Update 9/11/20. Do you take glucosamine for your arthritis pain? Does it help? If not, maybe you are using the wrong kind. There are different kinds of glucosamne and all versions don't appear be equally effective. Here are bombshell facts most people don't know. These facts are hardly ever mentioned in supplement ads or infomercials. Glucosamine is one of the best selling over the counter supplements that people use for arthritis. Some research suggests it may help sagging skin too. But you need to use the right type.
Fact #1 What Type of Glucosamine Are You Using?
Go get your glucosamine supplement right now and look at the back label. I'll bet you a nickel you see “glucosamine HCL” in the ingredients list. Guess what? Glucosamine HCL is not the best type to use. Most people do not know that there are actually 3 main types of glucosamine in supplements.
- Glucosamine hydrochloride (HCL)
- Glucosamine Sulfate
- N-Acetyl Glucosamine (NAG)
Of these, glucosamine sulfate has most of the published peer-reviewed evidence that it reduces arthritis pain. I was one of the first people to alert the public to this fact in my book Nutritional Supplements What Works and Why
Glucosamine HCL has some studies to support its use but there are a lot more studies on glucosamine sulfate.
In fact, the National Institutes of Health (NIH) conducted a clinical trial called the GAIT Study. This was one of the largest glucosamine studies ever. They concluded that glucosamine HCL didn't work, except for very mild forms of arthritis.
Why Didn't The GAIT Study Work?
The GAIT study used glucosamine HCL. But why? Most of the good evidence is on the sulfate form. I think they goofed. If you are looking for a supplement, pay attention. Many supplements contain glucosamine HCL, which has less evidence. Look for glucosamine sulfate.
Fact #2. What Type of Arthritis?
Most ads for glucosamine products only say it helps arthritis. They almost never say osteoarthritis. Osteoarthritis (or OA for short) is the type of arthritis that glucosamine sulfate has been most consistently shown to help.
Even though most people have osteo arthritis, its ironic that glucosamine ads rarely mention this.
There are many conditions that come under the heading of arthritis but glucosamine only seems to help the pain of OA. Glucosamine does not appear to help arthritic conditions like:
- Rheumatoid arthritis
- Lyme disease
Fact #3. Glucosamine Does Not Re-grow Cartilage?
A lot of people think that glucosamine regrows joint cartilage but this has never been proven in any well-controlled published, peer-reviewed study. On the plus side, one study noted that long term use of glucosamine sulfate reduced the progression of osteoarthritis (by 54% compared to placebo). But as for how it works. I've never seen a good explanation that everybody agrees on.
Fact # 4. They Are Not Better Together
Most products combine glucosamine with chondroitin sulfate. But nobody is really sure if this combination is superior to glucosamine sulfate alone. I have not seen a definitive study proving that this combination is more effective. Here is a study that showed the combination of glucosamine HCL and chondroitin didn't work.
Also, some research links Chondroitin sulfate to prostate cancer.
So Does It Work?
While controversial, when it comes to helping arthritis pain, the research is strongest for glucosamine sulfate. The HCL form has less evidence. Intriguing preliminary evidence suggests N-acetyl glucosamine (NAG) may help tighten up sagging skin. See the NAG review.
Yanna Fattani says
Should I consider taking glucosamine supplement as a pro-active move to avert future joint pains? Is that a wise thing to do? Is it safe to take glucosamine while I’m taking blood pressure drug?
Hi Yanna, good question. I’m not sure of the answer. I dont think there is any evidence that taking glucosamine – when you dont have arthritis – can prevent you from getting it in the future, there was a study that found glucosamine sulfate slowed down the progression of osteoarthritis. Ive never seen anyone try to duplicate that study, which is unfortunate.
There are many different types of blood pressure medications. My advice is to ask your pharmacist. She/he can give you a much better answer about that. Let us know what your pharmacist says.
