Glucosamine is a compound naturally produced by the body that’s also commonly used as a joint health supplement.
Despite being a popular treatment for osteoarthritis, much of the research on glucosamine’s benefits is dubious.
This has led many scientists to question whether glucosamine has any real benefit, and propose that many (or all) of glucosamine’s benefits are due to the placebo effect.
In this article, we’ll give you an evidence-based answer to the question: “does glucosamine work?”
We’ll review the research on all of the most popular glucosamine supplements such as glucosamine sulfate, glucosamine and chondroitin, and glucosamine and chondroitin with MSM, the most common glucosamine side effects, and more.
Table of Contents
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What Is Glucosamine?
Glucosamine is a chemical compound known as an amino sugar that’s naturally found in the human body (mostly in the joints and cartilage), in the shells of shellfish such as lobsters, crabs, and shrimps, and in some fungi.
In the human body glucosamine plays a key role in the production of glycosaminoglycans and glycoproteins—molecules that are used in the formation and repair of your joints, ligaments, tendons, cartilage, and synovial fluid (the shock-absorbing, lubricating liquid located between your joints).
As we age, our body’s ability to produce glucosamine can become impaired. This can lead to joint pain and dysfunction, as well as to conditions such as osteoarthritis.
What Is Glucosamine Used For?
Glucosamine is most commonly used in joint health supplements.
The glucosamine used in glucosamine supplements is normally harvested from the shells of shellfish or synthesized in a lab, and comes in several different forms, including glucosamine sulfate, N-acetyl glucosamine, and glucosamine hydrochloride.
Supplement manufacturers often combine glucosamine with other ingredients that are also believed to treat joint pain and dysfunction such as chondroitin (glucosamine and chondroitin) and methylsulfonylmethane, or “MSM” (glucosamine and chondroitin with MSM).
Chondroitin is a natural compound found in connective tissue that helps to maintain the viscosity in joints, stimulates cartilage repair, and inhibits enzymes that degrade cartilage.
Some studies suggest that glucosamine and chondroitin work synergistically (they’re more effective when taken together than they are when taken individually) though other research shows this isn’t the case.
MSM is a naturally occurring organosulfur compound (a natural substance that contains sulphur) found in plants, humans, and animals that inhibits the breakdown of cartilage.
MSM is often paired with glucosamine because it bolsters its sulphur content, which may help preserve joint health.
Glucosamine: Benefits
Champions of glucosamine believe glucosamine supplements can help to treat a variety of health conditions, including . . .
However, these beliefs are based on the findings of very few (often unconvincing) studies, and probably shouldn’t be taken as read until we have more robust evidence.
The main reason people supplement with glucosamine is to treat osteoarthritis—a degenerative joint disease characterized by the deterioration of cartilage between bones that leads to pain and decreased mobility, typically in the knees, shoulders, hands, hips, feet, and spine.
Despite glucosamine’s widespread use to treat osteoarthritis (research shows that 20% of the US adult population used glucosamine in 2008) there’s much controversy surrounding its efficacy.
For example, in a study conducted by scientists at the University of Padova, researchers pored over the results of 47 high-quality studies which included a total of 22,037 participants, and found that glucosamine may improve knee osteoarthritis pain to a small degree, though more research is needed to say this with any certainty.
Basically, a major “meh.”
In another large review conducted by scientists at Erasmus University Medical Center Rotterdam, researchers found that glucosamine supplements didn’t significantly improve hip or knee osteoarthritis pain or function compared with a placebo.
This jives with the findings from another review that suggests any positive effects of glucosamine supplementation are due to the placebo effect alone.
It’s a similar story when it comes to supplements containing glucosamine and chondroitin and glucosamine, chondroitin, and MSM.
While some evidence shows that glucosamine and chondroitin supplements may have a small but positive effect on joint health, most other studies have found this isn’t the case.
