Overview

N-acetyl glucosamine is a chemical that comes from the outer shells of shellfish. It can also be made in labs.

Don't confuse N-acetyl glucosamine with other forms of glucosamine, such as glucosamine hydrochloride or glucosamine sulfate. They may not have the same effects.

Read glucosamine product labels carefully for their content. Most glucosamine products contain glucosamine sulfate or glucosamine hydrochloride. Although glucosamine sulfate and glucosamine hydrochloride are marketed together in combination products with N-acetyl glucosamine, there haven't been any human studies that have evaluated these combinations for treating osteoarthritis.

You may also see chitosan as an ingredient in some glucosamine products. Chitosan is a form of N-acetyl glucosamine that has been chemically altered.

N-acetyl glucosamine is used for osteoarthritis, aging skin, knee pain, and inflammatory bowel disease (IBD), but there is no good scientific evidence to support these uses.

Classification

Is a Form Of:

Chemical

Primary Functions:

Osteoarthritis, aging skin, knee pain

Also Known As:

GlcNAc, Glucosamine, Glucosamine-6-phosphate, Glucosamine N-Acetyl

How Does It Work?

N-acetyl glucosamine might help protect the lining of the stomach and intestines.

Uses

• Aging skin. Early research shows that applying a cream containing 2% N-acetyl glucosamine and 4% niacinamide to the face decreases dark spots caused by aging and sun exposure. It's unclear if applying a cream containing only N-acetyl glucosamine would have the same effect.
• 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 hydrochloride and glucosamine sulfate. It's also unclear if this lower risk is from glucosamine or from following healthier lifestyle habits.
• Long-term swelling (inflammation) in the digestive tract (inflammatory bowel disease or IBD). There is some early evidence that N-acetyl glucosamine taken by mouth or rectally might decrease symptoms of IBD in children with Crohn's disease or ulcerative colitis.
• Knee pain. Early research shows that taking N-acetyl glucosamine along with chondroitin sulfate does not relieve pain in middle-aged and older adults with long-term knee pain.
• 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 hydrochloride and glucosamine sulfate. It's also unclear if this lower risk is from glucosamine or from following healthier lifestyle habits.
• Osteoarthritis.
• Other conditions.

Recommended Dosing

The appropriate dose of N-acetyl glucosamine depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for N-acetyl glucosamine. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.

N-Acetyl Glucosamine (NAG) Supplements Frequently Asked Questions

What is N acetyl glucosamine used for?

N-acetyl glucosamine is used for osteoarthritis, aging skin, knee pain, and inflammatory bowel disease (IBD), but there is no good scientific evidence to support these uses.

What is nag supplement used for?

You may also see chitosan as an ingredient in some glucosamine products. Chitosan is a form of N-acetyl glucosamine that has been chemically altered. N-acetyl glucosamine is taken for osteoarthritis and inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease.

What should you not take with glucosamine?

There are reports that glucosamine may also reduce the effectiveness of certain drugs. So use caution when taking glucosamine if you take: acetaminophen (Tylenol) Certain chemotherapy drugs, including doxorubicin (Adriamycin, Rubex), etoposide (Etopiside), and teniposide (Vumon)

Where is N acetylglucosamine found?

Abstract. The amino sugar N-acetylglucosamine (GlcNAc) is well known for the important structural roles that it plays at the cell surface. It is a key component of bacterial cell wall peptidoglycan, fungal cell wall chitin, and the extracellular matrix of animal cells.

Is it OK to take NAC everyday?

There is no recommended daily allowance for NAC, because unlike vitamins, it's not an essential nutrient. The dosage used to prevent radio contrast dye damage is 600 mg to 1200 mg every 12 hours for 48 hours.

Can glucosamine cause liver damage?

Glucosamine and Chondroitin Linked to Liver Problems

The use of products containing glucosamine and/or chondroitin sulfate has been linked to changes in liver function in people with chronic liver disease, a study reports. Glucosamine is a compound that is naturally made in humans.

Is N acetyl glucosamine the same as glucosamine?

N-acetyl glucosamine is a chemical that comes from the outer shells of shellfish. Don't confuse N-acetyl glucosamine with other forms of glucosamine, such as glucosamine hydrochloride or glucosamine sulfate. They may not have the same effects. Read glucosamine product labels carefully for their content.

Is turmeric better than glucosamine?

As Dr Sarah Brewer says, 'Turmeric is a powerful anti-inflammatory. The turmeric helps your body to maintain a normal healthy inflammatory response, and the glucosamine has mild pain-relieving effects and cartilage-protective qualities.

What time of day should I take glucosamine?

In most studies on treating osteoarthritis, the typical dose was 500 milligrams of glucosamine sulfate, three times a day. Ask your doctor what he recommends for you. Some experts suggest you take it with meals to prevent an upset stomach.

s N acetylglucosamine a monosaccharide?

