Let’s continue the series on how not to have knee surgery. As promised in the last episode, It is time to review glucosamine. I am asked at least 4 times a day if this is a good idea to take. I too see the 1000’s of bottles of it at Costco in the first aisle, and people certainly seem to be buying it. On Saturday you can even sample the ‘Joint Juice’ of the week that is being sold.
What is glucosamine ?
Glucosamine is a molecule that helps form a part of a much bigger molecule called a glycosaminoglycan. These molecules attract water and act as a lubricant or shock absorber. They are found in abundance in cartilage that make up joint surfaces.
Chondroitin is also a component of these lubricating molecules.
So, the question is ‘does it work’ to make your knees feel better?
Does glucosamine reduce knee pain
There are many articles about this topic, with several articles that review other articles (meta-analysis). The most recent study, called the “MOVES” trial (Multicentre Osteoarthritis interVEntion trial with SYSADOA) conducted in Europe, was a large trial of over 600 patients with moderate to severe osteoarthritis of the knee. They showed that glucosamine hydrochloride and chondroitin was equivalent to celebrex in reducing the pain and inflammation of osteoarthritis.
Many of the articles referred to a big research study called the “GAIT Report” (Glucosamine/Chondroitin Arthritis Intervention Trial) that was funded by the National Institute of Health in 2006. This was a prospective randomized trial with 2 year followup. In this study there was no difference in joint space narrowing between using glucosamine alone, glucosamine with chondroitin, or placebo. Some patients with mild to moderate arthritis had some improvement in their condition.
Overall, these articles found four things:
1. Taking glucosamine and chondroitin together had no more benefit than taking either one alone. They may be less active when combined than when taken individually.
2. Several studies showed less pain and swelling, BUT several other studies showed no effect. The studies that found it to word showed it was long-term: usually at 3, 6 or 9 months after starting it. There were no safety concerns.
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3. Glucosamine SULFATE was more effective than glucosamine CHLORIDE and glucosamine HYDROCHLORIDE in lowering pain scores.
4. Using chondroitin sulfate alone may be getter than glucosamine alone or in combination.
The recommended dose of glucosamine hydrochloride is 1500mg a day and for chondroitin sulfate its 1250mg a day.
The more expensive brands tend to have better purity and potency.
In conclusion, there is no final consensus regarding the benefits of glucosamine and chondroitin. The more recent MOVES trial definitely showed patients were better taking this combination of glucosamine and chondroitin. What is clear is that we need is better credible research. If it is going to work, you need to take it for 90 days to see. There is no harm in trying it, and if $35 a month for a bottle of glucosamine sulfate helps you avoid the need for knee surgery, I’d sure take the pill !
Next time we will look at hyaluronic acid injections followed by anti-inflammatory foods.
Please send me your experience with glucosamine and its benefits or lack thereof on your knee arthritis !
My dear Dr Hacker,
This was a very interesting and informative article as always. Much of what you were describing in the article rang true to me. You’ll recall I was in to see you for my knees – and you had x-rays done. That by the way – I don’t recommend – as I was nearly crippled for a week following those x-rays. I’ll not let your tech get anywhere near me again! But you asked us to relate our experience with these pills. Yes – I take the Costco brand – with the combination. I have tried various strengths – with little to no noticeable difference. But the problem of doing it for years as I have – is I don’t know what my knees would be like without it. I take Natures Blend which is at the doses you recommend. However – we went to the mountains to camp this past weekend – and my knees go so bad – I could hardly get down and up. the elevation seemed to affect them. I’m looking forward to your continued articles. I’ll keep taking this stuff but I really have my doubts it does anything.
I would completely agree with you – and i’m sure many others would as well, that you have been taking it so long it is hard to know if it is making a difference or not. And it can be hard to consider stopping it for a while to find out. There are always more options to consider and my door is always open for you.
All the best and Happy Holidays !