Glucosamine – should I take it or not?

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As a 50-something now, with 40-odd years of running-based sports behind me, I have been wrestling for some years now with the ‘will I’ or ‘won’t I’ of Glucosamine.

It certainly seems to be a product of my generation, and I myself have taken the stuff for years. Many of my friends and acquaintances have as well.

As a result of those mis-spent years running on roads, I have also had two arthroscopies on each knee, and am probably due another pair soon. My GP, with a background in sports medicine (and several years being doctor for an AFL club), strongly recommended Glucosamine. The surgeons doing the arthroscopy also recommended it, along with a little ingredient called Chrondroitin.

After years of taking the stuff however, I couldn’t honestly say I could feel any difference. Of course, this is just anecdotal, and no one person can ever know whether or not it’s making any difference, can they? For all you know, you could be no worse off without it.

This is why we rely on doctors, who in turn rely on clinical testing.

After asking the question of my GP, the answers were less than enthusiastic. He takes them as a prophylactic – the stuff does no harm, and he can afford it, was his position. He also suggested consulting the Cochrane Review (http://www2.cochrane.org/reviews/). This is a terrific, non-profit organisation which aims to summarise in plain language the state of play across a whole range of medicine and alternative medicine.

Anyway, to cut a long story short, here’s their summary of the studies:

Best estimate of what happens after about 6 months

Pain: The high quality studies showed that pain improved about the same whether people took glucosamine or fake pills. If all of the studies are examined (including low quality and old studies), then glucosamine improved pain more than fake pills.

People who took fake pills had a pain score of 7 points on a 0 to 100 scale. Pain may improve by 10 more points with glucosamine than with fake pills.

Studies testing only the Rotta brand of glucosamine (including low quality and older studies) showed that glucosamine improved pain more than fake pills. People who took fake pills had a pain score of 6 points on a 0 to 20 scale. People who took the Rotta brand of glucosamine rated their pain 3 points lower than people who did not take glucosamine.

Function: The high quality studies show that glucosamine improved function more than fake pills when measured by one type of scale, but improved the same amount as fake pills when measured by another scale.

Studies testing only the Rotta brand of glucosamine (including low quality and older studies) showed that glucosamine improved function more than fake pills. People who took fake pills had a function score of 22 points on a 0 to 68 scale. People who took the Rotta brand of glucosamine had their ability to function improve by 2 points compared to people who did not take glucosamine.

There was no difference in the number of people who had side effects.  Side effects mainly included stomach upset and other joint pain.

So, in my book there’s not much to hang your hat on. Basically, the high quality studies show no improvement over placebo, while the lower quality ones show a 2 point improvement in pain on a scale of 68! Talk about marginal effects. That’s certainly not enough for me to be sucking these things down, even if they are harmless.

Smarties would be cheaper, tastier, and about as effective.

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9 thoughts on “Glucosamine – should I take it or not?

    Oh boy – Christmas has come early! « rationalbrain said:
    December 8, 2011 at 8:00 am

    […] And today I also read an article entitled EU quells buzz on royal jelly, in which a body called the European Food Safety Authority has sunk the boot into a whole range of health claims of one sort or another. In fact they’ve gone further than just safety, but have assessed products for efficacy. It appears that  the EU approved regulations in May 2006 to ensure that nutrition and health claims appearing on food products were scientifically proven. Well done EFSA. Our Therapeutic Goods Administration should take note. Apparently the EFSA has approved only 200 of 2500 health claims made by different products,with many more waiting in the wings. Amongst those products that get the thumbs down are royal jelly and its claim to boost the immune system, green tea and its claim to maintain healthy blood pressure, black tea and its claim to help focus attention, and glucosamine and its claim to improve joint pain and function (no doubt the EFSA finally read this). […]

    Swisse claims are full of holes « rationalbrain said:
    March 12, 2012 at 1:04 am

    […] (for example, krill oil in easing PMS symptoms), others are questionable – for example, see my article on […]

    […] re-wind the clock. Back in the early days of rationalbrain, I put the spotlight on this popular supplement, given my own personal interest in keeping my knees in good order after […]

    Ben Tuy Dearz said:
    September 24, 2013 at 9:49 am

    Hmm. I came here to look at your comments on Swisse Liver Detox, cos I’m taking it and just wondering whether to bother or not. So, thanks for your words of wisdom on that. Now, you’ve found that glucosamine doesn’t do it for you. I’m nearly 60 and have had 4 of those artheroscopies on one knee and 1 on my other and had constant mild pain for many years, as a result of genetics, cross country running, a lifetime with heaps of landing on my knees as well as a parachute accident and 2 water skiing accidents. As well as the vacuuming of my knees, I also used pain killer, anti-inflammatories, sleeping pills and alcohol to overcome the pain which would break up my sleep.

