Joint Care/Supps

[Blondell]

Is a glucosamine/msm supplement worth buying? If not, what's good for joint health that can be used--in addition to fish oils?

[mich56]

I think they are a great addition to fish oils, IMO.

[Aaron_F]

Research wise

Glucosamine for protecting joints - no evidence
Glucosamine for acute injuries - no evidence
Glucosamine for osteoarthritis - moderate evidence

MSN - minimal on most fronts

Fish oils - Rhematoid arthritis - High as hell doses

[cmberman1987]

Blahhhhhhhhhhhhhhhhhhh. Stay away from glucosamine. As Aaron said, there's no significant evidence supporting the notion they protect joints or are beneficial for joint health. I haven't been on the board long enough, but from my experience, alot of people don't know this:

GLUCOSAMINE BLOCKS THE EFFECTS OF INSULIN. Blood sugar levels to rise and stagnate in that state, increasing the likelihood, in susceptible people, of suffering the side effects of diabetes.

Source: Research project in my Food Technology class. I'm sure there's resources citing that information somewhere online.

Up your fish oils.

[Aaron_F]

GLUCOSAMINE BLOCKS THE EFFECTS OF INSULIN. Blood sugar levels to rise and stagnate in that state, increasing the likelihood, in susceptible people, of suffering the side effects of diabetes.

study fight

Oral glucosamine for 6 weeks at standard doses does not cause or worsen insulin resistance or endothelial dysfunction in lean or obese subjects.

* Muniyappa R,
* Karne RJ,
* Hall G,
* Crandon SK,
* Bronstein JA,
* Ver MR,
* Hortin GL,
* Quon MJ.

Chief, Diabetes Unit, National Center for Complementary and Alternative Medicine, National Institutes of Health, 10 Center Dr., Bldg. 10, Rm. 6C-205, Bethesda, MD 20892, USA.

Glucosamine is a popular nutritional supplement used to treat osteoarthritis. Intravenous administration of glucosamine causes insulin resistance and endothelial dysfunction. However, rigorous clinical studies evaluating the safety of oral glucosamine with respect to metabolic and cardiovascular pathophysiology are lacking. Therefore, we conducted a randomized, placebo-controlled, double-blind, crossover trial of oral glucosamine at standard doses (500 mg p.o. t.i.d.) in lean (n = 20) and obese (n = 20) subjects. Glucosamine or placebo treatment for 6 weeks was followed by a 1-week washout and crossover to the other arm. At baseline, and after each treatment period, insulin sensitivity was assessed by hyperinsulinemic-isoglycemic glucose clamp (SI(Clamp)) and endothelial function evaluated by brachial artery blood flow (BAF; Doppler ultrasound) and forearm skeletal muscle microvascular recruitment (ultrasound with microbubble contrast) before and during steady-state hyperinsulinemia. Plasma glucosamine pharmacokinetics after oral dosing were determined in each subject using a high-performance liquid chromatography method. As expected, at baseline, obese subjects had insulin resistance and endothelial dysfunction when compared with lean subjects (SI(Clamp) [median {25th-75th percentile}] = 4.3 [2.9-5.3] vs. 7.3 [5.7-11.3], P < 0.0001; insulin-stimulated changes in BAF [% over basal] = 12 [-6 to 84] vs. 39 [2-108], P < 0.04). When compared with placebo, glucosamine did not cause insulin resistance or endothelial dysfunction in lean subjects or significantly worsen these findings in obese subjects. The half-life of plasma glucosamine after oral dosing was approximately 150 min, with no significant changes in steady-state glucosamine levels detectable after 6 weeks of therapy. We conclude that oral glucosamine at standard doses for 6 weeks does not cause or significantly worsen insulin resistance or endothelial dysfunction in lean or obese subjects.

Short-term glucosamine infusion does not affect insulin sensitivity in humans.

* Pouwels MJ,
* Jacobs JR,
* Span PN,
* Lutterman JA,
* Smits P,
* Tack CJ.