N-Acetylglucosamine (GlcNAc), 2-acetamino-2-deoxy-β-d-glucose or 2-(acetylamino)-2-deoxy-d-glucose, is a monosaccharide derivative of glucose and is widely distributed worldwide. The molecular formula of this amino monosaccharide is C₈H₁₅NO₆, and its molecular weight is 221.21.

Can glucosamine and turmeric be taken together?

Interactions between your drugs

No interactions were found between Glucosamine & Chondroitin with MSM and turmeric. This does not necessarily mean no interactions exist.

Does glucosamine make you gain weight?

It turns out that most of the research had been done with glucosamine sulfate, the type of glucosamine I was taking. It turns out that glucosamine can cause weight gain or weight loss depending on your eating habits. In a high carb/low fat diet, it has the potential to cause weight gain.

Can glucosamine cause hair loss?

Common side effects may include: nausea, diarrhea, constipation; stomach pain, gas, bloating; hair loss.

Can you take too much glucosamine?

Glucosamine has been shown to be safe and well-tolerated. Common side effects are nausea, vomiting, abdominal pain, and diarrhea. There is a risk for severe and life-threatening allergic reactions to glucosamine in people with shellfish allergy or those with asthma.

What are the side effects of taking glucosamine?

Glucosamine sulfate can cause some mild side effects including nausea, heartburn, diarrhea, and constipation. Uncommon side effects are drowsiness, skin reactions, and headache. When given as a shot: Glucosamine sulfate is POSSIBLY SAFE when injected into the muscle as a shot twice weekly for up to 6 weeks.

Can glucosamine raise your blood pressure?

High blood pressure: Early research suggests that glucosamine sulfate can increase insulin levels. This might cause blood pressure to increase. However, more reliable research suggests that glucosamine sulfate does not increase blood pressure.

Can glucosamine be bad for you?

Glucosamine may affect blood sugar and insulin levels. Animal studies show that glucosamine may further increase LDL "bad" cholesterol levels if you eat a lot of fatty foods. More research is needed. Glucosamine may interfere with some medicines.

What is Nag in biology?

Peptidoglycan or murein is a polymer consisting of sugars and amino acids that forms a mesh-like layer outside the plasma membrane of most bacteria, forming the cell wall. The sugar component consists of alternating residues of β-(1,4) linked N-acetylglucosamine (NAG) and N-acetylmuramic acid (NAM).

Which is better for joints glucosamine or collagen?

A patented collagen ingredient may be twice as effective as glucosamine and chondroitin for joint health, according to results of randomized, double-blind study. The ingredient is often used in combination with chondroitin sulphate, extracted from animal cartilage, such as sharks.

