What is it?
It is important to read the labels of glucosamine products carefully since several different forms of glucosamine are sold as supplements. These products may contain glucosamine sulfate, glucosamine hydrochloride, or N-acetyl glucosamine. These different chemicals have some similarities. But they may not have the same effects when taken as a dietary supplement. Most of the scientific research on glucosamine has been done using glucosamine sulfate. See the separate listing for glucosamine sulfate. The information on this page is about glucosamine hydrochloride.
Dietary supplements that contain glucosamine often contain additional ingredients. These additional ingredients are frequently chondroitin sulfate, MSM, or shark cartilage. Some people think these combinations work better than taking just glucosamine alone. So far, researchers have found no proof that combining the additional ingredients with glucosamine adds any benefit.
Products that contain glucosamine and glucosamine plus chondroitin vary a great deal. Some do not contain what the label claims. The difference can range from 25% to 115%. Some products in the US that are labeled glucosamine sulfate are actually glucosamine hydrochloride with added sulfate. This product will likely have different effects than one containing glucosamine sulfate.
Glucosamine hydrochloride is used for osteoarthritis, rheumatoid arthritis, glaucoma, a jaw disorder called temporomandibular disorder (TMD), joint pain, and many other conditions, but there is no good scientific evidence to support these uses.
How effective is it?
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for GLUCOSAMINE HYDROCHLORIDE are as follows:
Insufficient evidence to rate effectiveness for...
- Heart disease. People who take glucosamine might have a lower risk of developing heart disease. But it's unclear what dose or form of glucosamine might work best. Other forms of glucosamine include glucosamine sulfate and N-acetyl glucosamine. It's also unclear if this lower risk is from glucosamine or from following healthier lifestyle habits.
- Depression. Early research shows that taking glucosamine hydrochloride for 4 weeks might improve symptoms of depression in some people with depression.
- Diabetes. People who take glucosamine might have a lower risk of developing diabetes. But it's unclear what dose or form of glucosamine might work best. Other forms of glucosamine include glucosamine sulfate and N-acetyl glucosamine. It's also unclear if this lower risk is from glucosamine or from following healthier lifestyle habits.
- High levels of cholesterol or other fats (lipids) in the blood (hyperlipidemia). Early research suggests that glucosamine hydrochloride does not affect cholesterol or triglyceride levels in people with high cholesterol.
- A disorder that affects the bones and joints, usually in people with selenium deficiency (Kashin-Beck disease). Early evidence shows that taking glucosamine hydrochloride along with chondroitin sulfate reduces pain and improves physical function in adults with a bone and joint disorder called Kashin-Beck disease. The effects of glucosamine sulfate on symptoms of Kashin-Beck disease are mixed when the supplement is taken as a single agent.
- Knee pain. There is some early evidence that glucosamine hydrochloride might relieve pain for some people with frequent knee pain. But other research shows that taking glucosamine hydrochloride along with other ingredients does not relieve pain or improve walking ability in people with knee pain.
- Osteoarthritis. There is conflicting evidence about the effectiveness of glucosamine hydrochloride for osteoarthritis. Most of the evidence supporting the use of glucosamine hydrochloride comes from studies of a particular product (CosaminDS). This product contains a combination of glucosamine hydrochloride, chondroitin sulfate, and manganese ascorbate. Some evidence suggests that this combination can improve pain in people with knee osteoarthritis. This combination might work better in people with mild-to-moderate osteoarthritis than in people with severe osteoarthritis. Another product (Gurukosamin & Kondoroichin) containing glucosamine hydrochloride, chondroitin sulfate, and quercetin glycosides also seems to improve knee osteoarthritis symptoms.
The effects of taking glucosamine hydrochloride along with only chondroitin sulfate are mixed. Some evidence shows that taking a specific product (Droglican) containing glucosamine hydrochloride and chondroitin sulfate reduces pain in adults with knee osteoarthritis. However, other research shows that formulas containing glucosamine hydrochloride and chondroitin sulfate are not effective at reducing pain in patients with knee osteoarthritis.
Most research suggests that taking glucosamine hydrochloride alone does not reduce pain in people with osteoarthritis of the knee.
More research has been done on glucosamine sulfate (see separate listing) than on glucosamine hydrochloride. There is some thought that glucosamine sulfate may be more effective than glucosamine hydrochloride for osteoarthritis. Most research comparing the two forms of glucosamine showed no difference. However, some researchers have criticized the quality of some of these studies.
