What is it?
There are different forms of glucosamine including glucosamine sulfate, glucosamine hydrochloride, and N-acetyl-glucosamine. These different chemicals have some similarities; however, they may not have the same effects when taken as a dietary supplement. Most of the scientific research done on glucosamine has been done on glucosamine sulfate. The information on this page pertains to glucosamine sulfate. For information on the other forms of glucosamine, see the specific pages for each of them.
Dietary supplements that contain glucosamine often contain additional ingredients. These additional ingredients are frequently chondroitin sulfate, MSM, or shark cartilage. Some people think these combinations work better than taking just glucosamine sulfate alone. So far, researchers have found no proof that combining the additional ingredients with glucosamine adds any benefit.
Some glucosamine sulfate products are not labeled accurately. In some cases, the amount of glucosamine actually in the product has varied from none to over 100% of the amount stated on the product's label. Some products have contained glucosamine hydrochloride when glucosamine sulfate was listed on the label.
Glucosamine sulfate is taken by mouth for osteoarthritis, glaucoma, weight loss, joint pain caused by drugs, a bladder condition called interstitial cystitis, jaw pain, joint pain including knee pain, back pain, multiple sclerosis, and HIV/AIDS.
Glucosamine is also in some skin creams used to control arthritis pain. These creams usually contain camphor and other ingredients in addition to glucosamine.
Glucosamine sulfate is used parenterally for osteoarthritis.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for GLUCOSAMINE SULFATE are as follows:
Likely effective for...
- Osteoarthritis. Most research on glucosamine sulfate has measured its effectiveness on osteoarthritis of the knee. However, there is some evidence that it might also help osteoarthritis of the hip or spine.
Some research suggests that glucosamine reduces pain of osteoarthritis in the knee about as well as the over-the-counter pain reliever acetaminophen (Tylenol). It also seems to reduce pain about as much as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Motrin, Advil) and piroxicam (Feldene). However, there is a difference between glucosamine sulfate and these drugs in the time it takes to reduce pain. The NSAIDs, such as Motrin, Advil, and Feldene, relieve symptoms and reduce pain usually within about 2 weeks, but glucosamine sulfate takes about 4-8 weeks.
Glucosamine sulfate does not seem to decrease pain in everyone who takes it. Some people get no benefit. Some research shows that glucosamine sulfate might not work very well for people with more severe, long-standing osteoarthritis, or for people who are older or heavier.
In addition to relieving pain and improving joint function, glucosamine sulfate might also slow the breakdown of joints in people with osteoarthritis who take it long-term. Some researchers hope that glucosamine sulfate might keep osteoarthritis from getting worse as quickly as it otherwise might. There is some evidence that people who take glucosamine sulfate might be less likely to need total knee replacement surgery.
Insufficient evidence to rate effectiveness for...
- Joint pain caused by drugs that lower estrogen levels. Early research suggests that taking a combination of glucosamine sulfate and chondroitin sulfate in two or three divided doses daily for 24 weeks reduces pain in women taking drugs that lower estrogen levels for early stage breast cancer.
- Painful bladder syndrome (Interstitial cystitis). Early research suggests that taking a specific product containing glucosamine sulfate, sodium hyaluronate, chondroitin sulfate, quercetin, and rutin (CystoProtek, Tischon Corporation, Westbury, NY) four times daily for 12 months reduces symptoms of painful bladder syndrome.
- Joint pain. Research shows that taking a specific product containing glucosamine sulfate, methylsufonlylmethane, white willow bark extract, ginger root concentrate, Indian frankincense extract, turmeric root extract, cayenne, and hyaluronic acid (Instaflex Joint Support, Direct Digital, Charlotte, NC) in three divided doses daily for 8 weeks reduces joint pain. But this product doesn't seem to help joint stiffness or function.
- Knee pain. Some research shows that taking a specific product containing glucosamine sulfate, methylsufonlylmethane, white willow bark extract, ginger root concentrate, Indian frankincense extract, turmeric root extract, cayenne, and hyaluronic acid (Instaflex Joint Support, Direct Digital, Charlotte, NC) in three divided doses daily for 8 weeks reduces joint pain in people with knee pain. But this product doesn't seem to help joint stiffness or function. Other early research shows that taking 1500 mg of glucosamine sulfate daily for 28 days does not reduce knee pain in athletes following a knee injury. However, it does seem to improve knee movement.
- Multiple sclerosis. Early research shows that taking 1000 mg of glucosamine sulfate by mouth daily for 6 months might reduce the relapse of multiple sclerosis.
- Jaw pain (Temporomandibular disorder). Some research shows that taking glucosamine sulfate works about as well as the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen (Motrin, Advil, etc.) for relieving jaw pain. In some people, pain relief appears to continue for up to 90 days after glucosamine sulfate is discontinued. However, research suggests that when 1200 mg of glucosamine sulfate is taken by mouth daily for 6 months, jaw pain and the ability to open the jaw are not improved.
- Weight loss.
- Other conditions.
How does it work?
Joints are cushioned by the fluid and cartilage that surround them. In some people with osteoarthritis, the cartilage breaks down and becomes thin. This results in more joint friction, pain, and stiffness. Researchers think that taking glucosamine supplements may either increase the cartilage and fluid surrounding joints or help prevent breakdown of these substances, or maybe both.
