Ask the Expert: Does Glucosamine Work?
Dear Dr. Krant,
I would like to know if the supplements glucosamine and chondroitan sulfate are worth trying for osteoarthritis. I’ve heard of many people who have been helped. Do these supplements really work? Are they safe?
Glucosamine and chondroitan have been the subject of extensive interest in the medical community for some years. As far back as 2000, meta-analysis in JAMA found considerable variation, with inflated estimates of benefit from multiple studies (17 placebo-controlled clinical trials) of glucosamine and chondroitan. More recent data from the New England Journal of Medicine did not demonstrate benefit, although many users are convinced of the therapeutic efficacy (and potential for sparing non-steroidal use) of these neutraceuticals. At the very least, 1.5 grams of glucosamine are required for a minimum of 1 month (500 mg three times a day are recommended by manufacturers) before benefit can be assessed.
In my practice, glucosamine is suggested as a potential osteoarthritis treatment option in patients who are reluctant to take non-steroidals on a daily basis, and have mild disease activity which does not require articular injection or joint replacement. Although anecdotal data supports the use of glucosamine (ask any patient who uses it), careful analysis of trial data does not support its use. Remember to speak to your physician about your particular situation prior to trying them.
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Jonathan D. Krant, M.D., directs the teaching service in Rheumatology at Berkshire Medical Center in Pittsfield, Massachussetts. A busy clinician, he oversees the care of 6,000 patients and runs the clinical investigation unit at Berkshire Rheumatology Associates, where he is employed as a staff rheumatologist. He wrote about osteoarthritis for HealthCentral.