Studies looking at glucosamine, chondroitin, and MSM are similarly scattershot, though supporting research tends to be very low quality, so it’s best to take these results with a pinch of salt.
Thus, as things stand, it’s difficult to make a case for glucosamine supplementation, and until glucosamine has been more thoroughly researched, this is unlikely to change.
Glucosamine: Side Effects
Most studies show that glucosamine is safe for most people.
That said, some research shows that some unlucky folks may experience mild side effects such as nausea, upset stomach, heartburn, and diarrhea while supplementing with glucosamine.
There’s also some doubt as to whether glucosamine is considered safe when you have . . .
- Diabetes: One study found that glucosamine supplements may affect glucose levels in the body which can cause complications for people with diabetes or glucose intolerance.
Studies funded by glucosamine supplement manufacturers have since refuted this claim, though it’s still recommended that people with diabetes monitor their blood glucose levels more often when taking glucosamine.
- Asthma: One study showed that glucosamine may exacerbate asthma symptoms.
- Shellfish allergies: Research shows that people with shellfish allergies may want to avoid any glucosamine that’s been extracted from shellfish, though the risk is very small.
- Blood pressure or circulation issues: Studies show that glucosamine may affect blood pressure and blood clotting, and should be avoided if you take blood thinning medication.
It’s also not advisable to take glucosamine if you’re pregnant because no studies have looked at the effect of glucosamine on pregnant women yet.
What Are the Best Glucosamine Supplements?
Given the uncertainty surrounding the effectiveness of glucosamine, it’s difficult to give recommendations on the “best glucosamine supplements.”
Instead, let’s look at some of the best glucosamine alternatives.
There are plenty of other supplements that have been shown to reduce joint pain and enhance joint health and function, and that can help in treating conditions such as osteoarthritis.
Some of the best glucosamine alternatives are:
- Undenatured type II collagen: Undenatured type II collagen helps to “teach” the body’s immune system to stop attacking the collagen in your joints.
- Curcumin: Curcumin inhibits a pro-inflammatory enzyme known as cyclooxygenase (COX) which can cause achy, painful joints.
- Boswellia serrata: Boswellia serrata reduces joint inflammation and pain and inhibits an autoimmune response that can eat away at joint cartilage and eventually cause arthritis.
- Grape seed extract: Grape seed extract helps protect joints from damage in much the same way as Boswellia serrata.
- Agmatine sulfate: Agmatine enhances the function of the body’s opioid and cannabinoid systems, which relieves pain (including joint pain) caused by nerve irritation or damage.
You could take all of these ingredients separately, or you could just take Legion’s 100% natural joint supplement Fortify, which provides clinically effective doses of each ingredient.
(Oh, and if you aren’t sure if Fortify is right for you or if another supplement might be a better fit for your budget, circumstances, and goals, then take the Legion Supplement Finder Quiz! In less than a minute, it’ll tell you exactly what supplements are right for you. Click here to check it out.)
FAQ #1: Does glucosamine work?
It’s difficult to say.
For every study that shows glucosamine is effective for treating conditions such as osteoarthritis, there’s another that shows it’s not much cop.
That said, provided you aren’t diabetic, asmathic, allergic to shellfish, pregnant, and you don’t have any health conditions that affect your blood pressure or circulation, then it’s safe to try and see for yourself.
FAQ #2: Should I take glucosamine for joint pain?
It’s difficult to say whether you should take glucosamine for joint pain because there’s so much conflicting evidence about its effectiveness.
However, provided you aren’t diabetic, asmathic, allergic to shellfish, pregnant, and you don’t have any health conditions that affect your blood pressure or circulation, then it’s safe to try to see if it works for you.
That said, there are more proven alternatives to glucosamine that you can take to treat joint pain, such as undenatured type II collagen, curcumin, grape seed extract, and agmatine sulfate.
And if taking more surefire supplements sounds better than gambling on glucosamine, try Legion’s 100% natural joint supplement Fortify, which provides clinically effective doses of all of the ingredients above.
