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Glucosamine sulphate occurs naturally in joint structures in the body and is an important compound in the manufacture of cartilage, which covers and protects the ends of bones. When cartilage degeneration leads to loss of mobility and accompanying pain, glucosamine sulphate supplements can help.

Cartilage degeneration is the main cause of osteoarthritis, the most common form of arthritis. According to the Arthritis Society of Canada (arthritis.ca), it afflicts nearly one in 10 Canadians, making it one of the most prevalent diseases.

The Effects of Aspirin and Ibuprofen

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Aspirin and ibuprofen remain the most common form of treatment for osteoarthritis. These drugs reduce pain and inflammation, thus offering some relief. However, high dosages are usually needed to achieve these results, increasing risk of side effects such as heart attack, tinnitus (ringing in the ears), and stomach upset.

Another side effect is the ability of NSAIDs to actually inhibit cartilage repair. It appears that while NSAIDs are effective in suppressing symptoms, they actually inhibit cartilage formation and thus accelerate the progression of the disease. In fact, clinical studies have associated NSAID use with acceleration of osteoarthritis and increased joint destruction. This, in part, may explain why individuals with osteoarthritis who are on medications usually worsen with time.

Why Glucosamine Works

A breakthrough came decades ago when European researchers noted that as some people age they seem to lose their ability to manufacture sufficient quantities of glucosamine. Researchers found that this loss gives rise to a decrease in the water-holding capacity of the joint (its level of synovial or lubricating fluid), which then leads to a decreased ability of the cartilage to act as a shock absorber.

Eventually researchers began administering glucosamine to patients with osteoarthritis and the results were so impressive that clinical studies soon followed.

Researchers found that glucosamine stimulates the manufacture of cartilage components and promotes the incorporation of sulphur into cartilage. In other words, glucosamine not only stimulates the manufacture of natural substances that are necessary for proper joint function but also plays an important role in stimulating joint repair.

Studies Prove the Point

Numerous double-blind studies have shown glucosamine sulphate produces results comparable to NSAIDs in relieving the pain and inflammation associated with osteoarthritis. Researchers have concluded that although glucosamine sulphate exhibits little anti-inflammatory effect and no direct pain-relieving effects, it does appear to address the underlying cause of osteoarthritis.

In a double-blind placebo study involving 212 patients with osteoarthritis of the knee, 106 patients were given 1,500 mg of glucosamine sulphate daily for three years; the other group was given a placebo for the same period. Joint space measurements of the knees were done before and after the three-year period. At the end of the study, the group taking glucosamine sulphate had less joint space narrowing than the placebo group. In the study published in 2001 in the medical journal Lancet, researchers concluded that glucosamine sulphate did, in fact, reduce the progression of the disease and thus should be considered as a disease-
modifying agent in osteoarthritis.

In another study that compared glucosamine sulphate with ibuprofen it was shown that although pain scores in the ibuprofen group decreased faster in the first two weeks, by the fourth week the group receiving 1,500 mg of glucosamine sulphate daily was doing significantly better than the ibuprofen group (see graph below).

This demonstrates that the beneficial results of glucosamine are more obvious the longer it is used. Treatment with glucosamine takes time because it is not a pain-relieving or anti-inflammatory drug. But once it begins to work repairing and building new cartilage, glucosamine will produce much better results than prescription and over-the-counter medications.

Common Concerns

Many people wonder whether it is best to take glucosamine in combination with chondroitin, but no strong scientific research proves that these supplements work better together.

Individuals who have allergies to shellfish often believe they cannot take glucosamine because it is derived from chitin, a substance found in the shells of shrimp, lobsters, and crabs. But the pure glucosamine sulphate distributed by regulated companies will not trigger allergic reactions.

Diabetics, however, should contact their health care provider before using glucosamine sulphate, as the supplement contains glucose.

Glucosamine Versus Ibuprofen

Dr. Gaetano Morello is a licensed naturopathic doctor practising at the West Vancouver Wellness Centre.

Source: alive #300, October 2007

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