Clinical Studies

• ^ a b Wilkens P, et al. No effect of 6-month intake of glucosamine sulfate on Modic changes or high intensity zones in the lumbar spine: sub-group analysis of a randomized controlled trial. J Negat Results Biomed. (2012)
• ^ a b c Min ZH, Zhou Y, Zhang HM. Effect of treatment based on syndrome differentiation by Chinese medicine on post-traumatic elbow arthritis. Chin J Integr Med. (2010)
• ^ a b c Nguyen P, et al. A randomized double-blind clinical trial of the effect of chondroitin sulfate and glucosamine hydrochloride on temporomandibular joint disorders: a pilot study. Cranio. (2001)
• ^ a b c d e Reichelt A, et al. Efficacy and safety of intramuscular glucosamine sulfate in osteoarthritis of the knee. A randomised, placebo-controlled, double-blind study. Arzneimittelforschung. (1994)
• ^ a b c d Vajaradul Y. Double-blind clinical evaluation of intra-articular glucosamine in outpatients with gonarthrosis. Clin Ther. (1981)
• ^ a b c d D'Ambrosio E, et al. Glucosamine sulphate: a controlled clinical investigation in arthrosis. Pharmatherapeutica. (1981)
• ^ a b c Dahmer S, Schiller RM. Glucosamine. Am Fam Physician. (2008)
• ^ a b c d e f Aghazadeh-Habashi A, Jamali F. The glucosamine controversy; a pharmacokinetic issue. J Pharm Pharm Sci. (2011)
• ^ Lapane KL, et al. Use of complementary and alternative medicine among patients with radiographic-confirmed knee osteoarthritis. Osteoarthritis Cartilage. (2012)
• ^ PATTERNS OF MEDICATION USE IN THE UNITED STATES 2006.
• ^ Active ingredient consistency of commercially available glucosamine sulfate products.
• ^ a b Sawitzke AD, et al. The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial. Arthritis Rheum. (2008)
• ^ Glucosamine, Chondroitin Sulfate, and the Two in Combination for Painful Knee Osteoarthritis.
• ^ a b c d Sawitzke AD, et al. 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)
• ^ a b Rozendaal RM, et al. Effect of glucosamine sulfate on hip osteoarthritis: a randomized trial. Ann Intern Med. (2008)
• ^ a b Meulyzer M, et al. Comparison of pharmacokinetics of glucosamine and synovial fluid levels following administration of glucosamine sulphate or glucosamine hydrochloride. Osteoarthritis Cartilage. (2008)
• ^ a b c d e f g h i Clegg DO, et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. (2006)
• ^ a b c d e f Vlad SC, et al. Glucosamine for pain in osteoarthritis: why do trial results differ. Arthritis Rheum. (2007)
• ^ a b c d Henrotin Y, Mobasheri A, Marty M. Is there any scientific evidence for the use of glucosamine in the management of human osteoarthritis. Arthritis Res Ther. (2012)
• ^ a b c Zhang W, et al. OARSI recommendations for the management of hip and knee osteoarthritis, part I: critical appraisal of existing treatment guidelines and systematic review of current research evidence. Osteoarthritis Cartilage. (2007)
• ^ a b c Zhang W, et al. OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines. Osteoarthritis Cartilage. (2008)
• ^ a b c Zhang W, et al. EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. (2005)
• ^ a b c d Jordan KM, et al. EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis. (2003)
• ^ a b c [No authors listed. Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. American College of Rheumatology Subcommittee on Osteoarthritis Guidelines. Arthritis Rheum. (2000)
• ^ a b Setnikar I, et al. Pharmacokinetics of glucosamine in man. Arzneimittelforschung. (1993)
• ^ Kirkham SG, Samarasinghe RK. Review article: Glucosamine. J Orthop Surg (Hong Kong). (2009)
• ^ Single dose pharmacokinetics and bioavailability of glucosamine in the rat.
• ^ a b c Setnikar I, Rovati LC. Absorption, distribution, metabolism and excretion of glucosamine sulfate. A review. Arzneimittelforschung. (2001)
• ^ Glucosamine for osteoarthritis of the knee.
• ^ a b c d e f g Reginster JY, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet. (2001)
• ^ Improved Sensitive High Performance Liquid Chromatography Assay for Glucosamine in Human and Rat Biological Samples with Fluorescence Detection.
• ^ a b Burdett N, McNeil JD. Difficulties with assessing the benefit of glucosamine sulphate as a treatment for osteoarthritis. Int J Evid Based Healthc. (2012)
• ^ Cordoba F, Nimni ME. Chondroitin sulfate and other sulfate containing chondroprotective agents may exhibit their effects by overcoming a deficiency of sulfur amino acids. Osteoarthritis Cartilage. (2003)
• ^ a b c d e f g h Herrero-Beaumont G, et al. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum. (2007)
• ^ A method of preparing a therapeutically active crystalline form of glucosamine sulphate.
