Date Published: 19 April 2007

Why all the excitement about Glucosamine?

Glucosamine Hydrochloride (Vegan) N033 (Capsules)

Glucosamine is generally available from healthfood shops in the form of tablets that may be taken as food/dietary supplements. The supplement glucosamine is commonly sold and used to alleviate the symptoms of osteoarthritis. We heard about it from a customer who suffers from arthritis and asked us to supply it. Food/dietary supplements are not available for sale from www.ivyrose.co.uk but we can tell you about other online shops that do sell these - see opposite.

This page features more information about glucosamine itself, its chemistry and ingredients.

What is Glucosamine ?

Chemically, glucosamine is a molecular compound whose formula is C6H13NO5, molar mass 179.17 g/mol. It is also known by other names, including 2-Amino-2-deoxy-D-glucose and (3R,4R,5S,6R)-3-Amino-6-(hydroxymethyl)oxane-2,4,5-triol (IUPAC nomenclature).

Glucosamine is one of a group of chemicals known as amino sugars.

It is a precursor in the biochemical synthesis of glycosylated proteins and lipids (fats). More specifically, D-glucosamine is made naturally in the form of glucosamine-6-phosphate, which is synthesized from fructose-6-phosphate and glutamine. The formation of glucosamine-6-phosphate is the first step in the natural biochemical production of UDP-N-acetylglucosamine, which is then used for making glycosaminoglycans, proteoglycans, and glycolipids.

What is Glucosamine used for ?

Glucosamine is used by the body for the repair of cartilage, muscles, ligaments and other organs. All of these tissues are constantly being broken down and repaired. Difficulties can arise when the breakdown of tissues occurs more quickly than the body can repair them. Glucosamine is sometimes taken - as a food supplement - to help to increase the rate of regeneration of tissues and so enable the rate of repair of tissues to keep up with breakdown (e.g. by arthritis sufferers).

Where does Glucosamine come from ?

Glucosamine occurs naturally in the human body and is also present - but in very small quantities - in what is considered to be a "normal" diet. However, diets vary widely according to location in the world, local customs, availability of foodstuffs, religious requirements, and non-religious ethical considerations e.g. of vegetarians and vegans. When people mention that they are "taking glucosamine" in most cases they are probably referring to use of a dietary supplement that is widely available in tablet form and is sold by healthfood shops and online.

Until recently the only glucosamine available in tablet form was derived from shellfish. Although there were some arguments that - since glucosamine is derived from the shells of these animals while the allergen is within the flesh of the animals - it was still safe for use by people who have a shellfish allergy, some shellfish allergy sufferers may have been understandably reluctant. Apart from considerations of allergic reaction to the source of the glucosamine, this would also be unacceptable to vegetarians and vegans.

Vegan glucosamine is now available due to a recently developed method of extracting glucosamine through a process of fermentation of corn starch. The panel on the right-hand-side of this page (above-right, shows on large devices only) includes further information about Vegan Glucosamine.

Are there any safety concerns about the use of Glucosamine ?

It is always a good idea to be concerned about the safety, possible side-effects, and dosage of food supplements, any form of medicine or treatment, and even about appropriate/safe quantities of foods and beverages.

In the case of glucosamine, we have already mentioned the shellfish origin of some commercially available glucosamine supplements. Vegetarians and vegans will also want to be aware of this and check the labels on glucosamine purchased in healthfood shops.

Other concerns that have been raised about the use of glucosamine include the possibility that excessive consumption of glucosamine could contribute to diabetes by interfering with the normal regulation of the hexosamine biosynthesis pathway (scientifically discussed and disputed). More research is being undertaken, especially concerning obese users as they may be particularly sensitive to the effects (if any) of glucosamine on insulin resistance.

What are the explanations used to describe how Glucosamine may be able to help with arthritis?

