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A study published in the Annals of the Rheumatic Diseases (online, July 28, 2017) concluded that glucosamine lacks evidence of effectiveness. Although the researchers don’t come right out and say it, the implications of their report are that any improvements people report with this dietary supplement are probably imaginary. Before you give up on glucosamine, though, read on.
What They Did:
The new analysis of glucosamine was based on a review of six studies. It concluded that:
“there is no evidence to support the use of glucosamine for treatment of hip or knee OA in general and an absence of evidence to support the use of glucosamine for clinically relevant subgroups of OA according to baseline pain severity, BMI, sex, structural abnormalities and presence of inflammation.”
Five of the studies were randomized controlled trials comparing glucosamine to placebo. The scientists analyzed the results carefully to determine whether there might be some subgroups that respond well to this popular supplement. They could not find any groups that had reductions in pain or improved function compared to placebo.
What They Could Not Do:
The investigators were frustrated by the fact that data from approximately 15 other studies would have been helpful but were not made available. Based on the data they reviewed, however, they concluded that:
“Currently, there is no good evidence to support the use of glucosamine for hip or knee OA” [osteoarthritis].
Contrary Data on Glucosamine:
A year ago a study of crystalline glucosamine sulfate showed that this form was as effective as NSAIDs in alleviating joint pain (Current Medical Research and Opinion, June, 2016).
Another study from this spring reported that the same patented glucosamine formulation worked better than acetaminophen (International Journal of Rheumatic Diseases, online March 23, 2017). However, the company that makes this product chose not to share its data with the reviewers.
Stories from Readers:
We recognize that anecdotes are not science. Accounts from readers can never compare to randomized, double-blind, placebo-controlled clinical trials. That said, we suspect that some people benefit from glucosamine and others do not. The special crystalline formulation might be effective, but the raw data are not readily available. Here are some stories for your consideration:
Dorothy in Virginia says thumbs up:
“My 80-year-old husband and I have taken glucosamine with chondroitin for as long as it has been available. Every time we stop taking it, we get knee problems.
“Years ago, we had a small dog who developed leg problems and could no longer jump up into her favorite chair. After taking glucosamine with chondroitin, she was pain free and could jump into her chair again.”
Jim in Winchester, VA offers this perspective:
“Emphasis needs to be given to the form of glucosamine used. Hearing many reports from People’s Pharmacy [PP] over the years, it seems that positive results for glucosamine use glucosamine SULFATE while less positive results come from the use of glucosamine hydrochloride.
“The GAIT trial used glucosamine hydrochloride, and failed to get positive results. PP cites above a 2016 study with a very positive result where ‘a crystalline glucosamine SULFATE formulation is equivalent to nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen.’ Medline Plus specifies that glucosamine SULFATE is ‘Likely effective for’ osteoarthritis, but glucosamine hydrochloride has ‘Insufficient evidence to rate effectiveness for’ osteoarthritis.”
Garry in Kentucky shares this intriguing review:
“Back in the 1980s, there was a survey with over 2 thousand veterinarians responding. 85% of respondents reported good to excellent results with Glucosamine. Glucosamine was first used by horse racing veterinarians. With the big money involved in treating thoroughbreds, I’m sure the vets didn’t fool around with things that did not produce results.
“Concerning the study showing glucosamine to be ineffective on knees, a subsequent study demonstrated effectiveness providing 2000 mg. was taken in a single dose. The usual 1500 mg. in divided doses was not effective for the knees. Using the single dose 2000 mg my knees healed up nicely over a few weeks.
“When I was in my fifties I was diagnosed with arthritis. Taking the usual 1500 mg. daily gradually eliminated all symptoms. I do not take or recommend chondroitin. Little is absorbed and what is absorbed may end up residing in the prostate. It is not known to cause any issues with the prostate but on the other hand who wants an aberrant substance where it does not belong.”
What has been your experience with glucosamine or glucosamine and chondroitin? Share in the comment section.
If you would like to read more about other approaches to controlling arthritis pain, we offer our Guide to Alternatives for Arthritis.