• ^ a b Persiani S, et al. Glucosamine oral bioavailability and plasma pharmacokinetics after increasing doses of crystalline glucosamine sulfate in man. Osteoarthritis Cartilage. (2005)
• ^ Akarasereenont P, et al. Bioequivalence study of 500 mg glucosamine sulfate in Thai healthy volunteers. J Med Assoc Thai. (2009)
• ^ a b c Reginster JY. The efficacy of glucosamine sulfate in osteoarthritis: financial and nonfinancial conflict of interest. Arthritis Rheum. (2007)
• ^ Altman RD, et al. Commentary: osteoarthritis of the knee and glucosamine. Osteoarthritis Cartilage. (2006)
• ^ a b c d e f g h i Towheed TE, et al. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. (2005)
• ^ a b c d e f Pujalte JM, Llavore EP, Ylescupidez FR. Double-blind clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis. Curr Med Res Opin. (1980)
• ^ a b c Drovanti A, Bignamini AA, Rovati AL. Therapeutic activity of oral glucosamine sulfate in osteoarthrosis: a placebo-controlled double-blind investigation. Clin Ther. (1980)
• ^ a b Crolle G, D'Este E. Glucosamine sulphate for the management of arthrosis: a controlled clinical investigation. Curr Med Res Opin. (1980)
• ^ a b c d e f g Pavelká K, 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)
• ^ a b c d e f g Noack W, et al. Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis Cartilage. (1994)
• ^ a b c d e f McAlindon TE, et al. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA. (2000)
• ^ a b c d e f g Richy F, et al. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis. Arch Intern Med. (2003)
• ^ a b c d e f Simon RR, et al. A comprehensive review of oral glucosamine use and effects on glucose metabolism in normal and diabetic individuals. Diabetes Metab Res Rev. (2011)
• ^ a b c Neale RJ, Wiseman G. The use of dietary-restricted rat intestine for active transport studies. J Physiol. (1969)
• ^ a b QUASTEL JH. Intestinal absorption of sugars and amino acids. Am J Clin Nutr. (1960)
• ^ a b WILSON TH, LANDAU BR. Specificity of sugar transport by the intestine of the hamster. Am J Physiol. (1960)
• ^ Faust RG, et al. Active sugar transport by the small intestine. The effects of sugars, amino acids, hexosamines, sulfhydryl-reacting compounds, and cations on the preferential binding of D-glucose to tris-disrupted brush borders. J Gen Physiol. (1968)
• ^ Aghazadeh-Habashi A, et al. Single dose pharmacokinetics and bioavailability of butyryl glucosamine in the rat. J Pharm Pharm Sci. (2006)
• ^ Aghazadeh-Habashi A, et al. Single dose pharmacokinetics and bioavailability of glucosamine in the rat. J Pharm Pharm Sci. (2002)
• ^ Crociani F, et al. Degradation of complex carbohydrates by Bifidobacterium spp. Int J Food Microbiol. (1994)
• ^ Salyers AA, et al. Fermentation of mucin and plant polysaccharides by strains of Bacteroides from the human colon. Appl Environ Microbiol. (1977)
• ^ Hirayama BA, et al. Sodium-dependent reorganization of the sugar-binding site of SGLT1. Biochemistry. (2007)
• ^ Persiani S, et al. Synovial and plasma glucosamine concentrations in osteoarthritic patients following oral crystalline glucosamine sulphate at therapeutic dose. Osteoarthritis Cartilage. (2007)
• ^ a b c d e f Biggee BA, et al. Low levels of human serum glucosamine after ingestion of glucosamine sulphate relative to capability for peripheral effectiveness. Ann Rheum Dis. (2006)
• ^ a b c Biggee BA, et al. Effects of oral glucosamine sulphate on serum glucose and insulin during an oral glucose tolerance test of subjects with osteoarthritis. Ann Rheum Dis. (2007)
• ^ Rosenborg S, et al. Clinically significant CYP2C inhibition by noscapine but not by glucosamine. Clin Pharmacol Ther. (2010)
• ^ Noyszewski EA, et al. Preferential incorporation of glucosamine into the galactosamine moieties of chondroitin sulfates in articular cartilage explants. Arthritis Rheum. (2001)
• ^ Bassleer C, Rovati L, Franchimont P. Stimulation of proteoglycan production by glucosamine sulfate in chondrocytes isolated from human osteoarthritic articular cartilage in vitro. Osteoarthritis Cartilage. (1998)
• ^ Bassleer C, Henrotin Y, Franchimont P. In-vitro evaluation of drugs proposed as chondroprotective agents. Int J Tissue React. (1992)
• ^ Kim MM, et al. Glucosamine sulfate promotes osteoblastic differentiation of MG-63 cells via anti-inflammatory effect. Bioorg Med Chem Lett. (2007)
• ^ a b Block JA, et al. The effects of oral glucosamine on joint health: is a change in research approach needed. Osteoarthritis Cartilage. (2010)
• ^ Effects of Glucosamine and Chondroitin Sulfate on Cartilage Metabolism in OA: Outlook on Other Nutrient Partners Especially Omega-3 Fatty Acids.
