The Australian Rheumatology Association notified this week people not to take the glucosamine supplement for their osteoarthritis due to possible allergic side effects.
What is the evidence behind this last piece of advice? And do you really need to stop taking it?
How did we get here?
For years, glucosamine has been marketed as a treatment for osteoarthritiswhich can happen when the protective cartilage in the joints wears down over time.
This is despite conflicting evidence on the effectiveness of the supplement. Yet many patients may buy glucosamine, assuming that even if it doesn’t help, at least it’s “natural” and therefore won’t do any harm.
The study found that hundreds of allergic reactions to glucosamine have been reported to Australia’s medicines watchdog, the Therapeutic Goods Administration (TGA).
So is it safe for you to take glucosamine? In short, if it works for you and you haven’t had any side effects, and your doctor and pharmacist know you’re taking it, it’s likely to be safe based on the multiple trials conducted at this day.
What is glucosamine?
Glucosamine is a natural substance that the body uses to help build joint tissue, such as cartilage and tendons. In a supplement, glucosamine can be made from the shells of shrimp and other crustaceans, or it can be made synthetically in a factory.
Whether it works for managing osteoarthritis seems open to debate. the latest evidence suggests little or no clinical benefit.
But advice to generalists on how to deal osteoarthritis says the problem is not limited to glucosamine.
When the Royal Australian College of General Practitioners reviewed around 62 other possible medicines and treatments for osteoarthritis of the knee and hip (which include registered medicines and complementary medicines), none were supported by high-quality evidence. to say they worked. Most of the evidence was based on low or very low quality studies.
Is glucosamine really as dangerous as they say?
the Australian study found 336 cases of side effects to glucosamine (and another supplement used for osteoarthritis called chondroitin) were reported to the TGA over 11 years. Of these, 263 cases were allergies, which ranged from mild to severe.
We are uncertain whether these reactions included those of people with known seafood or sulfur allergies, as they would increase their risk of a reaction to glucosamine (glucosamine can come in different formulations, including glucosamine sulfate).
But one big percentage of people take glucosamine daily in Australia with no harmful effects. The cases reported to the TGA concern only 30 people per year, with 16% of allergic reactions considered serious.
Beyond allergic reactions, there are other safety issues with glucosamine.
For example, if you take glucosamine and a medicine that thins the blood (such as warfarin after a stroke), it may increase your risk of bleeding.
While the Australian Rheumatology Association has warned people to stop taking glucosamine, other advice is not so clear cut.
Arthritis Australia reports Glucosamine is a relatively safe treatment option for people with osteoarthritis and has relatively few side effects compared to traditional medications.
And the guidelines for general practitioners on how to manage osteoarthritis of the knee and hip makes a “conditional” recommendation not to use it, due to uncertainty about the balance between potential harms and benefits.
So what should I do?
What if you take glucosamine? If it works for you and you want to continue using it, do so only on the advice of your doctor. This is especially the case if you have underlying medical conditions such as diabetes, allergies or asthma.
Then tell your pharmacist so they can check for any interactions with your other medications, which may increase your risk of side effects. You are at greater risk if you are also taking warfarin or any other type of blood-thinning medication.
Finally, if you have any unwanted side effects from glucosamine, stop using it immediately and report them to your doctor.