Yanna Fattani says
Thank you very much for your prompt reply Joe. I appreciate greatly your honest answer which may help me save money from having to purchase something that may not even be necessary. I was prompted to get the glucosamine supplement after reading Dr Axe’s article (https://draxe.com/glucosamine/) on how glucosamine can help and one or two other articles on the same topic. I’ve been having pains in my neck, hands and fingers and I begin to wonder if it’s the onset of arthritis and thought that maybe by taking glucosamine, it might help my condition. The glucosamine that I’m going to purchase is manufactured by MäritzMayer – Laboratories – Maximum Strength Glucosamine Chondroitin MSM Arthritis Pain Relief 60caps.
I’d like to honestly ask you Joe, what is the best way to take care of our joints without taking supplements? Oh by the way, I’ve been taking Perindopril for my high blood pressure.
Thank you so much Joe for helping to enlighten people like me. Your article and answers have helped people like me to make better decision.
Hi Yanna, have you gotten a formal diagnosis of arthritis in your hands and neck? I’d say do that so that you know for sure its arthritis. As for help your joints without taking supplements, here are a few things you can do:
stay active. the joints get lubrication when we move so exercise regularly. that includes both aerobic exercise like walking and resistance training.
Lose weight if you need to. Sometimes being overweight can put stress on our joints and contribute to arthritis. Also excess weight might increase inflammation chemicals which can make arthritis worse. If you are overweight, then losing weight might also help your blood pressure too.
Eat more fruits and veggies. These foods contain natural pain killing compounds and they are just very healthy. We cant go wrong eating a salad a day.
A good book to read is How Not To Die. I’ve read it and it’s fascinating. It tells about how eating better can reduce various health issues. It has information on high blood pressure and arthritis too.
Thanks for the nice words Yanna. I’m happy to be of help 🙂
Yanna Fattani says
Joe, you’re one very efficient MD when it comes to replying to readers’ queries. Again I can’t thank you enough for your prompt and insightful comment. I must admit I was rather hasty in thinking the pain I was having in my neck and hands could be due to arthritis when I haven’t even had it diagnosed. I have a doctor who had a very simple answer when I mentioned my condition to him: “Ahh, it’s normal for people of your age to have pains in the neck, hands, etc” So I never bothered to ask him again and try to look for answer elsewhere.
Honestly Joe, I’m just grateful we have someone like you. Your answer made me think. Why do I even suspect I have arthritis? Maybe because now there’s an abundance of materials that you can read not to mention the ubiquitous advertisements for health products. It’s too easy to make your own uneducated conclusion and scare yourself. Thanks Joe for knocking some sense into my head.
I’ve been doing stretching exercises and yoga on and off; now I have to try to be more disciplined and do them on a regular basis, not when the mood moves me. I don’t have weight problem, if anything I’m slightly underweight. I do household chores and walk or cycle to the stores, so I think I’m quite active. I try to eat fruits and vegetables at every meal. So I think I have no problem following your suggestions.
Hope you’ll be around a long time Joe, for people like me need someone like you to give us an honest, unbiased opinion on health matters.
Hi Yanna, you are very welcome. I’m not an MD though. I have degrees in exercise science and chemistry/biology. The About Page of this site tells more about me. I hope I’m around for a long time. My grandmother lived to 104 🙂
I just read the Quackwatch article on this, that quoted the results of a study, saying much as you have here, but then ignored the distinctions, and made blanket claims that (all) glucosamine is useless, including in it’s headline, thus potentially misleading people into not taking something that could help and being stuck with unnecessary pain and limitations.
Unfortunately no place for comments ( I wonder why).
Is quackwatch just a cover for the Pharmaceuticals industry or something ? The tone would fit that.
Thanks for the more accurate description.
Hi Simon, you are very welcome. Quackwatch has been around a long time and is a well respected site. I know in some circles glucosamine is controversial and think some of that might be due to differences in study outcomes between glucosamine sulfate and glucosamine HCL. I dont feel they are the same thing. I do think researchers better at taking notice of the types they choose for research. I’m looking forward to better studies in the future.
