Glucosamine and chondroitin are administered for the treatment of osteoarthritis. Osteoarthritis primarily affects the knee, hip, and wrist joints (Burchum et al., 2021,p.1336).
Glucosamine is used by the body to make cartilage and synovial fluid. Chondroitin promotes cartilage hydration. Glucosamine may help people with osteoarthritis in a number of ways (Burchum et al., 2022, p.1013) .
First, it can be used as a substrate for the production of cartilage and synovial fluid. Second, it can stimulate chondrocytes, the cartilage and synovial fluid-producing cells in joints (Burchum et al., 2022, p.1013).
Action (continued)
Finally, it inhibits the production of cytokines that are involved in joint inflammation and cartilage breakdown (Burchum et al., 2022, p.1013).
Chondroitin aids in the preservation of cartilage.
Effectiveness
Bruyere et al., 2016, reported that glucosamine and chondroitin have only moderate effects on pain and that chronic administration can have disease-modifying effects, delaying structural changes in the joints.
Research on the efficacy of glucosamine and chondroitin in osteoarthritis has produced conflicting results. The majority of studies show no improvement in pain relief; however, some studies show a modest improvement in joint structure(Burchum et al., 2022, p.1013).
Effectiveness (Continued)
The American College of Rheumatology updated its recommendations for osteoarthritis management in 2019. The expert panel advised providers not to use glucosamine, chondroitin and combination products for management of osteoarthritis of the knee, hip, and/or hand after reviewing the evidence (Burchum et al., 2022, p.1013).
However, the American College of Rheumatology conditionally recommended chondroitin for osteoarthritis for patients with osteoarthritis of the hand based on a single trial of chondroitin use for patients with hand arthritis in which pain relief was demonstrated and harm was not (Burchum et al., 2022, p.1013).
Side Effects
The most common side effects are gastrointestinal disturbances such as nausea, heartburn, diarrhea, and constipation. Other side effects include; hyperglycemia, headache, drowsiness, skin reactions. It does not have any severe adverse effects (Burchum et al., 2022,p.1013).
Also, most commercial glucosamine is produced from exoskeletons of shellfish (shrimp), glucosamine should be used with caution in patients with shellfish allergy (Burchum et al., 2022, p.1013).
Interactions
Glucosamine can interact with antiplatelet or anticoagulant( such as aspirin, warfarin, heparin) and thus can increase the risk for bleeding (Burchum et al., 2022, p.1013).
This supplement can antagonize the effect of antidiabetics (Burchum et al., 2021, p.1013).
Taking glucosamine with acetaminophen together might reduce the effectiveness of both the supplement and the medication.
References
Burchum, J. R., & Rosenthal, L. D. (2022). Lehne's Pharmacology for Nursing Care (10th ed.). Elsevier.
Bruyère, O., Altman, R. D., & Reginster, J.-Y. (2015). Efficacy and safety of glucosamine sulfate in the management of osteoarthritis: Evidence from real-life setting trials and Surveys. Seminars in Arthritis and Rheumatism. https://www.sciencedirect.com/science/article/pii/S0049017215002899
Mayo Foundation for Medical Education and Research. (2020). Glucosamine. Mayo Clinic. Retrieved July 5, 2022, from https://www.mayoclinic.org/drugs-supplements-glucosamine/art-20362874