Some researchers think the "sulfate" part of glucosamine sulfate is also important. Sulfate is needed by the body to produce cartilage. This is one reason why researchers believe that glucosamine sulfate might work better than other forms of glucosamine such as glucosamine hydrochloride or N-acetyl glucosamine. These other forms do not contain sulfate.
Are there safety concerns?
Glucosamine sulfate is POSSIBLY SAFE when injected into the muscle as a shot twice weekly for up to 6 weeks or when applied to the skin in combination with chondroitin sulfate, shark cartilage, and camphor for up to 8 weeks.
Glucosamine sulfate can cause some mild side effects including nausea, heartburn, diarrhea, and constipation. Uncommon side effects are drowsiness, skin reactions, and headache. These are rare.
Special precautions & warnings:Pregnancy or breast-feeding: There is not enough reliable scientific information available to know if glucosamine sulfate is safe to take during pregnancy or while breast-feeding. Until more is known, do not take glucosamine sulfate while pregnant or breast-feeding.
Asthma: There is one report linking an asthma attack with taking glucosamine. It is not known for sure if glucosamine was the cause of the asthma attack. Until more is known, people with asthma should be cautious about taking products that contain glucosamine.
Diabetes: Some early research suggested that glucosamine sulfate might raise blood sugar in people with diabetes. However, more recent and more reliable research now shows that glucosamine sulfate does not seem to affect blood sugar control in people with type 2 diabetes. Glucosamine appears to be safe for most people with diabetes, but blood sugar should be monitored closely.
High cholesterol: Animal research suggests that glucosamine may increase cholesterol levels. In contrast, glucosamine does not seem to increase cholesterol levels in humans. However, some early research suggests that glucosamine might increase insulin levels. This might cause cholesterol levels to increase. To be cautious, if you take glucosamine sulfate and have high cholesterol. Monitor your cholesterol levels closely.
High blood pressure: Early research suggests that glucosamine sulfate can increase insulin levels. This might cause blood pressure to increase. However, more reliable research suggests that glucosamine sulfate does not increase blood pressure. To be cautious, if you take glucosamine sulfate and have high blood pressure, monitor your blood pressure closely.
Shellfish allergy: Because some glucosamine sulfate products are made from the shells of shrimp, lobsters or crabs, there is concern that glucosamine products might cause allergic reactions in people who are allergic to shellfish. However, allergic reactions in people with shellfish allergy are typically caused by the meat of shellfish, not the shell. There are no reports of allergic reactions to glucosamine in people who are allergic to shellfish. There is also some information that people with shellfish allergy can safely take glucosamine products.
Surgery: Glucosamine sulfate might affect blood sugar levels and might interfere with blood sugar control during and after surgery. Stop taking glucosamine sulfate at least 2 weeks before a scheduled surgery.
Are there interactions with medications?
- Warfarin (Coumadin)
- Warfarin (Coumadin) is used to slow blood clotting. There are several reports showing that taking glucosamine sulfate with or without chondroitin increases the effect of warfarin (Coumadin), making blood clotting even slower. This can cause bruising and bleeding that can be serious. Don't take glucosamine sulfate if you are taking warfarin (Coumadin). Many natural medicines can interact with warfarin (Coumadin).
- Medications for cancer (Antimitotic chemotherapy)
- Some medications for cancer work by decreasing how fast cancer cells can copy themselves. Some scientists think that glucosamine sulfate might increase how fast tumor cells can copy themselves. Taking glucosamine sulfate along with some medications for cancer might decrease the effectiveness of these medications for cancer. Any person who is receiving chemotherapy should talk with their health provider before taking glucosamine sulfate.
Some of these medications are etoposide (VP16, VePesid), teniposide (VM26), and doxorubicin (Adriamycin).
- Acetaminophen (Tylenol, others)
- There is some concern that taking glucosamine sulfate and acetaminophen (Tylenol, others) together might affect how well each works. However, more information is needed to know if this interaction is a big concern. For now, most experts say it is okay to use both together.
- Medications for diabetes (Antidiabetes drugs)
- There has been concern that glucosamine sulfate might increase blood sugar in people with diabetes. There was also the concern that glucosamine sulfate might decrease how well diabetes medications work. However, research now shows that glucosamine sulfate probably does not increase blood sugar in people with diabetes. Therefore, glucosamine sulfate probably does not interfere with diabetes medications. To be cautious, if you take glucosamine sulfate and have diabetes, monitor your blood sugar closely.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
Are there interactions with herbs and supplements?
- There are no known interactions with herbs and supplements.
Are there interactions with foods?
- There are no known interactions with foods.
What dose is used?
- For osteoarthritis: 1500 mg once daily or 500 mg three times daily, either alone or together with 400 mg of chondroitin sulfate two or three times daily, has been used for up to 3 years. Also glucosamine sulfate 750 mg twice daily in combination with turmeric root extract 500 mg twice daily has been used for 6 weeks.
- For osteoarthritis: A cream containing 30 mg/gram of glucosamine sulfate, 50 mg/gram of chondroitin sulfate, 140 mg/gram of chondroitin sulfate, 32 mg/gram of camphor, and 9 mg/gram of peppermint oil has been applied to the skin as needed for 8 weeks.
- For osteoarthritis: 400 mg of glucosamine sulfate has been injected twice weekly for 6 weeks.
Glucosamine Hydrochloride and N-Acetyl Glucosamine are different than Glucosamine Sulfate. For information on these different products, see the Glucosamine Hydrochloride and N-Acetyl Glucosamine listings.
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.
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