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How to use Glucosamine

Scientific Name: Glucosamine

Other Names: 2-Amino-2-Deoxyglucose, Chitosamine, Glucosamine Hydrochloride, Glucosamine Sulfate, N-acetyl Glucosamine

Who is this for?

Glucosamine is available in several different forms that are usually called “salts”. Most of the clinical studies investigating glucosamine’s medical effects have used a salt known as glucosamine sulfate, but other salts such as glucosamine hydrochloride and n-acetyl glucosamine are also sold widely. While all the salts of glucosamine contain the same general components, they may not all produce the same effects in the body. No studies have compared them, so not enough information is available about potential differences in their activity to know whether they are interchangeable.

Alone or combined with another dietary supplement called chondroitin, glucosamine has been studied extensively for treating osteoarthritis (OA), a condition that generally results from wear-and-tear on joints. In OA, deterioration of the cartilage, which cushions the joints, leads to pain, swelling, and loss of movement. Since glucosamine provides a major component of cartilage, it is believed that glucosamine may delay further degeneration. It may also actually help to repair deteriorating cartilage. Chondroitin is believed to provide a different chemical important in the formation of cartilage, but its effects are not as well defined as glucosamine’s. Although glucosamine has been studied most for treating OA of large joints such as knees and hips, it has also showed some effectiveness for relieving arthritis in the jaw, which is also known as the temporomandibular joint (TMJ).

Glucosamine is also important for healthy skin. Adequate amounts of it in the blood are necessary for the production of hyaluronic acid, one of the substances essential to heal skin injuries. Therefore, glucosamine plays a major role in the healing of surgical incisions and skin wounds. In a few studies, participants who began taking supplemental glucosamine before surgery and continued taking it until their incisions were completely healed showed generally faster healing with less scarring than other participants who did not take glucosamine. Wound dressings that contain a modified type of glucosamine known as poly-N-acetyl glucosamine are being studied to stop major bleeding. In other research, a few studies evaluating whether supplemental glucosamine helps to prevent or reverse wrinkling have had mixed results. Because natural production of hyaluronic acid decreases as individuals age, decreases in it may contribute to wrinkling of the skin. It is thought that increasing glucosamine may help the skin stay more resilient.

In a few small studies, n-acetyl glucosamine has shown promise for treating inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis. N-acetyl glucosamine forms part of an enzyme needed to produce mucus. Therefore, it is believed to increase the production of mucus that lines the lower gastrointestinal tract, providing a protective effect. More research for this possible use is needed.

When should I be careful taking it?

Very little information is available on how glucosamine might affect a developing fetus, an infant, or a small child. Therefore, its use is not recommended during pregnancy, while breast-feeding, or during early childhood.

The source of glucosamine is not required to be stated on the label. Since it may be made from crabs, lobsters, shrimp, or other shellfish; individuals who are allergic to these foods may also be allergic to glucosamine. Individuals with a sensitivity to shellfish should not use glucosamine.

Results from recent small studies showed no negative effects from glucosamine supplementation in individuals with diabetes. However, it is possible that glucosamine – particularly in doses higher than recommended amounts – may prompt the pancreas to produce less insulin as well as interfere with the use of insulin by muscle cells. In individuals with diabetes, blood sugar levels may become too high and diabetes may not be well controlled.

What side effects should I watch for?

The main side effects reported during clinical trials with all salts of glucosamine were mild and temporary gastrointestinal complaints such as constipation or diarrhea, cramping, gas, heartburn, and nausea. Drowsiness and headache were also associated with taking glucosamine sulfate.

What interactions should I watch for?

Recently, one case was reported of a tendency toward excessive bleeding in an individual taking both warfarin and a glucosamine/chondroitin supplement. Warfarin is an anticoagulant drug taken to prevent blood clots by “thinning the blood”. Although this possible interaction has not been confirmed, individuals who take anticoagulants or a related group of drugs known as antiplatelet agents should not take glucosamine.

