Glucosamine chondroitin help for osteoarthritis - Information on glucosamine hydrochloride supplement
Glucosamine hydrochloride or glucosamine hcl

Glucosamine is made from the combination of a sugar - hence the first part of the name glucos(e) - and an amine, which is a derivative of ammonia containing nitrogen (N) and hydrogen (H) atoms.
   Glucosamine is found largely in cartilage and plays an important role in its health and resiliency. As we age, we lose some of the glucosamine and other substances in cartilage. This can lead to thinning of cartilage and the onset and progression of osteoarthritis. It is important to note that there are a variety of important substances within cartilage and glucosamine ingestion, by itself, should not be viewed as the complete answer. Click here to buy Glucosamine or another popular product with glucosamine called Joint-Power-Rx.

 Joint Power Rx with glucosamine
Glucosamine and chondroitin alone may not be enough for full joint protection. This powerful formula includes glucosamine, chondroitin, MSM, and several additional herbal extracts and nutrients that play a role in joint health.  

Joint Power Rx Supplement Facts:
Serving Size: 4 Capsules - one month supply
Servings Per Container: 30

Glucoamine and osteoarthritis
Glucosamine has hardly been evaluated in conditions other than arthritis. Hence it is not clear whether glucosamine is helpful in those with damage to cartilage or joints due to musculoskeletal injuries. Glucosamine does help rebuild cartilage in osteoarthritis patients, but it is unlikely that it would help joints where the cartilage has been surgically removed. Similarly, gucosamine has not been tested in autoimmune diseases involving joints such as lupus and rheumatoid arthritis. Those with artificial joints are not likely to be helped by glucosamine since they have no cartilage. For more glucosamine arthritis info. For more information on Joint Power Rx.

Glucosamine as good as acetaminophen for osteoarthritis pain
Researchers from Madrid, Spain, compared the benefit of glucosamine sulfate versus acetaminophen (Tylenol) on the symptoms of knee osteoarthritis during a 6-month treatment course. Patients were randomly assigned to receive oral glucosamine sulfate 1,500 mg once daily, acetaminophen 3 gm a day, or placebo. There were more responders to glucosamine sulfate (39%) and acetaminophen (33%) than to placebo (21%). The findings of this study indicate that, in the long run, glucosamine sulfate is more effective than placebo and as or more effective than acetaminophen in treating knee osteoarthritis symptoms.
   Acetaminophen reduces joint pain quicker than glucosamine but it can cause harm to the liver, even at doses of one gram a day. We do not think it is a good drug to be taken long term for a chronic condition such as osteoarthritis. There is a possibility that if glucosamine is combined with chondroitin and other nutrients or herbs it may be more beneficial than by itself.

Glucosamine hcl mechanism of action
Glucosamine reduces oxidative stress on chondrocytes by increasing haem oxygenase. Treatment with sulfated glucosamine to human chondrocytes and macrophages inhibits radical simulated oxidation of membrane lipids, proteins and DNA in a dose-dependent manner.

Glucosamine hcl studies
Initial results of two highly anticipated clinical trials involving the use of glucosamine and/or chondroitin by individuals experiencing pain from osteoarthritis were announced in September, 2005. The good news is that these two studies show strong support for use of both nutrients by osteoarthritis patients to relieve pain. The multi-centered Glucosamine Chondroitin Arthritis Intervention Trial (GAIT) conducted by NIH involved 1,500 osteoarthritis patients who were supplemented with 1,500 mg a day glucosamine hydrochloride and/or 1,200 mg a day chondroitin sulfate. They were compared to other groups who received the prescription pain medication celecoxib (Celebrex™) or placebo. The studies lasted 24 weeks. Preliminary results indicate that both celecoxib and glucosamine - chondroitin combination significantly reduced knee pain compared to placebo. These findings were mirrored by the preliminary results of another multi-centered clinical study, the European-sponsored Glucosamine Unum in Die Efficacy (GUIDE) Trial, which compared the effect of glucosamine sulfate (1,500 mg/day) vs. acetaminophen (3,000 mg/day) or placebo over 24 weeks. Researchers reported that glucosamine sulfate was more effective than acetaminophen, and concluded that glucosamine sulfate might be the preferred symptomatic medication in knee osteoarthritis.
     With time, we are finding out that the prescription pain medicines for osteoarthritis have potentially serious side effects, and even the non prescription medicines such as naprosyn and acetaminophen are not risk free. Hence, it is great to find alternatives to these medicines. Interestingly, both forms of glucosamine, the sulfate and the hydrochloride, appear to be effective.

Does glucosamine influence cholesterol levels?
A Danish study was conducted in order to determine if glucosamine influences the fasting blood levels of cholesterol and triglycerides. A group of patients over 40 years of age with joint pain received either 1500 mg per day of glucosamine or placebo. No significant differences between the glucosamine group and the placebo group with respect to cholesterol and triglycerides were observed.