I am considering taking Glucosamine as to see if it will help with my knee joint pain. I have had 2 arthroscopies and chrondoplastys (1 in each knee). My right had considerable cartilage damage, with nearly 2cm damage behind the right knee cap and articular area. The left a small amount of damage behind the left knee cap. The torn tatty cartilage has now been removed from both knees via surgery, but has left a ‘bone on bone’ problem in the right knee! Ouch!
I asked my Surgeon about Glucosamine and Chrondoitin – he is skeptical but says that Vets swear by Glucosamine! But no harm to give it a try if I can afford it? – So I have been thinking about giving it a go? Can you advise if I were to try it – what quantity? Just Glucosamine Sulphate by itself or combined? And they come in different strengths, is the greater strength any better? And is it better to take a big amount in one go or stagger the intake throughout the day? It might not make any difference but I am prepared to give it a 6 month trial? Many thanks for any advise.
Hi CH, I’d opt for just glucosamine sulfate to start off. I think that has the most evidence. Give it about 4-8 weeks to know if its working. 1500 mg/day is what most studies use. Im not a fan of chrondroitin sulfate. I dont think it matters if you spread it out or take it all at once.
Let me know what happens if you give it a try.
Thank you for you advise. It will be interesting to see if it helps – particularly the right knee, as that is very painful and clunky!
I shall keep you posted.
Sounds good CH, I’ll look forward to it 🙂
I use a Glucosamine, Chondroitin & MSM supplement and also a rounded tablespoon of gelatin each day. With knee issues…regular exercise makes all the difference. In my experience you need to keep exercising while avoiding injury.
Your knee condition is fairly poor though. In your case I’d say that the best you can do is to limit further damage.
The bottom line is that glucosamine supplementation lowers human mortality
Glucosamine and Chondroitin Sulfate have already been shown in a large epidemiological study to lower overall mortality and reduce cancer risks – a 5-year study of 77,719 elderly residents of Washington State. We found several publications based on different analyses of data based on this population.
A 2010 publication suggests that taking high doses of glucosamine or prolonged use it glucosamine reduces levels of SIRT1, leads to apoptosis of pancreatic cells and could increase the risk of developing diabetes. Glucosamine sulfate 750mg — Do not exceed.
In September 2012, I devoted an entire issue to the importance of adding meat broths and/or gelatin (10–25 grams a day/1–2 tablespoons) to your diet. After a couple of months of incorporating these essential raw materials for joint repair into my diet, the positive results I’ve witnessed have been nothing short of amazing. And to make sure I’m covering all the bases, I also use a daily joint supplement. Alternatives newsletter
The researchers divided 53 men in their seventies who had sarcopaenia into two groups. One group took 15 g collagen peptide daily for three months; the other group took a placebo. The researchers used BodyBalance, a peptide produced by Gelita. Gelita also helped fund the study.
“Moreover, the study has demonstrated that the combination of resistance exercise and collagen peptide GELATIN supplementation resulted in a more pronounced improvement of body composition, as indicated by a significant increase in muscle mass and decrease in fat mass, compared with placebo. In addition, muscular strength was significantly improved after collagen peptide intake compared with the training program plus placebo.”
Hi Bob, can you provide links to the studies you mentioned about glucosamee and SIRT1 and collagen and body comp? I’d enjoy reading the studies. Thanks.
That reference might have come from a newsletter….I did not harvest a link for it….too big of a hurry? Might be on the anti-aging firewalls site somewhere?
Your verification process is absurd???
If I am allergic to sulfa drugs, can I safely take the glucosamine sulfate?
Hi JoAnn, Im not sure. I recommend you show the product you are interested in to your doctor and pharmacist.
hi, I am also allergic to sulfa meds, but am taking glucosamine sulfate for years without any allergic reaction.
Hi, very good piece and makes me think what I am taking,I am a pro soccer player who has had 2 ACL reconstructions plus meniscus repair. I currently take osteo biflex and extra collagen support type 1,2 & 3. Would you recommend this type of joint support for my case? Thanks
Hi Brian, thanks. I have not seen research on those things. Do you feel better when you take them? I have seen some arthritis research on type 2 collagen although I’m skeptical of it (because it’s a protein- how isn’t it digested when we eat it?). What does your sports medicine doc say about them?
