Benefits of Glucosamine
By Myprotein Writer Chris Tack
Clinical Specialist Physiotherapist and Manager Guys & St Thomas’ Private Physiotherapy Service (London, UK)
Owner & Lead Clinician of All Powers Rehabilitation & Conditioning
Diet supplementation is BIG business. Across the planet use of supplements by the athletic population is reported to range from 40% to 88% (1-3). Approximately 30,000 types of supplement are available to purchase in the US alone (4).
Osteoarthritis (OA) is an increasingly prevalent disease globally (5). Knee OA in individuals over 45 years old has been reported as between 19.2% and 27.8% and increasing with age (6). It has also been well reported that degenerative changes consistent with OA are often seen on knee MRI scans of those with NO symptoms (7-8). This type of arthritis (and the changes which occur) could be considered a common and “normal” part of life as we age.
With these two facts it is crazy that a supplement such as glucosamine is not more popular. In the US the use of glucosamine is approximately 5% (slightly higher- between 7-9%- in the elderly) (9).
In a study of elite Team GB junior athletes 62% reported taking a supplement (10). However, less than 1% reported taking glucosamine! They instead were more keen on taking supplements they saw as “performance enhancing”- such as carb loaded energy drinks (41.7%), whey protein (21.3%) and creatine (13.4%). Even natural sleep aid melatonin was used more than glucosamine (1%).
In a survey of adult elite athletes between 19-29 years of age (11) the more mature athletes took a greater health preservation outlook of taking care of their bodies. However, whilst they reported a higher rate of taking supplements such as vitamin C (70.4%), echinacea (30.8%) and multi-vitamin (72.7%), NONE reported taking glucosamine to prevent joint problems.
The aim of this article is no explain how perhaps these athletes are missing a trick, and why you may want to take a better look at how glucosamine can be of benefit to your health and training.
What is glucosamine?
Glucosamine is an amino sugar (aminosaccharide) which is acted upon by enzymes to create chains of different molecules which form proteins and lipids (fats).
It constructs part of a large molecule called chitin, which makes up the shells of crustaceans (crabs, lobsters, etc.) and insects.
As such the dietary form is commonly produced through breaking down these exoskeletons.
One of the key proteins that are formed from glucosamine is aggrecan, which makes up a key component of cartilage (the extracellular matrix) and provides support to withstand cartilage compression (12).
The most common form of glucosamine supplement is as glucosamine sulphate.
These are available as powders, tablets and soft gel capsules. There are even tubes of gels to apply topically by rubbing into your joints (although minimal evidence is available as to the benefits of this form of application).
How does glucosamine work?
(The Science bit)
(The Science bit)
When in sufficient concentration in the extracellular matrix (ECM), part of the aggrecan protein molecule called the glycosaminoglycan (GAG) chain modifies pressure within cartilage by causing movement of fluid into the tissue. This change in pressure works to counter compressive loads (13).
Normally, through years of movement and loads in our joints we can cause a disruption in cartilage tissue which is sub clinical and innocuous. This means we change the tissue slightly but have no symptoms.
A disorder such as osteoarthritis (defined as tissue change AND presence of symptoms) is characterised by an increase in cartilage tissue turnover due to load and compression, with greater amounts of catabolism (break down) than synthesis (production) (14).
Needless to say then, the greater amount of glucosamine available, then greater the amount of aggrecan, and therefore, the greater the amount of support against tissue compression.
Most tests of the function of glucosamine have been done in vitro– meaning in a Petri dish in a lab- however this does indicate benefits which are transferable to our anatomy.
Other benefits of glucosamine include:
– Reducing the production of compounds which lead to arthritis, including prostaglandin E2 (15-16).
It also makes a benefit at the level of our genes, mainly in inhibiting the expression of genes which cause cartilage changes in OA (18). This occurs through preventing destruction of cartilage cells and occurs in greater amounts with application of glucosamine sulphate compared to glucosamine hydrochloride (19-20).
In addition, glucosamine:
– Reduces inflammation within joints.