Divisions of General Internal Medicine, University Medical Center, 6500 HB Nijmegen, The Netherlands. m.pouwels@endo.azn.nl

Overactivity of the hexosamine biosynthetic pathway may underlie hyperglycemia-associated insulin resistance, but to date human studies are lacking. Hexosamine pathway activation can be mimicked by glucosamine (GlcN). In the present placebo-controlled study we determined whether GlcN infusion affects insulin resistance in vivo. In 18 healthy subjects, we applied the double forearm balance technique (infused arm vs. control arm) combined with the euglycemic hyperinsulinemic clamp (60 mU/m(2).min insulin) for at least 300 min. During the clamp, subjects received infusions in the brachial artery of 4 micromol/dL.min GlcN from 90-240 min (n = 6) or from 0-300 min (n = 6) or saline (placebo; n = 6). We studied the effects of GlcN on forearm glucose uptake (FGU; infused arm vs. control arm, and vs. placebo experiments) and on whole body glucose uptake. GlcN infusion raised the plasma GlcN concentration in the infusion arms to 0.42 +/- 0.14 and 0.81 +/- 0.46 mmol/L; plasma GlcN remained very low (< 0.07 mmol/L) in the control arms and in the placebo group. GlcN infusion did not change forearm blood flow. During insulin, FGU increased more than 10-fold. At all time points, FGU was similar in the GlcN-infused arm compared with the control arm and was not different from FGU in the placebo experiments. Similar results were obtained for forearm arteriovenous glucose differences or extraction and for whole body glucose uptake. Thus, despite relevant GlcN concentrations for 5 h in the infused forearm, GlcN had no effect on insulin-induced glucose uptake. These results do not support involvement of the hexosamine pathway in the regulation of insulin sensitivity in humans, at least not in the short-term setting.

[Aaron_F]

The Effect of Oral Glucosamine Sulfate on Insulin Sensitivity in Human Subjects
Joseph G. Yu, MD1,2,3, Sarah M. Boies, BS1,2,3 and Jerrold M. Olefsky, MD1,2,3

1 Department of Medicine, Division of Endocrinology and Metabolism, University of California San Diego, La Jolla, California
2 Veterans Administration San Diego Healthcare System, San Diego, California
3 The Whittier Institute for Diabetes, La Jolla, California

As glucosamine is presently in wide use due to its purported beneficial effects in patients with osteoarthritis, it seemed important to consider its possible adverse effects on glucose metabolism. Many subjects who take glucosamine for osteoarthritis are obese, insulin resistant, diabetic, or at risk for the development of diabetes, and it is established that glucosamine induces insulin resistance in rats and mice. Hypotheses suggest that glucosamine causes insulin resistance by directly entering the hexosamine biosynthetic pathway. It has been proposed that this provides a model for glucotoxicity-induced defects in insulin action and secretion (1), since, under hyperglycemic conditions, a larger amount of glucose flux is metabolized through the hexosamine pathway. Therefore, we undertook this study to determine if glucosamine, taken at recommended doses for the treatment of osteoarthritis, had any detrimental effect on glucose metabolism.

Seven obese (BMI >=27 kg/m2) and seven lean subjects (BMI <=27) participated in the study. Three of the obese subjects and two of the lean subjects had impaired glucose tolerance (IGT). Each subject had a baseline 4-h meal tolerance test (MTT) and a frequently sampled intravenous glucose tolerance test, before and after 4 weeks of glucosamine sulfate (500 mg, three times/day).

At baseline, fasting plasma glucose and insulin levels were 5.4 &#177; 0.3 mmol/l and 14.4 &#177; 3.6 &#181;U/ml in the obese subjects compared with 4.8 &#177; 0.3 and 10.8 &#177; 4.9 in the lean subjects, respectively. After 4 weeks of treatment with glucosamine sulfate, there were no changes in fasting plasma glucose, insulin, or lipoprotein levels.

