What’s the Bottom Line?
How much do we know about glucosamine and chondroitin supplements?
- We have some information about the safety and usefulness of glucosamine and chondroitin from large, high-quality studies in people.
What do we know about the effectiveness of glucosamine and chondroitin supplements?
- Research results suggest that chondroitin isn’t helpful for pain from osteoarthritis of the knee or hip.
- It’s unclear whether glucosamine helps with osteoarthritis knee pain or whether either supplement lessens osteoarthritis pain in other joints.
What do we know about the safety of glucosamine and chondroitin supplements?
- Studies have found that glucosamine and chondroitin supplements may interact with the anticoagulant (blood-thinning) drug warfarin (Coumadin). Overall, studies have not shown any other serious side effects.
- If you take glucosamine or chondroitin supplements, tell your health care providers. They can do a better job caring for you if they know what dietary supplements you use.
What Are Glucosamine and Chondroitin?
Glucosamine and chondroitin are structural components of cartilage, the tissue that cushions the joints. Both are produced naturally in the body. They are also available as dietary supplements. Researchers have studied the effects of these supplements, individually or in combination, on osteoarthritis, a common type of arthritis that destroys cartilage in the joints.
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What the Science Says About Glucosamine and Chondroitin for Osteoarthritis
For the Knee or Hip
Glucosamine
Major studies of glucosamine for osteoarthritis of the knee have had conflicting results.
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Chondroitin
In general, research on chondroitin has not shown it to be helpful for pain from knee or hip osteoarthritis.
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Joint Structure
A few studies have looked at whether glucosamine or chondroitin can have beneficial effects on joint structure. Some but not all studies found evidence that chondroitin might help, but the improvements may be too small to make a difference to patients. There is little evidence that glucosamine has beneficial effects on joint structure.
Experts’ Recommendations
Experts disagree on whether glucosamine and chondroitin may help knee and hip osteoarthritis. The American College of Rheumatology (ACR) has recommended that people with knee or hip osteoarthritis not use glucosamine or chondroitin. But the recommendation was not a strong one, and the ACR acknowledged that it was controversial.
For Other Parts of the Body
Only a small amount of research has been done on glucosamine and chondroitin for osteoarthritis of joints other than the knee and hip. Because there have been only a few relatively small studies, no definite conclusions can be reached.
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What the Science Says About Safety and Side Effects
- No serious side effects have been reported in large, well-conducted studies of people taking glucosamine, chondroitin, or both for up to 3 years.
- However, glucosamine or chondroitin may interact with the anticoagulant (blood-thinning) drug warfarin (Coumadin).
- A study in rats showed that long-term use of moderately large doses of glucosamine might damage the kidneys. Although results from animal studies don’t always apply to people, this study does raise concern.
- Glucosamine might affect the way your body handles sugar, especially if you have diabetes or other blood sugar problems, such as insulin resistance or impaired glucose tolerance.
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More to Consider
- If your joints hurt, see your health care provider. It’s important to find out what’s causing your joint pain. Some diseases that cause joint pain—such as rheumatoid arthritis—may need immediate treatment.
- If you take warfarin or have blood sugar problems, make sure you talk to your doctor about potential side effects if you are considering or taking glucosamine or chondroitin supplements.
- If you’re pregnant or nursing a child, it’s especially important to see your health care provider before taking any medication or supplement, including glucosamine or chondroitin.
- Help your health care providers give you better coordinated and safe care by telling them about all the health approaches you use. Give them a full picture of what you do to manage your health.
Key References
- Ali AA, Lewis SM, Badgley HL, et al. Oral glucosamine increases expression of transforming growth factor β1 (TGFβ1) and connective tissue growth factor (CTGF) mRNA in rat cartilage and kidney: implications for human efficacy and toxicity. Archives of Biochemistry and Biophysics. 2011;510(1):11–18.
- Cahlin BJ, Dahlström L. No effect of glucosamine sulfate on osteoarthritis in the temporomandibular joints—a randomized, controlled, short-term study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2011;112(6):760–766.
- Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. New England Journal of Medicine. 2006;354(8):795–808.
- Dostrovsky NR, Towheed TE, Hudson RW, et al. The effect of glucosamine on glucose metabolism in humans: a systematic review of the literature. Osteoarthritis and Cartilage. 2011;19(4):375–380.
- Gabay C, Medinger-Sadowski C, Gascon D, et al. Symptomatic effects of chondroitin 4 and chondroitin 6 sulfate on hand osteoarthritis: a randomized, double-blind, placebo-controlled clinical trial at a single center. Arthritis & Rheumatism. 2011;63(11):3383–3391.
- Herrero-Beaumont G, Ivorra JA, Del Carmen Trabado M, et al. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis & Rheumatism. 2007;56(2):555–567.
- Hochberg MC, Altman RD, April KT, et al. American College of Rheumatology 2012 recommendations for the use of nonpharmacologic and pharmacologic therapies in osteoarthritis of the hand, hip, and knee. Arthritis Care & Research. 2012;64(4):465–474.
- Knudsen JF, Sokol GH. Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: case report and review of the literature and MedWatch database. Pharmacotherapy. 2008;28(4):540–548.
- Pavelká K, Gatterová J, Olejarová M, et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Archives of Internal Medicine. 2002;162(18):2113–2123.
- Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial.Lancet. 2001;357(9252):251–256.
- Reichenbach S, Sterchi R, Scherer M, et al. Meta-analysis: chondroitin for osteoarthritis of the knee or hip. Annals of Internal Medicine. 2007;146(8):580–590.
- Sawitzke AD, Shi H, Finco MF, et al. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Annals of the Rheumatic Diseases. 2010;69(8):1459–1464.
- Sawitzke AD, Shi H, Finco MF, et al. The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial. Arthritis & Rheumatism. 2008;58(10):3183–3191.
- Thie NM, Prasad NG, Major PW. Evaluation of glucosamine sulfate compared to ibuprofen for the treatment of temporomandibular joint osteoarthritis: a randomized double blind controlled 3 month clinical trial. Journal of Rheumatology. 2001;28(6):1347–1355.
- Wilkens P, Scheel IB, Grundnes O, et al. Effect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis: a randomized controlled trial. JAMA. 2010;304(1):45–52.