Besides causing pain in joints, osteoarthritis may lead to neck pain, headaches, back pain, tennis elbow, and other symptoms, many of which we normally wouldn't associate with osteoarthritis. It is therefore vital to address the underlying cause. An increasing number of studies show that glucosamine can halt the progression of osteoarthritis and, subsequently, slam the brakes on the accompanying pain. It is, however, important to choose glucosamine in drug form with the type of glucosamine called glucosamine sulfate in order to obtain the desired effect.
Osteoarthritis is a widespread disease. An estimated 50% of people older than 40 years of age and practically every individual from 60 and onward are believed to be affected by it. In fact, many people have osteoarthritis without feeling pain, or the pain may vary in strength and be particularly noticeable in the wintertime, in the morning, or only when the affected joint is strained. Because osteoarthritis eventually affects most people and may cause different symptoms, it is an advantage to learn more about the disease and how it can be prevented or treated with glucosamine. A European group of experts (rheumatologists, clinicians etc.) specifically recommends glucosamine sulfate as first-line therapy for mild to moderate osteoarthritis, as glucosamine helps deal with the underlying cause in the long run.
Osteoarthritis causes many symptoms
It takes many years for osteoarthritis to develop. The joint cartilage slowly disappears, causing the exposed bone ends to grind against one another. The missing cartilage is replaced by bone growths called osteophytes, while ligaments and joint capsules thicken, causing muscles and tendons to grow weaker.
As there are no nerves in the joint cartilage itself, the pain originates from surrounding tissues as a result of pressure on the bones, inflammation, tension and infiltration.
Osteoarthritis in one place may spread via a type of fibrous tissue called facies and cause symptoms in other places, which the following examples illustrate:
Glucosamine sulfate restores cartilage and has an anti-inflammatory effect
Glucosamine consists of an amino acid and sugar (glucose). Glucosamine sulfate is glucosamine combined with sulfur (sulfate) and is a component of different building blocks in joint cartilage. Glucosamine sulfate also inhibits cartilage deterioration by means of different enzymatic processes. This is why glucosamine sulfate also has anti-inflammatory properties.
Research on drugs and nutritional supplements - not the same thing
In recent years, experts have been in a heated debate over the effect of glucosamine on osteoarthritis. Part of this argument is a result of faulty interpretations of different meta-analyses (where several studies are compared to reach a joint conclusion). According to an article written by a large group of rheumatologists and other experts in Current Medical Research and Opinion, the problem with these meta-analyses is that they fail to distinguish between glucosamine in the form of medical drugs and the ones that are classed as nutritional supplements. There is a significant difference, as drug-type glucosamine is subject to scrutinous control, while glucosamine in the form of food supplements is not, which is why the quality of the latter is often questionable.
It matters what type of glucosamine you choose
First of all, one should always choose a high-quality glucosamine preparation, and the best way to be sure of that is to choose one that is classed as a medical drug. Also, it is important to realize that different glucosamine sources work differently. For instance, glucosamine hydrochloride (a commonly used form in supplements) has not demonstrated convincing results in scientific studies like glucosamine sulfate has. This difference alone has created a substantial amount of confusion in the whole discussion about glucosamine's effect.
Glucosamine sulfate gets a comeback in new report
According to a report issued by the financially independent European expert group ESCEO (European Society for Clinical and Economic Aspects of Osteoarthritis), supplementation with glucosamine sulfate should be first-line treatment for light to moderate osteoarthritis before resorting to anti-inflammatory medicine, which is associated with serious side effects and death. The researchers even found that glucosamine sulfate inhibits interleukin-1, which is known to cause inflammation and damage to joints.
Did you know that Glucosamine sulfate contributes to rebuilding of the joint cartilage at the same time as inhibiting painful inflammation?
Glucosamine sulfate does not only work on local osteoarthritis - here is why
Glucosamine sulfate relieves light to moderate osteoarthritis in joints that still have enough cartilage for remodeling. Many people who take glucosamine sulfate even observe that it works in tissues that are not directly affected by osteoarthritis. There are cases where headaches or back pain suddenly disappear. As described earlier, osteoarthritis symptoms may propagate to other parts of the body, so once the cartilage begins to rebuild itself in the affected joint(s) the inflammation disappears.
Glucosamine sulfate as a nutritional supplement - what to expect
Glucosamine sulfate is mainly extracted from shellfish. Most studies have used daily dosages of around 1,200-1,500 mg. The majority of study participants notice a pain-relieving effect or improved joint function within 2-6 weeks. In some cases, the effect is not observed before three months have passed. If glucosamine sulfate has a positive effect within three months, it makes sense to continue to maintain the cartilage improvement. If, however, no effect is registered within this period, supplementation should be discontinued, as it is not likely to work.
In Denmark (and possibly other European countries), glucosamine is classed as a medical drug that is approved for the treatment of light to moderate knee osteoarthritis. However, several studies have shown that glucosamine (as glucosamine sulfate) is able to relieve other types of osteoarthritis, as well. It therefore makes sense to give glucosamine sulfate a try with any kind of osteoarthritis. It is even possible to use glucosamine sulfate in smaller dosages to prevent osteoarthritis, for instance by older people who still have no noticeable symptoms or those with a family history of osteoarthritis or who have strained their joints all their life.
Be cautious - and stick with the drug version
There is a huge net-based market for glucosamine products. But it is important to be cautious and choose glucosamine preparations (as glucosamine sulfate) that are classed as medical drugs, simply to avoid some of the problems that have been seen with glucosamine products as nutritional supplements. After all, it is these inferior products that are the main reason why many studies have failed to show an effect.
Nelson AE et al.: A systematic review of recommendations and guidelines for the management of osteoarthritis: The Chronic Osteoarthritis Management Initiative of the U.S Bone and Joint initiative. PubMed 2014
Keld Østergaard. Glukosaminsulfat. Medi-Com 2003
Glucosamine Sulfate vs Glucosamine HCL
A review of glucosamine for knee osteoarthritis: why patented crystalline glucosamine sulfate should be differentiated from other glucosamines to maximize clinical outcomes - Current Medical Research and Opinion -
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