After 4 weeks of treatment with glucosamine sulfate, there was no change in the area under the 4-h plasma glucose curve (AUCgluc) (1,551 &#177; 55 vs. 1,539 &#177; 55 mmol &#183; l-1 &#183; min-1) and the 4-h MTT plasma insulin curve (AUCins) (17,903 &#177; 8,745 vs. 17,861 &#177; 9,406 mU/l &#183; min) in all subjects.

Insulin sensitivity was significantly reduced at baseline in the obese compared with the lean subjects (lean: 3.58 &#177; 0.6; obese: 1.2 &#177; 0.4 x 10-4 min-1 &#183; &#181;U-1 &#183; ml-1; P < 0.01). After 4 weeks of treatment with glucosamine, there was no difference in insulin sensitivity in the combined group of subjects (2.37 &#177; 0.46 vs. 2.55 &#177; 0.58; P = 0.67), nor was there any difference when the subjects were analyzed according to BMI (obese or lean) or glucose tolerance (normal glucose tolerant or IGT).

Although there are many studies showing that acute or chronic administration of glucosamine and activation of the hexosamine pathway can cause insulin resistance, few studies on humans exist. Monauni et al. (2) reported that acute, short-term (6-h) intravenous glucosamine infusion had no detectable effects on glucose metabolism during a euglycemic clamp. Similarly, Pouwels et al. (3) reported that a 5-h infusion of glucosamine did not affect whole-body glucose uptake in human subjects. To date, there have been no studies on the chronic effects of oral glucosamine on insulin sensitivity.

We did not measure plasma glucosamine levels or metabolites of the hexosamine pathway, and, as such, it is possible that the glucosamine load given to our subjects may have been insufficient to produce insulin resistance. However that was not the intent of this study. We wanted to determine whether the recommended dose of glucosamine for treatment of osteoarthritis was detrimental to glucose metabolism in humans, and our data indicate that it is not. Given the common usage of glucosamine supplementation in insulin-resistant and other susceptible populations, these negative findings have significant clinical interest. Based on our results, we think it is unlikely that long-term treatment regimens or the use of glucosamine in diabetic subjects would lead to adverse effects on glucose metabolism. However, since we did not study these specific conditions, definitive conclusions on these issues warrant further study.

Footnotes

Address correspondence to Jerrold M. Olefsky, MD, University of California San Diego (0673), 9500 Gilman Dr., La Jolla, CA 92037. E-mail: jolefsky@ucsd.edu.

References

1. Unger RH, Grundy S: Hyperglycemia as an inducer as well as a consequence of impaired islet function and insulin resistance: implications for the management of diabetes. Diabetologia 28: 119–121, 1985[Medline]
2. Monauni T, Zenti MG, Cretti A, Daniels MC, Targher G, Caruso B, Caputo M, McClain D, Del Prato S, Giaccari A, Muggeo M, Bonora E, Bonadonna RC: Effects of glucosamine infusion on insulin secretion and insulin action in humans. Diabetes 49: 926–935, 2000[Abstract]
3. Pouwels MJ, Jacobs JR, Span PN, Lutterman JA, Smits P, Tacks CJ: Short-term glucosamine infusion does not affect insulin sensitivity in humans. J Clin Endocrinol Metab 86: 2099–2103, 2001[Abstract/Free Full Text]

[cmberman1987]

Ah! STUDY FIGHT! HOLD!

[cmberman1987]

Effects of oral glucosamine sulphate on serum glucose and insulin during an oral glucose tolerance test of subjects with osteoarthritis.

* Biggee BA,
* Blinn CM,
* Nuite M,
* Silbert JE,
* McAlindon TE.

Division of Rheumatology, Tufts New England Medical Center, Boston, Massachusetts, USA.

