Glucosamine is a natural compound found in healthy cartilage. Natural glucosamine levels drop as people age. The most common glucosamine supplement on the market is glucosamine sulfate. Glucosamine sulfate is a normal constituent of glycosaminoglycans in synovial fluid and cartilage matrix. It may help counteract the gradual deterioration of the joint with age.
Chondroitin Sulfate can be found in bone, human cartilage, cornea, skin and the walls of arteries. It is derived from bovine and calf cartilage or manufactured by synthetic means. Chondroitin sulfate is one of the building blocks of cartilage. In osteoarthritis, the cartilage in the joints breaks down. Taking chondroitin sulfate might slow this breakdown.
Glucosamine is commonly taken combined with chondroitin and may allow for reduced doses of non-steroidal anti-inflammatory agents. Function and pain relief are improved in knee osteoarthritis with glucosamine sulfate and/or chondroitin sulfate.
Bruyer et al. performed a three-year randomized, placebo-controlled, prospective study to determine the effect of glucosamine and chondroitin on symptom and function in 212 patients with knee osteoarthritis. There was a significant reduction in joint space narrowing in patients with mild arthritis. The researchers also reported similar efficacies for both glucosamine and chondroitin in other double-blinded, control studies.
Older adults, children, and pregnant women should avoid glucosamine since studies among these groups do not exist. Chondroitin should be used carefully in patients using blood thinning drugs since chondroitin is chemically similar to some of these drugs. Possible side effects of glucosamine include skin rash, drowsiness, headache, heartburn, diarrhea, and nausea.
The response to glucosamine sulfate is slower than NSAIDs (non-steroidal anti-inflammatory drugs). 1500 mg daily, in divided doses, for patients with symptomatic osteoarthritis should be considered. If there is no response after three months, then glucosamine sulfate should be discontinued.
In the treatment of pain from osteoarthritis, chondroitin sulfate can be used in the amounts of 1200 mg per day or 400 mg three times a day.
Talk to your doctor before using either glucosamine sulfate and/or chondroitin sulfate.
Jose Veliz MD is the medical director of Palomar Spine & Pain, in Escondido, CA (North San Diego County).