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Enter glucosamine, a compound naturally produced by the body that has received a lot of attention as a joint health supplement for decades now.
Researchers are still sussing out the specifics as to how exactly glucosamine addresses inflammation and joint pain, but they have at least determined that it works.
What’s more, glucosamine is very safe, and can be accompanied by a similar compound to enhance the above effects.
First things first: What is this stuff, and how does it help with joint issues?
Glucosamine sulfate is already produced and used by our bodies to create molecules that give our cartilage viscoelasticity, which refers to a substance that can both stretch and retain its shape.
In order to understand how glucosamine facilitates tissue healing in the body’s largest weight-bearing joints (called synovial joints), we have to very briefly review how these joints are structured.
Ever wonder why some classroom skeletons and/or anatomical drawings have those pink, fleshy-looking orbs surrounding the larger joints?
Those orbs are called joint capsules, and they’re vital to joint health—let’s use the hip as an example.
Tough connective tissue stretches from the “ball” that is the upper end of the thigh bone and connects to the “socket” that is the c-shaped opening in the pelvis, forming a joint capsule that encases both ends of the hip joint.
One important purpose of the synovial joint capsule is to house synovial fluid, which cushions and lubricates both ends of the joint like a liquid shock absorber; this prevents painful and damaging bone-on-bone contact.
Glucosamine is not only vital to producing both synovial fluid and cartilage itself, but it can even slow down the breakdown of cartilage in certain cases of ongoing inflammation.
Now to the research.
With the anatomy and physiology briefing still fresh in your mind, let’s see what the research has to say about glucosamine’s role in supporting the cartilage that lines our joints.
According to an article published in the International Journal of Rheumatology by Germany’s Johanna-Etienne hospital, glucosamine can play both offense and defense when it comes to joint support.
“As basic components of cartilage and synovial fluid, they (glucosamine and similar compounds) stimulate the anabolic process of the cartilage and synovial fluid, and their anti-inflammatory action can delay many inflammation-induced processes in the cartilage,” says the author.
Specifically, glucosamine suppresses proinflammatory substances like prostaglandin E2 (PGE2) and nitric oxide (NO), per the finding.
This dual capacity of glucosamine to stimulate cartilage/synovial fluid growth and protect against inflammation in the cartilage is especially important for a couple of reasons.
First, it makes glucosamine an excellent choice for athletes, who need both of these functions to perform consistently, and secondly, it means people experiencing tissue inflammation may have access to a less damaging alternative to chronic NSAID (non-steroidal anti-inflammatory drugs) use.
This is a healthy start, but the pathology of osteoarthritis is far more involved than run-of-the-mill inflammation, so we need to take a closer look to see if glucosamine really fits the bill.
An academic review from an Army General Training Hospital in Greece reports on the ambivalent nature of clinical trial reports when it comes to glucosamine’s superiority over NSAIDs for patients with tissue inflammation.
For example, the 15 randomized clinical trials assessed by this review reported “moderate effect sizes,” while other reviews found that glucosamine had little to no effect on inflammation.
So, is that as clear as it’s going to get for the moment?
Fortunately, we at least have a list of proposed mechanisms of glucosamine to work with, even if they don’t hold true in every case of arthritis.
The review cites studies that explain glucosamine’s ability to intervene with inflammation, cartilage breakdown, and the immune system’s role in promoting inflammation on a cellular level.
Going one step further, studies have also found that glucosamine can directly suppress the amount of “catabolic” enzymes, which are substances that break down molecules into simpler, smaller forms.
Combined with its ability to aid in cartilage and synovial fluid production, we know for sure that this naturally produced sugar has the potential to slow inflammatory processes.
Researchers now need to identify and work around the apparent roadblocks so this supplement can be developed for more consistent results.
A trial conducted by epidemiologists at the Harvard School of Public Health confirms the anti-inflammatory action of glucosamine, but with a few asterisks.
First, the 217-participant trial reports that, while glucosamine did indeed suppress two “biomarkers of systemic inflammation,” it doesn’t suppress the several other compounds involved.
This distinction, along with the fact that conditions like arthritis involve much more than simple inflammation, helps explain the varying levels of success among arthritis patients given glucosamine.
Another important qualifier we can tack onto glucosamine in order to enhance outcomes is the need for a molecularly similar compound: chondroitin.
