Glucosamine, Chondroitin, MSM Products
Glucosamine and chondroitin sulfate are substances found naturally in the body. Glucosamine is a form of amino sugar that is believed to play a role in cartilage formation and repair. Chondroitin sulfate is part of a large protein molecule (proteoglycan) that gives cartilage elasticity.
Both glucosamine and chondroitin sulfate are sold as dietary or nutritional supplements. They are extracted from animal tissue: glucosamine from crab, lobster or shrimp shells; and chondroitin sulfate from animal cartilage, such as tracheas or shark cartilage.
What do they do?
Past studies show that some people with mild to moderate osteoarthritis (OA) taking either glucosamine or chondroitin sulfate reported pain relief at a level similar to that of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. Some research indicates that the supplements might also slow cartilage damage in people with OA.
Treatment with oral glucosamine is commonly used for the treatment of osteoarthritis. Since glucosamine is a precursor for glycosaminoglycans, and glycosaminoglycans are a major component of joint cartilage, supplemental glucosamine may help to rebuild cartilage and treat arthritis. However, there is little evidence that any clinical effect of glucosamine works this way (Laverty et al., 2005; Biggee et al., 2005). Its use as a therapy for osteoarthritis appears safe but there is conflicting evidence as to its effectiveness.
A typical dosage of glucosamine salt is 1,500 mg per day. Glucosamine contains an amino group that is positively charged at physiological pH. The anion included in the salt may vary. Commonly sold forms of glucosamine are glucosamine sulfate and glucosamine hydrochloride. The amount of glucosamine present in 1500 mg of glucosamine salt will depend on which anion is present  and whether additional salts are included in the manufacturer's calculation. Glucosamine is often sold in combination with other supplements such as chondroitin sulfate and methylsulfonylmethane.
In the United States, glucosamine is not approved by the Food and Drug Administration for medical use in humans. However, since glucosamine is classified as a dietary supplement, evidence of safety and efficacy is not required, so long as it is not advertised as a treatment for a medical condition . Nevertheless, glucosamine is a popular alternative medicine and has become extensively used by consumers for the treatment of osteoarthritis. It is also considered an acceptable treatment in veterinary medicine. 
In Europe, glucosamine is approved as a medical drug and is sold by Rottapharm (in the form of glucosamine sulfate).
Glucosamine has been studied as a medical therapy since at least the early 1980s. The clinical studies have consistently reported that glucosamine appears safe. Although no allergic reactions have been reported, glucosamine is usually derived from shellfish, so individuals with an allergy to shellfish may wish to avoid glucosamine. Alternative sources using fungal fermentation of corn are available. Another concern has been that the extra glucosamine could contribute to diabetes by interfering with the normal regulation of the hexosamine biosynthesis pathway (Buse, 2006), but several investigations have found no evidence that this occurs (Scroggie et al., 2003). The U.S. National Institutes of Health is currently conducting a study of supplemental glucosamine in obese patients, since this population may be particularly sensitive to any effects of glucosamine on insulin resistance. . Finally, in the United States, glucosamine is sold as a dietary supplement, so safety and formulation is solely the responsibility of the manufacturer.
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