Glucosamine is arguably the most popular supplement for joint health worldwide. It is often used alongside other natural remedies such as chondroitin, turmeric, ginger, and Boswellia.
Scientific research shows that glucosamine can reliably support joint conditions such as knee osteoarthritis.
Osteoarthritis is the most common form of joint disease (arthritis), and scientists believe it occurs due to the wear and tear of the joint cartilage. These collagenous structures cushion your joints.
As joint cartilage degenerates, it leads to joint stiffness, pain, inflammation, restricted mobility, and reduced quality of life.
In this article, you will learn more about the science behind the most popular natural joint supplement and the management of osteoarthritis, including its effectiveness, safety, and how to take it for the best results.
What is glucosamine, and how does it work?
Glucosamine is an amino sugar, a sugar molecule bound to nitrogen .
It is a monosaccharide that the body uses to produce long chains of polysaccharides called glycosaminoglycans, naturally found in bones and cartilage .
One of the most prominent glycosaminoglycans is hyaluronic acid which is part of the synovial fluid inside the joint space and helps lubricate joints.
As a nutritional supplement, glucosamine acts as a substrate for producing new glycosaminoglycans, which help lubricate and cushion the joints. Glucosamine supplementation helps reduce pain and slow down cartilage degradation.
Studies also confirm that slowing collagen and cartilage breakdown is the primary mechanism of glucosamine supplementation to help manage arthritis symptoms. One of the most frustrating is knee pain, which dramatically affects daily life .
However, scientists suggest this is not the only mechanism via which glucosamines can help protect collagen and cartilage inside your joints. Glucosamine may also help reduce inflammation by blocking a molecule called Interleukin-1 (IL-1) .
IL-1 is an immune system molecule that mediates inflammation and the breakdown of damaged cartilage tissues.
By reducing interleukin-induced collagen breakdown, glucosamine helps reduce the progression of joint conditions such as knee osteoarthritis. This mechanism is supported by studies reporting reduced markers of cartilage degradation .
Where is glucosamine found naturally?
Glucosamine can be found naturally in most human and animal tissues, but its highest concentrations are in bones, joints, and cartilage.
However, the primary source of supplemental glucosamine sulfate is shellfish shells. They are a natural source of glucosamine in the form of chitin. Manufacturers process the chitin from the shells of these animals via a method called hydrolyzation.
Some manufacturers also produce glucosamine from non-animal sources such as fermented corn to provide supplements suitable for vegans, vegetarians, and individuals with intolerance or hypersensitivity to shellfish.
Two primary forms of glucosamine are found in supplements - glucosamine sulfate and glucosamine hydrochloride. Both can be derived from either shellfish or via fermentation.
Both glucosamine HCl and sulfate will undergo hydroxylation in your intestinal tract to form free glucosamine, which then goes into your bloodstream and reaches your joints.
However, studies suggest that glucosamine sulfate is much more effective when compared to glucosamine hydrochloride.
In fact, glucosamine hydrochloride appeared to be utterly ineffective in one meta-analysis, which directly compared the benefits of the two forms . In comparison, glucosamine sulfate showed significant benefits in patients with joint problems.
That is likely because of the higher bioavailability of glucosamine sulfate, which is about 6-fold higher than the bioavailability of glucosamine hydrochloride, according to studies . Therefore, glucosamine sulfate is the more popular and effective form of glucosamine.
How should I take glucosamine?
Glucosamine is orally active, which means it will be effective if you take it as an oral supplement. Currently, scientists do not know precisely how much of the glucosamine you ingest will get absorbed into your intestines, although researchers suggest that the bioavailability of glucosamine sulfate may reach 90% .
However, doses up to 1500 mg lead to a linear increase in glucosamine serum levels .
The benefits of glucosamine are dose-dependent. Since the efficacy of glucosamine supplementation increases with higher doses, most studies recommend taking up to 3000 mg daily for reducing pain in conditions such as knee osteoarthritis.
However, due to the limited absorption, it is essential to split your daily intake into 2-3 servings, each containing 500-1000 mg of glucosamine.
In general, you should always select glucosamine sulfate due to its superior effectiveness compared to glucosamine hydrochloride. Make sure to take it alongside food as it is thought to maximize absorption.
Does glucosamine really work for your joints?
As previously mentioned, glucosamine works to reduce arthritis complaints by slowing down the degradation of joint cartilage, reducing pain, and improving joint lubrication and mobility.
Numerous studies and meta-analyses have confirmed that supplementation with glucosamine, either alone or in combination with other dietary substances, can significantly improve pain and mobility.
One of the most recent meta-analyses covered ten clinical trials and a total sample size of more than 3800 participants with knee osteoarthritis . According to the researchers, glucosamine supplements led to a significant reduction in joint pain compared to the placebo group.