(Or if you’d like to know which other supplements to take to reach your health and fitness goals, take the Legion Supplement Finder Quiz.)
FAQ #3: What’s the difference between glucosamine, glucosamine and chondroitin, and glucosamine and chondroitin with MSM?
To improve its effectiveness, supplement manufacturers often pair glucosamine with other ingredients such as chondroitin and MSM.
Chondroitin is another natural compound found in connective tissue that helps to maintain the viscosity in joints, stimulates cartilage repair, and inhibits enzymes that degrade cartilage. MSM is a sulfurous compound that helps inhibit the breakdown of cartilage.
As is the case with glucosamine, supplements containing glucosamine and chondroitin, and glucosamine, chondroitin, and MSM may improve joint health, but more research is needed before we can be certain about their effects.
FAQ #4: Is glucosamine for dogs or humans?
Glucosamine can be safely used to treat dogs with joint issues such as osteoarthritis, but it’s not clear from the research whether it offers any benefit. Basically, everything you learned about glucosamine for humans applies to tail-waggers, too.
Scientific References +
- Dahmer, S., & Schiller, R. (2008). Glucosamine. American Family Physician, 78(4), 471–476. www.aafp.org/afp.
- M, M., A, Z., & K, K. (2012). Determination of glucosamine in fungal cell walls by high-performance liquid chromatography (HPLC). Journal of Agricultural and Food Chemistry, 60(42), 10511–10515. https://doi.org/10.1021/JF303488W
- PJ, L., KD, D., & LR, T. (2008). Glucosamine inhibits the synthesis of glycosaminoglycan chains on vascular smooth muscle cell proteoglycans by depletion of ATP. Archives of Physiology and Biochemistry, 114(2), 120–126. https://doi.org/10.1080/13813450802033909
- Casale, J., & Crane, J. S. (2021). Biochemistry, Glycosaminoglycans. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK544295/
- Grumezescu, A. M., & Holban, A. M. (n.d.). Value-added ingredients and enrichments of beverages.
- J, V., TR, R., LR, B., JM, E.-D., L, W., D, D., D, S., & SB, L. (2006). Do shrimp-allergic individuals tolerate shrimp-derived glucosamine? Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 36(11), 1457–1461. https://doi.org/10.1111/J.1365-2222.2006.02590.X
- CL, D., & RW, M. (1999). Nutraceuticals as therapeutic agents in osteoarthritis. The role of glucosamine, chondroitin sulfate, and collagen hydrolysate. Rheumatic Diseases Clinics of North America, 25(2), 379–395. https://doi.org/10.1016/S0889-857X(05)70074-0
- L, L., J, W., R, K., & TA, H. (2000). In vivo chondroprotection and metabolic synergy of glucosamine and chondroitin sulfate. Clinical Orthopaedics and Related Research, 381, 229–240. https://doi.org/10.1097/00003086-200012000-00027
- MW, O., TL, P., & JN, H. (2002). Inhibition of articular cartilage degradation by glucosamine-HCl and chondroitin sulphate. Equine Veterinary Journal. Supplement, 34, 224–229. https://doi.org/10.1111/J.2042-3306.2002.TB05423.X
- CG, J., AH, P., JD, S., C, H., S, K.-R., JG, B., CL, H., & DO, C. (2010). The human pharmacokinetics of oral ingestion of glucosamine and chondroitin sulfate taken separately or in combination. Osteoarthritis and Cartilage, 18(3), 297–302. https://doi.org/10.1016/J.JOCA.2009.10.013