- Rheumatoid arthritis (RA). Early research shows that taking a specific glucosamine hydrochloride product (Rohto Pharmaceuticals Co.) in combination with prescription medical treatments reduces pain compared to a sugar pill. However, this product does not seem to decrease inflammation or reduce the number of painful or swollen joints.
- Stroke. People who take glucosamine might have a slightly lower risk of having a stroke. But it's unclear what dose or form of glucosamine might work best. Other forms of glucosamine include glucosamine sulfate and N-acetyl glucosamine. It's also unclear if this lower risk is from glucosamine or from following healthier lifestyle habits.
- A group of painful conditions that affect the jaw joint and muscle (temporomandibular disorders or TMD). Early research shows that taking a combination of glucosamine hydrochloride, chondroitin sulfate, and calcium ascorbate twice daily reduces joint swelling and pain, as well as noise made at the jaw joint, in people with temporomandibular disorder.
- A group of eye disorders that can lead to vision loss (glaucoma).
- Back pain.
- Other conditions.
How does it work?
Some researchers believe that glucosamine hydrochloride might not work as well as glucosamine sulfate. They think the "sulfate" part of glucosamine sulfate is the important factor because sulfate is needed by the body to produce cartilage.
Are there safety concerns?
Some glucosamine products do not contain the labeled amount of glucosamine or contain excessive amounts of manganese. Ask your healthcare provider about reliable brands.
Special precautions & warnings:Pregnancy and breast-feeding: There isn't enough reliable information to know if glucosamine hydrochloride is safe to use when pregnant or breast-feeding. Stay on the safe side and avoid use.
Asthma: Glucosamine hydrochloride might make asthma worse. If you have asthma, use caution with glucosamine hydrochloride.
Diabetes: Some preliminary research suggests that glucosamine might raise blood sugar in people with diabetes. However, more reliable research indicates that glucosamine does not seem to significantly affect blood sugar control in people with type 2 diabetes. Glucosamine with routine blood sugar monitoring appears to be safe for most people with diabetes.
Glaucoma: Glucosamine hydrochloride might increase the pressure inside the eye and could worsen glaucoma. If you have glaucoma, talk to your healthcare provider before taking glucosamine.
High cholesterol: There is some concern that glucosamine might increase cholesterol levels in some people. Glucosamine might increase insulin levels. High insulin levels are associated with increased cholesterol levels. However, this effect has not been reported in humans. To be on the safe side, monitor your cholesterol levels closely if you take glucosamine hydrochloride and have high cholesterol levels.
High blood pressure: There is some concern that glucosamine might increase blood pressure in some people. Glucosamine might increase insulin levels. High insulin levels are associated with increased blood pressure. However, this effect has not been reported in humans. To be on the safe side, monitor your blood pressure closely if you take glucosamine hydrochloride and have high blood pressure.
Shellfish allergy: There is some concern that glucosamine products might cause allergic reactions in people who are sensitive to shellfish. Glucosamine is produced from the shells of shrimp, lobster, and crabs. Allergic reactions in people with shellfish allergy are caused by the meat of shellfish, not the shell. But some people have developed an allergic reaction after using glucosamine supplements. It is possible that some glucosamine products might be contaminated with the part of the shellfish meat that can cause an allergic reaction. If you have a shellfish allergy, talk to your provider before using glucosamine.
Surgery: Glucosamine hydrochloride might affect blood sugar levels and might interfere with blood sugar control during and after surgery. Stop using glucosamine hydrochloride at least 2 weeks before a scheduled surgery.
Are there interactions with medications?
- Warfarin (Coumadin)
- Warfarin (Coumadin) is used to slow blood clotting. There are several reports showing that taking glucosamine hydrochloride with or without chondroitin increases the effect of warfarin (Coumadin) on blood clotting. This can cause bruising and bleeding that can be serious. Don't take glucosamine hydrochloride if you are taking warfarin (Coumadin).
- Medications for cancer (Topoisomerase II inhibitors)
- Some medications for cancer work by decreasing how fast cancer cells can copy themselves. Some scientists think that glucosamine might block these medications from decreasing how fast tumor cells can copy themselves. Glucosamine hydrochloride is one form of glucosamine. Taking glucosamine hydrochloride along with some medications for cancer might decrease the effectiveness of these medications.
Some medications used for cancer include etoposide (VP16, VePesid), teniposide (VM26), mitoxantrone, daunorubicin, and doxorubicin (Adriamycin).
