II. Pathophysiology

  1. Glucosamine is endogenous amino sugar, a precursor of glycosaminoglycans
  2. Glycosaminoglycans are present in joint structures such as Synovial Fluid
  3. Effects
    1. Stimulates chondrocyte metabolism
    2. May have anti-inflammatory effects at higher dose

III. Source

  1. Marine exoskeleton or
  2. Synthetically derived

IV. Efficacy

  1. Appears more effective than Placebo at relieving Osteoarthritis-related Joint Pain
    1. Effect requires at least one month of therapy
  2. Less Knee Joint space narrowing with Glucosamine over Placebo in 3 years
    1. Reginster (2001) Lancet 357:251-6 [PubMed]

V. Dosing

  1. Glucosamine 500 mg orally three times daily

VI. Adverse Effects

  1. Gastrointestinal upset
  2. Hemoglobin A1C and Serum Glucose are NOT impacted (contrary to initial reports)
    1. Scroggie (2003) Arch Intern Med 163:1587-90
  3. Glucosamine is safe in shellfish allergy (despite marine exoskeleton source)
    1. Gray (2004) J Allergy Clin Immunol 114:459-60 [PubMed]

VII. Drug Interactions

  1. Warfarin (Coumadin)
    1. Warfarin's Anticoagulation effect is increased

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