Nutritional Supplement

Glucosamine for Sports & Fitness

Glucosamine

Where to Find It

Glucosamine is not present in significant amounts in most diets. Supplemental sources are derived from the shells of shrimp, lobster, and crab, or may be synthesized.

Best Form to Take

Glucosamine is available in several forms. The glucosamine sulfate (GS) form (stabilized with a mineral salt) is the only form clearly shown in clinical trials to be effective for osteoarthritis. For this reason, it is the preferred form.

GS is stabilized with one of two mineral salts: sodium chloride (NaCl) or potassium chloride (KCl).33,34 Although they both appear to effectively stabilize GS, the use of KCl as a stabilizer seems preferable since the average Western diet already provides far too much salt (NaCl) and not enough potassium. However, most of the research has been done with the NaCl-stabilized form.

Concerns have been raised about the quality of GS products on the market. In one study, the amount of glucosamine contained in 14 commercially available glucosamine products varied from 41% to 108% of the amount stated on the label.35 Even when the weight of the sulfate molecule was included, 11 of the 14 products contained less than the amount of glucosamine stated on the label. Some manufacturers may include the weight of the stabilizing salts (NaCl or KCl) in the total weight of the product, without stating so on the label.

Glucosamine hydrochloride (GH) has been widely available as a dietary supplement for years, but only one trial has evaluated this form of glucosamine as a single remedy for OA.36 This trial found only minor significant benefits from 1,500 mg per day of GH for eight weeks, in people with osteoarthritis of the knee who were also taking up to 4,000 mg per day of acetaminophen. To more fairly evaluate the effects of GH, future research should involve people not taking pain-relieving medication.

How to Use It

Healthy people do not need to routinely supplement with glucosamine. Most research with people who have osteoarthritis, uses 500 mg three times per day of GS. Appropriate amounts for other conditions are not known.

References

1. Reginster JY, Deroisy R, Rovati L, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 2001;357:251-6.

2. Pavelka K, Gatterova J, Olejarova M, et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med 2002;162:2113-23.

3. McAlindon TE, LaValley MP, Gulin JP, Felson DT. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA 2000;283:1469-75 [review].

4. Houpt JB, McMillan R, Wein C, Paget-Dellio SD. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol 1999;26:2423-30.

5. Braham R, Dawson B, Goodman C. The effect of glucosamine supplementation on people experiencing regular knee pain. Br J Sports Med 2003;37:45-9.

6. Tapadinhas MJ, Rivera IC, Bignamini AA. Oral glucoseamine sulfate in the management of arthrosis: report on a multi-centre open investigation in Portugal. Pharmatherapeutica 1982;3:157-68.

7. Giordano N, Nardi P, Senesi M, et al. The efficacy and safety of glucosamine sulfate in the treatment of gonarthritis. Clin Ter 1996;147:99-105.

8. D'Ambrosio E, Casa B, Bompani G, et al. Glucosamine sulphate: a controlled clinical investigation in arthrosis. Pharmatherapeutica 1981;2(8):504­8.

9. Crolle G, DiEste E. Glucosamine sulfate for the management of arthrosis. Curr Ther Res 1980;7:104-9.

10. Qiu GX, Gao SN, Giacovelli G, et al. Efficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis. Arzneimittelforschung 1998;48:469-74.

11. Reichelt A, Förster KK, Fischer M, et al. Efficacy and safety of intramuscular glucosamine sulfate in osteoarthritis of the knee. Arzneimittelforschung 1994;44:75-80.

12. Drovanti A, Bignamini AA, Rovati AL. Therapeutic activity of oral glucosamine sulfate in osteoarthritis: a placebo­controlled double­blind investigation. Clin Ther 1980;3:260-72.

13. Vaz AL. Double­blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulphate in the management of osteoarthritis of the knee in out­patients. Curr Med Res Opin 1982;8:145-9.

14. Pujalte JM, Llavore EP, Ylescupidez FR. Double-blind clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis. Curr Med Res Opin 1980;7(2):110-4.

15. Poolsup N, Suthisisang C, Channark P, Kittikulsuth W. Glucosamine long-term treatment and the progression of knee osteoarthritis: systematic review of randomized controlled trials. Ann Pharmacother 2005;39:1080-7.

16. Rindone RP. Randomized controlled trial of glucosamine for treating osteoarthritis of the knee. West J Med 2000;172:91-4.

17. Wilkens P, Scheel IB, Grundnes O, et al. Effect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis: a randomized controlled trial. JAMA 2010;304:45-52.

18. Reginster JY, Deroisy R, Rovati L, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 2001;357:251-6.

19. Nakamura H, Masuko K, Yudoh K, et al. Effects of glucosamine administration on patients with rheumatoid arthritis. Rheumatol Int 2007;27:213-8.