- Medications for diabetes (Antidiabetes drugs)
- Glucosamine hydrochloride is one form of glucosamine. There has been concern that glucosamine might increase blood sugar in people with diabetes. There has also been concern that glucosamine might decrease how well medications used for diabetes work. But higher quality research now shows that taking glucosamine hydrochloride probably doesn't increase blood sugar or interfere with diabetes medications in people with diabetes. But to be cautious, if you take glucosamine hydrochloride and have diabetes, monitor your blood sugar closely.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
Are there interactions with herbs and supplements?
- Chondroitin sulfate
- Taking chondroitin sulfate together with glucosamine hydrochloride might reduce blood levels of glucosamine. In theory, taking glucosamine hydrochloride with chondroitin sulfate might reduce the absorption of glucosamine hydrochloride.
Are there interactions with foods?
- There are no known interactions with foods.
What dose is used?
To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.
- Kumar PNS, Sharma A, Andrade C. A pilot, open-label investigation of the efficacy of glucosamine for the treatment of major depression. Asian J Psychiatr. 2020;52:102113. View abstract.
- Ma H, Li X, Zhou T, et al. Glucosamine use, inflammation, and genetic susceptibility, and incidence of type 2 diabetes: a prospective study in UK Biobank. Diabetes Care. 2020;43:719-25. View abstract.
- Navarro SL, Levy L, Curtis KR, Lampe JW, Hullar MAJ. Modulation of Gut Microbiota by Glucosamine and Chondroitin in a Randomized, Double-Blind Pilot Trial in Humans. Microorganisms. 2019 Nov 23;7. pii: E610. View abstract.
- Restaino OF, Finamore R, Stellavato A, et al. European chondroitin sulfate and glucosamine food supplements: A systematic quality and quantity assessment compared to pharmaceuticals. Carbohydr Polym. 2019 Oct 15;222:114984. View abstract.
- Hoban C, Byard R, Musgrave I. Hypersensitive adverse drug reactions to glucosamine and chondroitin preparations in Australia between 2000 and 2011. Postgrad Med J. 2019 Oct 9. pii: postgradmedj-2019-136957. View abstract.
- Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol. 2020 Feb;72:220-33. View abstract.
- Tsuruta A, Horiike T, Yoshimura M, Nagaoka I. Evaluation of the effect of the administration of a glucosamine containing supplement on biomarkers for cartilage metabolism in soccer players: A randomized double blind placebo controlled study. Mol Med Rep. 2018 Oct;18:3941-3948. Epub 2018 Aug 17. View abstract.
- Ma H, Li X, Sun D, et al. Association of habitual glucosamine use with risk of cardiovascular disease: prospective study in UK Biobank. BMJ. 2019 May 14;365:l1628. View abstract.
- Kanzaki N, Ono Y, Shibata H, Moritani T. Glucosamine-containing supplement improves locomotor functions in subjects with knee pain: a randomized, double-blind, placebo-controlled study. Clin Interv Aging. 2015;10:1743-53. View abstract.
- Esfandiari H, Pakravan M, Zakeri Z, et al. Effect of glucosamine on intraocular pressure: a randomized clinical trial. Eye. 2017;31:389-394.
- Murphy RK, Jaccoma EH, Rice RD, Ketzler L. Glucosamine as a Possible Risk Factor for Glaucoma. Invest Ophthalmol Vis Sci 2009;50:5850.
- Eriksen P, Bartels EM, Altman RD, Bliddal H, Juhl C, Christensen R. Risk of bias and brand explain the observed inconsistency in trials on glucosamine for symptomatic relief of osteoarthritis: a meta-analysis of placebo-controlled trials. Arthritis Care Res (Hoboken). 2014;66:1844-55. View abstract.
- Murphy RK, Ketzler L, Rice RD, Johnson SM, Doss MS, Jaccoma EH. Oral glucosamine supplements as a possible ocular hypertensive agent. JAMA Ophthalmol 2013;131:955-7. View abstract.
- Levin RM, Krieger NN, and Winzler RJ. Glucosamine and acetylglucosamine tolerance in man. J Lab Clin Med 1961;58:927-932.
- Meulyzer M, Vachon P, Beaudry F, Vinardell T, Richard H, Beauchamp G, Laverty S. Comparison of pharmacokinetics of glucosamine and synovial fluid levels following administration of glucosamine sulphate or glucosamine hydrochloride. Osteoarthritis Cartilage 2008;16:973-9. View abstract.
- Wu H, Liu M, Wang S, Zhao H, Yao W, Feng W, Yan M, Tang Y, Wei M. Comparative fasting bioavailability and pharmacokinetic properties of 2 formulations of glucosamine hydrochloride in healthy Chinese adult male volunteers. Arzneimittelforschung. 2012 Aug;62:367-71. View abstract.