• ^ Mroz PJ, Silbert JE. Effects of {3H}glucosamine concentration on {3H}chondroitin sulphate formation by cultured chondrocytes. Biochem J. (2003)
• ^ a b c d Momomura R, et al. Evaluation of the effect of glucosamine administration on biomarkers of cartilage and bone metabolism in bicycle racers. Mol Med Report. (2013)
• ^ a b c d Yoshimura M, et al. Evaluation of the effect of glucosamine administration on biomarkers for cartilage and bone metabolism in soccer players. Int J Mol Med. (2009)
• ^ a b c d Kanzaki N, et al. 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. (2012)
• ^ Herrero-Beaumont G, et al. The reverse glucosamine sulfate pathway: application in knee osteoarthritis. Expert Opin Pharmacother. (2007)
• ^ Rajapakse N, et al. Sulfated glucosamine inhibits MMP-2 and MMP-9 expressions in human fibrosarcoma cells. Bioorg Med Chem. (2007)
• ^ Chan PS, Caron JP, Orth MW. Effects of glucosamine and chondroitin sulfate on bovine cartilage explants under long-term culture conditions. Am J Vet Res. (2007)
• ^ Differential down-regulation of COX-2 and MMP-13 in human skin fibroblasts by glucosamine-hydrochloride.
• ^ Rafi MM, Yadav PN, Rossi AO. Glucosamine inhibits LPS-induced COX-2 and iNOS expression in mouse macrophage cells (RAW 264.7) by inhibition of p38-MAP kinase and transcription factor NF-kappaB. Mol Nutr Food Res. (2007)
• ^ Wilkens P, et al. Effect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis: a randomized controlled trial. JAMA. (2010)
• ^ Beattie PF, Meyers SP. Magnetic resonance imaging in low back pain: general principles and clinical issues. Phys Ther. (1998)
• ^ Kjaer P, et al. Magnetic resonance imaging and low back pain in adults: a diagnostic imaging study of 40-year-old men and women. Spine (Phila Pa 1976). (2005)
• ^ Albert HB, Manniche C. Modic changes following lumbar disc herniation. Eur Spine J. (2007)
• ^ Stuber K, Sajko S, Kristmanson K. Efficacy of glucosamine, chondroitin, and methylsulfonylmethane for spinal degenerative joint disease and degenerative disc disease: a systematic review. J Can Chiropr Assoc. (2011)
• ^ a b Fujita T, et al. The effect of active absorbable algal calcium (AAA Ca) with collagen and other matrix components on back and joint pain and skin impedance. J Bone Miner Metab. (2002)
• ^ a b Leffler CT, 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)
• ^ Shankland WE 2nd. The effects of glucosamine and chondroitin sulfate on osteoarthritis of the TMJ: a preliminary report of 50 patients. Cranio. (1998)
• ^ Thie NM, Prasad NG, Major PW. Evaluation of glucosamine sulfate compared to ibuprofen for the treatment of temporomandibular joint osteoarthritis: a randomized double blind controlled 3 month clinical trial. J Rheumatol. (2001)
• ^ a b Cahlin BJ, Dahlström L. No effect of glucosamine sulfate on osteoarthritis in the temporomandibular joints--a randomized, controlled, short-term study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. (2011)
• ^ Dascombe BJ, et al. Nutritional supplementation habits and perceptions of elite athletes within a state-based sporting institute. J Sci Med Sport. (2010)
• ^ Gorsline RT, Kaeding CC. The use of NSAIDs and nutritional supplements in athletes with osteoarthritis: prevalence, benefits, and consequences. Clin Sports Med. (2005)
• ^ Vad V, et al. Exercise recommendations in athletes with early osteoarthritis of the knee. Sports Med. (2002)
• ^ Duclos ME, et al. Significance of the serum CTX-II level in an osteoarthritis animal model: a 5-month longitudinal study. Osteoarthritis Cartilage. (2010)
• ^ Ostojic SM, et al. Glucosamine administration in athletes: effects on recovery of acute knee injury. Res Sports Med. (2007)
• ^ a b Lequesne MG, et al. Indexes of severity for osteoarthritis of the hip and knee. Validation--value in comparison with other assessment tests. Scand J Rheumatol Suppl. (1987)
• ^ DiNubile NA. Glucosamine and chondroitin sulfate in the management of osteoarthritis. Commentary. Postgrad Med. (2009)
• ^ Baime MJ. Glucosamine and chondroitin sulfate did not improve pain in osteoarthritis of the knee. ACP J Club. (2006)
• ^ Hart L. Are glucosamine and/or chondroitin sulfate effective for knee osteoarthritis. Clin J Sport Med. (2006)
• ^ Hochberg MC. Nutritional supplements for knee osteoarthritis--still no resolution. N Engl J Med. (2006)
• ^ Ernst E. Glucosamine and chondroitin sulfate for knee osteoarthritis. N Engl J Med. (2006)
• ^ Vassiliou VS. Glucosamine and chondroitin sulfate for knee osteoarthritis. N Engl J Med. (2006)
• ^ Lehmann R, et al. Efficacy and tolerability of lumiracoxib 100 mg once daily in knee osteoarthritis: a 13-week, randomized, double-blind study vs. placebo and celecoxib. Curr Med Res Opin. (2005)
