|
|
| General
Information |
Common Name: |
Glucosamine |
|
Scientific
Name:
|
2_Amino-2
deoxyglucose |
| Other
Names: |
 |
Chitosamine.
|
|
Glucosamine
sulphate.
|
|
| What
is it? |
|
An
Aminoglycoside or Aminosugar. Glucosamine is not an herbal extract.
Glucosamine is prepared synthetically or extracted from shellfish.
It
is found in cell membranes, mucopolysaccharides, and chitin, the
horny substance in the exoskeleton of crabs, beetles, and various
marine invertebrates and microorganisms.
It
is included in this section because of its efficacy as an alternative
treatment of osteoarthritis .
|
| Arthritis
Plan |
(Ref:
The Arthritis cure plan by Dr. Theodosakis).
|
Number
|
Action
|
Comment
|
| 1. |
Consultations with
a physician |
The author encourages
a proper diagnosis be made. |
| 2. |
Glucosamine and
chondroitin sulphate |
Doses outlined -
adjusted versus symptoms and divide 2-4 time/day. |
| 3. |
Vitamin C 500 -
4000mg and Manganese 50mg. |
Antioxidants |
| 4. |
Improve biomechanics
|
Physiotherapists/Sports
medicine/Neuromuscular therapists. |
| 5. |
Exercise |
PhyPhysiotherapists/Sports
medicine/ Neuromuscular therapists |
| 6. |
Healthy diet |
Encouraged strongly |
| 7. |
Fight Depression |
Very important |
| 8. |
Use traditional
medications |
Surgery is a final
option only. |
| 9. |
Maintain a positive
attitude |
Don't obsess about
the condition |
|
| Indications
& Historical Uses |
|
Relief
of osteoarthritis. Other recommended uses are for tendonitis and,
bursitis. Glucosamine is sold as a dietary supplement to decrease
pain and improve mobility in people suffering from osteoarthritis
,a progressive disease of cartilage degeneration. It is also billed
as a chemical to support healthy joint and connective tissue.
It has been suggested ,by some sources , that it may even prevent
or postpone the development of osteoarthritis in certain groups
,such as the elderly and the athletes.
|
| Contraindications
& Precautions |
|
Contraindications:
None known. See
Caution.
Precautions:
Patients allergic to sulphates should take glucosamine Hydrochloride
(not sulphate). Also these patients must not take Chondroitin
Sulfate. Since Glucosamine is extracated from shellfish, persons
who are allergic to shellfish should exercise caution, though
there have been no reported cases of these allergies to glucosamine.
See
Caution.
Adverse
Side Effects:
Rare cases of nausea, vomiting, diarrhea have been reported.
Drug
Interactions:
No known drug interactions.
It
is safe to take glucosamine with blood pressure medications, non-steroidal
anti inflammatory drugs, and for diabetics on hypoglycaemic agents.
( but close monitoring of blood sugar levels is recommended ).
|
| Dosage
Information |
|
How
Supplied:
|
500mg
capsules. |
|
Dosage:
|
Daily
Doses of Glucosamine and Chondroitin sulphate:
| Weight |
Glucosamine
Sulphate |
Chondroitin
sulphate |
| <120
pounds |
1000mg |
800mg |
| 120-200
pounds |
1500mg |
1200mg |
| >200
pounds |
2000mg |
1600mg |
If no effect
within 12 weeks of treatment, discontinue treatment.
|
| Pharmacology
|
|
Glucosamine
,an amino sugar, is the building block for certain glyosaminoglycans.
In vitro, it has been shown to stimulate proteoglycan synthesis
by human chondrocytes. It also has some innate anti-inflammatory
properties ,independent of prostaglandin synthesis. There are
some studies ,mainly in the European literature, suggesting that
1500mg daily of glucosamine sulphate is equivalent to1200mg of
ibuprofen in the control of osteoarthritis symptoms.
Glucosamine
is also involved in the formation of nails, tendons, skin, eyes,
bones, ligaments and other connective tissues in the body .
Osteoarthritis
involves a progressive degeneration of cartilage glycoaminoglycans
[GAGs], components of cartilage that enable joints to move smoothly.
The theory behind taking glucosamine supplements ,which are critical
to the synthesis of GAGs, is that by flooding the system with
them the production of these GAGs will be stimulated. Theoretically,
the end result would be cartilage regeneration and joint repair.
Many studies have shown that glucosamine is absorbed rapidly from
the intestines, and transported to the connective tissues. It
helps in the restoration of damaged joint tissue in osteoarthritis,
especially in conjunction with Chondroitin Sulfate or devil's
claw.
Chondroitin
sulphate is a glycosaminoglycan and is a main constituent of proteoglycans.