The participants who were given glucosamine also achieved reduced joint narrowing by an average of 0.2 mm less than the control group.
Another meta-analysis by the highly reputable scientific organization Cochrane reported that glucosamine supplementation led to a 28% reduction in pain and about 21% improvement in functionality .
The researchers deduced these results using data from 20 trials and 2570 participants with knee osteoarthritis.
How long does it take for glucosamine to start working?
Overall, the research shows that glucosamine supplementation has a significant benefit for joint health and mobility. Yet, it may take several months of supplementation before there is a noticeable reduction in pain and discomfort.
A meta-analysis of randomized controlled trials published over a period of 22 years revealed that it might take up to 4 months until there is a significant improvement in the symptoms .
Moreover, the benefits of reducing pain and improving mobility continue to compound with prolonged supplementation, reaching a maximum after three years of taking glucosamine daily.
To maximize the effectiveness of glucosamine, it is best to start supplementation as early as possible since its primary benefit is slowing down cartilage breakdown and reducing inflammation.
Does glucosamine have side effects?
Glucosamine is widely accepted as one of the safest supplements for joint health, and most patients experience no side effects during supplementation.
One of the few adverse reactions you may experience is flatulence, which only occurs when supplementing with doses that exceed the recommendations. No other side effects have been reported so far.
Some preliminary in-vitro and animal experiments have suggested that supplementing with glucosamine sulfate may reduce your cells' sensitivity to insulin due to the similarity between glucosamine and glucose.
However, these concerns have been refuted by the latest clinical research. In fact, a meta-analysis that included studies lasting for up to 3 years showed that glucosamine does not increase insulin resistance, nor does it affect glucose metabolism even in patients with type 2 diabetes .
Therefore, glucosamine is safe to supplement for managing conditions such as knee osteoarthritis in both non-diabetic and diabetic individuals.
Can you take glucosamine if you have a shellfish allergy?
Because glucosamine sulfate is often sourced from shellfish shells such as shrimp, crab, or lobster, people with shellfish allergies often avoid it for fear of hypersensitivity reactions.
Indeed, there are reports about people with shellfish allergy who have experienced severe adverse effects after taking glucosamine supplements.
A report also suggests a link between taking glucosamine and an increased incidence of asthma attacks .
Yet, recent studies in patients with shellfish allergy reveal that taking a glucosamine supplement does not trigger any hypersensitivity reactions even 24 hours after the supplementation .
The American Academy of Allergy, Asthma, and Immunology also declares that people with shellfish allergies can safely take and tolerate glucosamine supplements .
That's because most supplements containing glucosamine lack the shellfish's proteins that can trigger an allergic reaction.
Nevertheless, the amount of research on the topic is scarce, so people with shellfish allergies, especially those with life-threatening hypersensitivity, should consult a doctor or medical specialist, such as an allergist, before taking glucosamine.
An allergist may also offer you a medically supervised oral challenge with glucosamine to assess your tolerance.
Should I take glucosamine with other supplements?
Glucosamine can be safely combined with most other supplements to help support joint health. Moreover, it may have additive or synergistic effects with some supplements, increasing their overall effectiveness.
One of the most popular combinations is glucosamine and chondroitin sulfate. Chondroitin is a major component of joint cartilage and is usually produced from natural sources, such as bovine cartilage.
Studies have shown that chondroitin sulfate may have additive effects to those of glucosamine by reducing joint swelling .
Another supplement that is often combined with glucosamine due to its additive effect is methylsulfonylmethane (MSM). Similarly to chondroitin, MSM also helps reduce joint swelling, but it also acts as an antioxidant to help reduce chronic inflammation.
A study in 118 patients with knee osteoarthritis reported that a combination of glucosamine and MSM leads to significant improvement in joint pain and mobility and a higher reduction in swelling compared to either supplement alone .
Another herb that not only adds to the benefits of glucosamine but also acts synergistically is Boswellia serrata. Glucosamine and Boswellia potentiate each other's effects, and animal studies report that the synergism between the two led to anti-arthritic effects comparable to those observed with NSAIDs .
Moreover, studies show that joint supplements containing glucosamine and other natural ingredients such as chondroitin sulfate, MSM, and Boswellia have equally good safety profiles compared to taking glucosamine sulfate alone .
Therefore, it is not only effective but also safe to take glucosamine supplements if you are looking for joint pain and stiffness relief.
Keep in mind to look for joint health supplements that contain ingredients with synergistic effects, such as glucosamine + chondroitin, and have undergone third-party testing, which guarantees their purity, safety, and efficacy.
Note: This article is for informational purposes only and not intended for use as medical advice. Always consult your healthcare provider before starting any dietary supplement.