• ^ Altman RD, Moskowitz R. Intraarticular sodium hyaluronate (Hyalgan) in the treatment of patients with osteoarthritis of the knee: a randomized clinical trial. Hyalgan Study Group. J Rheumatol. (1998)
• ^ Glucosamine Unum In Die {Once A Day} Efficacy (GUIDE) Trial: Glucosamine Sulfate in Patients With Knee Osteoarthritis.
• ^ a b c d Usha PR, Naidu MU. Randomised, Double-Blind, Parallel, Placebo-Controlled Study of Oral Glucosamine, Methylsulfonylmethane and their Combination in Osteoarthritis. Clin Drug Investig. (2004)
• ^ a b c d McAlindon T, et al. Effectiveness of glucosamine for symptoms of knee osteoarthritis: results from an internet-based randomized double-blind controlled trial. Am J Med. (2004)
• ^ a b Houpt JB, et al. Effect of glucosamine hydrochloride in the treatment of pain of osteoarthritis of the knee. J Rheumatol. (1999)
• ^ a b c Rindone JP, et al. Randomized, controlled trial of glucosamine for treating osteoarthritis of the knee. West J Med. (2000)
• ^ a b c d Hughes R, Carr A. A randomized, double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee. Rheumatology (Oxford). (2002)
• ^ Altman R, et al. Design and conduct of clinical trials in patients with osteoarthritis: recommendations from a task force of the Osteoarthritis Research Society. Results from a workshop. Osteoarthritis Cartilage. (1996)
• ^ Kerzberg EM, et al. Combination of glycosaminoglycans and acetylsalicylic acid in knee osteoarthrosis. Scand J Rheumatol. (1987)
• ^ Egger M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. (1997)
• ^ Sterne JA, Gavaghan D, Egger M. Publication and related bias in meta-analysis: power of statistical tests and prevalence in the literature. J Clin Epidemiol. (2000)
• ^ Towheed TE, et al. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev. (2001)
• ^ a b Qiu GX, et al. Efficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis. Arzneimittelforschung. (1998)
• ^ a b Müller-Fassbender H, et al. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage. (1994)
• ^ Lopes Vaz A. Double-blind clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulphate in the management of osteoarthrosis of the knee in out-patients. Curr Med Res Opin. (1982)
• ^ Glucosamine sulphate for the management of arthrosis: A controlled clinical investigation.
• ^ Cibere J, et al. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis. Arthritis Rheum. (2004)
• ^ The effects of milk protein concentrate on the symptoms of osteoarthritis in adults: an exploratory, randomized, double-blind, placebo-controlled trial.
• ^ a b c d Wandel S, et al. Effects of glucosamine, chondroitin, or placebo in patients with osteoarthritis of hip or knee: network meta-analysis. BMJ. (2010)
• ^ Petersen SG, et al. Nonsteroidal anti-inflammatory drug or glucosamine reduced pain and improved muscle strength with resistance training in a randomized controlled trial of knee osteoarthritis patients. Arch Phys Med Rehabil. (2011)
• ^ PATTERNS OF MEDICATION USE IN THE UNITED STATES 2006.
• ^ Incidence of Diagnosed Diabetes per 1,000 Population Aged 18–79 Years, by Sex and Age, United States, 1997–2010.
• ^ a b Copeland RJ, Bullen JW, Hart GW. Cross-talk between GlcNAcylation and phosphorylation: roles in insulin resistance and glucose toxicity. Am J Physiol Endocrinol Metab. (2008)
• ^ The subcellular distribution of terminal N-acetylglucosamine moieties. Localization of a novel protein-saccharide linkage, O-linked GlcNAc.
• ^ Slawson C, Housley MP, Hart GW. O-GlcNAc cycling: how a single sugar post-translational modification is changing the way we think about signaling networks. J Cell Biochem. (2006)
• ^ Hart GW, Housley MP, Slawson C. Cycling of O-linked beta-N-acetylglucosamine on nucleocytoplasmic proteins. Nature. (2007)
• ^ Dias WB, Hart GW. O-GlcNAc modification in diabetes and Alzheimer's disease. Mol Biosyst. (2007)
• ^ Altered glycan-dependent signaling induces insulin resistance and hyperleptinemia.
• ^ a b Marshall S, Bacote V, Traxinger RR. Discovery of a metabolic pathway mediating glucose-induced desensitization of the glucose transport system. Role of hexosamine biosynthesis in the induction of insulin resistance. J Biol Chem. (1991)
• ^ a b Heart E, Choi WS, Sung CK. Glucosamine-induced insulin resistance in 3T3-L1 adipocytes. Am J Physiol Endocrinol Metab. (2000)
• ^ a b Bouché C, et al. The cellular fate of glucose and its relevance in type 2 diabetes. Endocr Rev. (2004)
• ^ Wu G, et al. Glutamine metabolism to glucosamine is necessary for glutamine inhibition of endothelial nitric oxide synthesis. Biochem J. (2001)
