Glucosamine chondroitin is a popular combination supplement for joint pain, but its effect remains controversial. A small number of cases of hepatitis occurring while on glucosamine or glucosamine chondroitin have been reported, resulting in an assumed causal relationship. The Committee on Toxicity from the United Kingdom conducted an investigation of these case reports, concluding that the likelihood glucosamine is a cause of hepatitis is very low. The lack of a plausible relationship between glucosamine chondroitin and hepatitis has resulted in the conclusion that these cases of hepatitis are most likely idiosyncratic, which means occurring without a known cause.
Glucosamine is a naturally occurring chemical in our bodies that plays a key role in the building of cartilage and the fluid which cushions our joints. Glucosamine is available as a supplement which is either obtained from shellfish or produced in a laboratory. Some researchers believe that glucosamine sulfate is more effective than glucosamine hydrochloride because sulfate is needed for the building of cartilage. Unfortunately, the effect of glucosamine remains controversial. The Glucosamine/Chondroitin Arthritis Intervention Trial concluded that overall patients did not experience significant pain relief with either glucosamine, chondroitin or the combination over placebo.
Chondroitin sulfate is also a naturally occurring chemical found in the joint cartilage in our bodies. Supplements are usually manufactured from cow cartilage. While the theory is that chondroitin supplements can help slow the breakdown of cartilage there is lack of evidence to support this claim. In addition, there is a great variability in the manufacturing of chondroitin or chondroitin plus glucosamine products. Some products have been found to contain no chondroitin or higher than stated levels despite the labeling.
Side Effects and Liver Damage
Even though the effects of glucosamine chondroitin therapy is controversial, these products are relatively safe. Common side effects to both supplements are upset stomach, diarrhea, and constipation. Both products come from animal sources so specific caution should apply. Glucosamine is often derived from shellfish so if you have allergies to shellfish you should avoid these products or buy glucosamine that has been manufactured in a laboratory. Chondroitin, manufactured from cow cartilage has a very low risk of transmitting animal borne diseases, but caution should be exercised. The specific review by the COT on glucosamine and chondroitin causing liver damage has indicated that it is unlikely a cause and effect and more likely the result of either other drugs or supplements taken by those few patients or an idiosyncratic development that cannot be explained.
If you are suffering from joint pain and prefer to try a supplement, glucosamine and chondroitin may work for you. Caution should be exercised if you are taking other medicines or supplements since multiple combinations may cause untoward reactions. Always check with your physician before starting any new supplement. If you have allergies to shellfish you should avoid glucosamine.
Is This an Emergency?
- Medline Plus: Glucosamine Sulfate; January 18, 2011
- Medline Plus: Chondroitin Sulfate; November 18, 2010
- NCCAM: Questions and Answers: NIH Glucosamine/chondroitin Arthritis Intervention Trial Primary Study; October 2008
- Medical News Today: Data Does Not Indicate Glucosamine Damages Liver; May 2009
- University of Maryland Medical Center: Glucosamine; June 21, 2009