- Liang CM, Tai MC, Chang YH, Chen YH, Chen CL, Chien MW, Chen JT. Glucosamine inhibits epidermal growth factor-induced proliferation and cell-cycle progression in retinal pigment epithelial cells. Mol Vis 2010;16:2559-71. View abstract.
- Raciti GA, Iadicicco C, Ulianich L, Vind BF, Gaster M, Andreozzi F, Longo M, Teperino R, Ungaro P, Di Jeso B, Formisano P, Beguinot F, Miele C. Glucosamine-induced endoplasmic reticulum stress affects GLUT4 expression via activating transcription factor 6 in rat and human skeletal muscle cells. Diabetologia 2010;53:955-65. View abstract.
- Kang ES, Han D, Park J, Kwak TK, Oh MA, Lee SA, Choi S, Park ZY, Kim Y, Lee JW. O-GlcNAc modulation at Akt1 Ser473 correlates with apoptosis of murine pancreatic beta cells. Exp Cell Res 2008;314(11-12):2238-48. View abstract.
- Yomogida S, Hua J, Sakamoto K, Nagaoka I. Glucosamine suppresses interleukin-8 production and ICAM-1 expression by TNF-alpha-stimulated human colonic epithelial HT-29 cells. Int J Mol Med 2008;22:205-11. View abstract.
- Ju Y, Hua J, Sakamoto K, Ogawa H, Nagaoka I. Glucosamine, a naturally occurring amino monosaccharide modulates LL-37-induced endothelial cell activation. Int J Mol Med 2008;22:657-62. View abstract.
- Qiu W, Su Q, Rutledge AC, Zhang J, Adeli K. Glucosamine-induced endoplasmic reticulum stress attenuates apolipoprotein B100 synthesis via PERK signaling. J Lipid Res 2009;50:1814-23. View abstract.
- Ju Y, Hua J, Sakamoto K, Ogawa H, Nagaoka I. Modulation of TNF-alpha-induced endothelial cell activation by glucosamine, a naturally occurring amino monosaccharide. Int J Mol Med 2008;22:809-15. View abstract.
- Ilic MZ, Martinac B, Samiric T, Handley CJ. Effects of glucosamine on proteoglycan loss by tendon, ligament and joint capsule explant cultures. Osteoarthritis Cartilage 2008;16:1501-8. View abstract.
- Toegel S, Wu SQ, Piana C, Unger FM, Wirth M, Goldring MB, Gabor F, Viernstein H. Comparison between chondroprotective effects of glucosamine, curcumin, and diacerein in IL-1beta-stimulated C-28/I2 chondrocytes. Osteoarthritis Cartilage 2008;16:1205-12. View abstract.
- Lin YC, Liang YC, Sheu MT, Lin YC, Hsieh MS, Chen TF, Chen CH. Chondroprotective effects of glucosamine involving the p38 MAPK and Akt signaling pathways. Rheumatol Int 2008;28:1009-16. View abstract.
- Scotto d'Abusco A, Politi L, Giordano C, Scandurra R. A peptidyl-glucosamine derivative affects IKKalpha kinase activity in human chondrocytes. Arthritis Res Ther 2010;12:R18. View abstract.
- Shikhman AR, Brinson DC, Valbracht J, Lotz MK. Differential metabolic effects of glucosamine and N-acetylglucosamine in human articular chondrocytes. Osteoarthritis Cartilage 2009;17:1022-8. View abstract.
- Uitterlinden EJ, Koevoet JL, Verkoelen CF, Bierma-Zeinstra SM, Jahr H, Weinans H, Verhaar JA, van Osch GJ. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants. BMC Musculoskelet Disord 2008;9:120. View abstract.
- Hong H, Park YK, Choi MS, Ryu NH, Song DK, Suh SI, Nam KY, Park GY, Jang BC. Differential down-regulation of COX-2 and MMP-13 in human skin fibroblasts by glucosamine-hydrochloride. J Dermatol Sci 2009;56:43-50. View abstract.
- Wu YL, Kou YR, Ou HL, Chien HY, Chuang KH, Liu HH, Lee TS, Tsai CY, Lu ML. Glucosamine regulation of LPS-mediated inflammation in human bronchial epithelial cells. Eur J Pharmacol 2010;635(1-3):219-26. View abstract.
- Imagawa K, de Andrés MC, Hashimoto K, Pitt D, Itoi E, Goldring MB, Roach HI, Oreffo RO. The epigenetic effect of glucosamine and a nuclear factor-kappa B (NF-kB) inhibitor on primary human chondrocytes--implications for osteoarthritis. Biochem Biophys Res Commun 2011;405:362-7. View abstract.
