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Vitamins Information (Home) > Quick Information > Glucosamine/Chondroitin Glucosamine and chondroitin are building blocks of connective tissue and are key components of the joints. For detailed discussions of these nutrients, please see the individual articles for glucosamine sulfate and chondroitin sulfate. Glucosamine is a simple molecule that is available as a supplement in several forms: glucosamine sulfate, glucosamine hydrochloride and N-acetyl-glucosamine (NAG). The glucosamine sulfate (GS) form (stabilized with a mineral salt, such as sodium chloride or potassium chloride) is the only form consistently shown in clinical trials to be effective for people with osteoarthritis (OA). Chondroitin sulfate(CS) is a much larger and more complex molecule than GS. Like glucosamine, it is a major constituent of cartilage and has been the subject of many clinical trials. CS supplementation has proven to be an effective treatment for people with OA. When to take glucosamine, chondroitin sulfate, or both: The popular idea that GS is clinically "preferred" over CS, or that CS is "not necessary," has not been examined (let alone supported) by appropriate comparative research. An analysis of controlled clinical trials evaluated the independent effects of GS and CS in the treatment of OA. The authors concluded that the overall efficacy in trials of CS for people with OA exceeded the overall efficacy of GS for people with that condition. However, more than one-third of CS supplements have been reported to contain less than 40% of the amount of CS listed on the label. Moreover, no single clinical trial has compared the effects of the two supplements. Many people with osteoarthritis take combinations of CS and GS or glucosamine HCl. This practice may be based on the suggestion, made in a best-selling book, that GS and CS in combination have stronger effects than either supplement alone. Although this idea may sound appealing, and may be harmless, it is based only on anecdotes and hypotheses. The theory that GS and CS work synergistically in the treatment of osteoarthritis remains unproven. To date, no clinical trials have compared glucosamine/chondroitin combinations with either of the supplements taken individually. One preliminary trial found that the combination of glucosamine HCl (1,600 mg per day), CS (1,200 mg per day), and calcium ascorbate (1,000 mg per day) was effective at reducing joint noise, pain, and swelling in people with osteoarthritis of the temporomandibular joint (TMJ, or jaw joint). However, this study was not well controlled and the outcomes measured were highly subjective. Moreover, participants in this study were allowed to use aspirin and ibuprofen, so the exact effects of the nutrient combination cannot be accurately assessed. Similarly, the combination of glucosamine HCl (1,500 mg per day), CS (1,200 mg per day), and manganese ascorbate (228 mg per day) was evaluated in a double-blind trial and was associated with significant symptom reduction and improvement on x-ray for osteoarthritis of the knee (less so for spine). However, subjects were allowed to use acetaminophen for pain, and comparative effects of a glucosamine HCl/chondroitin sulfate combination and the individual nutrients were not examined.
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