Glucosamine
Als je regelmatig de advertenties voor
supplementen leest dan zul je regelmatig een supplement tegenkomen met de naam
Glucosamine.
Waarom dit supplement zoveel aandacht krijgt blijkt wel uit onderstaande
onderzoeken en artikelen. Lijkt op een medicijn maar is een supplement dat
kan helpen bij gewrichtsproblemen. Uit Portugees onderzoek is ook gebleken
dat glucosamine sulfate kan helpen tegen pijnklachten bij knie artrose.
Verder blijkt het even effectief te zijn
als Ibuprofen zonder de nadelen van deze pijnstiller. Zelf heb ik nog een fijne ervaring
achter de rug na pijn klachten aan mijn schouder. We hadden nog een setje mooie roze
Ibuprofen liggen dus die maar genomen maar kreeg gelijk overal uitslag, leek wel
of ik onder een zonnebank had gelegen. Weer wat geleerd....
Een baanbreker op het gebied van
glucosamine is Kris Kuiper die al enige jaren bezig is met de verkoop en promotie in
Nederland.
Ron
Supplement dat
gewrichten repareert zit farma dwars
,,De farmacie is niet blij
glucosamine'', zegt Kris Kuiper. ,,Steeds meer mensen ontdekken het. Vroeg of laat gaan de
farmaconcerns dat merken in hun omzet.'' Kris Kuiper is een specialist. Weinig mensen
weten zoveel over glucosamine als hij - maar Kuiper verdiept zich ondertussen al jarenlang
in het wonderlijke supplement. Glucosamine repareert kapotte gewrichten, en werkt zo
krachtig dat het soms eerder aan een medicijn doet denken dan aan een supplement.
Tegelijkertijd is het veilig. In proeven op mensen hebben onderzoekers nooit gevaarlijke
bijwerkingen kunnen ontdekken. ,,De belangrijkste bijwerking is eigenlijk dat een kleine
groep mensen met een allergie voor schaaldiertjes er verkeerd op kan reageren'', zegt
Kuiper. ,,Glucosamine wordt gemaakt uit schilden van krabben en garnalen, en in de
supplementen kunnen eiwitten zitten waar die groep gevoelig voor is.''
Ga naar het volledige artikel (Ergogenics.org)
Soelaas voor krakende wagens?
Glucosamine is een aminomonosaccharide.
Het is een bouwstof voor glycosaminoglycanen en proteo-glycanen die in bijna alle weefsels
voorkomen, waaronder kraakbeen. Tevens stimuleert het in vitro de kraakbeencellen tot de
synthese van glycosaminoglycanen en proteoglycanen. Glucosamine wordt gebruikt bij
artrose, het vermindert de pijn en geeft een geringe functieverbetering van het gewricht.
Na een periode van 2 tot 4 weken is glucosamine net zo effectief in pijnverlichting als
een laag-gedoseerd NSAID. Het chondroprotectief effect is niet bewezen. Glucosamine wordt
ook als voedingssupplement gebruikt.
http://www.pharmaselecta.nl/cgi-perl/show.pl?id=2005091
Glucosamine even effectief als
ibruprofen
Glucosamine therapy compared to ibuprofen
for joint pain.
Ruane R, Griffiths P. Primary Care and
Community Pharmacy,
King's College London.
The conclusion is that glucosamine is
effective in relieving joint pain associated with osteoarthritis. Glucosamine's
pain-relieving effects may be due to its cartilage-rebuilding properties; these
disease-modifying effects are not seen with simple analgesics and are of particular
benefit. In practice glucosamine can be used as an alternative to anti-inflammatory drugs
and analgesics or as a useful adjunct to standard analgesic therapy.
Source: Br J Community Nurs. 2002
Mar;7(3):148-52
GUIDE RESULTS TAP GLUCOSAMINE
SULFATE AS PREFERRED MED FOR THE PAIN OF KNEE OSTEO ARTHRITIS
Medical investigation results indicate
that glucosamine sulfate may have more ability to control pain due to knee osteoarthritis
than does acetaminophen, according to research presented this week at the American College
of Rheumatology Annual Scientific Meeting in San Diego, California.
Glucosamine, which is dispensed as a
prescription drug in Europe and available as a dietary supplement in the U.S. , has been
suggested to improve cartilage biology and counteract factors contributing to joint
degeneration, inflammation and symptoms of osteoarthritis.