BACKGROUND: and objective: Glucosamine is suggested to affect glucose transport and insulin resistance. The effects of oral glucosamine on serum glucose and insulin levels at the initiation and throughout the duration of a 3-h oral glucose tolerance test were examined. METHODS: Sera from 16 patients with osteoarthritis, but with no other diagnosed medical condition who had fasted overnight, were obtained every 15-30 min during the 3 h of continued fasting and during the 3 h after ingestion of 75 g of glucose with or without ingestion of 1500 mg of glucosamine sulphate. Glucose was analysed by high-performance liquid chromatography using a Metrohm-Peak 817 Bioscan, and the area under the curve (AUC) for glucose was calculated. Insulin was measured by radioimmunoassay every 30 min for 2 h. RESULTS: Three participants who were found to have previously undiagnosed abnormalities of glucose tolerance demonstrated significant (p = 0.04) incremental elevations in glucose levels after ingestion of glucosamine sulphate. The other 13 participants also had mean incremental elevations that were not significant (p = 0.20). Glucosamine sulphate ingestion had no effect on insulin levels. CONCLUSION: The results suggest that glucosamine ingestion may affect glucose levels and consequent glucose uptake in patients who have untreated diabetes or glucose intolerance.

[cmberman1987]

February 2-0-0-7

[cmberman1987]

Your first study was deemed 'complete' in 2006. I've seen this one. I haven't seen the second; So, unsure of the date.

[Aaron_F]

Effects of oral glucosamine sulphate on serum glucose and insulin during an oral glucose tolerance test of subjects with osteoarthritis.

* Biggee BA,
* Blinn CM,
* Nuite M,
* Silbert JE,
* McAlindon TE.

Division of Rheumatology, Tufts New England Medical Center, Boston, Massachusetts, USA.

BACKGROUND: and objective: Glucosamine is suggested to affect glucose transport and insulin resistance. The effects of oral glucosamine on serum glucose and insulin levels at the initiation and throughout the duration of a 3-h oral glucose tolerance test were examined. METHODS: Sera from 16 patients with osteoarthritis, but with no other diagnosed medical condition who had fasted overnight, were obtained every 15-30 min during the 3 h of continued fasting and during the 3 h after ingestion of 75 g of glucose with or without ingestion of 1500 mg of glucosamine sulphate. Glucose was analysed by high-performance liquid chromatography using a Metrohm-Peak 817 Bioscan, and the area under the curve (AUC) for glucose was calculated. Insulin was measured by radioimmunoassay every 30 min for 2 h. RESULTS: Three participants who were found to have previously undiagnosed abnormalities of glucose tolerance demonstrated significant (p = 0.04) incremental elevations in glucose levels after ingestion of glucosamine sulphate. The other 13 participants also had mean incremental elevations that were not significant (p = 0.20). Glucosamine sulphate ingestion had no effect on insulin levels. CONCLUSION: The results suggest that glucosamine ingestion may affect glucose levels and consequent glucose uptake in patients who have untreated diabetes or glucose intolerance.


IF we are to play study fight, we also must examine the bizzare nature of this trial

IF we look at the actual document rather than the crap abstract. The subjects took part in four trials. First three were done 1-2 weeks apart, the last one was several months later.

There was four protocols measured. 1500mg glucosamine in visit 1, 75g glucose at visit 2, 1500mg glucosamine+75g glucose at visit 3 and finally a control without either.

For a good trial, the actual treatment at each visit would have been randomised to remove some of the time effect. This was not done adding more bias into the trial.

Overall, there was no effect of glucosamine on the blood sugar responses following glucosamine.

However, the authors took the strange step of subsampling the three outliers that produced a result. Which just reeks of the researchers going out of their way to grab little bits of data to create the story that they want. The subjects also had raised blood glucose levels at the start, which should have been screened for/selected for, in the first place.

Combine this with the issues with study design and it starts laying questions in the reliability of the result, especially as its relying on a subsample of three, count em, three frikin people.

Combine this fun result with other trials showing no effect, I would probably bank on the side of no real effect rather than any significant effect on glucose metabolism.

[Aaron_F]

February 2-0-0-7

you understnad that a newer study does not supplant an older one? it just adds to the pool of knowledge.

and that newer =/= better especially with 1

but if we want to play, the abstract you posted

Accepted 14 June 2006,
Published Online First 3 July 2006

2 - 0 - 0 -6

[cmberman1987]

I am completely aware of the fact that new studies only contribute to the existing base of research.