Combining Glucosamine with Drugs
 Glucosamine may be taken together with acetaminophen or NSAIDs such as ibuprofen and naproxen. After glucosamine starts working in a few weeks, hopefully the dose of the drugs can be reduced or eliminated. I am not aware of glucosamine interacting with other medicines.

 Glucosamine and allergies
Those who are allergic to sulfates may take glucosamine hydrochloride and not glucosamine sulfate, and they should avoid chondroitin sulfate. Glucosamine is derived from shrimp, oyster and crab shells and chondroitin is derived from cartilage of cows, pigs, and sharks. There is no synthetically made glucosamine on the market.

Glucosamine hydrochloride or sulfate?
Glucosamine is available as glucosamine sulfate or glucosamine hydrochloride. A review of the scientific literature shows glucosamine is likely to be helpful for many patients with osteoarthritis. Almost all of the studies done with glucosamine have used the sulfate form since a company in Europe funded the studies, and we know that it works. However, the hydrochloride form has been used by doctors for many years and it seems to work just as well. The hydrochloride form is cheaper. The positive effects of glucosamine reducing joint pain are often noticed within a few weeks.

Long term safety
Based on our current understanding, glucosamine can be taken for extended periods, months and years. Thus far, after being on the market for quite a number of years, there have not been any reports in the medical literature of any significant side effects resulting from the use of glucosamine. However, as with most nutrients and medicines, long term effects are not clearly known. It is best pregnant women not take glucosamine until more is known about this interaction.

Glucosamine and Diabetes
We are not aware of any significant changes to blood sugar resulting from glucosamine ingestion. The dose of glucosamine, one or two grams a day, is minimal as a sugar source compared to the amounts of carbohydrates found in the foods we consume. One study indicates that glucosamine is safe in diabetes.
   In a study published in Archives of Internal Medicine, 38 elderly patients with type 2 diabetes were divided into two groups. The first group took 1500 mg of glucosamine a day combined with 1200 mg of chondroitin sulfate. Chondroitin is another supplement often used in combination with glucosamine to treat osteoarthritis. The other group took placebo pills. Two-thirds of the dose was taken in the morning and one-third in the evening. The study lasted for 90 days. Blood studies were done to evaluate blood sugar levels, and also levels of hemoglobin A1c, a specific blood marker than can tell us average blood sugar levels over long periods of time. There was no statistically significant rise in hemoglobin A1c levels in those who took glucosamine.
     Comments: Patients with diabetes are often at risk from toxic effects from many of the current treatments for osteoarthritis, such as the NSAIDs like ibuprofen or naprosyn. These medicines cause stomach ulcers and kidney damage if used for prolonged periods. Glucosamine provides a safe and natural alternative.

Timing of glucosamine hydrochloride ingestion
It's difficult to say when the best time or frequency to take glucosamine, whether with or without food, but a good option is to take glucosamine before meals. All 1,500 mg a day can be taken at one time or split in two or three divided doses throughout the day.

Glucosamine allergy and shellfish
 As a general rule, it does not appear that those with a shellfish or shrimp allergy would have an allergic reaction to glucosamine supplements

Q. I understand that glucosamine has been shown in a study not to react in people who have a shellfish/shrimp allergy. I have a medically documented, from allergy testing, class 4 reaction, (which is extreme), to shellfish including shrimp, lobster, and scallops. I get a reaction from glucosamine that is a gastrointestinal upset with loose bowels. After suffering for a while I found out that my glucosamine supplement was to blame. Symptoms stopped when the supplements stopped. I would venture to quess that the test subjects class 2 reactions were not strong enough to show a clinical reaction with the glucosamine, but that a subclinical reaction could still have taken place including stress on the autoimmune system.
   A. We are sure we would classify loose bowels as an allergic reaction to glucosamine supplement ingestion.

Glucosamine and Condroitin
 If glucosamine itself is not helpful in relieving arthritic symptoms, it may be combined with condroitin and other nutrients. Alternatively, glucosamine and condroitin can be started together with several other nutrients.  

 Can glucosamine pills be absorbed from the stomach and end up in cartilage?
Yes. After oral administration of glucosamine sulfate, 90% is absorbed. (Sulfate means that the glucosamine is attached to a sulfur and oxygen atoms.)
   In a study done in Italy, two healthy male volunteers were given 250 mg of oral GS, tagged with radioactive carbon 14 as a tracer, in the morning on an empty stomach. The radioactive GS was found an hour later in blood and then later in other tissues. The researchers state, "GS very rapidly diffuses in most tissues and organs and that it has a special tropism (attraction) for articular tissue (cartilage) and for bone." These volunteers were also given GS intravenously (IV) and intramuscularly (IM). The amount of GS in blood after oral administration was only a quarter of the amount available by IV and IM. Therefore oral administration is effective, but not as good as IV or IV. When oral GS is absorbed, it first goes to the liver where a large portion gets broken down into smaller molecules such as carbon dioxide, urea and water.

