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Glucosamine - Herb Interactions, Side Effects and Precautions of Use

Common Trade Names

Multi-ingredient preparations: Arth-X Plus, Bioflex, Enhanced Glucosamine Sulfate, F1exi-Factors, Glucosamine Complex, Glucosamine Mega, Joint Factors, Nutri-Joint, Ultra Maximum Strength Glucosamine Sulfate

Common Forms

Various molecular forms of glucosamine are available, including chlorhydrate, D-glucosamine, hydrochloride, N-acetyl, sulfate, and with potassium chloride added. The preferred form appears to be glucosamine sulfate.

Capsules: 250 mg, 375 mg, 500 mg, 600 mg, 1,000 mg

Tablets: 63 mg, 87 mg, 375 mg, 500 mg, 600 mg, 750 mg

Source

Glucosamine is a natural substance found in mucopolysaccharides, mucoproteins, and chitin. Glucosamine sulfate is synthetically manufactured.

Chemical Components

Glucosamine sulfate is the sulfate salt of 2-amino-2-deoXY-D-chitin glucopyranose.

Actions

Glucosamine is believed to stimulate production of cartilage components and allow rebuilding of damaged cartilage. Early in vitro studies found that culture-derived fibroblast increased mucopolysaccharide and collagen synthesis when glucosamine was added .

In vivo and in vitro studies conducted in rats demonstrated that glucosamine can severely impair insulin secretion and beta-cell secretory dysfunction similar to that observed in patients with type 2 diabetes mellitus .

Uses for Glucosamine

Glucosamine is thought to be useful as an antarthritic in patients with osteoarthritis or other joint disorders.

Dosage

The dose used in several clinical trials was 500 mg P.O. t.i.d.

Other dosages were based on patient weight: If weight is below 120 lb (54 kg), 1,000 mg of glucosamine plus 800 mg of chondroitin sulfates; between 120 and 200 lb (91 kg), 1,500 mg of glucosamine plus 1,200 mg of chondroitin sulfates; and above 200 lb, 2,000 mg of glucosamine plus 1,600 mg of chondroitin sulfates.

Adverse Reactions

CNS: drowsiness, headache.

GI: abdominal pain, constipation, diarrhea, epigastic discomfort, heartburn, nausea.

Skin: rash.

Other: anaphylaxis.

Contraindications And Precautions

Avoid using glucosamine in patients who are hypersensitive to glucosamine or any of its components, in pregnant or breast-feeding women, and in children; effects are unknown.

Interactions and Side Effects

The herb glucosamine has none reported side effects, so you can start using it without any problem.

Special Considerations

1. Monitor blood glucose levels in diabetic patients.
2. Inform the patient that human clinical trials evaluating glucosamine are lacking.
3. Suggest other accepted pharmacologic treatment before starting therapy with glucosamine.
4. Explain that the long-term effect on beta-cell secretory function in humans is unknown and could be harmful, especially to patients with diabetes or impaired glucose tolerance.
5. Points of interest
6. The Arthritis Foundation does not recommend glucosamine for osteoarthritis or any forms of arthritis because of the lack of efficacy data.
7. The FDA has not reviewed any studies that confirm claims made for this herb.

Commentary

Several trials have demonstrated that glucosamine sulfate can improve symptoms of osteoarthritis. Many contain major study design flaws and critical problems with data analysis, placing their conclusions in jeopardy. Furthermore, all trials do not support the efficacy of glucosamine over placebo. There are few large, controlled clinical trials evaluating the use of glucosamine with chondroitin sulfates that identify positive benefits. Large-scale, long-term, adequately designed, rigorous, controlled studies are needed before glucosamine's role in the treatment of bone and joint disorders can be determined.