- Butawan, M., Benjamin, R. L., & Bloomer, R. J. (2017). Methylsulfonylmethane: Applications and Safety of a Novel Dietary Supplement. Nutrients, 9(3). https://doi.org/10.3390/NU9030290
- J, E., M, H., Y, H., & Y, I. (2013). Assessment of safety and efficacy of methylsulfonylmethane on bone and knee joints in osteoarthritis animal model. Journal of Bone and Mineral Metabolism, 31(1), 16–25. https://doi.org/10.1007/S00774-012-0378-9
- Parcell, S. (n.d.). Sulfur in human nutrition and applications in medicine - PubMed. Retrieved November 2, 2021, from https://pubmed.ncbi.nlm.nih.gov/11896744/
- Esfandiari, H., Pakravan, M., Zakeri, Z., Ziaie, S., Pakravan, P., & Ownagh, V. (2017). Effect of glucosamine on intraocular pressure: a randomized clinical trial. Eye, 31(3), 389. https://doi.org/10.1038/EYE.2016.221
- A, G., L, A., NN, N., DJ, P., B, C., & M, D. (2011). N-acetylglucosamine inhibits T-helper 1 (Th1)/T-helper 17 (Th17) cell responses and treats experimental autoimmune encephalomyelitis. The Journal of Biological Chemistry, 286(46), 40133–40141. https://doi.org/10.1074/JBC.M111.277814
- Pearce-Pratt, R., & Phillips, D. M. (1996). Sulfated polysaccharides inhibit lymphocyte-to-epithelial transmission of human immunodeficiency virus-1. Biology of Reproduction, 54(1), 173–182. https://doi.org/10.1095/BIOLREPROD54.1.173
- Ma, H., Li, X., Sun, D., Zhou, T., Ley, S. H., Gustat, J., Heianza, Y., & Qi, L. (2019). Association of habitual glucosamine use with risk of cardiovascular disease: prospective study in UK Biobank. BMJ, 365. https://doi.org/10.1136/BMJ.L1628
- H, N., K, M., K, Y., T, K., T, K., & T, K. (2007). Effects of glucosamine administration on patients with rheumatoid arthritis. Rheumatology International, 27(3), 213–218. https://doi.org/10.1007/S00296-006-0197-1
- G, H.-B., JA, I., M, D. C. T., FJ, B., P, B., E, M.-M., J, P., JL, M., A, P., A, L., D, A., M, F., & J, B. (2007). Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis and Rheumatism, 56(2), 555–567. https://doi.org/10.1002/ART.22371
- Sen, R., & Hurley, J. A. (2021). Osteoarthritis. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK482326/
- Sibbritt, D., Adams, J., Lui, C.-W., Broom, A., & Wardle, J. (2012). Who Uses Glucosamine and Why? A Study of 266,848 Australians Aged 45 Years and Older. PLoS ONE, 7(7), 41540. https://doi.org/10.1371/JOURNAL.PONE.0041540
- Gregori, D., Giacovelli, G., Minto, C., Barbetta, B., Gualtieri, F., Azzolina, D., Vaghi, P., & Rovati, L. C. (2018). Association of Pharmacological Treatments With Long-term Pain Control in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis. JAMA, 320(24), 2564. https://doi.org/10.1001/JAMA.2018.19319
- J, R., RM, R., M, van M., HJW, B., M, D., KS, D., LS, L., T, M., W, Z., & S, B. Z. (2017). Subgroup analyses of the effectiveness of oral glucosamine for knee and hip osteoarthritis: a systematic review and individual patient data meta-analysis from the OA trial bank. Annals of the Rheumatic Diseases, 76(11), 1862–1869. https://doi.org/10.1136/ANNRHEUMDIS-2017-211149
- N, D. (2018). Glucosamine and Chondroitin Sulfate: What Has Been Learned Since the Glucosamine/chondroitin Arthritis Intervention Trial. Orthopedics, 41(4), 200–207. https://doi.org/10.3928/01477447-20180511-06
- T, O., Y, I., M, A., A, S., H, H., T, I., T, D., K, Y., AZ, C., Y, L., & K, H. (2018). Effects of glucosamine in patients with osteoarthritis of the knee: a systematic review and meta-analysis. Clinical Rheumatology, 37(9), 2479–2487. https://doi.org/10.1007/S10067-018-4106-2