Jane
Melbourne, FL
I am an older person, I mean really.
No, G and C has not helped my arthritis, but through the years, over and over again, I have heard mention of this drug for helping others, in one part of the body…the knees.
I cannot tell you how many folks have told me about relief of pain in the knees, when taking this drug; it is almost unbelievable.
My grandson, as a young man, worked with his dad in the pool business. He began to experience deep pain in the knees, with all the digging he was doing. I sent him several bottles of G and C. He raved about the help it gave him. He was in his twenties. He is 40 now and pain free. He is only one example. I would always recommend trying it for knee pain.
Dan
New York
An elderly kitty of mine had arthritis so terrible that she SCREAMED if I picked her up – which is how I learned about her disability, such as cats hide their illnesses.
After 2 weeks of taking 2 and then 1 capsule a day, mixed in some canned food, she was literally leaping around the house again. This stuff, @ .50 per day, bought her another 5 years of life, until she wore out at age 24.
Cindy M. B
Seattle, WA
Really, isn’t it to be expected that Glucosamine WILL work for a certain percentage of people who take it? In studies to determine efficacy of a drug, isn’t it the case that a majority of the people in the study have to experience positive results in order to determine that the benefits are “statistically significant?” But what of the minority of people who do find beneficial results? Seems like they should count too. You just don’t know which camp you’ll fall into until you try the product. Right?
Kathryn
PA
I have been using glucosamine sulfate with chondroitin and MSM for more than 10 years. My knee pain disappears when taking the pills regular. At times when I am very busy unknowing I forget to take them for several days. My knees start hurting again. Then I remember and get back on track, taking the pills again and the pain leaves. I wouldn’t do without the pills. When we go on vacation I take a supply along.
Hank
Granite Bay, CA
I started taking glucosamine and chondroitin for back/joint problems. Within a month, I noticed a lot of “floaties” in the eyes. They became very bothersome. Previously, I have only had a few and very rarely. I discontinued taking the glucosamine and chondroitin and within 6 months my eyes were back to being okay as before. I will never take it again.
Heather
Dallas, TX
I started taking Glucosamine around 15+ years ago. I was in my mid-forties and had knee pain as well as what sounded like “Rice Krispy” knees when walking upstairs. It took several minutes each morning to be able to walk normally when I got out of bed. I’m pushing 60 now, and for years I have had next to no pain, quiet knees on the stairs, and I hop out of bed and walk just fine. I totally credit Glucosamine!
Muhammad
Manchester
I have been taking this stuff more than ten months for my knee pain without any relief. I think this is just waste of time and money.
Glucosamine Sulphate plus Chondroitin Sulphate plus MSM I have purchased from many different health stores. None has helped me at all. I was told if I use them for six months I would get relief. Therefore I kept taking them in the hope that I may get some relief, but they were no help at all. I am going to give up now. If any body knows any better product for knee pain relief please let me know. I shall appreciate it. Thank you.
Margie
Houston
I took glucosamine for several years and feel it did help with arthritis pain. Then I read studies that it can raise eye pressure and be dangerous for those with glaucoma. Therefore, I stopped taking it before my cataract surgeries, as there is already a risk of increased pressure with the surgery.
After being off for 3 months I restarted it. After about two weeks, I started having frequent and distressing episodes of fast heart rate and skipped beats. It took awhile of searching to see if there was anything that could be causing it. (Of course, my Doctor was following this also. I tend to have these symptoms with some meds and with some foods I’m allergic to).
One day I looked up side effects of glucosamine and was surprised to find it can cause heart arrhythmias. I stopped taking it, and gradually the symptoms stopped. I can only surmise that by stopping and starting it with my cataract surgery I must have triggered an intolerance. People should be aware that natural and alternative remedies can have side effects too.
Ellen C
Dallas, Texas
Just a note to say that our physicians are sometimes deeply indebted to the pharmaceutical
industry as are researchers. I tend to trust what people who use a remedy say about it
above what research and doctors will say. There is so much money involved in drugs these days that they do not want any competition. However, I do find a doctor here and there who is trying to get good information about herbal and home remedies. I always refer them to this column as well as a couple of other sources for reliable information.