Like glucosamine, it has been shown to stimulate proteoglycan
synthesis by human chondrocytes. Chondroitin sulphate also has
some innate anti-inflammatory properties, independent of prostaglandin
synthesis. Both compounds are natural and may be beneficial in
the treatment of osteoarthritis .
|
|
Active
Ingredients:
|
Glucosamine
is a combination of glucose and glutamine
|
| Origin
& Processing |
|
Glucosamine
is extracted from shellfish, and purified & standardized to form
Glucosamine Sulfate. Glucosamine is also prepared synthetically.
|
| Scientific
References |
|
Bassleer C, Malaise M, University of L B (1997): Chondroitin
Sulfate: its in-vitro Effects on Human Articular Chondrocytes
Cultivated in Clusters. 3rd, International Congress of the
Osteoarthritis Research Society Osteoarthritis in Focus:
5, Suppl A,:69.
|
|
Bassleer C, Henrotin Y, Franchiment P. (1992): in-vitro
Evaluation of Drugs Proposed as Chondroprotective Agents.
Int J Tissue React, 14:231-241.
|
|
Bourgeois P I. Chales G, Dehais J, Delcambre B, Dreyfus
P, Kuntz J, Rosenberg S (1997): Efficacy and Tolerability
of Chondrotin Sulfate 1200mg/dfe Vs. Chondrotin Sulfate
3 x 400 mg/d Vs. Placebo. 3rd, International Congress of
the Osteoarthritis Research Society Osteoarthritis in Focus:
5, Suppl A,:69.
|
|
Bucci L, Podr G et al (1997): Efficacy and Tolerability
of 2 x 400 Mg Oral Chondroitin Sulfate as a Single dose
in the Treatment of Knee Osteoarthritis. 3rd, International
Congress of the Osteoarthritis Research Society Osteoarthritis
in focus: 5, Suppl A:69.
|
|
Camus J P (1972): verification de action de l'acid Chondroitin
suifurique cnez des malades arthrosiques. Laboratories Gremy-Longuet.
Paris.
|
|
Crivelli E, Voy E D (1987): Etude de pnase IV sur action
des soses orales del sulfate articulations. Der informaierte
Artz Gazette Medicinale, 3.
|
|
Crolle G, D'Este E (1980): Glucosamine sulphate for the
management of arthrosis. Current Medical Research and Opinion
Vol.7, No.2.
|
|
D'Angnolo B (1986): Valutazione degli effetti coilaterali
e della efficacia nel sintmo del dolore (in pazienti artosici)
del galattosamino glucuronogllcano solfato. Clin. Eur. Fasc.,
XXV (March-April). 275-280.
|
|
Droranti A, Bignamini A A, Rorati A I, Italy (1980): Therapeutic
Activity of Oral Glucosamine in Osteoarthrosis: a placebo-controlled
double-blind investigation Clinical therapeutics, vol. 3,
no. 4.
|
|
D'Ambrosio, Casa B, Bompani R, Scali G (1981): Glucosamine
Sulphate: a Controlled Clinical Investigation in arthrosis.
Pharmatheutica, 2 (8):504.
|
|
Fioravanti A., Franci A., Anselmi F., Fattorini L., Marcolongo
R. (1991) Clinical Efficacy and tolerance of Galactosoaminoglucuronoglycan
Sulfate in the Treatment of Osteoarthritis. Drugs Exptl.
Clin. Res. XVII (1) 41-44.
|
|
Garzya G. (1986): Orale Chondroitin sulfatmedikation zur
Benandung von Arthrosen: Therapiewoche, 33, 4238.
|
|
Hardingham T (1997): Chondroitin Sulphate and Joint Disease.
3rd, International Congress of the Osteoarthritis Research
Society Osteoarthritis in Focus: 5, Wuppl A,:69.
|
|
Helli MP, Vignon E, annefeld M, Richard M (1996): The Effects
of Glucosamine on the Human Osteoarthritic Chondrocytes.
The 9th Eular Symposium, Madrid, 7-10.
|
|
Jenoure P. et al (1986): Lesions degeneratives du gerou.