According to Dr Trisha Macnair (writing on the BBC website in 2007), " research suggests that glucosamine may have some effect in slowing the progression of arthritis (known as a chondroprotective effect), by helping to keep the cartilage in joints healthy. But it's getting harder to do research on glucosamine simply because it's increasingly difficult to find people with osteoarthritis who aren't already taking it". This suggests that the widespread use of glucosamine - based on personal recommendations and testimonials - is actually making it more difficult to test glucosamine using scientifically accepted methods. Therefore, practical scientific tests of glucosamine may be limited.

Theoretical descriptions of how glucosamine taken orally may have the effect of decreasing the progression of arthritis include the following:

Glucosamine is a biochemical that occurs naturally in the body where it is used to produce the connective tissues present at the joints. It stimulates the production of proteoglycans in cartilage. More specifically, as glucosamine is a precursor for (which means that it is necessary for the production of, and can in the right circumstances lead to biochemical generation of) glycosaminoglycans, and glycosaminoglycans are a major component of joint cartilage, it is argued that glucosamine taken as a dietary supplement may help to rebuild cartilage and hence to slow down and reduce the effects of arthritis.

What is the evidence that Glucosamine is effective in alleviating the symptoms of arthritis ?

One of the reasons for the rise in popularity of glucosamine back in 1990s USA was the best selling book "The Arthritis Cure" (1996) by Dr Jason Theodosakis, an orthopedic surgeon in North Carolina. According to the synopsis of this book: "Since Its original publication in 1996, The Arthritis Cure has swept the nation, providing amazing relief for the millions who suffer chronic arthritis pain. By outlining a nine-point program that includes ASU, a new, effective arthritis fighting supplement, this revised edition describes a programme that can halt, reverse, and possibly even cure degenerative osteoarthritis.". Although Dr Theodosakis used glucosamine to reduce the number of patients who needed joint replacements his strategy also included exercise and more general good nutrition. While interesting, and highly popular, this book is intended for the general reader and is unlikely to be as persuasive to the medical establishment as research published in a peer reviewed, refereed journal.

A short time after publication of "The Arthritis Cure", an independent review of medical evidence was published in the form of the Bandolier Report [the link to this report has been removed because the page had been taken-down]. This stated that although glucosamine did not have an immediate effect, after about a month it could work as well as standard pain killers and after two months it may even be more effective. As is true of many reports, the authors also stated that more work was needed to investigate the medium and long term effects/benefits. The Cochrane Review reached similar conclusions in 2000. The Lancet (a prestigious peer-reviewed medical journal) published an article in 2001, which is thought to be the first medically accepted evidence that glucosamine may be appropriate for treating bone/joint conditions such as arthritis. However,soon afterwards the British Medical Journal (BMJ) included an article (editorial, ref. http://bit.ly/O0AWTx) entitled Glucosamine for osteoarthritis: magic, hype, or confusion? in June 2001. This includes the bold title: "It's probably safe but there's no good evidence that it works".

An updated version of the Bandolier study was then made available in December 2001, stating that "there have been two more systematic reviews published [since the original Bandolier Report on this subject], and one superb three year study, all of which support the original conclusion [our underline] ". This second Bandolier Report concluded that:

" Evidence that glucosamine (and chondroitin) is effective in osteoarthritis continues to build. We now have two top class reviews of older, short, studies that come to this conclusion, and a new randomised trial of some quality that demonstrates a clear disease-modifying effect, as well as showing improvements in pain and functioning and an absence of long-term harm. Added to this is the accumulating volume of anecdotal evidence from professionals who prescribe glucosamine with good effect, and of individual who use it and report the same good effects.
_ ...
_ One practical point that emerges from several studies is that glucosamine takes about a month to exert its full effects. ...
"

In conclusion, most of the material we have found on this subject supports use of glucosamine but the debate is on-going as research also continues. In many cases arthritis sufferers will try anything safe, affordable, and reasonably promising in an attempt to relieve joint pain and restore use of problem joints. As far as we are aware, at the present time there is no UK pharmaceutical standard for glucosamine so products sold in healthfood shops and online may vary.

** Note: This article is for general interest/information. It is not medical advice. **

Source: IvyRose Article.

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