Hey my question is what should I take? I don’t have arthritis, but I am an avid rock climber, and ride motorcycles. So my hands are constantly sore. . Along with a lot of my joints. Due to the excessive use. .
Are there any brands, or specific types I should take? Any advice on the B6 info posted above?
Hi Ajay, if you dont have arthritis, you dont need glucosamine. I wonder if you are just over exercising? People do say that they have had good results with over the counter creams like Australian Dream (the link goes to my review). I dont think you need vitamin B6 as its pretty much everywhere in foods.
Since you exercise a lot, I’ve written reviews on
Delayed muscle soreness
Over training syndrome
See those also for more insights
I am looking to start a glucosamine Sulfate regiment. I saw one that I was thinking of using but on the ingredient list it refers to it as glucosamine Sulfate 2kci. Does the 2kci change how it works?
Cheryl, not at all, they are basically the same thing. Keep me posted if it works for you.
As an update I have been taking the glucosamine Sulfate 2kci now for just shy of 6 weeks. I have noted that at work when I crouch very low, I am able to spring up much better. That is not why I started the regiment but it was the first thing I noticed. I am taking for TMJ and dental connective tissue.
I also take Basic B complex from Thorne, Calcium citrate and in the winter I take D in liquid form. That’s all I take. (New Hampshire – Snow is about 6 feet high in my back yard!)
I really appreciate your help. It made me confident to try the glucosamine.
Thank you again, Cheryl
Cheryl, you are very welcome and I’m glad you are feeling a difference. You have my sincere sympathies on the snow. #ugh.
Andrew Goetsch says
Before you look at a study, look at the sponsor. Companies like Johnson and Johnson, who have a vested interest in these treatments not working tend to be behind some studies and prime funders of organizations who conduct others, like the Arthritis foundation. The source of the Glucosamine can also make or break the study. Not all brands are equal, and some are plain bogus. Picking one or the other can decide the results of the study before it starts.
Andrew, fortunately many journals now show affiliations that might show conflicts of interest. I do agree the type of glucosamine can play a role in the outcomes.
A NOTICE for those with arthritis and taking NSAIDS:
“In order for B vitamins to work in your body, your liver must convert them to their active form. For B6, the active form is called pyridoxal-5-phosphate, or P5P for short. The researchers discovered that using either celecoxib (Celebrex) or naprosyn (Aleve) for more than six months impairs the conversion of B6 to P5P. This renders it useless. That means that much of the B6 that is in your diet is wasted if you are regularly taking these drugs.”
“In the 1960s, a Texas physician by the name of Dr. John Ellis discovered that a deficiency of a certain B vitamin was one of the causes of arthritis, particularly arthritis of the hands. And what was that B-vitamin? You guessed it – B6. Dr. Ellis also discovered that taking a vitamin B6 supplement often eliminates carpal tunnel syndrome and trigger finger. Makes you wonder how many people out there are perpetuating their arthritis or carpal tunnel syndrome by taking the very drugs they think they need for the symptoms.”
Frank Shallenberger, MD
REF: Chang HY, Tang FY, Chen DY, et al. Clinical use of cyclooxygenase inhibitors impairs vitamin B-6 metabolism. Am J Clin Nutr. 2013, Dec;98(6):1440-9.
R, thanks for that information. I did my MS thesis on cyclooxygenase so your reference brought back lots of memories!
Razvan Florentin Popescu says
Just bought some for me (basketball) and for my grandparents.
So I guess I’ll test it, and if there are good signs, we’ll have to take it for the rest of our lives?
Razvan, yes if it works, it looks like you would have to take it forever. If it works you might try experimenting with how many days per week works. Most people I’ve met take it every day but I wonder if for some, taking only a few days per week might work as well? I hope it helps you.
I take a formula that works for me….
I’d recommend the full dose and give it time…at least 3 months. Only $12 / month.
note: this is not an advertisement…just something that seems to work for a good price.
