Firstly, exactly what is glucosamine sulphate?
Glucosamine sulphate is a naturally occurring chemical found in the fluid that surrounds joints. It's also found in dietary supplements, where the source is the shells of shellfish. Sometimes it is also manufactured in the lab.
There are different forms of glucosamine, including glucosamine sulphate, glucosamine hydrochloride and N-acetyl-glucosamine. Glucosamine sulphate is the most studied form.
Often, in glucosamine supplements, ingredients such as chondroitin sulfate or MSM are added.
Can it help ease arthritis symptoms?
The Natural Medicines Comprehensive Database, which rates effectiveness of a product or ingredient based on scientific evidence, rates glucosamine sulfate likely effective for osteoarthritis, especially of the knee, and there is some evidence that it may also help osteoarthritis of the hip or spine.
According to the Database, some research has even gone so far as to suggests that glucosamine reduces osteoarthritis knee pain about as well as the over-the-counter pain reliever acetaminophen (Paracetemol).
It also seems to reduce pain about as much as the nonsteroidal anti-inflammatory drugs (NSAIDs) ibuprofen (Nurofen, Motrin, Advil) and piroxicam (Feldene).
But there is a difference between glucosamine sulfate and these drugs in the time it takes to reduce pain.
Most NSAID relieve symptoms and reduce pain usually within about 2 weeks, but the glucosamine sulfate takes about 4-8 weeks.
Glucosamine sulfate also does not seem to decrease pain as much for people with more severe, long-standing osteoarthritis, or for people who are older or heavier.
Are there any other benefits beside pain relief?
In addition to relieving pain, glucosamine sulfate might also slow the breakdown of joints in people with osteoarthritis who take it long-term.
Some researchers hope that glucosamine sulfate might keep osteoarthritis from getting worse as quickly as it otherwise might.
There is some evidence that people who take glucosamine sulfate might be less likely to need total knee replacement surgery.
What about glucosamine combined with other therapies?
According to a paper published in Arthritis Research & Therapies, 'progressive walking', combined with glucosamine sulphate supplementation, has shown to improve the symptoms of osteoarthritis.
Researchers found that patients who walked at least two bouts of 1 500 steps each on three days of the week reported significantly less arthritis pain, an significantly improved physical function.
Dr Kristiann Heesch worked with a team of researchers from The University of Queensland, Australia, to carry out the trial in 36 osteoarthritis patients (aged 42+ years). All patients received the dietary supplement for six weeks, after which they continued to take the supplement during a 12-week progressive walking program.
The program, called Stepping Out, included a walking guide; a pedometer; weekly log sheets and a weekly planner, all intended to help patients adopt the exercise regime.
Seventeen patients were randomly assigned to walk five days per week, while the remaining 19 were instructed to walk three days a week.
The team found that both groups achieved significant improvement in their symptoms, however being encouraged to walk five days a week was not more effective than being encouraged to walk three days.
"These findings are not surprising given that the three-day and five-day walking groups did not differ significantly in the mean number of days actually walked per week, the mean number of daily steps walked, nor their weekly minutes of physical activity," Dr Heesch said.
"They provide preliminary evidence that osteoarthritis sufferers can benefit from a combination of glucosamine sulphate and walking 3000 steps per day for exercise, in bouts of at least 1500 steps each, on at least three days per week".
This amount of walking is less than current physical activity recommendations for the general population, but follows the recommendations for people with arthritis.
When not to take glucosamine
According to the UK Arthritis Research, if you’re allergic to shellfish, you should make sure that you take the shellfish-free variety.
You should also be cautious about taking glucosamine if you have diabetes. Glucosamine might increase your blood sugar level and it may mean that you need to adjust your treatment to make sure it carried on working. There are several reports of interaction between glucosamine and anti-diabetic treatments.
There are also some reports of possible interaction with chemotherapy drugs and drugs that lower blood cholesterol.
Extensive information about glucosamine