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July 25, 2004
I have changed my opinion
I am quite skeptical when it comes to the claims made by supplement and ‘nutraceutical’ manufacturers. Sure we all need vitamins and minerals but I don’t think taking concentrated extract of some strange leaves will really improve our health. I find however that the vast majority, indeed almost all, ‘supplements’ are an effective method of separating patients from their money.
However a relative has asked my opinion on the use glucosamine tablets for osteoarthritis of the knee. I conducted a review of the pertinent literature and have found studies that show that glucosamine may prove valuable.
It is important to rely on studies conducted by independent researchers (those conducted by employees of, or funded by the supplement manufacturers may have skewed results). An encouraging study conducted by an office of the World Health Organization (a UN organization recognized for its research) shows that glucosamine can be effective in the management of osteoarthritis of the knee in postmenopausal women. An abstract is available on PubMed here.
Another double blind study from Denmark showed that glucosamine can be effective at cartilage protection in patients with osteoarthritis (OA) of the knee. That too is available at PubMed here.
A most illuminating article “Glucosamine and Osteoarthritis: Glucosamine products, said to slow or even halt the progression of osteoarthritis, are rising in popularity. But do they work?” from Am J Nurs. 2004 Feb;104(2):54-9; quiz 68-9. (The American Journal of Nursing: February 2004, page 54-59) Unfortunately I cannot link to this directly but if you are unable to access this locally a librarian will be quite happy to acquire it for you. It is noted in the article that glucosamine can control symptoms and may produce some reversal of the disease process.
If you can only read one of the articles I mentioned this would be the one.
It appears that the optimal daily dosage of glucosamine is 1500mg for patients under 200 pounds. Please do not begin taking glucosamine without talking to your health care provider. Diabetics, those allergic to shellfish, and nursing mothers should most assuredly contact their physicians before beginning glucosamine therapy as it is an amino sugar made from chitin that is produced from selfish (it can be made synthetically) and no studies have been done in pregnant women to assure glucosamine’s safety in pregnancy.
So I no longer lump glucosamine (and for that matter glucosamine- chondroitin preparations – although I don’t feel as strongly about chondroitin) in the don’t waste your money category. Controlled double blind studies conducted by reputable investigators has convinced me that glucosamine may be effective in treating osteoarthritis of the knee.
Posted by Matthew at July 25, 2004 11:34 AM