“food supplement glucosamine promotes longevity in aging mice by approximately 10 percent due to improved glucose metabolism.”
R, thanks for the heads up and and ‘Im glad glucosamine is helping you. The product is Swanson Mobility Essentials and its on Amazon too for the same price in case anyone wondered.
Thanks also for that study on the mice. It was interesting and Ive added it to my files. Lets hope it does the same thing for people 🙂
Some evidence for glucosamine and chondroitin?
“Glucosamine and chondroitin reduce mortality significantly. Fish oil lowers mortality by an almost significant amount, and ginkgo is not far off a statistically significant effect too.”
R, studies like the one referenced on that website, while valuable, are also difficult to pin down if the supplement caused the good thing or if it was something else. The researchers just followed a bunch of people (78K) for several years and watched what supplements they used. I do like that the website cautioned smokers against using beta carotene supplements.
Le Nguyen says
I have to buy a lot of these as gifts for people in my country and they are all believe that Glucosamine making a big different. These facts hep me a lot. Very concise and understandable!
all of these comments are very confusing. My question is this.
Joe, if you were a fairly active athelic person, and had some knee and other joint issues, what would you use and recommend to help the symtoms.
i really need some advice, from someone other than a phyician.
wess, I think its best to get an idea of what is causing your joint problems. is it osteoarthritis? an X Ray will tell you if it is. if it turns out you have some osteoarthritis, then glucosamine sulfate is what I’d try first. If you didn’t have osteoarthritis, then I dont feel this supplement would help. I would then consider physical therapy to try to better strengthen the muscles around the joints. I do think your doctor is the best person to help get the answers you are seeking.
thanks so much for your quite response. The minor knee discomfort comes from playing alot of tennis on hard courts. Currently i am taking 2 tablets consisiting of 1500 mg of Glucosamine Sulfate, 1200 mg Chondroitin salfate and 500mg MSM.
in your opinion do you think this best combination, or is there another supplement your would recommend. thanks wess
wess, I think glucosamine sulfate alone is all you should need. MSM also has some evidence but I dont feel chondroitin sulfate does anything. Id stick with glucosamine sulfate alone for 4 to 8 weeks first to see if it helps. Do see if you indeed have osteoarthritis though.
Joe, again thanks for your quit response. It is really nice to communicate with someone who is not so negative about natural products and vitamins.
I have another question..What do your experiences show about taking AMINO Acids. is it ok to communicate via my E-mail, or would you prefer another method?
I heard from a well known TV Doctor, that if you take Amino Acids composed of the following supplements,Glycine, Arginine,Lysine,Omithine along with exercise, it can boost your HGH levels naturally. I don’t want to put you on the spot,however, i do value your opinions and knowledge.
Hi Wess, no worries, Im happy to help you here and hopefuly it will help others as well who may be asking the same questions
As for amino acids, Id rather you eat protein rather than individual amino acids. That way you get a more broad specturm of amino acids. supplements usually contain lots of certain “sexy” amino acids (like glutamine, arginine etc) and less of others. But we need them all to make proteins, not just a few of them.
I think I might know what TV doctor you are referring to but when it comes to amino acids boosting growth hormone levels, the thing is that it often takes a lot – and sometimes the research involves injecting them. Often the rise in GH is not much and doesn’t last long. I know both strength training and aerobic exercise will raise GH levels (and testosterone) but Im skeptical of amino acids like the ones you mentioned. Id rather you get a good protein powder or protein shake – or eat food – than take individual amino acids. Its also worth getting your growth hormone levels tested also to see what they are.
Joe, what should i look for in a good protein shake or powder?
Wess, Id look for one that has 20-25 grams of protein per scoop and about 100 or so calories per scoop. Whey protein, which comes from milk, is what makes up the protein of most powders and its source of protein. I like these brands
Amazon Link.” target=”_blank”>Dymatize chocolate protein powder
Amazon Link.” target=”_blank”>Isopure chocolate protein powder
I linked to these on Amazon so you could check them out. Local health food stores have them also.