For example, when I was in the ER recently at our local hospital, the doctor and I talked about ginger for nausea. He told me that he always recommends it to his pregnant patients with morning sickness as well as to people who have other issues with nausea or who are on chemo. He is middle-eastern and I suspect he has a greater interest in other-than-drug remedies.
Daniel
SC
One problem I have observed concerning all drug tests, (the best of my knowledge) is that they are all done on sick people. Most medical doctors will agree to this. This drug has helped me, also dropping it means in a day or so, pain in several joints. I am almost 80 yrs old and have only one aliment: cardio myopathy. Which to my knowledge has no connection to joint pain. Studies or none, I plan to continue to use this drug.
Gregory G
San Antonio Texas
Glucosamine with chondroitin has worked well for me. During the 1980’s when I started running on a regular basis I experience knee pain and was advised by veteran runners to take Glucosamine with chondroitin and it worked well for me, the knee pain subsided. I was 40 then and have been taking it since. I am now 72 and have not experience any knee pain. I highly recommend it.
Pat
Seattle
The only think I can add to this conversation is that my 15 lb 11 year old Havanese (dog) has been having some ‘knee’ problems. The vet (mainstream, not holistic) recommended giving her a glucosamine/chondroitin supplement. I give her an expensive, high quality one. She has gone from being unable to jump onto the couch or into the back seat of the car to acting like she was 6 years old again. She seems more alive and definitely more active. I’m sure it is not a placebo effect.
ariel
Glucosamine raises my blood sugar. Otherwise I would like to take it.
ariel
USA
I would love to take glucosamine. Cannot, it raises blood sugars.
Mary
Chicago
Glucosamine really helped me. Years ago, maybe in my late 40s(?), my hips and knees were killing me, especially going up stairs and getting out of cars. I started taking glucosamine – do not know if it was sulfate or HCl. About 6-8 weeks later, it suddenly dawned on me that my knees and hips were WAY WAY better! I was stunned. I still take it, but only the sulfate type thanks to the advice of Andrew Lessman on HSN. At 69, my knees and hips are still so much better than they were in my late 40s. I KNOW it’s due to glucosamine sulfate. Will take it forever. I feel bad that people don’t give it a try for at least 2 months. No one can convince me it doesn’t work!!
Genie
In the Encyclopedia of Nutritional Supplements by Murray, glucosamine sulfate is is 97% absorbed whereas HCL is only 4 %. I originally took it for a bone spur in my neck. I still take 500mg a day and have no arthritis at 76. Lady at WF told me it came into the States for prize dogs and horses. It’s under prescription in the Netherlands.
Gayle
West columbia
Tried glucosamine gummies for two months twice a day. No relief. Maybe condroitin would be better but this pills are HUGE. Can’t swallow anything that large. Gayle
Mary
Wisconsin
I tried glucosamine with chondroitin very skeptically about 1990. After 6 months I realized the knee pain had disappeared. I decided to test it and stopped it for 2 weeks. The knee pain returned and within 1 1/2 weeks I was back on it.
Meg
I had bone on bone pain in my knees and was mostly immobilized in pain. I began a regimen of glucosamine sulfate, physical therapy to strengthen quads that had weakened as I went lame, and lost 15 pounds. I continued the glucosamine sulfate for years and am convinced that I rebuilt that cartilage. Maintaining a lower weight is part of it, and I continue to do the leg lifting as part of a physical therapy regimen I do at home.
When I shifted accidentally to glucosamine chloride, I had reoccurrence of knee pain that was alleviated by going back on glucosamine sulfate. My conclusion is that glucosamine sulfate works for me and glucosamine chloride is a loser. I no longer have to take the glucosamine although it helps with arthritis of the spine as well. I might add that glucosamine is not a fast fix and a regimen of 2 times a day over a period of months is necessary to initiate treatment and maintain treatment. I found no value in adding condroitan.
