As the weather gets colder, the number of osteoarthritis patients in the hospital has recently increased. The strange thing is that many patients are asking the same question: “Doctor, for treating osteoarthritis, is glycosaminosulfate better? Or glycosaminoglycan hydrochloride?” After inquiring in detail, we learned that everyone has read the recent online spread. Of an article. The article stated that the treatment of osteoarthritis was ineffective except for “certain” glucosamine. In fact, the scientific nature of the article is open to question. However, patients with osteoarthritis are also generally concerned about the difference between these two types of glycosaminoglycans and which is better in terms of efficacy.
Glucosamine works slowly
Osteoarthritis is caused by the degeneration of articular cartilage, bone hyperplasia at the joint edge, synovial disease, muscle atrophy and weakness. At present, the cause of the disease is unknown, and it is highly suspected to be related to age (older, normal aging of joints), obesity (overweight, increased wear and tear), trauma and genetic factors (naturally prone to joint problems). Osteoarthritis is a degenerative disease. As we age, the incidence increases and the condition worsens. Therefore, osteoarthritis often causes disability in elderly patients. Of course, with the increasing number of obese young people, osteoarthritis has also begun to become a disease that afflicts young people. The pathological changes of osteoarthritis are gradually aggravated and irreversible. Therefore, there is no cure for osteoarthritis. We can only think of ways to delay the progression of the disease.
Glucosamine, also known as glucosamine, is commonly known as glycosaminoglycan. It is one of the most commonly used drugs for the treatment of osteoarthritis. It is also recommended by the Orthopedic Branch of the Chinese Medical Association in the “Guidelines for Diagnosis and Treatment of Osteoarthritis”. Slow-acting drugs”. It is called a “slow-acting drug” because it is used as a raw material for the synthesis of articular cartilage. It takes a period of time to block the pathological process of osteoarthritis. It is not as immediate as “eat it today and it will work tomorrow”.
It is safe to take glucosamine because it is naturally present in the body and can be synthesized in the body under normal conditions. It is an important component in the formation of cartilage matrix. When exogenous amino sugar is given, it can promote cartilage regeneration.
Who sings the leading role, who plays the supporting role
The initial preparation process of glucosamine is very simple: soak the shells of shrimps and crabs in dilute hydrochloric acid to remove the calcium; then cook them with alkaline water to remove the protein, etc., to obtain chitin (that is, acetylated glucosamine) , And then hydrolyze the chitin with hydrochloric acid to obtain glucosamine hydrochloride. This was discovered in 1876 by the surgeon and pharmacist Georg Lederhaus.
Of course, now we have very high requirements for the environment, and we don’t allow this kind of acid cooking and alkaline cooking to pollute the environment. Most of them use biological methods (such as enzymatic hydrolysis) to prepare glucosamine. However, glucosamine must form a salt with an acid (hydrochloric acid, sulfuric acid or other acid) to become a drug. Therefore, you will see that there are glucosamine hydrochloride and glucosamine sulfate.
One point of knowledge that must be clear is that glucosamine really affects osteoarthritis.
Which amino sugar is good?
First look at the stability: the drug must remain stable, and the stability of amino sugar hydrochloride is better than that of amino sugar sulfate. Sulfuric acid is easy to absorb moisture in a humid environment, and will quickly dissolve and change color (from white to brownish yellow), so please pay attention to moisture when storing.
Secondly, look at the purity: due to the production method, most of the amino sugar contains 20% sodium or potassium, so it is not suitable for cardiovascular disease (high sodium can easily lead to heart failure, high blood pressure) and kidney disease (the potassium is easy to Causes hyperkalemia) patients with long-term use.
Look at the curative effect again: In 2001, Professor Qiu Guixing of Peking Union Medical College Hospital and others published a “Parallel Controlled Clinical Study on the Treatment of Osteoarthritis with Glucosamine Hydrochloride/Sulphate Glucosamine”. The study found that glucosamine hydrochloride can relieve knee joint pain, reduce swelling and improve joint mobility Similar to glucosamine sulfate, the total effective rate is similar, the curative effect is similar, the safety is the same, the adverse reaction is mild, and the patient is well tolerated.
Finally, let’s look at the absorption: In 2008, researchers such as Meulyzer in Canada also published a study comparing the absorption of glucosamine hydrochloride and glucosamine sulfate. It was found that there was no difference in the degree of absorption and the rate of absorption of the two amino sugars. Glucosamine sulfate and Glucosamine hydrochloride are indiscriminately decomposed into glucosamine and hydrochloride/sulfate when absorbed in gastric juice and intestinal juice. Glucosamine alone (without hydrochloric acid or sulfuric acid) absorbs into the blood and works. Therefore, both amino sugar hydrochloride and amino sugar sulfate are floating clouds. The hero who really plays a role-amino sugar, does not ask about his background.
Therefore, everyone should not be fooled by marketing under the banner of “academic”, and believe that all kinds of glucosamine approved by the State Drug Administration are of guaranteed quality, safe and effective.
Four things to keep in mind
Intimate reminder from the pharmacist: Whether it is glycosaminoglycan hydrochloride or glycosaminosulfate, you can relieve symptoms after taking it, delay the progression of arthritis, and have no intolerable side effects, which is a good “amino sugar”.
Please note when taking Glucosamine:
①If you have cardiovascular disease (hypertension, congestive heart failure, etc.) or chronic kidney disease (prone to hyperkalemia), long-term use of Glucosamine containing high sodium or potassium is not recommended.
②Current evidence suggests that the daily intake of ammonia sugar must be sufficient (generally >1g) to be effective, and that the dose is too low is a comfort effect at best.
③In order to reduce gastrointestinal irritation, it is recommended to take it during or after meals.
④Some amino sugars are prepared from seafood (shrimp skin, crab shell). If you are allergic to seafood, it will induce asthma and other allergic diseases. You should know the source of the product and whether it is allergic before use.