Glucosamine is an amino sugar consisting of sugar (glucose) possessing an amino (NH2) group. Glucosamine sulphate is simply glucosamine to which a sulphur-containing molecule (sulphate) has been added. Glucosamine sulphate is a “building block” common to large sugar molecules such as hyaluronan, chondroitin sulphate, and keratan sulphate, which are all important sugar molecules in articular cartilage.

How long has glucosamine sulphate been used?

Glucosamine sulphate has been used for more than 25 years. The results of the first scientific studies concerning the treatment of osteoarthritis were published as early as 1980.

What affect does glucosamine sulphate have on patients suffering from osteoarthritis?

Glucosamine sulphate has an analgesic (pain-killing) effect. In addition, it improves the function of the affected joints. Improved function means that the joint moves more freely and permits greater movement. In the case of osteoarthritis in the knees and hips, improved movement means that patients can walk more freely and cover greater distances. In addition, scientific studies have shown that glucosamine sulphate can halt or at least slow the development of osteoarthritis. This effect of glucosamine sulphate is what makes it so interesting, as there is no other medicine that can do this.

How great is the analgesic effect of glucosamine sulphate on osteoarthritis?

Scientific studies have shown that the analgesic effect of glucosamine sulphate is as good as that of arthritis medicine (ibuprofen). The effect of arthritis medicine can be felt slightly sooner than the effect of glucosamine sulphate, but after as little as two weeks glucosamine sulphate is just as effective as arthritis medicine.

Can glucosamine sulphate rebuild worn-down articular cartilage?

At present, the answer to this question is “no”. There are currently two scientific studies that have followed patients with osteoarthritis in the knee for three years. The patients have either been given glucosamine sulphate or placebo (i.e. “non-treatment” in the form of inactive tablets). The patients who received glucosamine sulphate reported good analgesic effects and achieved improved function, measured as the distance they could walk. However, the most remarkable result of the studies is, that no further development of osteoarthritis was observed in the patients who received glucosamine sulphate. The trial subjects who were given placebo did not report the same analgesic effect, nor did they show any improvement in joint function. Worse still, x-ray examinations clearly showed that during the three years for which the study ran, they lost articular cartilage and developed osteophytes around their joints. All the patients who took part in the studies had mild (second stage) or moderate (third stage) osteoarthritis.

Can glucosamine sulphate prevent osteoarthritis?

This is not yet known. The best way to prevent the onset of osteoarthritis must be to ensure that normal joints are only subjected to normal loads. If a joint is abnormal, or if the load on the joint is abnormal, then the first stage (early osteoarthritis) has already begun. This means that the condition has already started but cannot yet be identified by standard x-ray examination. In this case, it is reasonable to assume that glucosamine sulphate would have a beneficial effect - perhaps an even greater effect than that observed in cases of mild (second stage) and moderate (third stage) osteoarthritis. However, precisely because standard x-ray examination cannot reveal the first stage, it is very difficult to conduct examinations at this stage. Consequently, we may not know the answers for some time.

Does glucosamine sulphate have an effect on severe osteoarthritis?

Severe osteoarthritis (fourth stage) is distinguished by the fact that large areas of the articular cartilage have been worn away completely. In other words, there are no cartilage cells that can use the glucosamine sulphate administered. Therefore, glucosamine sulphate has little effect on severe osteoarthritis.

On which conditions, ailments, and illnesses does glucosamine sulphate have a beneficial effect?

The scientific research that has been conducted on glucosamine sulphate has involved patients with osteoarthritis in various joints. The majority of the studies concern osteoarthritis in the knee joints, but osteoarthritis in the hips, fingers, backbone, and jaw joints has also been studied. Unfortunately, patients are not always aware that the condition, ailment, or illness from which they are suffering is actually osteoarthritis. The distinguishing feature of osteoarthritis is that it is a chronic ailment, which means that the symptoms may often have been building up for months or even years. The symptoms do not have to be present all the time; they can often appear only for periods at a time. The combination of pain in or around a joint and problems with articulating the joint - for example in the form of stiffness, or creaking or grating sounds - are generally clear indications of osteoarthritis. Therefore, many of the conditions we simply write off as an old sporting injuring or industrial injury are actually osteoarthritis. Numerous conditions should draw the attention to osteoarthritis and, in particular, to the prevention of osteoarthritis. These include: The neck - whiplash The jaw - crunching and grating noises, impaired ability to chew The back - slipped disc, scoliosis (crooked back) and Scheuermann's disease Shoulder and arm - frozen shoulder, chronic cases of “mouse arm”, tennis or golf elbow, and tenosynovitis (peritendinitis). Knee - injury to the meniscus, tendons, or other ligaments. Ankle/foot - serious or recurring sprains. Always consult your doctor, chiropractor, or physiotherapist before commencing treatment with glucosamine sulphate.

The text is an extract from the book: Glucosamine sulphate - questions and answers about the new osteoarthritis medicine. By Keld Ostergaard, DC, MD, Ph.D. DC: Doctor of Chiropractic: Pre-Chriopractic Course, University of Odense, Denmark. DC, Anglo-European College of Chiropractic, the United Kingdom. Awarded “Outstanding Academic Student” of graduating class. Authorization as a chiropractor, National Board of Health, Denmark. MD: Doctor of Medicine: BS (Bachelor of Science of medicine), University of Odense, Denmark. MD, University of Copenhagen, Denmark. Authorization as a physician, National Board of Health, Denmark. Permission to practice independently as a physician, National Board of Health, Denmark. Ph.D: Doctor of Philosophy: Awarded “Gold Medal” for 1 year research project regarding osteoarthritis, University of Copenhagen, Denmark. Ph.D for 3 year research project regarding osteoarthritis, University of Copenhagen, Denmark. Research fellowship from Foundation for Chiropractic Education and Research (FCER). Awarded “Research Prize of the Danish Chiropractor's Association”. Awarded “Queen Ingrid's Reseach Prize”, Danish Rheumatism Association. Keld Ostergaard has written more than 100 scientific and popular articles, chapters, and books regarding the subject of osteoarthritis.