Joint Effort: What You Don’t Know about Glucosamine by Jerry Brainum 4/21

 

 

Whenever I'm asked about supplements that help to heal joint problems,the first one I think about is glucosamine. Glucosamine is a supplement derived from shellfish and is often combined with another joint nutrient, chondroitin Sulfate. While the standard medical treatment for arthritis is usually non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, such drugs reduce pain but do nothing to forestall the ongoing destruction of joint tissue that occurs with arthritis. This is where glucosamine differs, in that it does slow down joint destruction. While glucosamine will also reduce pain, the onset of action in that regard is much slower than drugs because of the poor blood supply within connective tissue. In effect, it can take weeks or months for glucosamine to show beneficial effects. The problem there is that the majority of studies that have examined glucosamine have not lasted long enough to show beneficial effects.

Another problem with glucosamine studies is that they use the wrong form. The best supplemental form of glucosamine is glucosamine sulfate (GS), although many supplements instead contain glucosamine hydrochloride, which doesn't work nearly as well.  In addition, there is some evidence that exercise and glucosamine usage are synergistic. In practical terms, studies have shown that glucosamine appears to work far better in those who are physically active compared to those who are sedentary. This likely has to do with the increased blood circulation that is a characteristic  of exercise. As noted, joints are largely composed of connective tissue, which has a poor blood supply. Exercise may help by increasing blood circulation within joints that allows greater entry of glucosamine into the joints, with subsequent greater healing effects. Indeed, studies with athletes show that when they ingest 3,000 milligrams a day of glucosamine, it suppresses a marker of collagen breakdown called CTX-2. Collagen is the primary protein found in connective tissue, and this suggests that glucosamine helps to prevent the breakdown of collagen, thus limiting joint breakdown.

Other effects noted with glucosamine supplementation include increase range of joint motion and increased rehabilitation time.

Glucosamine itself is a combination of a sugar attached to a protein. It is made in the human body, and is also found in shellfish, which is the source of most glucosamine supplements. Glucosamine is found in large amounts in joints and cartilage and is a structural component of keratin, the primary connective tissue protein of hair and nails, as well as hyaluronic acid, sometimes known as "joint fluid," since it's found within joint spaces where it provides a protective cushioning effect.  Many glucosamine supplements are often underdosed, meaning that the dose appearing on the product label isn't what's found in the supplement. One reason for this is that most glucosamine supplements have added potassium hydrochloride to stabilize glucosamine and prevent it from forming crystals. Sometimes more potassium is added to the product which lowers the glucosamine content. Whether . . .