Der informierte Artz/Gazette Medicinale, 7.
|
|
Jimenez SA, Dodge G R, Thomas J (1996): the Effects of Glucosamine
On Human Chondrocyte Gene Expression. The 9th Eular symposium,
Madrid, 7-10 October, pp 8-10.
|
|
Karzel K. domenjoz R (1971): Effect of Hexosamine Derivatives
and Uronic Acid Derivatives on Glycosaminoglycan Metabolism
of fibroblast Cultures. Pharmacol, 5:337-345.
|
|
Kim JJ, Conrad H E (1974): Effect of D-glucosamine Concentration
on the Kinetics of Mucopolysaccharides Biosynthesis in Cultured
Chick Embryo Vertebral Cartilage. J Biol Chem, 249: 3091-3097.
|
|
Maier R, Wilhelmi G (1982): Neue experimentelle Ergebnisse
uber korperdestruktion und Protektion. Der Kassernartz,
22. 16.
|
|
McCarty MF (1994): the Neglect of Glucosamine as a Treatment
for Osteoarthritis - a Personal Perspective. Medical Hypotheses,
42:323-327.
|
|
Muller-fabender Hans, Gerhard L, Bach, Wolfgang Haase, Rovati
L C (1994): Glucosamine sulfate Compared to Ibuprofen in
Osteoarthritis of the Knee. Osteoarthritis and Cartilage
2, 61-69.
|
|
Nerucci F, Fioravanti A, Bisogno S, Spinelli G, Marcolongo
R, (1997): evaluation of the Chondroitin Sulfate Effects
on Chondrocytes' cultures Placed in a Pressurization System.
3rd, International Congress of the Osteoarthritis Research
society Osteoarthritis in Focus: 5, Suppl A, :69, May.
|
|
Noack W, Fischer M, Forster K K, Rovati, L C , Setnikar
I (1994): Glucosamine Sulfate in Osteoarthritis of the Knee.
Osteoarthritis Cartilage (United Kingdom), 2/1 (51-59).
|
|
Oliviero U, sorrentino GP, De Paola P, Tranfaglia E, D'alessandro
A, Carifi S, Porfido FA, Cerio R, Grasso A M, Policicchio
D, Di Grezia F, Sorrentino P, Lingetti M (1991): Effects
of the Treatment with Matrix on Elderly People with Chronic
Articular Degeneration Drugs Exptl-Clin. Res. XVII (1) 45-51.
|
|
Paroli E, Antonilli L and Biffoni M (1991): a Pharmacological
Approach to Glycosaminoglycans. Drugs under Experimental
and Clinical Research, XVII (1):9-20.
|
|
Rietro M, Manopulo R, Galati M, Boccanera L, Saponati G
and Bocchi L (1996): Comparison of the Antiinflammatory
Efficacy of Chondroitin Sulfate and Diclofenac Sodium in
Patients with Knee Osteoarthxifis. J Rheumaro I, 23: 1385-91.
|
|
Pujalte J M, Llavore E P, and Ylescupidez F R, (1980): double-blind
Clinical Evaluation of Oral Glucosamine Sulphate in the
Basic Treatment of Osteoarthrosis Current Medical Research
and Opinion Vol.7, No.2.
|
|
Raiss R (1985): Effect of D-glucosamine on Experimentally
Injured Articular Cartilage. Comparative Morphometry of
the Ultra Structure of Chondrocytes. Fortschritte Der Medizin.
103 (24) 658.
|
|
Reichelt A, Fbrsterc KK, Fischer M B, Rovatie L C, and Setnikar
I (1994): Efficacy and Safety of Intramuscular Glucosamine
Sulfate in Oseoarthritis of the Knee. Arzneim. Forsch./Drug
Res. 44 (1), Nr. 1.
|
|
Roden, L (1956): Effect of Hexosamines on the Synthesis
of Chondroitin sulphuric Acid in-vitro. Ark. Kemi., 10,
345.
|
|
Ronca G (1997): Anti-inflammatory Activity of chondroitin
sulfate. 3rd, International Congress of the International
Congress of the Osteoarthritis Research Society Osteoarthritis
in Focus: 5, Suppl A, :69.
|
|
Rovetta G (1991): Galactosaminoglycuronoglycan Sulfate (Matrix)
in Therapy of Tibiofibular Osteoarthritis of The Knee. Drugs
Exptl. Clin. Res. XVII (1) 53-57.
|
|
Serni U (1993): Profile of Glucosamine as a Example of Slow
Acting Drug in Osteoarthritis. In: Proceedings of the Xviii
th Congress of Rheumatology. Rev Esp Reumatol, 20(suppl):222.
|
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Setnikar I, Cerada R, Pacinic M A, et al. (1991 b): Antireactive
Properties of Glucosamine sulfate. Arzneimittel-forshung,
41 (1), Nr. 2, 157-161.
|
|
Tapadinhas M J (1982): Oral glucosamine sulphate in the
management of arthrosis: report on a multi-centre open investigation
in Portugal. Pharmatherapeutica, 3, 157.
|
|
Uebelhart D, Zhang J, Thonar E, Williams J (1997): Acute
Degradation of Articular Cartilage in the Rabbit: Protective
Effect of Chondroitin 4 & 6 sulfate. 3rd, International
Congress of the Osteoarthritis Research Society Osteoarthritis
Focus: 5, Suppl A, :69.
|
|
Vidal Y., Plana R R, Bizzarri D, Rovatie A I, (1978): Articular
Cartilage Pharmacology, I. In-vitro Studies on Glucosamine
and Nonsteroidal Anti-inflammatory Drugs. Pharmacol. Res.