- Yomogida S, Kojima Y, Tsutsumi-Ishii Y, Hua J, Sakamoto K, Nagaoka I. Glucosamine, a naturally occurring amino monosaccharide, suppresses dextran sulfate sodium-induced colitis in rats. Int J Mol Med 2008;22:317-23. View abstract.
- Sakai S, Sugawara T, Kishi T, Yanagimoto K, Hirata T. Effect of glucosamine and related compounds on the degranulation of mast cells and ear swelling induced by dinitrofluorobenzene in mice. Life Sci 2010;86(9-10):337-43. View abstract.
- Hwang MS, Baek WK. Glucosamine induces autophagic cell death through the stimulation of ER stress in human glioma cancer cells. Biochem Biophys Res Commun 2010;399:111-6. View abstract.
- Park JY, Park JW, Suh SI, Baek WK. D-glucosamine down-regulates HIF-1alpha through inhibition of protein translation in DU145 prostate cancer cells. Biochem Biophys Res Commun 2009;382:96-101. View abstract.
- Chesnokov V, Sun C, Itakura K. Glucosamine suppresses proliferation of human prostate carcinoma DU145 cells through inhibition of STAT3 signaling. Cancer Cell Int 2009;9:25. View abstract.
- Tsai CY, Lee TS, Kou YR, Wu YL. Glucosamine inhibits IL-1beta-mediated IL-8 production in prostate cancer cells by MAPK attenuation. J Cell Biochem 2009;108:489-98. View abstract.
- Kim DS, Park KS, Jeong KC, Lee BI, Lee CH, Kim SY. Glucosamine is an effective chemo-sensitizer via transglutaminase 2 inhibition. Cancer Lett 2009;273:243-9. View abstract.
- Kuo M, Zilberfarb V, Gangneux N, Christeff N, Issad T. O-glycosylation of FoxO1 increases its transcriptional activity towards the glucose 6-phosphatase gene. FEBS Lett 2008;582:829-34. View abstract.
- Kuo M, Zilberfarb V, Gangneux N, Christeff N, Issad T. O-GlcNAc modification of FoxO1 increases its transcriptional activity: a role in the glucotoxicity phenomenon? Biochimie 2008;90:679-85. View abstract.
- Naito K, Watari T, Furuhata A, Yomogida S, Sakamoto K, Kurosawa H, Kaneko K,Nagaoka I. Evaluation of the effect of glucosamine on an experimental rat osteoarthritis model. Life Sci 2010;86(13-14):538-43. View abstract.
- Weiden S and Wood IJ. The fate of glucosamine hydrochloride injected intravenously in man. J Clin Pathol 1958;11:343-349.
- Satia JA, Littman A, Slatore CG, Galanko JA, White E. Associations of herbal and specialty supplements with lung and colorectal cancer risk in the VITamins and Lifestyle study. Cancer Epidemiol Biomarkers Prev 2009;18:1419-28. View abstract.
- Audimoolam VK, Bhandari S. Acute interstitial nephritis induced by glucosamine. Nephrol Dial Transplant 2006;21:2031. View abstract.
- Ossendza RA, Grandval P, Chinoune F, Rocher F, Chapel F, Bernardini D. [Acute cholestatic hepatitis due to glucosamine forte]. Gastroenterol Clin Biol. 2007 Apr;31:449-50. View abstract.
- Wu D, Huang Y, Gu Y, Fan W. Efficacies of different preparations of glucosamine for the treatment of osteoarthritis: a meta-analysis of randomised,double-blind, placebo-controlled trials. Int J Clin Pract 2013;67:585-94. View abstract.
- Provenza JR, Shinjo SK, Silva JM, Peron CR, Rocha FA. Combined glucosamine and chondroitin sulfate, once or three times daily, provides clinically relevant analgesia in knee osteoarthritis. Clin Rheumatol 2015;34:1455-62.View abstract.
- Kwoh CK, Roemer FW, Hannon MJ, Moore CE, Jakicic JM, Guermazi A, Green SM, Evans RW, Boudreau R. Effect of oral glucosamine on joint structure in individuals with chronic knee pain: a randomized, placebo-controlled clinical trial. Arthritis Rheumatol. 2014 Apr;66:930-9. View abstract.
- Hochberg MC, Martel-Pelletier J, Monfort J, Möller I, Castillo JR, Arden N,Berenbaum F, Blanco FJ, Conaghan PG, Doménech G, Henrotin Y, Pap T, Richette P, Sawitzke A, du Souich P, Pelletier JP; on behalf of the MOVES Investigation Group. Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib. Ann Rheum Dis 2016;75:37-44. View abstract.
