Glucosamine and chondroitin B
In knee pain the effect is small and borderline significant; it does not restore cartilage
Citable fact
«Glucosamine and chondroitin» — evidence level B. Dosage: Glucosamine sulfate 1500 mg per day and chondroitin sulfate 800–1200 mg per day in courses of 3–6 months have been studied. No safe upper level has been established; in diabetes, blood glucose monitoring is required. Source: PMID 29947998, permanent link to the source in the list below.
How it works
Substrates for the synthesis of cartilage proteoglycans; a weak anti-inflammatory effect is also discussed. Oral bioavailability is low, and incorporation into cartilage in humans has not been proven.
Dosage and intake
Glucosamine sulfate 1500 mg per day and chondroitin sulfate 800–1200 mg per day in courses of 3–6 months have been studied. No safe upper level has been established; in diabetes, blood glucose monitoring is required.
In divided doses or once with food; the effect is assessed no earlier than after 2–3 months.
Forms
Glucosamine sulfate (better documented) and hydrochloride, as well as chondroitin sulfate, have been studied; data on the hydrochloride are weaker.
What is confirmed
- A small reduction in pain in knee osteoarthritis in meta-analyses
- A small improvement in joint function in some studies
- Good tolerability at doses up to 1500 mg of glucosamine per day
Adverse effects and limitations
- The effect is small and in several large studies did not differ from placebo
- Glucosamine may raise blood glucose — monitoring in diabetes
- Allergy to mollusks, from which the raw material is often obtained, is possible
- Glucosamine may enhance the effect of warfarin — INR monitoring
Interactions
- Warfarin: cases of INR increase have been described
- Possible effect on glucose metabolism with glucose-lowering drugs
Who must not use it
- Under 18 years: No data; not recommended.
- Pregnancy and lactation: No safety data; not recommended.
- diabetes mellitus
- allergy to mollusks
- warfarin use
- pregnancy and lactation
Sources
- Effect of glucosamine and chondroitin sulfate in symptomatic knee osteoarthritis: a systematic review and meta-analysis of randomized placebo-controlled trials · Simental-Mendía M, Sánchez-García A, Vilchez-Cavazos F · Rheumatology international, 2018 · PMID 29947998
- Essential Features of Third-Party Certification Programs for Dietary Supplements: A Consensus Statement · Eichner AK, Coyles J, Fedoruk M · Current sports medicine reports, 2019 · PMID 31082891
See also
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