• ^ Glucosamine-Induced Endoplasmic Reticulum Dysfunction Is Associated With Accelerated Atherosclerosis in a Hyperglycemic Mouse Model.
• ^ Elevated nucleocytoplasmic glycosylation by O-GlcNAc results in insulin resistance associated with defects in Akt activation in 3T3-L1 adipocytes.
• ^ Buse MG, et al. Enhanced O-GlcNAc protein modification is associated with insulin resistance in GLUT1-overexpressing muscles. Am J Physiol Endocrinol Metab. (2002)
• ^ Housley MP, et al. O-GlcNAc regulates FoxO activation in response to glucose. J Biol Chem. (2008)
• ^ Hepatic glucose sensing via the CREB coactivator CRTC2.
• ^ a b Buse MG. Hexosamines, insulin resistance, and the complications of diabetes: current status. Am J Physiol Endocrinol Metab. (2006)
• ^ Hresko RC, et al. Glucosamine-induced insulin resistance in 3T3-L1 adipocytes is caused by depletion of intracellular ATP. J Biol Chem. (1998)
• ^ a b Ross SA, et al. Development and comparison of two 3T3-L1 adipocyte models of insulin resistance: increased glucose flux vs glucosamine treatment. Biochem Biophys Res Commun. (2000)
• ^ Baron AD, et al. Glucosamine induces insulin resistance in vivo by affecting GLUT 4 translocation in skeletal muscle. Implications for glucose toxicity. J Clin Invest. (1995)
• ^ Robinson KA, Sens DA, Buse MG. Pre-exposure to glucosamine induces insulin resistance of glucose transport and glycogen synthesis in isolated rat skeletal muscles. Study of mechanisms in muscle and in rat-1 fibroblasts overexpressing the human insulin receptor. Diabetes. (1993)
• ^ Shankar RR, Zhu JS, Baron AD. Glucosamine infusion in rats mimics the beta-cell dysfunction of non-insulin-dependent diabetes mellitus. Metabolism. (1998)
• ^ a b Glucosamine induces insulin resistance in vivo by affecting GLUT 4 translocation in skeletal muscle. Implications for glucose toxicity.
• ^ Giaccari A, 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)
• ^ Balkan B, Dunning BE. Glucosamine inhibits glucokinase in vitro and produces a glucose-specific impairment of in vivo insulin secretion in rats. Diabetes. (1994)
• ^ Monauni T, et al. Effects of glucosamine infusion on insulin secretion and insulin action in humans. Diabetes. (2000)
• ^ Roda A, et al. Development and validation of a sensitive HPLC-ESI-MS/MS method for the direct determination of glucosamine in human plasma. J Chromatogr B Analyt Technol Biomed Life Sci. (2006)
• ^ Pham T, et al. Oral glucosamine in doses used to treat osteoarthritis worsens insulin resistance. Am J Med Sci. (2007)
• ^ Tapadinhas MJ, Rivera IC, Bignamini AA. Oral glucosamine sulphate in the management of arthrosis: report on a multi-centre open investigation in Portugal. Pharmatherapeutica. (1982)
• ^ Albert SG, et al. The effect of glucosamine on Serum HDL cholesterol and apolipoprotein AI levels in people with diabetes. Diabetes Care. (2007)
• ^ 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)
• ^ Muniyappa R, 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)
• ^ Yu JG, Boies SM, Olefsky JM. The effect of oral glucosamine sulfate on insulin sensitivity in human subjects. Diabetes Care. (2003)
• ^ Laferrère B, et al. Effect of oral glucosamine sulfate on serum leptin levels in human subjects. Nutrition. (2004)
• ^ 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)
• ^ Giordano N, et al. The efficacy and safety of glucosamine sulfate in the treatment of gonarthritis. Clin Ter. (1996)
• ^ Rovati LC. Clinical research in osteoarthritis: design and results of short-term and long-term trials with disease-modifying drugs. Int J Tissue React. (1992)
• ^ The history of Kashin-Beck disease.
• ^ Kashin-Beck's disease.
• ^ Yue J, et al. Chondroitin sulfate and/or glucosamine hydrochloride for Kashin-Beck disease: a cluster-randomized, placebo-controlled study. Osteoarthritis Cartilage. (2012)
• ^ Zhang YX, et al. Effects of chondroitin sulfate and glucosamine in adult patients with Kaschin-Beck disease. Clin Rheumatol. (2010)
• ^ Liu W, et al. Kashin-Beck disease in Sichuan, China: report of a pilot open therapeutic trial. J Clin Rheumatol. (2012)
• ^ Chopra A, Saluja M, Tillu G. Ayurveda-modern medicine interface: A critical appraisal of studies of Ayurvedic medicines to treat osteoarthritis and rheumatoid arthritis. J Ayurveda Integr Med. (2010)
• ^ a b Chopra A, et al. Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial. Rheumatology (Oxford). (2013)
• ^ a b Trč T, Bohmová J. Efficacy and tolerance of enzymatic hydrolysed collagen (EHC) vs. glucosamine sulphate (GS) in the treatment of knee osteoarthritis (KOA). Int Orthop. (2011)