My husband is a veterinarian who started using glucosamine for arthritis in dogs and had a lot of success before anybody thought about giving it to people. He found that dogs that couldn’t go up and down stairs could suddenly run up and down. And he found that dogs who had lost their playfulness could go back to chasing Frisbees. If it works in animals, it is unlikely to be a placebo effect.
Kenneth
central Illinois
By the time I was 62 my knees hurt so much that every time I got up out of a chair I was in pain for several steps. There were times that I sat in the car wrapped in blankets rather than go into the shopping mall with my wife to do Christmas shopping. I just could not deal with the painful walking. I want to a Sports Medicine Clinic and asked for evaluation of my knees. The xrays didn’t show anything more remarkable than “62 year old knees”.
I was advised to try glucosamine three times a day. “It works for about half the time. If it hasn’t worked in two months it’s not going to work for you so stop taking it.” I was also advised that I was not replacing my walking shoes often enough and the soles were not absorbing as much stress as they are supposed to do (so now I buy cheap walking shoes every 6 months).
I had dramatic benefit. I’m now 72 and I never think about my knees and per my FitBit, I average about 8000 steps a day. I’ve shifted to “triple strength” glucosamine just once a day. I always get well recognized brands – not cut rate stores. I would not have qualified for the study which evaluated effect of glucosamine in persons with the diagnosis of osteoarthritis. My knee xrays don’t say I have osteoarthritis – but I sure had lots of knee pain and I’m greatful for the benefit I’ve gotten in reversing that pain.
keith
Texas
I’ve had knee and hips problems for years (I’m 67). I took glucosamine and chondroitin supplements for three or four years and never noticed any difference. My orthopedist told me some people find it helps and some don’t. He said if it didn’t help, don’t spend the money. Like I said I never felt like it helped so I stopped.
Ellen
TX
Advanced arthritis in my knee caused such pain that I could barely stand on that leg when I first stood. After reading your article recently that a higher quality chondroitin did show relief from arthritis pain, I tried this supplement (in combination with glucosamine – Cosamin DS). It provided almost instant relief. Within three days I no longer hobbled around the house.
Janice
Hillsborough, NC
Have been taking glucosamine chondroitin for years with excellent results. Of course it helps not to be overweight as every additional pound is 4 pounds of stress on the knee. Even a small weight gain can cause me to feel the difference. For those that have an elevated glucose it has helped me to take chromium picolinate to alleviate any problems with glucose. A small study using phytochromium with gestational diabetics at UNC Hospitals (never published as lead investigator was in national guard and sent to Germany and replacement was pregnant) showed remarkable benefit in glucose control vs. placebo.
Kevin
MB - Manitoba
“…the implications of their report are that any improvements people report with this dietary supplement are probably imaginary” Glucosamine and chondroitin greatly helped my dog. Dramatic improvement. I guess he just imagined it and was able to climb stairs again with a great imagination.
HN
Florida
I searched but can’t find the amount of glucosamine that was used in this study (unless I pay for the full text). So I would caution others to be suspicious of the poor results, especially after other previous studies using 1,200mg to 1,500mg of glucosamine showed positive results. Also, one of the authors of this study is “supported by grants from Sanofi Aventis, Abbvie, Fidia, Samumed and Pfizer and personal fees from Flexion Therapeutics, Samumed, Plexxikon Inc, Regeneron, Orthogen and McNeil Consumer HC” and another author is “supported by personal fees from Galapagos NV, FlexionTherapeutics, Johnson & Johnson, Regeneron, Össur and Samumed.” I’d be very hesitant to share this study’s poor results with others.
Luke
I read reports that glucosamine can make cholesterol levels go sky high. Glucosamine is a natural substance formed in joints (joint fluid) so I guess someone thought if one ate it, it would help joints, although that does not make any sense since the body breaks proteins and sugars down and uses it as food. These tablets are made from animal products like shellfish or cow bones. So who knows.
Sidney
Port st lucie
I have been on glucosamine chondtotin with Msm and when I stop I feel pain all over. Years ago I took Msm alone and it worked wonders. I hate taking meloxicam for long term health problems but for now I have no choice.