I usually take these and toss them into the blender when I make smoothies. Here is my smoothie recipe.
Tim Hall says
How about the supplements that add MSN to the mixture?
Tim, MSM does have some evidence that it might help osteoarthritis as well. its less than glucosamine sulfate but it does exist.
I was recently at the Dr.’s getting treatment for osteoarthritis in my neck. I asked him about Glucosamine & Chondroitin and he mentioned it’s been shown to have little effect (citing a couple studies), if any. I had always thought the opposite and was going to try it until our discussion.
I had heard about Boswellia and wondered if you had done any research on that and if it looked like it might be a good alternative.
Dee, I’m guessing your doctor is probably thinking about glucosamine HCL (which is in most products). While I never close the door on it, the research is stronger for glucosamine sulfate. Its not a slam dunk but Id give it more credence than glucosamine HCL.
Im not too impressed with what I see on chondroitin sulfate but Ive heard some people say its helped them. The research overall on it though is not too good.
As for Boswellia, there are a few studies on this herb helping osteoarhtirits. what little evidence out there that has good results uses about 100 mg per day if that helps you.
While Im not completely convinced, people have been reporting pain relef with a product called Anatabloc. Again, no promises and that product is expensive.
Ellie Topnik says
Have you heard of a product called Jusuru??
I can’t seem to get the science on it?
Ellie, I look at it. It looks like its a collagen supplement that also has condroitin sulfate and hyalurinic acid. If it helps arthritis pain, I think the most likely ingredient is condroitin sulfate (it has a few studies). Hyalurinic acid I dont think will work beause its evidence mostly stems from injecting it and I believe its digested after being taken orally. Collagen might help but I think its effects would be minimal at best. I covered all of these ingredients in my book about supplements
Due to a lifetime of intense physical activity in sports, my right knee suddenly became swollen, painful with each step and warm to the touch. I could no longer kneel on that knee without intense pain.
An MRI disclosed a torn ligament plus a touch of arthritis. Surgery was recommended. So, loaded up on glucosamine and chondroitin, to no avail.
Then, I learned about Jusuru (now rebranded as Liquid Biocell). They provide a number of human clinical trials, published and peer reviewed.
After consuming 2 oz, twice per day, after 5 weeks, my knee seemed normal…no pain whatsoever, no swelling, no warmth to the touch.
After a year, religiously using the product, I went for another MRI. The results were the same as the original. So, I still require the surgery, but as long as my knee feels normal, I’m holding back on the surgery and using the product.
PS: Thanks for your thoroughness!
Steve, I’ve heard of Jusuru and Liquid Biocell. They are on my list to review. I appreciate the feedback and am happy that’s been helping you. Continued success!
Ben. glad your parents are getting relief. I have also run into people who say they feel better after using glucosamine HCL and that is inline with the research -it works best for mild osteoarthritis. Even though I say glucosamine sulfate has the most proof, the main thing is that your mom feels better -and that’s whats important 🙂
I just had a look on their website and the type of glucosamine is glucosamine hydrochloride. Mum has osteo-arthritis and Dad has rheumatoid. I don’t know how it all works but I can’t see someone standing behind a product with a 100% money back guarantee if it doesn’t work at all – at least not for very long, unless they have a lot of money to throw away. And mum and dad say it is great, so… If I was desperate for answers I would give it a go and if it doesn’t work I’d get my money back – I haven’t lost anything.
I would be happy to buy a placebo if it relieved the pain better than anything else and had a money-back guarantee – and was safe! What I am saying is, at the end of the day a certain amount must come back to people’s experience with the product.
My mum has arthritis in her knees and it was really bothering her for years. She ended up being recommended a supplement from New Zealand called Pure Vitality. It comes with a 100% money-back guarantee so there’s not really anything to loose. Mum and dad have been using it for years now and say it is great. It is based on deer antler velvet (also controvercial in Western medicine but apparrently was quite a big thing in early Chinese medicine) and has glucosamine and chondroitin.