David Nahali, DC View Entire Blog
What Type of Glucosamine Supplement Is Best?
With the dozens of brands and different types of glucosamine supplements available, how do you know which is the most effective one to choose? The majority of glucosamine supplements on the market come with other substances included, such as chondroitin sulfate and methylsulfonylmethane (MSM), which are advertised as making glucosamine more effective. However, in recent years, there have been a host of scientific studies performed on the effectiveness (or ineffectiveness) of glucosamine in treating joint pain, and the studies have revealed that not all glucosamine is the same.
Glucosamine supplements come in two different basic forms: glucosamine sulfate and glucosamine hydrochloride. A number of meta-analyses that have examined the effectiveness of glucosamine alone have found that glucosamine hydrochloride was essentially no more effective than placebo in reducing joint pain, with or without the addition of chondroitin or other dietary supplements promoted for treating joint pain. However, in a number of studies, taking 1,500 mg of oral crystalline glucosamine sulfate has proven effective in relieving pain and stiffness in the joints, particularly in those who suffer from knee pain.
Presently, only a single pharmaceutical company (Rottapharm, marketed under the DONA(tm) brand in the US) manufactures crystalline glucosamine sulfate (using a patented process), so it seems likely that almost anything else you find on the shelves of your local health food store will be ineffective (apart from a possible placebo effect).
Two three-year studies reported that DONA(tm) crystalline glucosamine sulfate was an effective supplement. The first study, published in The Lancet in 2001, found that there was less joint space loss in those taking the glucosamine sulfate as compared with placebo. The second study, reported in JAMA's Archives of Internal Medicine in 2003,found similar results to the previous study and concluded that these results "suggest that glucosamine sulfate could be a disease modifying agent in osteoarthritis." It should be noted, however, that both of these studies were industry-funded, so there may be some bias involved in the results. That said, if you plan on giving glucosamine a try, DONA(tm) is the most likely form of glucosamine to be effective in relieving your joint pain.
Though some forms of glucosamine are synthesized from fermented corn, if you are vegan, crystalline glucosamine sulfate will not be for you, as it is made from shellfish exoskeletons and there are no alternatives currently manufactured. Those with shellfish allergies are in luck, however, as the manufacturer of DONA(tm) states that there is no problem for those with shellfish allergies taking their product, as it is chemically synthesized from highly purified chitin, which is not the allergen responsible for causing allergic reactions to shellfish. However, if you do have a shellfish allergy, it's always a good idea consult your doctor before taking glucosamine sulfate, just to be sure.

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