When it comes to famous combinations, we typically think of peanut butter and jelly or Jack and Jill, but when it comes to wellness, especially joint health, glucosamine and chondroitin often comes to mind. This natural combination has been featured extensively in the scientific literature.

What is glucosamine chondroitin?

Both glucosamine and chondroitin are naturally produced in the body. Glucosamine is a water-soluble amino monosaccharide that is found in high quantities in joint cartilage and synovial fluid. Chondroitin is a sulfated glycosaminoglycan that is also a major component of joint cartilage. (7) Both substances protect and stimulate joint cartilage, while also suppressing inflammation. (7) Glucosamine and chondroitin are available as dietary supplements, often formulated together because of their synergistic benefit.

Glucosamine chondroitin supplement benefits

High concentrations of glucosamine and chondroitin are present in joints. As a result, the most widely recognized benefit of glucosamine chondroitin is for osteoarthritis, but it has also exhibited benefits for rheumatoid arthritis, inflammation, and the gut microbiome.

Osteoarthritis

Osteoarthritis is a degenerative joint condition in which the cartilage in the joints breaks down causing wear and tear. This condition typically occurs in the hands, hips, and knees, (1) and the decline of cartilage and lubrication causes pain, stiffness, and swelling. While the risk of osteoarthritis increases with age, other factors that can lead to osteoarthritis include genetics, joint injury or overuse, and obesity. (1)

 

 

Woman holding back
Glucosamine chondroitin supplementation may help relieve pain associated with osteoarthritis.

 

According to a 2018 meta-analysis of randomized controlled trials, chondroitin alleviated pain and improved joint function compared to a placebo, while glucosamine significantly improved stiffness compared to a placebo. (10)

A 2015 meta-analysis of 54 different studies involving 16,427 patients found that the combination of glucosamine and chondroitin produced clinically significant improvements in pain relief and function compared to baseline and was equally as effective as the drug celecoxib, which is routinely used to treat symptomatic osteoarthritis. (9) In this analysis, the researchers also found that there was a much higher rate of gastrointestinal adverse events with celecoxib compared to the placebo, while the glucosamine-chondroitin combination was well tolerated.

It’s clear that glucosamine chondroitin supplement benefits osteoarthritis but what about rheumatoid arthritis?

Rheumatoid arthritis

The etiologies of osteoarthritis and rheumatoid arthritis are very different. Osteoarthritis is a degenerative joint condition caused by wear and tear negatively impacting cartilage and synovial fluid, whereas rheumatoid arthritis is an autoimmune condition that can destroy joint function. (8) That could be why the research involving glucosamine and chondroitin is not as definitive when it comes to rheumatoid arthritis.

A 2007 randomized trial showed that glucosamine did help alleviate symptoms in patients with rheumatoid arthritis. (5) However, another 2009 study showed that while glucosamine chondroitin was effective at improving pain symptoms and function in patients with osteoarthritis, it was not effective for patients with rheumatoid arthritis. (4)

One possible explanation for these differences may be attributed to the anti-inflammatory effects of glucosamine chondroitin.

Inflammation

Glucosamine chondroitin, alone and in combination, can reduce markers of inflammation. A 2014 study demonstrated that people taking chondroitin had 36% lower high-sensitivity C-reactive protein (hsCRP) level and 27% lower prostaglandin E2-metabolite (PGE-M) levels compared to non-users of chondroitin. Further, those taking glucosamine had 28% lower hsCRP and 24% lower PGE-M compared to non-users of glucosamine. (2)

A 2019 prospective study also found that habitual glucosamine use was associated with decreased risk of cardiovascular disease events, which the researchers speculate is probably due to the anti-inflammatory actions. (3)

 

Woman looking in a mirror
Glucosamine chondroitin has been shown to reduce markers of inflammation.

 

This anti-inflammatory effect may also improve other conditions such as inflammatory bowel disease, heart disease, or autoimmune conditions.

Gut microbiome

A systematic review of in vivo and human studies showed that chondroitin in particular had beneficial effects on the gut microbiome because it can increase Bacteroides that help regulate symbiosis in the gut. The researchers believe that this is, in part, because both glucosamine and chondroitin have limited intestinal absorption and are predominantly utilized by gut microbiota to protect the gut barrier, which positively influences the host’s microbial community. (6)

The bottom line

The combination of glucosamine and chondroitin provides several health benefits, especially when it comes to joint health. Research demonstrates that people with osteoarthritis can achieve symptomatic relief while also improving joint function and protecting cartilage and synovial fluid. Glucosamine chondroitin may also offer anti-inflammatory, cardiovascular, and gut health benefits, effects that warrant further study.

If you are a patient interested in glucosamine chondroitin supplements, consider consulting with an integrative healthcare provider for guidance.

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  1. Centers for Disease Control & Prevention. (2020, July 27). Osteoarthritis. https://www.cdc.gov/arthritis/basics/osteoarthritis.htm
  2. Kantor, E. D., Lampe, J. W., Navarro, S. L., Song, X., Milne, G. L., & White, E. (2014). Associations between glucosamine and chondroitin supplement use and biomarkers of systemic inflammation. Journal of Alternative and complementary Medicine, 20(6), 479-485.
  3. Ma, H., Li, X., Sun, D., Zhou, T., Ley, S. H., Gustat, J., Heianza, Y., & Qi, L. (2019). Association of habitual glucosamine use with risk of cardiovascular disease: prospective study in UK Biobank. BMJ, 365.
  4. Matsuno, H., Nakamura, H., Katayama, K., Hayashi, S., Kano, S, & Yudoh, K. (2009). Effects of an oral administration of glucosamine-chondroitin-quercetin glucoside on synovial fluid properties in patients with osteoarthritis and rheumatoid arthritis. Bioscience, Biotechnology, and Biochemistry, 73, 2.
  5. Nakamura, H., Masuko, K, Yudoh, K, Kato, T, Kamada, T., & Kawahara, T. (2007). Effects of glucosamine administration on patients with rheumatoid arthritis. Rheumatol Int, 27(3), 213-8.
  6. Shmagel, A., Demmer, R., Knights, D., Butler, M., Langsetmo, L, Lane, N. E., & Ensrud, K. (2019). The effects of glucosamine and chondroitin sulfate on gut microbial composition: a systematic review of evidence from animal and human studies. Nutrients, 11, 294.
  7. Vasiliadis, H. S., & Tsikopoulos, K. (2017). Glucosamine and chondroitin for the treatment of osteoarthritis. World J Orthop, 8(1), 1-11.
  8. Woetzel, D., Huber, R., Kupfer, P., Pohlers, D., Pfaff, M., Driesch, D., Haupl, T., Koczan, D., Steihl, P, Guthke, R., & Kinne, R. W. (2014). Identification of rheumatoid arthritis and osteoarthritis patients by trascriptome-based rule set generation. Arthritis Research & Therapy, 16:R84.
  9. Zeng, C., Wei, J., Li, H., Wang, L, Xie, D., Yang, T., Gao, S. Li, Y., Luo W., & Lei, G. (2015). Effectiveness and safety of glucosamine, chondroitin, the two in combination, or celecoxib in the treatment of osteoarthritis of the knee. Scientific Reports, 5, 16827.
  10. Zhu, X, Sang, L, Wu, D., Rong, J., & Jiang, L. (2018). Effectiveness and safety of glucosamine and chondroitin for the treatment of osteoarthritis: a meta-analysis of randomized controlled trials. J Orthop Surg Res, 13, 170.