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GLUCOSAMINE | |||||
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Glucosamine sulfate
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GENERAL INFORMATION: Glucosamine is a natural substance found in high concentrations in our joint structures. A combination of the amino acid, glutamine, and a sugar, glucose, glucosamine is incorporated into large structures within joint cartilage called proteoglycans. The proteoglycans function to attract water into the joint space for lubrication of the cartilage during movement. Glucosamine has been studied and utilized for reversing osteoarthritis, protecting joints and tendons from injury, and decreasing inflammation (see research below). OSTEOARTHRITIS: Osteoarthritis is also known as Degenerative Joint Disease and is the most common form of arthritisaffecting some 40 million Americans. The most oft-affected joints are weight-bearers like the knees, hips, and small joints of the hands. Cartilage destruction causes pain, deformity, and limitation of movement. Current treatment of this condition usually involves non-steroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen. Though these drugs can suppress the pain symptoms, they have not been found to contribute to any long-term cartilage repair. Glucosamine shows promise as a potential stimulator of the substances necessary for actual joint repair. European were the first to study the link between osteoarthritis and glucosamine levels. SCIENTIFIC SUPPORT: An Alternative Medicine Review stated glucosamine sulfate's primary biological role in halting or reversing joint degeneration to be its ability to act as an essential substrate (substance on which an enzyme acts) for the glycosaminoglycans needed during the formation of the structural matrix of joints (1). The Peking Union Medical College Hospital in China performed a double-blind therapeutic investigation on 178 Chinese patients suffering from osteoarthritis of the knee. The patients were divided into two groups of which one would receive a daily dose of 1,500 mg glucosamine and the other 1,200 mg ibuprofen. The study lasted four weeks. Both GS and IBU significantly reduced the symptoms of osteoarthritis with the trend of glucosamine to be more effective and much better tolerated (2). A group of German scientists made similar findings after a study performed on 200 hospitalized patients with active osteoarthritis of the knee. A randomized, double-blind study of glucosamine vs. ibuprofen found GS to be just as effective as ibuprofen on symptoms of knee OA but with far less adverse events as ibuprofen (6% to 35%) (3). The Naval Medical Department in Norfolk, Va., conducted a 16-week randomized double-blind placebo-controlled study of glucosamine (1,500 mg daily), chondroitin sulfate (1,200 mg daily), and manganese ascorbate (228 mg daily) to determine the efficacy of these substances on U.S. Navy divers and special warfare community with chronic pain and degenerative joint disease. They found the combination therapy to relieve symptoms of knee osteoarthritis (4). Yet another double-blind evaluation of glucosamine found results to be a definite improvement over antirheumatic drugs, the major drawbacks of which are action of short duration and side effects. The study concluded glucosamine therapy deserved a select place in the management of osteoarthritis (5). Another clinical trial tested oral glucosamine sulphate against placebo in a double-blind trial in 20 out-patients with established osteoarthrosis. Patients given glucosamine experienced earlier alleviation of symptoms compared with those who had placebo. The use of glucosamine also resulted in a significantly larger proportion of patients who experienced lessening or disappearance of symptoms within the trial period. Additionally, no adverse reactions were reported by patients treated with glucosamine (6). The efficacy and tolerance of a preparation of pure glucosamine sulphate was investigated in 30 patients with osteoarthrosis. Two groups of in-patients with chronic degenerative articular disorders received daily for 7 days either 400 mg glucosamine sulphate or a piperazine/chlorbutanol combination by intravenous or intramuscular injection. During both initial treatments, each symptom significantly improved, but to a faster and greater extent in the group treated with glucosamine. During the maintenance period, a further improvement was recorded in the patients treated with glucosamine, whereas in those on placebo the symptom scores increased almost to the pre-treatment level (7). The Department of Pharmacy at the University of Virginia evaluated glucosamine sulfate for the treatment of osteoarthritis. Their review concluded glucosamine to be as good as ibuprofen for osteoarthritis of the knee (8). A full review of existing studies on the efficacy of glucosamine by the Division of Rheumatology at the Case Western Reserve University School of Medicine in Cleveland, Ohio, found glucosamine to be superior to ibuprofen in treating osteoarthritis (9).
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