But, newer research, oftentimes (key term: OFTEN, not always) can be held more accountable as the preparatory process includes considerations of existing research.

Blah. I didn't mean for my statement to come off as: IF YOU TAKE GLUCOSAMINE, YOU WILL DEFINITELY BECOME DIABETIC AND THEN DIE. Rather, if research suggests glucosamine has no benefit in promoting joint health, and rather, that it might have a possible role in elevating glucose levels/blocking the effects of insulin, why bother with it?

[Aaron_F]

If you were talking about a paper from 1936 with no statistical analysis performed on the data, then it may be worth mentioning the age. But when you 're comparing 2006 to 2007 its pointless. The difference in age may be utterly due to publication dates or researchers fooking around before they write itup.

If your suffering from osteoarthritis, then you may want to bother with it.

[cmberman1987]

Considering osteoarthritis is that which plagues individuals in their middle to older ages, I'm pretty sure it's not relevant here. If B has osteoarthritis, it might be worth looking into, but...I'm pretty sure that's not the case.

[Aaron_F]

Just as worrying about the effects of glucosamine on diabetics or IGT

[homeschoolmom]

Considering osteoarthritis is that which plagues individuals in their middle to older ages, I'm pretty sure it's not relevant here.

There are plenty of us here in the "middle to older" ages. However I like to call it my prime! ;)

[Inatic]

Ha Erika, Prime for sure!
:thumb:

Aaron, how about plain unflavored Gelatin.

[cmberman1987]

Just as worrying about the effects of glucosamine on diabetics or IGT

You can win if you want.

[Aaron_F]

Aaron, how about plain unflavored Gelatin.

Gelatin is interesting, apart from being ground up collagen, it contains a good whack of hydroxyproline, of which can appear in hepatic circulation, and can potentially skip one of the steps in the manufacture of collagen.

There is not a lot out there in terms of research on it for joint health, I think there is some unpublished stuff out there.

[Aaron_F]

You can win if you want.

you have to be kidding

[Espi]

Hyaluronic acid beats glucosamine hands down, both for joints and skin health.

[Erik]

You can win if you want.

:blink:

[JGWright]

I win!

Why?

Because I WIN!



What movie?

[cmberman1987]

Of COURSE I'm kidding...I had class and couldn't stick around...That's all.

[cmberman1987]

I win!

Why?

Because I WIN!



What movie?

Goonies?

[cmberman1987]

Great, now I'm never gonna know the answer. :wavesad:

[char-dawg]

Anecdotally, I like Glucosamine + MSM for joint health. I've had some shoulder and elbow problems that it seemed to help with, and I know several older folks who have problems (mostly in their knees; they're very fat) who swear by the stuff.

FWIW, when I was taking it I noticed no effects at all on my insulin. :shrug:

It's a cheap supp; why not buy a month's worth and see what you think?

[Aaron_F]

I got a ton of ex-research glucosamine ages back, the only thing I noticed while taking it was sore joints.

[Espi]

The best results I ever had regarding lesser joint pain:
back in 2002 ketodiet because it blunts inflammation
However, when I reintroduced carbs I noticed that not all of them are created equal.
Taking out foods that are allergenic: no soy (lecithin), no gluten (and no dairy?).
Eating these foods again, bring back joint pain within 24hrs.

Must say that with 99% probablility I'm cursed with an auto-immune disease (not yet sure which one), so YMMV.

My partner's Golden Retriever who suffered hip atrophy badly and was going to be crippled for life acccording to the vet, saw near complete recovery after receiving:
hyaluronic acid, krill oil, SAMe Joint, Bone-Up

http://www.jarrow.com/supplimentImg/supp_facts_BU120_113006.gif

[JGWright]

Great, now I'm never gonna know the answer. :wavesad:


Big Daddy

[cmberman1987]

Big Daddy

A DAY later... :lol3:

Dammit. Big Daddy? I don't remember that part....

Thanks, though. I can go to bed tonight.