- Cerda C, Bruguera M, Parés A. Hepatotoxicity associated with glucosamine and chondroitin sulfate in patients with chronic liver disease. World J Gastroenterol 2013;19:5381-4. View abstract.
- Glucosamine for knee osteoarthritis--what's new? Drug Ther Bull. 2008: 46:81-4. View abstract.
- Fox BA, Stephens MM. Glucosamine hydrochloride for the treatment of osteoarthritis symptoms. Clin Interv Aging 2007;2:599-604. View abstract.
- Veldhorst, M. A., Nieuwenhuizen, A. G., Hochstenbach-Waelen, A., van Vught, A. J., Westerterp, K. R., Engelen, M. P., Brummer, R. J., Deutz, N. E., and Westerterp-Plantenga, M. S. Dose-dependent satiating effect of whey relative to casein or soy. Physiol Behav 3-23-2009;96(4-5):675-682. View abstract.
- Yue, J., Yang, M., Yi, S., Dong, B., Li, W., Yang, Z., Lu, J., Zhang, R., and Yong, J. Chondroitin sulfate and/or glucosamine hydrochloride for Kashin-Beck disease: a cluster-randomized, placebo-controlled study. Osteoarthritis.Cartilage. 2012;20:622-629. View abstract.
- Kanzaki, N., Saito, K., Maeda, A., Kitagawa, Y., Kiso, Y., Watanabe, K., Tomonaga, A., Nagaoka, I., and Yamaguchi, H. Effect of a dietary supplement containing glucosamine hydrochloride, chondroitin sulfate and quercetin glycosides on symptomatic knee osteoarthritis: a randomized, double-blind, placebo-controlled study. J.Sci.Food Agric. 3-15-2012;92:862-869. View abstract.
- Sawitzke, A. D., Shi, H., Finco, M. F., Dunlop, D. D., Harris, C. L., Singer, N. G., Bradley, J. D., Silver, D., Jackson, C. G., Lane, N. E., Oddis, C. V., Wolfe, F., Lisse, J., Furst, D. E., Bingham, C. O., Reda, D. J., Moskowitz, R. W., Williams, H. J., and Clegg, D. O. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann.Rheum.Dis. 2010;69:1459-1464. View abstract.
- Jackson, C. G., Plaas, A. H., Sandy, J. D., Hua, C., Kim-Rolands, S., Barnhill, J. G., Harris, C. L., and Clegg, D. O. The human pharmacokinetics of oral ingestion of glucosamine and chondroitin sulfate taken separately or in combination. Osteoarthritis Cartilage 2010;18:297-302. View abstract.
- Dudics, V., Kunstar, A., Kovacs, J., Lakatos, T., Geher, P., Gomor, B., Monostori, E., and Uher, F. Chondrogenic potential of mesenchymal stem cells from patients with rheumatoid arthritis and osteoarthritis: measurements in a microculture system. Cells Tissues.Organs 2009;189:307-316. View abstract.
- Nandhakumar J. Efficacy, tolerability, and safety of a multicomponent antiinflammatory with glucosamine hydrochloride vs glucosamine sulfate vs an NSAID in the treatment of knee osteoarthritis--a randomized, prospective, double-blind, comparative study. Integr Med Clin J 2009;8:32-38.
- Kawasaki T, Kurosawa H, Ikeda H, et al. Additive effects of glucosamine or risedronate for the treatment of osteoarthritis of the knee combined with home exercise: a prospective randomized 18-month trial. J Bone Miner Metab 2008;26:279-87. View abstract.
- Nelson BA, Robinson KA, Buse MG. High glucose and glucosamine induce insulin resistance via different mechanisms in 3T3-L1 adipocytes. Diabetes 2000;49:981-91. View abstract.
- Baron AD, Zhu JS, Zhu JH, et al. Glucosamine induces insulin resistance in vivo by affecting GLUT 4 translocation in skeletal muscle. Implications for glucose toxicity. J Clin Invest 1995;96:2792-801. View abstract.
- Eggertsen R, Andreasson A, Andren L. No changes of cholesterol levels with a commercially available glucosamine product in patients treated with lipid lowering drugs: a controlled, randomised, open cross-over trial. BMCPharmacol Toxicol 2012;13:10. View abstract.
- Shankland WE. The effects of glucosamine and chondroitin sulfate on osteoarthritis of the TMJ: a preliminary report of 50 patients. Cranio 1998;16:230-5. View abstract.
