Glucosamine: The Facts Behind The Hype
Part one can be found here – Glucosamine: Wonder Supplement or Marketing Goldmine
In the last post, I dealt with the science and maths of the popular supplement; Glucosamine.
Now it’s time to look at the known facts as opposed to just the manufacturer’s or marketer’s claims.
Known side-effects of Glucosamine
- May increase risk of developing insulin resistance (by entering the hexosamine biosynthetic pathway)
Now, if the introduction of glucosamine into your diet reduces pain levels and makes you feel more mobile or agile, I imagine all but the last one of those on the list is but a minor inconvenience for an improvement in quality of life.
Taking the last one into consideration though, it may be something worth taking a precaution on if you have other lifestyle risk factors (obesity, high triglyceride blood content, low levels of “good cholesterol”, high or marginally raised blood pressure, raised blood sugar [glucose levels].)
It is a disputed risk, there is some controversy around the claim, but when deciding whether to take something myself or not and when deciding if I should recommend a supplement, the hippocratic oath is always at the forefront of my mind – “If I can do no good, I will do no harm”, meaning that caution is advised.
Another less publicised risk is that the most common form of glucosamine available (Glucosamine Sulphate) is most often stabilised by salt – NaCl. People at risk of raised blood pressure or taking blood pressure reducing medication need to be very careful to avoid extra salt in any supplements. It is possible to obtain Sodium-free versions, but you do need to check carefully.
Additionally, Glucosamine can limit the action of loop diuretics (Bumetanide, Ethacrynic acid, Furosemide, Torsemide) and thiazide diuretics (Chlorothiazide, Hydrochlorothiazide, Indapamine), all medicines used in controlling high blood pressure.
What about all the extra substances partnered with Glucosamine?
Common ‘partner’ substances include Chondroitin and MSM (Methylsulfonylmethane). Less commonly, rose-hip can sometimes be included, as can Bromelain and Turmeric.
Again, claims are occasionally outrageous and less frequently backed by hard evidence.
Chondroitin, by all accounts is a molecule too large to be absorbed into the body as it is, and so theoretically would be digested and wasted as an oral supplement. On top of this, it has been linked with prostate cancer in a few studies, but results are inconclusive as to whether the cancer attracts the Chondroitin molecule or the Chondroitin molecule triggers the cancer. That said, men should take Chondroitin with extreme care and following careful reflection and adequate advice from a suitably qualified medical professional.
MSM has been widely lauded as an Osteo-Arthritis treatment with little evidence to back it up.
Anecdotally, a number of people have claimed better response to Glucosamine supplements partnered with MSM or Chondroitin than without, but the research is not supportive. If you want to try them to test effectiveness, you may have more luck with one than another.
Rose hip is regularly connected with reducing gastric irritation, which is probably the reason it is sometimes sold alongside Glucosamine; to counter-act the adverse digestive side-effects.
Cats Claw has been observed to have some anti-inflammatory properties, but also some fairly major kidney-related side-effects in people with certain pre-existing problems.
Bromelain is thought to have anti-inflammatory properties and preliminary animal studies as well as anecdotal evidence seem to support this, but it has been shown to have adverse drug interactions with anticoagulant and antibiotic medicines, so take with care.
Turmeric, lastly, with its active compound curcumin is thought to have a range of benefits including anti-inflammatory and antioxidant, both of which may be useful when supporting the conditions that Glucosamine would be used to combat. Recently, more evidence has been gathered from clinical trials to show genuine health benefits.
Glucosamine and it’s partners in summary
Yes, some studies have shown glucosamine to be beneficial to some people. Other studies have shown it to perform no better than placebo.
Some of the supplements that are bundled with glucosamine have, anecdotally given some added benefit or adjunct increased effectiveness of the Glucosamine itself, but they haven’t really been researched enough or provided hard-and-fast evidence to support their use.
If you don’t have a compromising health condition (e.g. diabetes or heart disease) and are not taking medication that may conflict with any of the substances I’ve mentioned, then you may well find some benefit in the use of Glucosamine and it’s associated complementary supplements. It may not be any greater than placebo, but we know from good quality research that placebo can account for a pain killing effect of between 26.9% (Benedetti 1996) and 56% (Petrovic et al. 2002) which is, when all things are considered, actually very good.
Next time, I’ll make some specific recommendations on the use of Glucosamine, instead of trying to hide my opinions away behind science and research.