What Are the Pros and Cons of Glucosamine for Joint Pain?

Glucosamine (2-amino-2-deoxy-D-glucose, GlcN) is an important aminohexose, formed by the substitution of one hydroxyl group of glucose by an amino group, and is easily soluble in water and hydrophilic solvents. Molecular formula C ₆ H ₁₃ O ₅ N, commonly known as amino sugar, referred to as amino sugar. Also known as glucosamine, widely present in nature, the chemical name is 2-amino-2-deoxy-D-glucose, usually as N-acetyl derivatives (such as chitin) or as N-sulfate and N-acetyl- 3-O-lactic acid ether (muramic acid) is present in microbial, animal-derived polysaccharides and conjugated polysaccharides. ^[1]

Glucosamine is essential for the biosynthesis of glucosaminoglycan (GAG). GAG is an important substance used in animal bodies to combine with water to form a buffer, lubricate and protect hyaline cartilage. Normally, glucose produces glucosamine in the body through the aminohexose biosynthetic pathway. Under normal physiological conditions, the level of glucosamine in extracellular fluid is lower than clinically detected. If glucosamine is supplemented in the diet, glucosamine is quickly transported to the cell through the glucose transport pathway, and glucose hexaphosphate is formed through phosphorylation, thereby entering the aminohexose biosynthesis pathway. ^[2]

When comparing the number of reported adverse drug reactions in patients in clinical studies, glucosamine is similar to placebo and is safe. The digestive system rarely has mild and transient gastrointestinal symptoms such as nausea, constipation, bloating, and diarrhea. Headache and insomnia are seen in the central nervous system, with occasional mild lethargy. Other hallucinations, memory loss, tremors, and migraines were reported. The cardiovascular system can develop palpitations, peripheral edema, and tachycardia. Allergic reactions may occur in some patients, including rash (measles-like rash), pruritus and erythema. There were reports of chest pain and throat tension. Sweating at night. In Chinese patients with osteoarthritis (OA), some researchers reported that the incidence of adverse reactions in the glucosamine hydrochloride group and the glucosamine sulfate group was 4.12% and 7.10%, respectively, mainly manifested by mild to moderate gastric discomfort and constipation. Another literature on liver injury caused by glucosamine hydrochloride. Those who are allergic to chitin extracted from shell aquatic animals (such as snails, shellfish and shrimps and crabs) are not allowed to take glucosamine drugs. The effects of glucosamine on lactation and children are unclear, so it is not suitable for lactating women. ^[4]

There is not much data and reports on the interaction of glucosamine with other drugs. Glucosamine can increase the absorption of tetracycline drugs in the gastrointestinal tract and reduce the absorption of oral penicillin or chloramphenicol. Taking at the same time

Glucosamine is safe, and no serious or fatal adverse reactions have been reported in the existing randomized clinical trials.

There are three main methods for producing GlcN, namely acid hydrolysis, enzymatic hydrolysis and microbial fermentation. ^[6]

When taking glucosamine, pay attention to the following points: (1) after trying traditional osteoarthritis treatment methods, if the patient is intolerant, you can choose glucosamine; (2) glucosamine has glucosamine sulfate and glucosamine hydrochloride. The glucosamine content is different, but the effect is similar, there is no essential difference; (3) if you want to try glucosamine, you should perform observation and treatment for 60 days, and then decide whether to continue treatment; (4) although allergic reactions are relatively rare However, since most of the commercialized glucosamine comes mainly from marine crustaceans, those who are allergic to crustaceans and patients with asthma should use it with caution; (5) Patients with diabetes should use large doses of glucosamine with caution. Studies have reported that glucosamine consumption at 1.5 g / d may affect insulin sensitivity and glucose transport. ^[7]