-6.

11. Vaz AL. Double¬blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulphate in the management of osteoarthritis of the knee in out¬patients. Curr Med Res Opin 1982;8:145-9.

12. Wilkens PScheel IBGrundnes OHellum CStorheim K.Effect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis: a randomized controlled trial. JAMA. 2010 Jul 7;304(1):45-52. doi: 10.1001/jama.2010.893.

13 Herrero-Beaumont GIvorra JADel Carmen Trabado MBlanco FJBenito PMartín-Mola EPaulino JMarenco JLPorto ALaffon AAraújo DFigueroa M,Branco J.Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum. 2007 Feb;56(2):555-67.

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