  • Anticoagulants include heparin and warfarin
  • Antiplatelets include Plavix and Ticlid

Glucosamine may interfere with insulin and oral drugs for diabetes, such as:

  • Actos
  • Amaryl
  • Avandia
  • glipizide (Glucotrol XL)
  • glyburide (Glynase)
  • Glyset
  • metformin (Glucophage)
  • Prandin
  • Precose

Because glucose may increase blood sugar levels, taking it with herbal products that lower blood sugar may result in blood sugar that is too high or too low. Herbals that may reduce blood sugar include:

  • Eleuthero
  • Fenugreek
  • Ginger (in high amounts)
  • Kudzu
  • Panax Ginseng

Although no cases of interactions with other herbal anticoagulants have been reported with glucosamine, it is possible that the risk of excessive or uncontrolled bleeding may be slightly higher if glucosamine is used with other herbs that may decrease blood clotting. Some of the most common herbal products that might inhibit blood clotting are:

  • Danshen
  • Devil’s Claw
  • Eleuthero
  • Garlic
  • Ginger (in high amounts)
  • Ginkgo
  • Horse Chestnut
  • Panax Ginseng
  • Papain
  • Red Clover
  • Saw Palmetto

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals.

Should I take it?

Glucosamine is a molecule that contains both sugar and protein. It is produced in the body, but its natural production slows down as individuals age. It is one of the essential components that the body uses in building and repairing tissues such as cartilage, heart valves, mucous membranes, and synovial fluid—the jelly-like substance that fills the joints. For supplemental use, glucosamine may be made in a laboratory. More often, however, it is obtained from natural sources such as the shells (also called exoskeletons) of crabs, lobsters, and other sea creatures.

Dosage and Administration

In the United States, glucosamine may be taken orally – typically as capsules and usually combined with chondroitin, manganese, vitamin C, or other dietary supplements. Occasionally, different salts of glucosamine may be combined into one product. Although study evidence does not prove that taking glucosamine and chondroitin together is more effective than glucosamine alone, the two products frequently are sold in combination. Less frequently, glucosamine is applied topically – again often in combination with chondroitin. In other countries, glucosamine is available in forms that may be injected into muscles or directly into joints.

By mouth, a typical daily dose of glucosamine ranges from 500 mg to 3,000 mg (one-half gram to 3 grams) per day. Many studies used glucosamine sulfate 500 mg three times a day to treat either OA or TMJ. Full effectiveness in controlling arthritis pain may take up to 4 weeks to develop after glucosamine has been started.

Note: Glucosamine and chondroitin are frequently sold in combination with the trace element manganese, because manganese is thought to be involved in cartilage production. A trace element is a substance that is required by the body in very small amounts for proper growth and functioning. However, care should be taken to limit manganese intake. The upper tolerable limit, which is the maximum amount that probably will not cause any side effects for most individuals taking manganese, has been set by the U.S. National Academy of Sciences at 11 mg per day for adults. Higher amounts of manganese may result in symptoms such as confusion, drooling, hallucinations, memory loss, stiff muscles, trembling, and other symptoms similar to Parkinson’s disease.

Summary

The major medical use of glucosamine – alone or with chondroitin – is to relieve joint pain and stiffness associated with osteoarthritis. It may help wounds to heal and some forms of glucosamine may also alleviate inflammatory bowel diseases.

Risks

Taking glucosamine derived from sea creatures may cause allergic responses in individuals who are allergic to shellfish. Individuals with diabetes may experience elevated blood sugar levels if they take glucosamine. Small children and pregnant or breast-feeding women may want to avoid taking glucosamine because little is known about its effects for these individuals.

Side Effects

Gastrointestinal complaints such as constipation, diarrhea, and nausea were attributed to taking glucosamine during studies. Some study participants who took glucosamine sulfate also reported drowsiness or headache.

Interactions

Glucosamine may increase the risk of excessive bleeding when it is taken with warfarin, other anticoagulant or antiplatelet drugs, aspirin, or herbal products that reduce the blood’s ability to clot. It may also increase blood sugar levels, thereby interfering with drugs or herbals that lower blood sugar.

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(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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