Glucosamine

Once a top-selling joint supplement, but large rigorous trials (GAIT, LEGS) show modest or no benefit over placebo for most osteoarthritis patients.

A rough internal score reflecting quantity, quality, and consistency of human evidence. Not a clinical recommendation.

The GAIT trial found glucosamine sulfate no better than placebo for knee OA pain overall, though a subgroup with moderate-to-severe pain showed improvement. European trials using crystalline glucosamine sulfate (Rottapharm) report better outcomes. The discrepancy may relate to formulation, dose, or trial design.

• May reduce joint pain in some osteoarthritis patients
• Possible cartilage-protective effects with long-term use
• Well-tolerated in most individuals

Standard dose is 1500 mg glucosamine sulfate daily, typically taken as 500 mg three times daily or as a single dose.

• Mild GI discomfort
• Nausea
• Possible allergic reaction in shellfish-sensitive individuals

Derived from shellfish in most formulations; alternatives exist for shellfish allergy. May affect blood glucose levels.

Results depend heavily on formulation (sulfate vs. HCl) and manufacturer. Prescription-grade crystalline glucosamine sulfate may differ from OTC products.

• Pain45
• Recovery35