- Liu W, Liu G, Pei F, et al. Kashin-Beck disease in Sichuan, China: report of a pilot open therapeutic trial. J Clin Rheumatol 2012;18:8-14. View abstract.
- Lee JJ, Jin YR, Lee JH, et al. Antiplatelet activity of carnosic acid, a phenolic diterpene from Rosmarinus officinalis. Planta Med 2007;73:121-7. View abstract.
- Nakamura H, Masuko K, Yudoh K, et al. Effects of glucosamine administration on patients with rheumatoid arthritis. Rheumatol Int 2007;27:213-8. View abstract.
- Yue QY, Strandell J, Myrberg O. Concomitant use of glucosamine may potential the effect of warfarin. The Uppsala Monitoring Centre. Available at: www.who-umc.org/graphics/9722.pdf (Accessed 28 April 2008).
- Knudsen J, Sokol GH. Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: Case report and review of the literature and MedWatch database. Pharmacotherapy 2008;28:540-8. View abstract.
- Muniyappa R, Karne RJ, Hall G, et al. Oral glucosamine for 6 weeks at standard doses does not cause or worsen insulin resistance or endothelial dysfunction in lean or obese subjects. Diabetes 2006;55:3142-50. View abstract.
- Tannock LR, Kirk EA, King VL, et al. Glucosamine supplementation accelerates early but not late atherosclerosis in LDL receptor-deficient mice. J Nutr 2006;136:2856-61. View abstract.
- Pham T, Cornea A, Blick KE, et al. Oral glucosamine in doses used to treat osteoarthritis worsens insulin resistance. Am J Med Sci 2007;333:333-9. View abstract.
- Messier SP, Mihalko S, Loeser RF, et al. Glucosamine/chondroitin combined with exercise for the treatment of knee osteoarthritis: a preliminary study. Osteoarthritis Cartilage 2007;15:1256-66. View abstract.
- Stumpf JL, Lin SW. Effect of glucosamine on glucose control. Ann Pharmacother 2006;40:694-8. View abstract.
- Qiu GX, Weng XS, Zhang K, et al. [A multi-central, randomized, controlled clinical trial of glucosamine hydrochloride/sulfate in the treatment of knee osteoarthritis]. Zhonghua Yi Xue Za Zhi 2005;85:3067-70. View abstract.
- Clegg DO, Reda DJ, Harris CL, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med 2006;354:795-808. View abstract.
- McAlindon T. Why are clinical trials of glucosamine no longer uniformly positive? Rheum Dis Clin North Am 2003;29:789-801. View abstract.
- Tannis AJ, Barban J, Conquer JA. Effect of glucosamine supplementation on fasting and non-fasting plasma glucose and serum insulin concentrations in healthy individuals. Osteoarthritis Cartilage 2004;12:506-11. View abstract.
- Weimann G, Lubenow N, Selleng K, et al. Glucosamine sulfate does not crossreact with the antibodies of patients with heparin-induced thrombocytopenia. Eur J Haematol 2001;66:195-9. View abstract.
- Rozenfeld V, Crain JL, Callahan AK. Possible augmentation of warfarin effect by glucosamine-chondroitin. Am J Health Syst Pharm 2004;61:306-307. View abstract.
- Guillaume MP, Peretz A. Possible association between glucosamine treatment and renal toxicity: comment on the letter by Danao-Camara. Arthritis Rheum 2001;44:2943-4. View abstract.
- Danao-Camara T. Potential side effects of treatment with glucosamine and chondroitin. Arthritis Rheum 2000;43:2853. View abstract.
- Yu JG, Boies SM, Olefsky JM. The effect of oral glucosamine sulfate on insulin sensitivity in human subjects. Diabetes Care 2003;26:1941-2. View abstract.
- Hoffer LJ, Kaplan LN, Hamadeh MJ, et al. Sulfate could mediate the therapeutic effect of glucosamine sulfate. Metabolism 2001;50:767-70.. View abstract.
- Braham R, Dawson B, Goodman C. The effect of glucosamine supplementation on people experiencing regular knee pain. Br J Sports Med 2003;37:45-9. View abstract.
- Scroggie DA, Albright A, Harris MD. The effect of glucosamine-chondroitin supplementation on glycosylated hemoglobin levels in patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized clinical trial. Arch Intern Med 2003;163:1587-90. View abstract.
- Tallia AF, Cardone DA. Asthma exacerbation associated with glucosamine-chondroitin supplement. J Am Board Fam Pract 2002;15:481-4.. View abstract.
