Glucosamine

__** Backround **__ Glucosamine is a natural compound that is found in healthy cartilage. Glucosamine sulfate is a normal constituent of glycoaminoglycans in cartilage matrix and synovial fluid. Available evidence from randomized controlled trials supports the use of glucosamine sulfate in the treatment of osteoarthritis, particularly of the knee. It is believed that the sulfate moiety provides clinical benefit in the synovial fluid by strengthening cartilage and aiding glycosaminoglycan synthesis. If this hypothesis is confirmed, it would mean that only the glucosamine sulfate form is effective and non-sulfated glucosamine forms are not effective. Glucosamine is commonly taken in combination with chondroitin, a glycosaminoglycan derived from articular cartilage. Use of complementary therapies, including glucosamine, is common in patients with osteoarthritis, and may allow for reduced doses of non-steroidal anti-inflammatory agents.
 * Glucosamine ** (C6H13NO5) is an amino sugar and a prominent precursor in the biochemical synthesis of glycosylated proteins and lipids. Glucosamine is part of the structure of the polysaccharides chitosan and chitin, which compose the exoskeletons of crustaceans and other arthropods , cell walls in fungi and many higher organisms. Glucosamine is one of the most abundant monosaccharides. It is produced commercially by the hydrolysis of crustacean // exoskeletons // or, less commonly by fermentation of a grain such as corn or wheat. In the US it is one of the most common non-vitamin, non-mineral, dietary supplements used by adults.

__**History**__ In the United States, glucosamine is marketed as a nutritional supplement. It is currently one of the most frequently taken dietary supplements for the treatment of osteoarthritis. Many patients with osteoarthritis (OA) claim that it is effective in relieving their symptoms, such as pain and limited range of motion. Glucosamine has been studied for four decades, with the first published study from Germany in 1969. Additional studies were performed in Europe and Asia in the 1980’s. These studies compared glucosamine to non-steroidal anti-inflammatory drugs (NSAIDS), the typical medications used to relieve symptoms of OA. In 1997, the use of glucosamine rocketed after being featured in the book, //The Arthritis Cure,// by Jason Theodasakis, MD. He described the use of chondroprotective agents like glucosamine sulfate and chondroitin sulfate as effective agents for the treatment of OA. He even stated that these agents could actually reduce the structural damage of the articular cartilage. There is also an increase use of these agents in the veterinary medicine world for the treatment of arthritis and hip dysplasia. With a number of short term trials suggesting that glucosamine has equal to or better efficacy than the currently used NSAIDS, and their current widespread use, the Office of Alternative Medicine of the National Institutes of Health and other researchers have begun conducting larger clinical trials that compare the long-term effects of glucosamine to placebo. Glucosamine is present in almost all human tissues and is highly concentrated in the cartilage and other connective tissues of the human body. Glucosamine, an aminomonosaccharide, is an intermediate substrate needed for the synthesis of glycosaminoglycan and proteoglycans by the joint cartilage in the human body. It is the glycosaminoglycan and proteoglycan components of cartilage which give cartilage its functional shock absorber effect. It is believed that glucosamine's positive benefits are due to its role in supporting the production of proteoglycan. It is this role as a cartilage building block that make it relevant to the treatment of osteoarthritis. Glucosamine is available in many forms from the pharmacy and health food stores. Forms include sulfate, hydrochloride, N-acetyl or chlorhydrate salt, and as a dextrorotary isomer. Almost all of the early studies are on glucosamine sulfate. Glucosamine is usually combined with chondroitin sulfate, another glycosaminoglycan, which may have some effect on maintaining joint fluid viscosity, stimulating cartilage synthesis, and inhibiting cartilage degradation. The effects of chondroitin have not been studied as widely as glucosamine.


 * __Facts__**


 * **If you experience common side effects, you may want to switch brands before giving up glucosamine altogether.**

Common side effects associated with glucosamine include: Glucosamine can cause a temporary increase in blood pressure and heart rate, including palpitations.
 * gas
 * soft stools
 * upset stomach
 * drowsiness
 * insomnia
 * headache
 * skin reactions
 * sun sensitivity
 * nail toughening


 * **Glucosamine is sold as a dietary supplement.**

The glucosamine sold as a supplement is extracted from animal tissue, specifically crab, lobster, or shrimp shells.Glucosamine is commonly taken in combination with chondroitin, a glycosaminogly can derived from articular cartilage. Use of complementary therapies, including glucosamine, is common in patients with osteoarthritis, and may allow for reduced doses of non-steroidal anti-inflammatory agents. Most resources suggest that glucosamine should be avoided in patients who are allergic to shellfish, while other resources (including the Arthritis Foundation) recommend talking to your doctor about your known allergy. Most allergies are caused by proteins in shellfish, not by chitin, the carbohydrate from which glucosamine is extracted. Again, this is important to discuss with your doctor!