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Happy Sunday! Today I would like to discuss glucosamine supplements. Clients with knee/joint issues, or clients who love to do high impact exercise, often ask me if they should be taking glucosamine to support their joints, and if so, which type. So let's dive deep into what really is glucosamine and what you should be taking into account!
Glucosamine currently can be found in the market in two main forms: glucosamine hydrochloride and glucosamine sulphate. Studies show that they can lead to reduction of joint pain, if taken at certain doses, over a specific period of time... Unfortunately, studies on the overall effect of glucosamine on knee-pain often do not take into consideration its different forms, or solely focus on the use of glucosamine sulphate and its effect on individuals experiencing osteoarthritis – a condition that doesn't apply to everyone! One study focusing on the different effects of each form of glucosamine found no significant differences regarding their effectiveness and/or safety... However, the two main forms differ regarding few aspects.
Starting with glucosamine concentration, while it can vary among manufacturers, countries and supplements, glucosamine hydrochloride tends to be present in higher concentrations (average of 98.5% versus 71% for glucosamine sulphate in powder forms). In contrast, concentration in glucosamine sulphate forms are usually lower and in greater variance.
Regarding source types, glucosamine sulphate is commonly derived from chitin in shellfish, while glucosamine hydrochloride can be derived from shellfish but also vegetarian sources. So if you are vegan or allergic to shellfish, you would like to stick to glucosamine hydrochloride.
For drug interactions, both forms have been reported to have the potential to increase the anticoagulant effects of warfarin, in addition to moderate interactions with chemotherapeutic agents, and minor interactions with diabetes drugs. So if you are not on any of these medications, taking glucosamine should be relatively safe. However, glucosamine sulphate has also been reported to possibly interact with acetaminophen in pain medications. If you are taking painkillers to help reduce your joint pain, please double check your supplement before mixing them!
In order to avoid as many drug interactions as possible, as well as potential allergic reactions, while providing higher concentrations of glucosamine, glucosamine hydrochloride would be the recommended supplement form for most of my clients. However, everyone is different! So make sure you and your nutrition professional takes into account all these factors before making a final decision.
Regarding dosage, one study establishes 2000mg as the recommended amount for symptom relief, after eight weeks. However, another study found that 1200mg did not lead to significant improvement. As the supplement is often found in 500mg capsules, you could try taking 1500mg daily, and increase the dosage if knee symptoms do not improve, up to 2000mg. However, dosage increase should be exercised with caution, as glucosamine hydrochloride could cause gastrointestinal tract upset such as dyspepsia, nausea, vomiting, diarrhea, and constipation.
Hope this was useful! Let us know if you have any questions or would like further nutritional support. Stay healthy!
Reference List
Braham, R., Dawson, B. and Goodman, C. (2003). The effect of glucosamine supplementation on people experiencing regular knee pain. British Journal of Sports Medicine, [online] 37(1), pp.45-49.
Bush, T., Rayburn, K., Holloway, S., Sanchez-Yamamoto, D., Allen, B., Lam, T., So, B., Greyber, E., Kantor, S. and Roth, L. (2007). Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Alternative Therapies, [online] VOL. 13, NO. 2(Mar/Apr 2007).
Eggertsen, R., Andreasson, Å. and Andrén, L. (2012). No changes of cholesterol levels with a commercially available glucosamine product in patients treated with lipid lowering drugs: a controlled, randomised, open cross-over trial. BMC Pharmacology and Toxicology, [online] 13(1).
Fox, B. (2008). Glucosamine hydrochloride for the treatment of osteoarthritis symptoms. Clinical Interventions in Aging, [online] Volume 2, pp.599-604.
Kanzaki, N., Ono, Y., Shibata, H. and Moritani, T. (2015). Glucosamine-containing supplement improves locomotor functions in subjects with knee pain a randomized, double-blind, placebo-controlled study. Clinical Interventions in Aging, [online] p.1743.
Murray, M. (2012). ‘Chapter 94: Glucosamine’, in Pizzorno, J. and Murray, M. Textbook of natural medicine (4th ed.). Edinburgh: Churchill Livingstone. p. 790.
Natural Medicines. (2019). Natural Medicines.
Qiu, G., Weng, X., Zhang, K., Zhou, Y., Lou, S., Wang, Y., Li, W., Zhang, H. and Liu, Y. (2005). A multi-central, randomized, controlled clinical trial of glucosamine hydrochloride/sulfate in the treatment of knee osteoarthritis. Zhonghua yi xue za zhi.
Tannock, L., Kirk, E., King, V., LeBoeuf, R., Wight, T. and Chait, A. (2006). Glucosamine Supplementation Accelerates Early but Not Late Atherosclerosis in LDL Receptor–Deficient Mice. The Journal of Nutrition, [online] 136(11), pp.2856-2861.
Towheed, T. (2003). Current status of glucosamine therapy in osteoarthritis. Arthritis & Rheumatism, [online] 49(4), pp.601-604.
Zhou, J. Z., Waszkuc, T., & Mohammed, F. (2005). Determination of glucosamine in raw materials and dietary supplements containing glucosamine sulfate and/or glucosamine hydrochloride by high-performance liquid chromatography with FMOC-Su derivatization: collaborative study. Journal of AOAC International, [online] 88(4), 1048-58.
Disclaimer
The material on this blog is not to be used by any commercial or personal entity without expressed written consent of the blog author. The statements on this blog are not intended to diagnose, treat, cure or prevent any disease. Always consult your personal physician for specific medical advice.
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