Glucosamine for arthritis

Keith, an 86-year old retired basketball coach, and PE teacher, limped down our clinic hallway last week to see me. “Getting older sure isn’t for sissies,” he answered as I asked him how things were going for him. 
“I had my left knee replaced five years ago, and now my right knee is going the same way. It’s this darn arthritis.” Settling his 7-foot seven-inch frame in the exam room chair, he asked me, “Would taking glucosamine help my knee? Is it safe to take with my other medicines?”
“Glucosamine helps relieve knee joint pain in 1 out of 3 people, helping them stay more active. Keeping active is the key thing because it’s the best way to combat the pain and stiffness of arthritis. Glucosamine is a very safe supplement to take, even with other medicines. If I were in your shoes, I’d definitely give it a try.” 
Keith has lots of company. Osteoarthritis is the most common chronic joint disease, affecting at least one out of every 10 older adults in the United States. Osteoarthritis causes cartilage to deteriorate, creating joint pain and stiffness. 
As it progresses, osteoarthritis causes the bones of your knee joint to move closer together. Imaging studies measuring the spacing of bones in your knee joint illustrate how as the spaces between the bones in the joint get smaller over time, the pain and stiffness of osteoarthritis get worse. 
Glucosamine is a compound produced by your body. There are three primary forms, each having a different role in supporting your health. The only type of glucosamine proven to be helpful against osteoarthritis is glucosamine sulfate. 
Glucosamine sulfate has been shown to slow down the progression of osteoarthritis by keeping the spaces inside knee joints from crowding closer together. One study compared people who took glucosamine for 1 to 3 years with a similar group that didn’t. Those who took glucosamine sulfate were 60% less likely to need a total knee replacement due to osteoarthritis than those not taking it. 
Although glucosamine sulfate can slow down the progression of osteoarthritis, it can’t stop it completely. It’s best for mild to moderate arthritis pain and stiffness, and less effective in people who are older or are overweight.
Glucosamine sulfate works better on knee joints than your hip joints, wrists, or your back. Unlike other types of pain medicine, glucosamine sulfate takes about 4 to 8 weeks to take full effect and is most effective when taken daily. Tylenol® (acetaminophen) also helps arthritis pain and stiffness and can be safely taken daily along with glucosamine. For flare-ups, Aleve® (naproxen) or Motrin-IB (ibuprofen) are more useful but can cause bleeding or kidney problems.
The most effective dose of glucosamine sulfate seems to be 1500 mg a day, which can either be taken all at once or divided into two or three doses. Taking glucosamine sulfate is as effective as taking six tablets of Extra-Strength Tylenol® every day. It can also be combined with other pain medicines for even more relief, like Tylenol® and anti-inflammatory medications like Aleve® (naproxen) or Motrin-IB (ibuprofen). 
Here Are 5 Tips on Taking Glucosamine Successfully:
1.  Take the “right stuff.”
Avoid glucosamine hydrochloride, and take glucosamine sulfate. For best results, take a total of 500mg-1500mg per day in 2 or 3 divided doses.
2.  Be patient. 
Allow 4 to 8 weeks for the full effect of glucosamine to take effect before giving up on it. 
3.  Use the powder formulation, not the tablets.
Crystalline glucosamine in a capsule or dissolved in water is more consistently effective than the tablet forms. The brand with the most favorable results is DONA crystalline powder. My patients have also reported dramatic results with VERY reasonably priced glucosamine crystalline powder from the company Bio-Alternatives, available online at, or by calling 1-866-882-0213.
4.  You can take glucosamine even if you are allergic to shellfish.
If you have a shellfish allergy, you can still take glucosamine safely. Shellfish allergies are to the meat, not to the shell, and glucosamine is processed from the shell.  
5.  If you take the blood thinner warfarin, tell your doctor. 
If you take Coumadin® or warfarin, glucosamine can increase your level of blood thinner. I have used glucosamine sulfate in my patients taking warfarin for decades, with excellent results. I recommend starting glucosamine two weeks before their next blood test is scheduled. Depending on the outcome of the blood test, I adjust their dose of warfarin as needed. 
Dr. Louise Achey, Doctor of Pharmacy, is a 40-year veteran of pharmacology and author of Why Dogs Can’t Eat Chocolate: How Medicines Work and How YOU Can Take Them Safely. Check out her NEW website for daily tips on how to take your medicine safely. 2020 Louise Achey

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