Q. I am 42 years old and trying to delay total knee surgery as long as possible. I heard that glucosamine supplements help, is that true?
A. Glucosamine supplements have been around for a long time. Because of this, they are one of the most studied and reviewed non-prescription pills on the market. Even several prestigious orthopedic and medical journals have published some findings from controlled, double-blind, placebo studies. Most of these studies test the effectiveness of the supplement on knee cartilage density and, of course, reduction of painful symptoms. Knee cartilage is made up of cells and there surrounding matrix. Without getting too scientific, most of the researchers are trying to reverse cartilaginous breakdown by balancing matrix production with matrix destruction. What they have found in some of the studies, is that glucosamine does just this by increasing the production of some molecules in the matrix (called GAGs for short).


The next question that I usually get asked is what type of glucosamine should I be taking? In order for the body to most readily absorb the supplement, they have found that it should be in the form of a salt. These include glucosamine bound to a sulfate (potassium or sodium) and glucosamine bound to hydrocloride. Of these, glucosamine hydrochloride has been found to be the most potent and readily absorbed, while decreasing gastrointestinal irritation, than the other forms.

Many of the supplements that you will find at the store also contain chondroitin as well. Chondroitin sulfate is the most abundant GAG present in the matrix and helps makes the cartilage strong, yet flexible. Some studies that take the 2 supplements in different pills have found that the chondroitin actually interferes with the absorption of glucosamine. My advice would be to first try and find the best right form of glucosamine (HCL) and then worry about the chondroitin later. The most studied and doctor recommended supplement on the market today is made by Nutramax Labs and is called Cosamin DS. This brand contains them both, but has been found successful in several studies in helping knee cartilage.

Most studies recommend between 1000-1500mg of glucosamine hydrochloride a day. As with all drugs and supplements, please consult with your physician to check interactions between other medications and supplements and to make sure that the slight increase in sodium or sugar in your diet will not affect blood pressure or diabetes.

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