Patients often ask me if I think taking glucosamine sulphate or chondroitin sulphate will help any joint deterioration or osteoarthritis. I always give the advice of the arthritis research campaign that it is perfectly reasonable to try 1500mg of glocosamine and 1200mg of chondroitin per day for 3 months and try to assess an improvement.
Glucosamine is a naturally occurring amino-monosaccharide found in high concentrations as a normal constituent in joints, in both the cartilage matrix, the smooth coating at the end of bone and synovial fluid, a nutrient rich liquid bathing and lubricating the joint.
Most supplements are manufactured synthetically or are derived from shellfish shells. It can commonly be found in two forms: glucosamine sulphate and glucosamine hydrochloride. Current evidence only supports glucosamine sulphate as being effective. Chondroitin(sometimes combined with glucosamine in supplements), is a large gel forming molecule. It forms part of cartilage and its properties include resisting compression.
Osteoarthritis(OA) is a degenerative condition where the cartilage on the end of bones within a joint begins to break down and grow in a disorganised fashion, exposing the bone below, which in turn may also start to grow in a disorganised way. It can be a painful condition affecting 10-20% of the population over the age of 65. Knee joints are the most commonly affected, then the hip.
How exactly glucosamine is meant to work is unknown, there are several hypotheses, from it preventing the inflammatory cascade, affecting the formation of hyaluronic acid in connective tissue, to the sulphate having a therapeutic affect. There is a belief that part of the disease process of O.A. could be due to a sulphate deficiency and human cartilage is particularly sensitive to this. There is some evidence that it has an anabolic and anticatabolic effect, meaning that it supports the building up of tissue and resists the break down of it.
Current evidence suggests that glucosamine may benefit people with joint degeneration, but only if taken in the sulphate form. More research is needed but it’s definitely worth conducting your own experiment to see if it works for you.