Glucosamine : Uses and Health Benefits

by MedlinePlus

Glucosamine is a natural compound that is found in healthy cartilage. Glucosamine sulfate is a normal constituent of glycoaminoglycans in cartilage matrix and synovial fluid.

Available evidence from randomized controlled trials supports the use of glucosamine sulfate in the treatment of osteoarthritis, particularly of the knee. It is believed that the sulfate moiety provides clinical benefit in the synovial fluid by strengthening cartilage and aiding glycosaminoglycan synthesis. If this hypothesis is confirmed, it would mean that only the glucosamine sulfate form is effective and non-sulfated glucosamine forms are not effective. Glucosamine is commonly taken in combination with chondroitin, a glycosaminoglycan derived from articular cartilage. Use of complementary therapies, including glucosamine, is common in patients with osteoarthritis, and may allow for reduced doses of non-steroidal anti-inflammatory agents.

Polysaccharides are becoming increasingly developed as therapeutics and medical products. Glycosaminoglycans that contain N-acetyl glucosamine constituents have been the focus of research leading to medical devices. A hemostatic bandage, the Syvek Patch, has been introduced in the recent past for the control of bleeding at vascular access sites in interventional cardiology and radiology procedures. This product consists of poly-N-acetyl glucosamine (pGlcNAc) isolated in a unique fiber crystalline structural form. Clo-Sur PAD and ChitoSeal, are also available as patch hemostats. These two products both use chitosan, another N-acetyl glucosamine containing glycosaminoglycan, as their active ingredient. Detailed use of these products will not be discussed in this review.

Evidence

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidence

Knee osteoarthritis (mild-to-moderate)

Based on human research, there is good evidence to support the use of glucosamine sulfate in the treatment of mild-to-moderate knee osteoarthritis. Most studies have used glucosamine sulfate supplied by one European manufacturer (Rotta Research Laboratorium), and it is not known if glucosamine preparations made by other manufacturers are equally effective. Results of a recent large clinical trial (GAIT) comparing the effects of glucosamine to celecoxib (Celebrex®) for treatment of knee osteoarthritis have yet to be published. A recent study or postmenopausal women found that glucosamine reduced joint space narrowing compared to placebo treatment.Although some studies of glucosamine have not found benefits, these have either included patients with severe osteoarthritis, or used products other than glucosamine sulfate . The evidence for the effect of glycosaminoglycan polysulphate is conflicting and merits further investigation. More well-designed clinical trials are needed to confirm safety and effectiveness, and to test different formulations of glucosamine.

Osteoarthritis (general)

Several human studies and animal experiments report benefits of glucosamine in treating osteoarthritis of various joints of the body, although the evidence is less plentiful than that for knee osteoarthritis. Some of these benefits include pain relief, possibly due to an anti-inflammatory effect of glucosamine, and improved joint function. Overall, these studies have not been well designed. Analyses, which group the existing studies together and isolate higher-quality research (meta-analyses) have found conflicting results, with improvement in some scales measuring pain and disability, but not in others. Although there is some promising research, more study is needed in this area before a firm conclusion can be made.

Chronic venous insufficiency

"Chronic venous insufficiency" is a syndrome that includes leg swelling, varicose veins, pain, itching, skin changes, and skin ulcers. The term is more commonly used in Europe than in the United States. Currently, there is not enough reliable scientific evidence to recommend glucosamine in the treatment of this condition.

Inflammatory bowel disease (Crohn's disease, ulcerative colitis)

Preliminary research reports improvements with N-acetyl glucosamine as an added therapy in inflammatory bowel disease. Further scientific evidence is necessary before a recommendation can be made.

Rheumatoid arthritis

Preliminary human research reports benefits of glucosamine in the treatment of joint pain and swelling in rheumatoid arthritis. However, this is early information, and additional research is needed before a conclusion can be drawn. The treatment of rheumatoid arthritis can be complicated, and a qualified healthcare provider should follow people with this disease.

Temporomandibular joint (TMJ) disorders

There is a lack of sufficient evidence to recommend for or against the use of glucosamine (or the combination of glucosamine and chondroitin) in the treatment of temporomandibular joint disorders.

Uses based on tradition or theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

AIDS, athletic injuries, back pain, bleeding esophageal varices (blood vessels in the esophagus), cancer, congestive heart failure, depression, diabetes, fibromyalgia, joint pain, knee pain, kidney stones, migraine headache, osteoporosis, pain, patellofemoral pain syndrome (PFPS- pain behind the knee cap), psoriasis, skin rejuvenation, spondylosis deformans (growth of bony spurs on the spine), wound healing, immunosuppression, topical hypopigmenting agent (combination product containing multiple ingredients).

About the Author

medlineplus.gov
MedlinePlus will direct you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations. MedlinePlus also has extensive information about drugs, an illustrated medical encyclopedia, interactive patient tutorials, and latest health news.