Part of the changes in joints which have arthritis is due to an increase in a specific signal protein called interleukin-1β (IL-1β). This protein is involved in mediating inflammation when cells are produced or broken down (as is the case with cartilage cells in arthritis).
A great study from 2010 (5) examined the proteins expressed by human cartilage cells when IL-1β (a pro-inflammatory response) is applied but the cells are concurrently treated with glucosamine.
It was found that the proteins which are modulated when glucosamine is applied are anti-inflammatory and reduce the breakdown of cells by IL-1β. They assist with balancing the degree of catabolism (breakdown) and synthesis (new cell production), as such preventing the normal cartilage damage seen in OA.
Now whilst these experiments were undertaken in a laboratory and were more akin to direct delivery in the joint (rather than oral administration) it remains clear that:
– Glucosamine shows benefits for the health of joint cartilage:
Which can considerably beneficial for sports people.
Benefits of glucosamine supplementation (Out of the Lab!)
I am the first to recognise that sometimes what occurs in a test tube in a lab will not be replicated in a real-life person.
However, a large number of studies have demonstrated that glucosamine may have real positive effects.
These results were confirmed by a trial which gave 1,500mg daily to a group of US Navy & special warfare servicemen with chronic knee and back pain.
This population showed reduction in a pain and function questionnaire, a physical examination score and running speed/ duration times (23).
The effects over a longer period (3 years) have also demonstrated that a benefit was found in reducing symptoms over the long term (24). However, it was also found again that the benefit was greater with glucosamine sulphate, rather than glucosamine hydrochloride.
Other studies have shown that:
– Glucosamine sulphate reduced pain and increased function with spinal arthritis (25)
– Oral glucosamine showed the same benefit in reducing pain and increasing the ability to undertake normal activities as 1,200mg of ibuprofen!
Now although the effect of ibuprofen occurred sooner (20% greater improvement after 2 weeks), at 4 weeks the improvements were equal (26). This is great news for anyone with joint pain who has side effects from (or dislikes) taking anti-inflammatory medications.
It also has to be recognised that a few studies contradict those described, and report that the benefit of glucosamine is only equal to that of placebo.
Traditionally, placebo tablets in trials examining knee arthritis tend to show a 30% improvement (27).
However, these studies (28-30) used the less effective form of glucosamine hydrochloride 3 times daily, rather than oral glucosamine sulphate once daily.
The gold standard of scientific evidence is generally considered to be a systematic review (where all the other studies and trials are analysed and results interpreted).
One of the larger databases and producers of such evidence is the Cochrane library, who summarised that use of glucosamine sulphate demonstrates pain reduction and physical improvement with low toxicity, supported by moderate to high quality evidence (31).
As suggested all emerging evidence suggests that a daily dose of 1,500mg of oral glucosamine sulphate is all that is required to gain its amazing joint preserving, pain relieving, activity promoting benefits!
Myprotein has a number of products which you could utilise to ensure your body has the required levels of glucosamine to stay healthy and prevent the normal joint changes which occur when you have an active daily lifestyle.
For example, the simple Myprotein Glucosamine Sulphate gel tablets provide a massive 1,000mg of glucosamine per serving and whilst the recommended dose is 1 per day, you can be safe in the knowledge that popping two will push you above the required level of 1,500mg without the risk of side effects.
Another amazing option is to go for the Myprotein Glucosamine Sulphate Powder which you can get unflavoured and can add to fruit juice or even as an extra ingredient in your daily protein cocktail!
There are also some great options for combined supplements where you can get glucosamine with added extras such as MSM (methylsulfonylmethane) or chondroitin, which work synergistically for even greater benefits!
When to take
With the safety confirmed of this supplement my recommendation is that it is best to take 1,500mg orally in one go, once per day.
Get the glucosamine in your system via tablet or powder and boost daily to ensure your joints sustain the benefit.
Take Home Message
Glucosamine is not a miracle cure. It does not reverse aging and it does not iron out wrinkles.
However, lots of good science shows that taking it daily can breathe life into our joints as we age.
Remember just because your joints change due to movement as you age it doesn’t mean you will (or should) have pain.
However, change they will nonetheless. Why not do something about it?