• ^ Lippiello L. Collagen Synthesis in tenocytes, ligament cells and chondrocytes exposed to a combination of Glucosamine HCl and chondroitin sulfate. Evid Based Complement Alternat Med. (2007)
• ^ Lippiello L, et al. In vivo chondroprotection and metabolic synergy of glucosamine and chondroitin sulfate. Clin Orthop Relat Res. (2000)
• ^ Orth MW, Peters TL, Hawkins JN. Inhibition of articular cartilage degradation by glucosamine-HCl and chondroitin sulphate. Equine Vet J Suppl. (2002)
• ^ a b Jackson CG1, et al. The human pharmacokinetics of oral ingestion of glucosamine and chondroitin sulfate taken separately or in combination. Osteoarthritis Cartilage. (2010)
• ^ Hochberg MC, Clegg DO. Potential effects of chondroitin sulfate on joint swelling: a GAIT report. Osteoarthritis Cartilage. (2008)
• ^ El-Gindy A, et al. Reflectance near-infrared spectroscopic method with Chemometric techniques for simultaneous determination of Chondroitin, glucosamine, and methyl sulfonyl methane. J AOAC Int. (2012)
• ^ Tsui T, et al. Understanding the role of scientific evidence in consumer evaluation of natural health products for osteoarthritis an application of the means end chain approach. BMC Complement Altern Med. (2012)
• ^ Parcell S. Sulfur in human nutrition and applications in medicine. Altern Med Rev. (2002)
• ^ Sack KE. Is glucosamine MSM effective for osteoarthritis. Postgrad Med. (2006)
• ^ a b Magrans-Courtney T, et al. Effects of diet type and supplementation of glucosamine, chondroitin, and MSM on body composition, functional status, and markers of health in women with knee osteoarthritis initiating a resistance-based exercise and weight loss program. J Int Soc Sports Nutr. (2011)
• ^ Nakasone Y, et al. Effect of a glucosamine-based combination supplement containing chondroitin sulfate and antioxidant micronutrients in subjects with symptomatic knee osteoarthritis: A pilot study. Exp Ther Med. (2011)
• ^ Selvan T, et al. A clinical study on glucosamine sulfate versus combination of glucosamine sulfate and NSAIDs in mild to moderate knee osteoarthritis. ScientificWorldJournal. (2012)
• ^ Mamani-Matsuda M, et al. Therapeutic and preventive properties of quercetin in experimental arthritis correlate with decreased macrophage inflammatory mediators. Biochem Pharmacol. (2006)
• ^ Jackson JK, et al. The antioxidants curcumin and quercetin inhibit inflammatory processes associated with arthritis. Inflamm Res. (2006)
• ^ Loeser RF, et al. Detection of nitrotyrosine in aging and osteoarthritic cartilage: Correlation of oxidative damage with the presence of interleukin-1beta and with chondrocyte resistance to insulin-like growth factor 1. Arthritis Rheum. (2002)
• ^ Yudoh K, et al. Potential involvement of oxidative stress in cartilage senescence and development of osteoarthritis: oxidative stress induces chondrocyte telomere instability and downregulation of chondrocyte function. Arthritis Res Ther. (2005)
• ^ Matsuno H, et al. Effects of an oral administration of glucosamine-chondroitin-quercetin glucoside on the synovial fluid properties in patients with osteoarthritis and rheumatoid arthritis. Biosci Biotechnol Biochem. (2009)
• ^ Gruenwald J, et al. Effect of glucosamine sulfate with or without omega-3 fatty acids in patients with osteoarthritis. Adv Ther. (2009)
• ^ a b Kim JC, et al. Synergistic antiinflammatory effects of pinitol and glucosamine in rats. Phytother Res. (2005)
• ^ a b Singh S, et al. Boswellic acids and glucosamine show synergistic effect in preclinical anti-inflammatory study in rats. Bioorg Med Chem Lett. (2007)
• ^ van Baar ME, et al. Effectiveness of exercise therapy in patients with osteoarthritis of the hip or knee: a systematic review of randomized clinical trials. Arthritis Rheum. (1999)
• ^ Ng NT, Heesch KC, Brown WJ. Efficacy of a progressive walking program and glucosamine sulphate supplementation on osteoarthritic symptoms of the hip and knee: a feasibility trial. Arthritis Res Ther. (2010)
• ^ Hathcock JN, Shao A. Risk assessment for glucosamine and chondroitin sulfate. Regul Toxicol Pharmacol. (2007)
• ^ Ebrahim V, Albeldawi M, Chiang DJ. Acute liver injury associated with glucosamine dietary supplement. BMJ Case Rep. (2012)
• ^ von Felden J, et al. Drug-induced acute liver injury mimicking autoimmune hepatitis after intake of dietary supplements containing glucosamine and chondroitin sulfate. Int J Clin Pharmacol Ther. (2013)
• Wangroongsub Y, et al. Comparable clinical outcomes between glucosamine sulfate-potassium chloride and glucosamine sulfate sodium chloride in patients with mild and moderate knee osteoarthritis: a randomized, double-blind study. J Med Assoc Thai. (2010)