On-going randomized, placebo-controlled,
double-blind trials are being conducted worldwide to assess the effectiveness of oral
glucosamine in combating the discomfort of knee osteoarthritis compared to standard
symptomatic medications . U.S. researchers from the National Institutes of Health are
utilizing GAIT (the Glucosamine/Chondroitin Arthritis Intervention Trial) to compare
nutraceutical glucosamine hydrochloride with the anti-inflammatory celecoxib (Celebrex),
dividing the glucosamine into three separate daily doses.
European researchers, employing GUIDE ,
have been comparing glucosamine sulfate with the typically-recommended acetaminophen which
is usually taken in three or four 1000 mg doses. The original prescription formulation of
glucosamine sulfate soluble powder used provided higher glucosamine levels in the blood to
mirror recent favorable glucosamine trials. (Glucosamine sulfate is a slightly different
substance than glucosamine hydrochloride. The formulation used in GUIDE is not comparable
to most formulations available in the U.S.)
GUIDE investigators followed 318 patients
(88 percent women) with symptomatic knee osteoarthritis. Based on randomized groupings,
patients took either oral glucosamine sulfate soluble powder (1500 mg once a day),
acetaminophen (1000 mg tablets three times a day), or a placebo over a six-month period.
All groups were allowed ibuprofen as needed.
Results showed that both glucosamine
sulfate and acetaminophen had greater efficacy than placebo use in reducing pain. However,
patients taking glucosamine sulfate appeared to experience more relief than did those on
acetaminophen.
“Once-daily 1500 mg oral doses of
glucosamine sulfate might be the preferred treatment for symptoms of knee
osteoarthritis,” summarizes Gabriel Herrero-Beaumont, MD, Director of the
Rheumatology Department, Jiménez Díaz Foundation - CAPIO, Madrid, Spain. “Based on
these results, physicians who typically recommended acetaminophen may well find their
patients gain more comfort taking glucosamine sulfate.”
The American College of Rheumatology is
the professional organization for rheumatologists and health professionals who share a
dedication to healing, preventing disability and curing arthritis and related rheumatic
and musculoskeletal diseases. For more information on the ACR's annual meeting, see www.rheumatology.org/annual.
Structural and symptomatic
efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive
meta-analysis.
Richy F, Bruyere O, Ethgen O, Cucherat M,
Henrotin Y, Reginster JY.
Faculty of Medicine, Department of Public
Health, Public Health and Epidemiology, University of Liege, Liege, Belgium.
Our study demonstrates the structural
efficacy of glucosamine and indistinguishable symptomatic efficacies for both compounds.
Regarding the relatively sparse data on glucosamine and joint space narrowing and the
absence of data on structural effects of chondroitin, further studies are needed to
investigate the relationship among time, dose, patient baseline characteristics, and
structural efficacy for an accurate, disease-modifying characterization of these 2
compounds.
Source: Pubmed.gov
Immunosuppressive effects of
glucosamine.
Ma L, Rudert WA, Harnaha J, Wright M,
Machen J, Lakomy R, Qian S, Lu L, Robbins PD, Trucco M, Giannoukakis N.
Department of Surgery, T. E. Starzl
Transplantation Institute, University of Pittsburgh School of Medicine, Pittsburgh,
Pennsylvania 15213, USA.
Our data demonstrate that glucosamine
suppresses the activation of T-lymphoblasts and dendritic cells in vitro as well as
allogeneic mixed leukocyte reactivity in a dose-dependent manner. There was no inherent
cellular toxicity involved in the inhibition, and the activity was not reproducible with
other amine sugars. More importantly, glucosamine administration prolonged allogeneic
cardiac allograft survival in vivo. We conclude that, despite its documented effects on
insulin sensitivity, glucosamine possesses immunosuppressive activity and could be
beneficial as an immunosuppressive agent.