    Then a friend suggested fish oil and glucosamine. I tried it for a month or so with no effect. Then I went to a naturopath who told me to increase my daily consumption of glucosamine to THREE tablets instead of one, and waddaya know? Within a few days, suddenly I was able to sleep nearly all the way thru the nite without any pain. That was in the late 90’s and now I don’t use any of those products – except alcohol, which I use for pleasure now. I’ve changed from fish oil to krill oil and instead of using the recommended 3 tablets of glucosamine, I get by on just 2. But the pain has gone and I’m able to sleep.

    If that’s the placebo effect, can you direct me to a site that sells placebo effect pills for joint pain please??

      rationalbrain responded:
      September 24, 2013 at 10:01 am

      It’s great that you’ve found that relief. My point however stills stands, that there are many trials, but no clinical evidence to support using them, a finding which also happen to match my experience with them. Like your alcohol for pleasure, if it feels good, well, nothing to lose right?

    corniculo said:
    December 9, 2013 at 4:22 am

    I believe you need 3 to 6 (1500 mg) glu. chondroite daily to see benefit. The simple reason company studies are favorable, while independent are not, is that a company knows how to ramp up the quality (to pharm grade) and quantity (cheaply).

    Certainly, the bottle will tell you a dose far below what is needed, just to make the product look affordable and dooable for swallowing.

    My BS detector goes off at the naysayers: they do not tell you the dose in the studies, or grade (source) of ingredients. When in doubt obfuscate.

      rationalbrain responded:
      December 9, 2013 at 8:59 am

      I’m not sure I understand your point.
      On what do you base your belief that you can achieve daily benefit – what the pharma companies tell you?
      If so, would it not be in their collective interests to advise the quantity and quality which will achieve real, testable benefits?
      The studies I’ve seen certainly do indicate dose – and that would be taken into account when assessing quality of the study included in the meta-analysis.
      Bottom line: from a user point of view, no benefit. The onus is on the vendors to change that – if a benefit can be obtained by changing dose/quality, then they should put up or shut up.

    corniculo said:
    December 9, 2013 at 4:38 am

    An example, with which many reading will relate: Headlines “Trial proves pressure washing add no benefit to peeling paint job”

    Reality: Fact #1 Standard Pressure washing using rental unit only gets 4% of loose paint off house in a day. (while hand scraping is .25% per day). #2 A water blaster tip will get %20 in a day or %40 in 2 days. #3 combined with a very aggressive sander for extra day, you get 85% off. And add one more blast, grind cycle (another day) you can get %95 loose off (a max of 4 days of material removal)

    Conclusion: the consumer knows no difference or will appreciate the added mess/abatement off old paint, so it makes no sense to offer anything more than a light standard wash (where the greatest dollar return will be).

    Conclusion #2: However, any independent study will show no statistical benefit from pressure washing, despite many uncaught paint chips. (Though-economics/regulations aside- the truth is a higher dosage, a better blaster tip (which takes more skill to use), and a combination with grinding, is exceptionally beneficial up to nearly total abatement of any loose old paint for the next 30 plus years.)

    skymoose said:
    November 23, 2014 at 3:55 am

    I do have to add this, if the Glucosamine is not taken with MSM, it’s of little use at all, don’t know the ratio but I’ll look into it. Glucosamine is naturally produced by the body, the idea is to add some more to your system.

    I have this personal experience with it. My mother 79, had bad knees, she was told that surgery was the only option but she was too old to go through the procedure. Her knees were swollen and very painful. I put her on Glucosamine/MSM after researching it. In 2 months her knees were back to pretty much normal and she could walk, couldn’t before. No placebo effect here, she just took it. She would panic when she was low on it.

    So if in reality there was a placebo effect, it was a hell of a one.

    Just thought I’d throw this in.

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