Orthomolecular - Glucosamine

Question 1

Glucosamine

Answer 1

Glucosamine is an aminosugar naturally present in most body tissues, with high concentrations in joints and cartilage.
* Glucosamine is required for the synthesis of glycoproteins, glycolipids, and glycosaminoglycans (GAGs), also known as mucopolysaccharides.
* These compounds are an important structural component of tendons, ligaments, cartilage, synovial fluid, mucous membranes and structures in the eye, blood vessels and heart valves.
glyco-= sugar
amino-= protein
-glycan = polysaccharide
aminosugar= sugar molecule with a nitrogen

Question 2

Supplement forms

Answer 2

Glucosamine can be supplemented in two different forms. All supplemental forms are highly bioavailable.
* Glucosamine-6-Phosphate (G6P) and N-Acetyl-Glucosamine (NAG) are naturally present within the human body.
o NAG is converted to hyaluronic acid (HLA) as needed. HLA is an important component of synovial fluid.
* Glucosamine sulphate is sourced from marine exoskeletons (so not suitable for vegetarians, vegans and those with seafood allergies). It appears to be absorbed better and hence result in higher tissue concentrations. Sulphate is found in synovial fluid and is required for GAG synthesis.
* Glucosamine hydrochloride is created synthetically from corn.
Exoskeleton —external skeleton that supports and protects the body of certain animals.
GAG - glycosaminoglycans

Question 3

Osteoarthritis

Answer 3

Therapeutic uses:
* Stimulates metabolism of chondrocytes in the articular cartilage and synovial cells in the synovial tissue. This slows joint degeneration and prevents joint space narrowing.
* Decreases inflammation by inhibiting the formation of cytokines such as interleukin-1.
* Pain reduction is comparable to NSAIDS. NSAIDS provide relief after two weeks compared to four to eight weeks for glucosamine sulphate.
* Less effective for severe, long-standing osteoarthritis.
* More effective combined with chondroitin and MSM.

• Dosage: 1500 mg daily or in three divided doses.
  chondrocyte = cell that produces cartilage

Question 4

IBD and intestinal permeability

Answer 4

Therapeutic Uses:
* NAG supports the GI epithelial barrier by enhancing mucin functionality, which is dramatically altered in those with IBD. Mucins are a group of proteins found in mucus that form a barrier and prevent microbial overgrowth.
* NAG also reduces biofilm formation associated with IBD.
* NAG can be also used in intestinal permeability.

• Dosage: 3–6 g daily for children; 6 g daily for adults in three divided doses. Administered orally or rectally.
  Exercise: What other nutrients and food sources can be used in cases of intestinal permeability?
• Glutamine: Amino acid (cabbage juice) – beneficial to intestinal health
• Zinc: Rapidly dividing cells (in epithelial barrier)
• Herbs e.g. Liquorice, goldenseal etc.

Question 5

Supplementation:

Answer 5

• Caution: Glucosamine supplements can be synthesised in the laboratory, however most are produced from the shells of crustaceans —so can be problematic for those with a seafood allergy.
• Mild adverse effects: GIT symptoms such as nausea, heartburn, diarrhoea, constipation as well as drowsiness, skin reactions and headaches.
• Interactions: Potential increase in the anticoagulant effect of warfarin, leading to increased risk of bleeding and bruising.