Not only did chondroitin outperform glucosamine in this trial, decreasing the two inflammation markers by eleven percent more in total, but it is much more effective at directly managing pain within the joint space.
Chondroitin is a “sulfated” molecule comprised of sugars, just like glucosamine.
Also like glucosamine, chondroitin is found in cartilage, and it assists with the preservation of cartilage and synovial fluid.
When the two compounds are taken together, joint pain outcomes improve significantly, but when glucosamine is taken alone, joint stiffness is the most dramatic improvement.
A meta-analysis of 26 articles by China’s Baoshan Center for Disease Control and Prevention concluded that “chondroitin is more effective than placebo on relieving pain and improving physical function (for osteoarthritis patients) … glucosamine showed effect on stiffness outcome.”
This is why leading supplement manufacturers like NOW use both glucosamine and chondroitin in their products; together, these two compounds can address pain, inflammation, and stiffness.
Breaking through industry standards with a 1350mg/tablet concentration of glucosamine (750mg) and chondroitin (600mg), NOW is one of the most economical and effective brands on the market.
In addition to the synergistic benefits of pairing these two compounds, NOW has kept them in their sulfate forms, which allows the body to easily and efficiently put these chemically recognizable ingredients to work.
We highly recommend NOW Extra Strength Glucosamine & Chondroitin for anyone experiencing joint pain, but as always, ensure to check with a physician before use.
glucosamine sulfate, chondroitin sodium sulfate, cellulose, stearic acid (vegetable source), silica and vegetable coating.
*contains shellfish (crab, shrimp, lobster, crayfish).
1500mg glucosamine chondroitin and 1200mg chondroitin sodium sulfate per serving (2 tablets). Available sizes include 60, 120, and 240 tablets.
Joint mobility and comfort
Whether or not glucosamine and chondroitin can rival the potency of non-steroidal anti-inflammatory drugs is a null point without the prospect of an improved safety profile.
Thankfully, the jury is much less split on this issue.
According to a two-year, 662-participant University of Utah study focusing on the “clinical efficacy and safety” of glucosamine and chondroitin, adverse events associated with these two compounds were found to be mild.
Only 64 out of the 662 patients reported adverse events at all, and only five of those were believed to be related to the glucosamine and chondroitin.
Here is what the study reported in terms of possible complications after glucosamine and/or chondroitin use:
Of particular importance when comparing glucosamine and chondroitin to NSAIDs is the fact that no gastrointestinal bleeding—a known side effect of NSAIDs—was observed.
Finally, neither glucosamine nor chondroitin have yet been proven to interact with prescription drugs in a clinically significant way.
Exercise, postural habits, dosage calculation, and consulting with your physician can increase your chances of success with a glucosamine and chondroitin supplement.
It’s imperative for glucosamine takers to understand the connection between consistent, low-impact exercise and joint health.
Glucosamine or not, movement allows the synovial fluid in our joint capsules to be squeezed out of the cartilage that lines joint surfaces, kind of like squeezing a sponge.
Even in advanced, chronic inflammation, more synovial fluid circulation means preserving what remains of the cartilage and joint surfaces for decreased pain and improved function.
On the other hand, staying still for too long works against the elasticity-promoting effects of glucosamine, the cartilage itself, and the muscles that support our joints.
When it comes to dosing, glucosamine and chondroitin aren’t approved by the FDA, so there’s no hard-and-fast standard, but we can turn to the evidence once again to see what works.
Most studies use 1,500mg/day as their unofficial standard, a number that varies according to weight and many other circumstantial factors, but some disagree as to whether or not 1,500mg/day is enough.
Sure, glucosamine and chondroitin quickly are quickly and efficiently absorbed into our tissues after oral ingestion, but according to a University of Liege (Belgium) study, 1,500mg/day (of one or the other, not both) can “barely reach the required therapeutic concentration in plasma and tissue.”
Your physician may be hesitant to draw a solid line regarding dosage as well, given that this product is unregulated, but it’s still important to confer with them about safety.
Take a little time to research an upstanding brand (like NOW’s glucosamine and chondroitin), start below or at the “standard” dose for your initial trial, and adjust as needed until, hopefully, your joint pain and inflammation fade into the background.
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