What is Glucosamine and How Does it Work?
Using Glucosamine for arthritis and related joint pain is now common practice in the field of medicine. It is so popular, that only multi-vitamins sell better that supplements containing some form of glucosamine. The results of supplementing glucosamine for arthritis has been studied for more than 20 years, and its benefits for treating arthritis has been well documented.
Glucosamine is what scientists call an amino sugar (glucose and glutamine), which is essentially involved in the synthesis of certain proteins and lipids (fats). More specifically, it is a precursor of glycosaminoglycans, which forms a major part of joint cartilage.Glycosaminoglycans are basically large protein molecules that act like a sponge to hold synovial fluid (the fluid in the joint), giving cartilage its elasticity. Glucosamine is found in almost all the tissues in the body, but joint cartilage contains higher concentrations than any other tissue.
Other evidence (although sparse) suggests that taking glucosamine for arthritis can block some of the enzymes that are partly responsible for cartilage degeneration. This is why doctors and researchers in the area of joint degeneration and joint pain became interested in its possible benefits.
The two types of Glucosamine
Typically, two forms of glucosamine are used as supplements: They are glucosamine hydrochloride and glucosamine sulphate. Most of the research on glucosamine was done on glucosamine sulphate (sometimes spelled as sulfate). There is some controversy over which form is the most effective, but most reliable sources on arthritis sources say that there really is no difference in terms of benefit to joint pain. Those arguing for glucosamine sulphate say that the sulphate part of glucosamine sulphate is what the affected joint needs to repair itself. The other side, those researchers favouring glucosamine hydrochloride, say that sulphides can cause digestive discomfort and allergic reactions in some people. Some sources suggest taking a combination of two types of glucosamine for the best result.
Everyone produces an amount of glucosamine in their bodies, keeping our joints healthy, but as we age, our bodies start producing less glucosamine, resulting in increased pressure on the weight bearing joints in your body. The increased pressure leads to the cartilage wearing away, which leads to the formation of bony spurs in the joint. This initially led to speculations that supplementing with glucosamine for arthritis could hold benefits.
The big hype around glucosamine probably also has to do with its advantages over non-steroidal anti-inflammatory drugs (NSAIDs like aspirin, ibuprofen, celebrex). The long term use of these drugs has all kinds of side effects, but glucosamine is regarded as much safer and even more effective. Some sources say that NSAIDs can actually speed up the breakdown of cartilage, something that you definitely do not want if you are suffering from any kind of joint pain. Glucosamine also fall more into the realm of preventative treatment, while NSAIDs really only treat the symptoms of your joint pain, masking the underlying cause: cartilage degeneration. Most people report that they can start weaning themselves off NSAIDs after 4-8 weeks of supplementing.
The usual dose of glucosamine is about 500 milligrams three times a day. Some recommend 1000 milligrams twice a day. The longer you use it, the more benefit you will feel. The safest is always to discuss dosages with your doctor before you take any supplement.
Benefits for Osteoarthritis
Glucosamine is probably the most talked about supplement when it comes to osteoarthritis. Glucosamine has been shown to benefit sufferers of osteoarthritis (both in humans, and interestingly in pets also!). It is proven to rehabilitate cartilage, renews synovial fluid and actually repairs the joints damaged by osteoarthritis.
So how exactly does it help your osteoarthritis? In the case of osteoarthritis, the ‘sponge’ between your joints becomes worn out. This leads to the formation of bony spurs that rub against each other when the joint is moved. Inflammation and pain is the result of a degenerated joint being forced to move. So, since glucosamine is used to build and maintain cartilage, it makes sense to supplement with it if you suffer from osteoarthritis.
In a study with 202 people with osteoarthritis of the knee, either receiving glucosamine or a placebo for three years, it was found that the people taking the glucosamine had a significant reduction in pain and stiffness. X-rays also showed that the cartilage of the people taking the glucosamine had no further degeneration of the cartilage of the knee.
So to summarise, how exactly does it work to benefit your osteoarthritis joint pain?
Basically, taking glucosamine for arthritis will help you in three different ways:
- Glucosamine causes the synovial fluid to be thicker and allows it to hold more fluid. The result is improved cushioning, better lubrication and better protection from general wear and tear on the joint.
- Glucosamine may also inhibit the breakdown of cartilage and actually protects the cartilage. Joints with higher levels of synovial fluids are generally healthier and less susceptible to wear and tear which, in turn, leads to inflammation.
- The other exciting find is that glucosamine can actually stimulate the chondrocytes (the cells that manufacture cartilage) to produce more cartilage. It also helps to incorporate sulphur into the cartilage. Sulphur is essential in keeping cartilage healthy.
Research backing glucosamine
Supplementing with glucosamine for arthritis has some solid scientific backing. Glucosamine works to stimulate joint function and repair. It is beneficial in assisting with 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 sulphate, for arthritis 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 experienced pain relief compared to 15% for ibuprofen. Because glucosamine is not an anti-inflammatory drug, it takes longer to start working, but it works equally well.
A more recent study was conducted in 2000 at ASA Harofeh Medical Center, in Ziffrin. 57 patients with osteoarthritis of the knee were treated for four weeks with glucosamine sulphate, chondroitin sulphate or a placebo. A record was kept of the knee pain at rest, standing or moving. No improvement was shown with the placebo group, but the other two groups showed a reduction in pain.
Another quite convincing study was done at the University of Liege in Belgium. 212 patients were randomly given glucosamine or a placebo over a three year period. The participants’ pain was measured every four months and x-rays were taken of their knees. In the placebo group, pain levels were recorded as getting worse and the x-rays showed that their cartilage was narrowing. The glucosamine group had no narrowing of the joints.
In 2003 researchers from the University of Western Australia gave a group of 24 patients with knee pain a daily dose of glucosamine. Most of the patients showed an improvement in joint mobility after 4-8 weeks. 88% of the patients had a reduction in knee pain after the 12 week experiment.
To compare the efficacy of ibuprofen to that of glucosamine a study was done where 200 patients with osteoarthritis of the knee were divided into two groups: One group receiving glucosamine sulphate, the other ibuprofen. The experiment lasted four weeks, during which the patients were assessed according to degree of pain relief and mobility measures. The ibuprofen group felt pain relief sooner, but from the second week there was practically no difference between the two groups in terms of pain relief and mobility improvement. The conclusion was that glucosamine was at least as effective as ibuprofen in treating the symptoms of osteoarthritis of the knee.
Supplementing glucosamine for arthritis has some solid backing in medical research. Speak to your doctor if you are unsure of any of the point mentioned in this fast guide. A last point to note is that glucosamine works best when taken with other arthritis supplements like MSM, chondroitin, white willow, turmeric and ginger.