Full article here
Efficacy of Glucosamine and
Chondroitin Sulfate May Depend on Level of Osteoarthritis Pain
In a study published in the New England Journal of Medicinei , the popular dietary
supplement combination of glucosamine plus chondroitin sulfate did not provide significant
relief from osteoarthritis pain among all participants. However, a smaller subgroup of
study participants with moderate-to-severe pain showed significant relief with the
combined supplements. This research was funded by the National Center for Complementary
and Alternative Medicine (NCCAM) and the National Institute of Arthritis and
Musculoskeletal and Skin Diseases (NIAMS), components of the National Institutes of Health
(NIH). Researchers led by rheumatologist Daniel O. Clegg, M.D., of the University of Utah,
School of Medicine, Salt Lake City, conducted the 4-year study known as the
Glucosamine/chondroitin Arthritis Intervention Trial (GAIT) at 16 sites across the United
States.
http://nccam.nih.gov/news/2006/022206.htm
NIH Glucosamine/Chondroitin Arthritis
Intervention Trial (GAIT)
GAIT is the first, large-scale, multicenter clinical trial in the United States to test
the effects of the dietary supplements glucosamine hydrochloride (glucosamine) and sodium
chondroitin sulfate (chondroitin sulfate) for treatment of knee osteoarthritis. The study
tested whether glucosamine and chondroitin sulfate used separately or in combination
reduced pain in participants with knee osteoarthritis.
http://nccam.nih.gov/research/results/gait/qa.htm
“The New England Journal of
Medicine” Reviews the GAIT Study: Glucosamine, Chondroitin Sulfate and the Two in
Combination for Painful Knee Osteoarthritis
While “The New England Journal of
Medicine” concludes that there is still no resolution for the use of supplements in
treating knee osteoarthritis (OA), much of the data coming out of the GAIT study
suggests otherwise.
While “The New England Journal of
Medicine” concludes that there is still no resolution for the use of supplements in
treating knee osteoarthritis (OA),
much of the data coming out of the GAIT study suggests otherwise.
Out of the 1,583 patients that were
randomized, 1,258 (80%) completed the study. In the overall population of all patients
with mild to moderate pain (WOMAC Pain 125-300mm), the results, for supplement use, while
positive, were not statistically significant.
Even the researchers themselves commented
that the study had a number of limitations. The high rate of response to placebo (60.1%)
and the relatively mild degree of pain from OA among participants, may
have limited the ability to detect the benefits of the treatments.
However, in the severe pain group (WOMAC
301-400mm) the G+CS combination (79.2%) scored higher than both P (placebo) 54.3% and CE
(celecoxib) 69.4%, concluding that the combination of glucosamine and chondroitin sulfate
is effective in treating moderate to severe pain in patients with knee OA. Researchers
also concluded that in this subgroup of patients with moderate to severe pain the
combination therapy significantly decreased knee pain as measured by the OMERACT-OARSI
response.
Also reported in “The New England
Journal of Medicine” was that treatment with chondroitin sulfate alone was associated
with a significant decrease in the incidence of joint swelling and effusion. There was a
statistical improvement of joint swelling for the overall population, 28.3% to 12.4%
(p=0.01) and celecoxib was from 26.1% to 13.4% (p=0.03).
Doctors treating patients are always
concerned about addressing a number of issues. Getting the pain under control is the first
step, however, dealing with all the other symptoms such as joint swelling, stiffness and
function is just as important. It is a vicious cycle; joint swelling in 90% of patients is
caused by joint effusion. Joint effusion is an increase of liquid inside the articular
space, which produces pain and functional incapacity. According to Nicholas DiNubile, MD
and orthopaedic surgeon, “It’s crucial when treating osteoarthritis to break
that cycle and treat the disease. I find that joint supplements are a very effective and
risk-free way of doing that and it’s good to have data that supports what I see in my
clinical practice everyday.”
While this major clinical trial is not
offering conclusive results, it suggests that there is a need for more research.
Physicians, however, are more pragmatic. They see the supplements work every day for their
patients who are suffering with OA. Jason Theodosakis M.D. has a decade of practical use
and two best selling books on the subject. According to Theodosakis, “With any
medical intervention, the risk/benefit/cost considerations must also be addressed.
Glucosamine/chondroitin have the best safety record of any prescription or
over-the-counter oral treatment for OA. The results of the GAIT study exulted the benefits
in those who actually needed the most relief and the cost of good quality (pharmaceutical
grade) supplements is approximately one dollar a day, a third of the price of the most
popular
drug prescribed.”
The selection process for the chondroitin
sulfate and glucosamine used in the GAIT study was exhaustive. The study was conducted
under pharmaceutical rather than dietary supplement regulations and, as
such, the supplements were held to stringent standards of pharmaceutical manufacturing
practices. Bioiberica is the leading manufacturer of pharmaceutical-grade chondroitin
sulfate and was selected by the
NIH as the exclusive supplier of chondroitin sulfate for the GAIT study. Its
CSb™Bio-Active brand of chondroitin sulfate used in the study is commercially
available in the US in Cosamin®DS.
