Alternative

Glucosamine

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Glucosamine, Glucosamine Sulfate

  • 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
  • Source
  1. Marine exoskeleton or
  2. Synthetically derived
  • Efficacy
  1. Appears more effective than Placebo at relieving pain
  2. Effect requires at least one month of therapy
  3. Less Knee Joint space narrowing with Glucosamine over Placebo in 3 years
    1. Reginster (2001) Lancet 357:251-6 [PubMed]
  • Dosing
  1. Glucosamine 500 mg orally three times daily
  • 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]
  • Drug Interactions
  1. Warfarin (Coumadin)
    1. Warfarin's Anticoagulation effect is increased