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+2 (Moderate Evidence)
- Glucosamine slows the progression of knee osteoarthritis when using the preparation manufactured by Rotta pharmaceuticals, according to two long term studies. A third study using a different formulation of glucosamine did not show any improvement.
- The placebo effect in osteoarthritis studies is actually very good. This means that even if you take a pill with no active ingredients, your brain and your body will work together to decrease your perceived level of pain if you believe the pill will help you. Glucosamine does do better than placebo.
- Nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen, naproxen, and others that are commonly used to treat osteoarthritis have the potential to cause serious side effects (such as ulcers, kidney failure, liver toxicity, and even heart attack and stroke). In studies comparing glucosamine with NSAIDs, glucosamine performed just as well, if not better, with far fewer side effects.
- The side effects are identical to those of placebo.
- Glucosamine is found naturally in the body and may be used by the body as a building block of cartilage.
- It is unclear why the Rotta preparation had better results than the other formulation. Some trials using other preparations have been positive while others have not. Future studies are needed.
- We really do not know why glucosamine works. Some say it is a building block for cartilage or that it stimulates the cartilage cells. This is likely not the mechanism, for blood levels of glucosamine are very low after taking it.
- Arthritis pain can take up to eight weeks to improve, and maximal improvement can take up to 12 weeks. This is a long time for someone in pain to have to wait to find out if a supplement will be of benefit.
- The best evidence we have for using glucosamine is in the treatment of knee osteoarthritis. It is not clear whether it will help other joints, such as the hip.
* *ADVISORY* *
Glucosamine may increase blood sugar levels in people with pre-diabetes or diabetes. If this is a concern, please discuss its use with your medical provider.
DOSAGE:1500 mg per day in one dose, or 750 mg twice daily.
CONCLUSION:We conclude that glucosamine is a safe and effective product for the treatment of knee osteoarthritis. If you use it, remember to include it in your list of medications when you visit your doctor and other health care providers.
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