How glucosamine hydrochloride works
Effects of glucosamine hydrochloride on the production of prostaglandin E2, nitric oxide and metalloproteases by chondrocytes and synoviocytes in osteoarthritis.
Clin Exp Rheumatol. 2004 May-Jun;22(3):293-9.
To determine the response of glucosamine hydrochloride on chondrocytes and synoviocytes in terms of prostaglandin E2 (PGE2), nitric oxide (NO) and matrix metalloproteases (MMPs). Chondrocytes and synoviocytes were prepared from joint specimens of patients who underwent total knee arthroplasty for osteoarthritis. Chondrocytes from patients with femoral neck fracture were served as a normal control. Culture cells were stimulated by 5 ng/ml of IL-1beta and treated with various concentration of glucosamine hydrochloride. Glucosamine hydrochloride at a concentration of 100 microg/ml suppressed PGE2 production, and partly suppressed NO production. Glucosamine also suppressed the production of MMPs from normal chondrocytes and synoviocytes but not from osteoarthritis chondrocytes. Glucosamine modulates the metabolism of chondrocytes and synoviocytes and its mode of action differs between cells and conditions.

Glucosmaine Studies
 Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies.
Bruyere O. WHO Collaborating Center for Public Health Aspect of Osteoarticular Disorders, Liege, Belgium.
Menopause. 2004 Mar-Apr;11(2):138-43.
To investigate the effect of glucosamine sulfate on long-term symptoms and structure progression in postmenopausal women with knee osteoarthritis (OA). DESIGN: This study consisted of a preplanned combination of two three-year, randomized, placebo-controlled, prospective, independent studies evaluating the effect of glucosamine sulfate on symptoms and structure modification in OA and post-hoc analysis of the results obtained in postmenopausal women with knee OA. Minimal joint space width was assessed at baseline and after 3 years from standing anteroposterior knee radiographs. Symptoms were scored by the algo-functional WOMAC index at baseline and after 3 years. All primary statistical analyses were performed in intention-to-treat, comparing joint space width and WOMAC changes between groups by ANOVA. Of 414 participants randomized in the two studies, 319 were postmenopausal women. At baseline, glucosamine sulfate and placebo groups were comparable for demographic and disease characteristics, both in the general population and in the postmenopausal women subset. After 3 years, postmenopausal participants in the glucosamine sulfate group showed no joint space narrowing [joint space change of +0.003 mm (95% CI, -0.09 to 0.11)], whereas participants in the placebo group experienced a narrowing of -0.33 mm. Percent changes after 3 years in the WOMAC index showed an improvement in the glucosamine sulfate group and a trend for worsening in the placebo group. This analysis, focusing on a large cohort of postmenopausal women, demonstrated for the first time that a pharmacological intervention with glucosamine for OA has a disease-modifying effect in this particular population, the most frequently affected by knee OA.

Glucosamine condroitin arthritis questions
Q. I understand hyaluronic acid is being promoted for joint health along with glucosamine hci and condroitin sulfate. What is the info on this supplement?
   A. See the link provided. We have not seen head to head comparisons between glucosamine hci, chondroitin, and hyaluronic acid.

Q. My question is about about glucosamine and condroitin. I would like to know your opinion about the efficacy. I have been taking glucosamine and condroitin somewhat regularly. I would like to know that there is a long term solution to osteoarthritis, especially since my arthritis is not that serious. I thought that since my arthritis is not very serious at all, then I could take the glucosamine condroitin combination, and my arthritis would remain in this condition without getting worse.
   A. It is difficult to predict what effect glucosamine and chondroitin have in any one individual, but statistically, a good number of people do find a benefit from the use of glucosamine chondroitin supplements.

Q. Would a glucosamine condroitin supplement offer benefits that go beyond a glucosamine hcl supplement by itself?
  A. Based on our evaluation of studies, we believe that the addition of a chondroitin to glucosamine hcl does add to the benefit.

Q. I would like to take a glucosamine supplement but both the tablet form and the liquid form give me digestive side effects (a bit sick to my stomach with bloating and gas). Do you have any suggestions for taking a glucosamine supplement? I've tried it in several different ways--before a meal, after a meal, etc. I'm a 49 year old female athlete (runner, soccer). I feel sure it would help some of my aches and pains.
   A. You may consider a different glucosamine product, or perhaps a combination product such as Joint Power Rx, or to try only a portion of a capsule or tablet, to see if the gastrointestinal side effects are still present on tiny amounts. Glucosamine side effects are minor and may disappear with time.

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