Glucosamine Sulfate Study Looked at Supplement Plus Therapy vs. Therapy Alone
However, there may be some good news in the future: A study published in August 2019 in the journal Aging Clinical and Experimental Research showed that taking the dietary supplement glucosamine sulfate in addition to conventional therapy — acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), or COX-2 inhibitors, coupled with physical exercises — may reduce pain and restore function better than conventional therapy alone. Over the course of six months, the researchers looked at 108 patients with knee and hand OA. Fifty-five patients were treated with 1,500 milligrams of crystalline glucosamine sulfate once a day in addition to conventional therapy for HOA. The control group of 53 patients received conventional therapy alone.
Results Showed Glucosamine Sulfate to Improve Pain and Function
The research team didn’t expect to see any changes until the six-month mark but were surprised to see results after just three months, reporting 18 percent difference in reduction of pain between the study and control group. The only side effects reported by the glucosamine sulfate group were some cases of mild and transient gastrointestinal upset.
Levels of Hand Disability Decreased With Combination Treatment
Study participants had to be at 40 points or higher on the visual analogue scale (VAS) for pain. (Patients rate their pain levels from 0 to 100, with 0 being no pain and 100 being the most severe pain). After treatment with glucosamine and standard therapy, study participants’ average pain levels went down 25 points. Hand function also improved based on functional score testing, indicating less hand disability in the treatment patients.
Good News: Study Not Funded by Industry
John Erickson, MD, orthopedic surgeon at Raleigh Hand to Shoulder Center in North Carolina, points out that this particular study was not funded by any supplement maker, “which is nice because a lot of the studies on supplements are industry-funded and are to subject to bias. This study needs to be followed up with a randomized controlled trial to prove that it works, but this is a promising start. Based on this, it’s reasonable to have patients try it for two to three months.”
Previous Studies on Glucosamine With Chondroitin Show Promise for Knees
Based on research published in May 2015 in Annals of the Rheumatic Diseases and a study published in April 2016 in Aging Clinical and Experimental Research, using glucosamine sulfate and chondroitin together have shown promise for knee osteoarthritis. Dr. Erickson coauthored an article in the Journal of Hand Surgery about the evidence for chondroitin and glucosamine together as a therapy, and found that the combination did offer some improvement on pain in hips and knees due to OA.
Talk to Your Doctor about Possible Interactions With Your Other Medication
According to the Mayo Clinic, glucosamine might reduce the efficacy of acetaminophen or increase the blood-thinning effects of warfarin.
What to Know About Glucosamine Supplements: They Aren’t All the Same
Naturally found in joint fluid, the glucosamine in oral supplements is laboratory made or comes from glucosamine found in shellfish. The study used a specific type of glucosamine — a prescription form of glucosamine sulfate salt, which underwent stabilization processing, unlike the over-the-counter forms. This means other types and forms of the supplement may not work the same. “The glucosamine sulfate salt studied here used the same dose as studied in previous research, which showed a reduction in factors that were activated in an inflammatory pathway. Other forms of unstable concentrations may or may not affect this pathway,” says Angie Botto-van Bemden, PhD, Director of OA Programs for the Arthritis Foundation, who is based in Atlanta.
European Supplements Different Than American Supplements
This study was done in Italy. Be aware the European supplements are different than American ones in that European products are regulated by their local government for purity and potency. In the United States, the U.S. Food and Drug Administration (FDA) does not review vitamins or supplements. “When you buy a bottle of supplements in America, you cannot be 100 percent sure of what you are buying. Also, we don’t prescribe supplements here but with a prescription in Europe, you know you are getting a good product,” cautions Erickson. Check ConsumerLab.com, which tests and rates various vitamin and supplement brands.
More Study Needed but a Positive Beginning
“I think this is an interesting study, which will hopefully lead to a new interventional option for patients who haven’t had satisfactory results from conventional therapy alone. We know placebo effect is high with glucosamine, yet we can account for this with novel questionnaires to address individual patient beliefs. I will be interested to see additional longer-term studies showing sustained benefit and safety while accounting for the placebo effect. This study shows it is safe, effective, and may be a good option for patients in addition to therapy. Or maybe we can eventually try glucosamine sulfate prior to NSAIDs or acetaminophen, which have reported side effects,” says Dr. Botto-van Bemden.