20. Morrison LM, Murata K. Absorption, distribution, metabolism and excretion of acid mucopolysaccharides administered to animals and patients. In: Morrison LM, Schjeide OA, Meyer K. Coronary heart disease and the mucopolysaccharides (glycosaminoglycans). Springfield: Charles C. Thomas, 1974, 109–27.

21. Denuziere A, Ferrier D, Damour O, et al. Chitosan-chondroitin sulfate and chitosan-hyaluronate polyelectrolyte complexes: biological properties. Biomaterials 1998;19:1275-85.

22. McCarty MF. Glucosamine for wound healing. Med Hypotheses 1996;47:273-5 [review].

23. Glade MJ. Polysulfated glycosaminoglycan accelerates net synthesis of collagen and glycosaminoglycans by arthritic equine cartilage tissues and chondrocytes. Am J Vet Res 1990;51:779-85.

24. Prudden JF, Wolarsky ER, Balassa L. The acceleration of healing. Surg Gynecol Obstet 1969;128:1321-6 [review].

25. Bucci L. Nutrition applied to injury rehabilitation and sports medicine. Boca Raton, FL: CRC Press, 1995, 193.

26. Sprengel H, Franke J, Sprengel A. Personal experiences in the conservative therapy of patellar chondropathy. Beitr Orthop Traumatol 1990;37:259–66 [in German].

27. Lysholm J. The relation between pain and torque in an isokinetic strength test of knee extension. Arthroscopy 1987;3:182–4.

28. Ziegler R, Rau R. Conservative or operative treatment for chondropathia patellae? Beitr Orthop Traumatol 1980;27:201–11 [in German].

29. Böhmer D, Ambrus P, Szögy A, et al. Treatment of chondropathia patellae in young athletes with glucosamine sulfate. In: Bachl N, Prokop L, Suckert R, eds. Current topics in sports medicine. Vienna: Urban & Schwarzenberg, 1984, 799.

30. Danczak E. Glucosamine and plant lectins in autistic spectrum disorders: an initial report on 6 children with uncontrolled diarrhoea. J Nutr Environ Med2004;14:327-330.

31. Danczak E. Glucosamine and plant lectins in autistic spectrum disorders: an initial report on 6 children with uncontrolled diarrhoea. J Nutr Environ Med2004;14:327-330.

32. Swinburne LM. Glucosamine sulphate and osteoarthritis. Lancet2001;357:1617 [Letter].

33. Drovanti A, Bignamini AA, Rovati AL. Therapeutic activity of oral glucosamine sulfate in osteoarthritis: a placebo­controlled double­blind investigation. Clin Ther 1980;3:260-72.

34. Vaz AL. Double­blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulphate in the management of osteoarthritis of the knee in out­patients. Curr Med Res Opin 1982;8:145-9.

35. Russell AS, Aghazadeh-Habashi A, Jamali F. Active ingredient consistency of commercially available glucosamine sulfate products. J Rheumatol 2002;29:2407-9.

36. Houpt JB, McMillan R, Wein C, Paget-Dellio SD. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol 1999;26:2423-30.

37. Tapadinhas MJ, Rivera IC, Bignamini AA. Oral glucoseamine sulfate in the management of arthrosis: report on a multi-centre open investigation in Portugal. Pharmatherapeutica 1982;3:157-68.

38. Murphy RK, Ketzler L, Rice RD, et al. Oral glucosamine supplements as a possible ocular hypertensive agent. JAMA Ophthalmol 2013;131:955–7.

39. Virkamaki A, Daniels MC, Hamalainen S, et al. Activation of the hexosamine pathway by glucosamine in vivo induces insulin resistance in multiple insulin sensitive tissues. Endocrinology 1997;138:2501-7.

40. Rossetti L, Hawkins M, Chen W, et al. In vivo glucosamine infusion induces insulin resistance in normoglycemic but not in hyperglycemic conscious rats. J Clin Invest 1995;96:132-40.

41. Barzilai N, Hawkins M, Angelov I, et al. Glucosamine-induced inhibition of liver glucokinase impairs the ability of hyperglycemia to suppress endogenous glucose production. Diabetes 1996;45:1329-35.

42. Russell AI, McCarty MF. Glucosamine in osteoarthritis. Lancet 1999;354:1641; discussion 1641-2 [letters].

43. Muniyappa R, Karne RJ, Hall G, et al. Oral glucosamine for 6 weeks at standard doses does not cause or worsen insulin resistance or endothelial dysfunction in lean or obese subjects. Diabetes 2006;55:3142-50.

44. Rovati LC, Annefeld M, Giacovelli G, et al. Glucosamine in osteoarthritis. Lancet 1999;354:1640; discussion 1641-2.

45. Reginster JY, Deroisy R, Rovati L, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 2001;357:251-6.

46. Matheu V, Bracia Bara MT, Pelta R, et al. Immediate-hypersensitivity reaction to glucosamine sulfate. Allergy 1999;54:643-50.

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The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2024.