Glucosamine is a popular remedy for joint pain, including aches caused by osteoarthritis. In 2008, American consumers spent a whopping $872 million on glucosamine, which is readily available over the counter as a supplement. But does it work?
Glucosamine, a component of cartilage, is generally derived from shellfish and made into capsules. It is often combined with chondroitin, a component of bone and cartilage, typically taken from cows or pigs. Many researchers and patients believed glucosamine held promise both to relieve pain and to actually slow the loss of cartilage associated with arthritis.
But despite patients' faith in the supplement, recent scientific research don't seem to bear out its benefits.
A study in the July 7 Journal of the American Medical Association looked at the effect of glucosamine on lower back pain from osteoarthritis and found that it worked no better than a placebo. The study took place over a one-year period and included 250 patients.
A major study, the Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT), that received a lot of attention was reported in the New England Journal of Medicine in 2006. Researchers assigned 1,583 patients, mean age of 59, who had osteoarthritis of the knee to one of five groups and looked at their levels of pain over a 24-week period. Participants were given either glucosamine, chondroitin, a combination of the two, celecoxib (Celebrex, an anti-inflammatory medication) or a placebo. The study concluded that glucosamine and chondroitin sulfate, either alone or in combination, did not effectively reduce pain for the patients overall. Celecoxib did help some people.
Not so fast, said the nonprofit Arthritis Foundation, a consumer advocacy organization. The glucosamine-chondroitin combo actually did reduce pain in those with moderate-to- severe knee arthritis, as the researchers also concluded. Because the study had an imbalance of people with mild pain – there were 20 times more people in the study with mild pain than with moderate-to-severe pain – their experience dominated the results, the Foundation noted. So perhaps it is more helpful for those with worse arthritis.
As for glucosamine's hope-for benefit of reducing deterioration of cartilage, that too has been a disappointment. A follow-up study of GAIT participants with moderate-to-severe osteoarthritis found that glucosamine and chondroitin did no better than a placebo in slowing cartilage loss. And another study of the group that ran for two years found that none of the treatments, including celecoxib, were any better than a placebo.
Still, several other previous studies had promising results, with glucosamine relieving pain better than a placebo, and equal or better than ibuprofen.
The bottom line on glucosamine from Consumer Reports:
These arthritis supplements aren't standing up well to recent scientific scrutiny...However, researchers say that the supplements might help certain patients, and other studies are ongoing. If you decide to try the pills, keep a daily record of your symptoms and stop taking the supplements after three months if you see no improvement.
If not always effective, research has found glucosamine to be generally safe with mild side effects. So if you suffer from arthritis it might not hurt to give it a try.