- Du XL, Edelstein D, Dimmeler S, et al. Hyperglycemia inhibits endothelial nitric oxide synthase activity by post-translational modification at the Akt site. J Clin Invest 2001;108:1341-8. View abstract.
- Pavelka K, Gatterova J, Olejarova M, et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: A 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med 2002;162:2113-23. View abstract.
- Adebowale AO, Cox DS, Liang Z, et al. Analysis of glucosamine and chondroitin sulfate content in marketed products and the Caco-2 permeability of chondroitin sulfate raw materials. JANA 2000;3:37-44.
- Nowak A, Szczesniak L, Rychlewski T, et al. Glucosamine levels in people with ischaemic heart disease with and without type II diabetes. Pol Arch Med Wewn 1998;100:419-25. View abstract.
- Olszewski AJ, Szostak WB, McCully KS. Plasma glucosamine and galactosamine in ischemic heart disease. Atherosclerosis 1990;82:75-83. View abstract.
- Yun J, Tomida A, Nagata K, Tsuruo T. Glucose-regulated stresses confer resistance to VP-16 in human cancer cells through a decreased expression of DNA topoisomerase II. Oncol Res 1995;7:583-90. View abstract.
- Pouwels MJ, Jacobs JR, Span PN, et al. Short-term glucosamine infusion does not affect insulin sensitivity in humans. J Clin Endocrinol Metab 2001;86:2099-103. View abstract.
- Monauni T, Zenti MG, Cretti A, et al. Effects of glucosamine infusion on insulin secretion and insulin action in humans. Diabetes 2000;49:926-35. View abstract.
- Das A Jr, Hammad TA. Efficacy of a combination of FCHG49 glucosamine hydrochloride, TRH122 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis. Osteoarthritis Cartilage 2000;8:343-50. View abstract.
- Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002. Available at: www.nap.edu/books/0309072794/html/.
- Does glucosamine increase serum lipid levels and blood pressure? Pharmacist's Letter/Prescriber's Letter 2001;17:171115.
- Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulfate on osteoarthritis progression: a randomised, placebo-controlled trial. Lancet 2001;357:251-6. View abstract.
- Almada A, Harvey P, Platt K. Effects of chronic oral glucosamine sulfate on fasting insulin resistance index (FIRI) in non-diabetic individuals. FASEB J 2000;14:A750.
- Leffler CT, Philippi AF, Leffler SG, et al. Glucosamine, chondroitin, and manganese ascorbate for degenerative joint disease of the knee or low back: a randomized, double-blind, placebo-controlled pilot study. Mil Med 1999;164:85-91. View abstract.
- Shankar RR, Zhu JS, Baron AD. Glucosamine infusion in rats mimics the beta-cell dysfunction of non-insulin-dependent diabetes mellitus. Metabolism 1998;47:573-7. View abstract.
- Rossetti L, Hawkins M, Chen W, et al. In vivo glucosamine infusion induces insulin resistance in normoglycemic but not in hyperglycemic conscious rats. J Clin Invest 1995;96:132-40. View abstract.
- Houpt JB, McMillan R, Wein C, Paget-Dellio SD. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol 1999;26:2423-30. View abstract.
- Kim YB, Zhu JS, Zierath JR, et al. Glucosamine infusion in rats rapidly impairs insulin stimulation of phosphoinositide 3-kinase but does not alter activation of Akt/protein kinase B in skeletal muscle. Diabetes 1999;48:310-20. View abstract.
- Holmang A, Nilsson C, Niklasson M, et al. Induction of insulin resistance by glucosamine reduces blood flow but not interstitial levels of either glucose or insulin. Diabetes 1999;48:106-11. View abstract.
- Giaccari A, Morviducci L, Zorretta D, et al. In vivo effects of glucosamine on insulin secretion and insulin sensitivity in the rat: possible relevance to the maladaptive responses to chronic hyperglycaemia. Diabetologia 1995;38:518-24. View abstract.
- Balkan B, Dunning BE. Glucosamine inhibits glucokinase in vitro and produces a glucose-specific impairment of in vivo insulin secretion in rats. Diabetes 1994;43:1173-9. View abstract.
- Adams ME. Hype about glucosamine. Lancet 1999;354:353-4. View abstract.
- Gruenwald J, Brendler T, Jaenicke C. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.
- Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. Terry C. Telger, transl. 3rd ed. Berlin, GER: Springer, 1998.
- Blumenthal M, ed. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.
- Monographs on the medicinal uses of plant drugs. Exeter, UK: European Scientific Co-op Phytother, 1997.