- M, F., M, A., L, N., M, V., L, B., S, S., S, J., L, M., J, E., R, N., M, W., & R, D. (2015). Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens. Annals of the Rheumatic Diseases, 74(5), 851–858. https://doi.org/10.1136/ANNRHEUMDIS-2013-203954
- Roman-Blas, J. A., Castañeda, S., Sánchez-Pernaute, O., Largo, R., & Herrero-Beaumont, G. (2017). Combined Treatment With Chondroitin Sulfate and Glucosamine Sulfate Shows No Superiority Over Placebo for Reduction of Joint Pain and Functional Impairment in Patients With Knee Osteoarthritis: A Six-Month Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial. Arthritis & Rheumatology, 69(1), 77–85. https://doi.org/10.1002/ART.39819
- Zhu, X., Sang, L., Wu, D., Rong, J., & Jiang, L. (2018). Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research, 13(1). https://doi.org/10.1186/S13018-018-0871-5
- Wonggokusuma, E., Setyohadi, B., Siagian, C., & Lubis, A. M. T. (2014). Effects of Glucosamine-Chondroitin Sulfate, Glucosamine-Chondroitin Sulfate-Methylsulfonylmethane, or Placebo in Patients with First and Second Grade of Knee Osteoarthritis: A Double Blind Randomized Controlled Study. Https://Doi.Org/10.1177/2325967114S00216, 2(11). https://doi.org/10.1177/2325967114S00216
- Vidyasagar, S., Mukhyaprana, P., Shashikiran, U., Sachidananda, A., Rao, S., Laxminarayana Bairy, K., Adiga, S., & Jayaprakash, B. (2004). Efficacy and Tolerability of Glucosamine Chondroitin Sulphate-Methyl Sulfonyl Methane (MSM) in Osteoarthritis of Knee in Indian Patients. IRANIAN JOURNAL OF PHARMACOLOGY & THERAPEUTICS, 3(2), 61–65. http://ijpt.iums.ac.ir
- X, L., GC, M., JP, E., V, R., & DJ, H. (2018). Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis. British Journal of Sports Medicine, 52(3), 167–175. https://doi.org/10.1136/BJSPORTS-2016-097333
- Zhu, X., Sang, L., Wu, D., Rong, J., & Jiang, L. (2018). Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research, 13(1). https://doi.org/10.1186/S13018-018-0871-5
- Henrotin, Y., Mobasheri, A., & Marty, M. (2012). Is there any scientific evidence for the use of glucosamine in the management of human osteoarthritis? Arthritis Research & Therapy, 14(1), 201. https://doi.org/10.1186/AR3657
- National Center for Biotechnology Information. (n.d.). D-Glucosamine | C6H13NO5 - PubChem. Retrieved November 2, 2021, from https://pubchem.ncbi.nlm.nih.gov/compound/D-glucosamine#section=Drug-Warnings
- Biggee, B. A., Blinn, C. M., Nuite, M., Silbert, J. E., & McAlindon, T. E. (2007). Effects of oral glucosamine sulphate on serum glucose and insulin during an oral glucose tolerance test of subjects with osteoarthritis. Annals of the Rheumatic Diseases, 66(2), 260. https://doi.org/10.1136/ARD.2006.058222
- Simon, R. R., Marks, V., Leeds, A. R., & Anderson, J. W. (2011). A comprehensive review of oral glucosamine use and effects on glucose metabolism in normal and diabetic individuals. Diabetes/Metabolism Research and Reviews, 27(1), 14. https://doi.org/10.1002/DMRR.1150
- Major, G. C., Doucet, E., Jacqmain, M., St-onge, M., Bouchard, C., & Tremblay, A. (2008). Multivitamin and dietary supplements, body weight and appetite: Results from a cross-sectional and a randomised double-blind placebo-controlled study. British Journal of Nutrition, 99(5), 1157–1167. https://doi.org/10.1017/S0007114507853335