Comm., 10, 557.
|
|
Vajaradul Y (1981): Double-Blind Clincal Evaluation of Intra-Articular
Glucosamine in Outpatients with Gonarthrosis. Clinical Therapeutics/vol.
3, No. 5.
|
|
Vaz A L (1982): Double-Blind Clinical Evaluation of the
Relative Efficacy of Ibuprofen and Glucosamine Sulphate
in the Management of Osteoarthrosis of the Knee in Out-patients.
Current Medical Research and Opinion: Vol. 8, 145.
|
|
Weyers W, Iseli D (1987): Pharmakologische Untersuchungen
zur antiphalogistisch Wirksamkeit Von Chondroitinsulfat.
II Mittelung. Therapiewoche Schweiz, 3, 864.
|
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EVIDENCE OF BIOAVAILABILITY.
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Setnikar I, Giachetti C, Zanolo G. (1986): Pharmacokinetics
of Glucosamine in the Dog and in Man. Drug Research, 36
(1):729-735.
|
|
Setnikar I, Giachetti C and Zanolo G. (1984): Absorption,
Distribution and Excretion of Radioactivity after a Single
Intravenous or Oral Parmatherapeutica, 3, (8)538.
|
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Setnikar I, R. Palumbo, S. Canali, and G. Zanolo, (1993):
Pharmacokinetics of Glucosamine in Man. Arzneim-Forsch /
Drug Res. 43(II), Nr 10.
|
|
Conte A (1995), Volpi N, Palmiera L, et Al. Biochemical
and Pharmacokinetic Aspects of Oral Treatment with Chondroitin
Sulfate. Arzneimittel-forshung, 45: 918-925.
|
|
Palmieri L. Conte A. Giovannini L. Lualdi P. Ronca G. (1990):
Metabolic Fate of Exogenous Chondroitin Sulfate in the Experimental
Animal. Arzneimittel-forschung. 40(3):319-23.
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CURRENT CLINICAL TRIAL ON GLUCOSAMINE AND CHONDROITIN.
|
|
HUMAN CLINICAL TRIAL #1.
|
|
Principal investigator: Amal K. Das, Jr., M.D.(an orthopedic
surgeon).
|
|
Institiution: Henderson Orthopedic Research Associates,
North Carolina. Study design: Almost 100 patients with chronic
pain and osteoarthritis (confirmed by X-Ray) in a double-blinded,
placebo-controlled, six-month clinical trial using Cosamin
DS (combination of 1,500 milligrams glucosamine and 1,200
milligrams of chondroitin daily).
|
|
Results: Knee osteoarthritis symptoms were measured by summary
disease scores and patient assessment of treatment effect,
recorded at clinic visits and in a dairy. The summary disease
score incorporated pain, stiffness and function using validated
questionnaires. Adverse events: Recorded, if any, in a daily
dairy specifying severity and no adverse reactions were
note. More details to follow up0on the publication of this
study.
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HUMAN CLINICAL TRIAL #2.
|
|
Prinicpal investigators: Dr. Alan Philippi, LCDR, MC, USNR
and Dr. Christopher Leffler, MD.
|
|
Institution: Medical Department Naval Special Warfare (SEAL).
Group Two, Naval Amphibious Base, Little Creek. Study design:
16-week, randomized, double-blinded,placebo-controlled crossover
design in 34 Navy SEALs, and divers by the Portsmouth Naval
Medical Center in Virginia.
|
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Results: Significant relief of knee pain but no improvement
in function after eight weeks on the supplements. More details
to follow upon the publication of this study.
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HUMAN CLINICAL TRIAL #3.
|
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Principal investigators: Dr. Joseph B. Houpt (Toronto, Canada).
|
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Study design: Double-blinded, placebo-controlled using glucosamine
in patients with oseoarthritis.
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Results: Still pending.
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HUMAN CLINICAL TRIAL #4.
|
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Principal investigators: Jason Theodosakis, M.D.,James Weaver,
D.D.S.
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Study design: Double-blinded, placebo-controlled using glucosamine
and chondroitin for prevention and treatment of osteoarthritis
in the TMJ.
|
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Results: Study is still in design and approval phase.
|
Several
new university-based, large animal studies, along with basic science
research continues to point to the disease-modifying benefits
of the two supplements on joint cartilage. For example, Dr. Louis
Lippiello, Ph.D., the Director of Basic Science at the Harrington
Arthritis Research Center in Phoenix, has found that glucosamine
and chondroitin work synergistically in promoting cartilage cell
activity
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To Index |
|