- Tallia, A. F., & Cardone, D. A. (n.d.). Asthma exacerbation associated with glucosamine-chondroitin supplement - PubMed. Retrieved November 2, 2021, from https://pubmed.ncbi.nlm.nih.gov/12463294/
- Henrotin, Y., Mobasheri, A., & Marty, M. (2012). Is there any scientific evidence for the use of glucosamine in the management of human osteoarthritis? Arthritis Research & Therapy, 14(1), 201. https://doi.org/10.1186/AR3657
- HC, G., PS, H., & RG, S. (2004). Is glucosamine safe in patients with seafood allergy? The Journal of Allergy and Clinical Immunology, 114(2), 459–460. https://doi.org/10.1016/J.JACI.2004.05.050
- Alshammari, E., & Alshammari, A. (2020). Glucosamine effects on lipids and blood pressure. International Journal of Research in Pharmaceutical Sciences, 11(1), 431–436. https://doi.org/10.26452/IJRPS.V11I1.1838
- V, R., JL, C., & AK, C. (2004). Possible augmentation of warfarin effect by glucosamine-chondroitin. American Journal of Health-System Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists, 61(3), 306–307. https://doi.org/10.1093/AJHP/61.3.306
- Lugo, J. P., Saiyed, Z. M., Lau, F. C., Molina, J. P. L., Pakdaman, M. N., Shamie, A. N., & Udani, J. K. (2013). Undenatured type II collagen (UC-II®) for joint support: a randomized, double-blind, placebo-controlled study in healthy volunteers. Journal of the International Society of Sports Nutrition, 10, 48. https://doi.org/10.1186/1550-2783-10-48
- S, A., H, I., Y, T., SK, S., S, S., & BB, A. (2006). Curcumin (diferuloylmethane) down-regulates expression of cell proliferation and antiapoptotic and metastatic gene products through suppression of IkappaBalpha kinase and Akt activation. Molecular Pharmacology, 69(1), 195–206. https://doi.org/10.1124/MOL.105.017400
- N, K., V, T., L, H., & R, K. (2003). Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee--a randomized double blind placebo controlled trial. Phytomedicine : International Journal of Phytotherapy and Phytopharmacology, 10(1), 3–7. https://doi.org/10.1078/094471103321648593
- MK, P., JS, P., ML, C., HJ, O., YJ, H., YJ, W., YM, H., MJ, P., HS, P., SH, P., HY, K., & JK, M. (2011). Grape seed proanthocyanidin extract (GSPE) differentially regulates Foxp3(+) regulatory and IL-17(+) pathogenic T cell in autoimmune arthritis. Immunology Letters, 135(1–2), 50–58. https://doi.org/10.1016/J.IMLET.2010.09.011
- KC, B. (2007). The debate over dopamine’s role in reward: the case for incentive salience. Psychopharmacology, 191(3), 391–431. https://doi.org/10.1007/S00213-006-0578-X
- H, Y., BK, L., KH, K., YS, J., & J, A. (2012). Protective effect of grape seed extract against oxidative stress-induced cell death in a staurosporine-differentiated retinal ganglion cell line. Current Eye Research, 37(4), 339–344. https://doi.org/10.3109/02713683.2011.645106
- O, K., Y, M., S, D., VH, G., & GM, G. (2010). Safety and Efficacy of Dietary Agmatine Sulfate in Lumbar Disc-associated Radiculopathy. An Open-label, Dose-escalating Study Followed by a Randomized, Double-blind, Placebo-controlled Trial. Pain Medicine (Malden, Mass.), 11(3), 356–368. https://doi.org/10.1111/J.1526-4637.2010.00808.X
- Bhathal, A., Spryszak, M., Louizos, C., & Frankel, G. (2017). Glucosamine and chondroitin use in canines for osteoarthritis: A review. Open Veterinary Journal, 7(1), 36. https://doi.org/10.4314/OVJ.V7I1.6