Glucosamine Forte 180 Tablets

Glucosamine has been on shelves for decades and the evidence still hasn't settled, so here's the triage our naturopaths run rather than a recommendation either way.

A good fit if

• You've got ongoing knee discomfort and you'll give it a few months
• You want glucosamine sulfate specifically, which is where the favourable evidence sits
• You avoid shellfish and want the corn-fermented version
• You'd rather understand a split evidence base than be sold a certainty

Check with us first if

• You have asthma, named alongside shellfish allergy as a caution group.
• You're on warfarin, where caution is advised though a review also reported no significant interaction.
• You take diabetes medicine, where caution is named although direct trial evidence was reassuring.
• You have kidney disease or take heart or blood pressure medicine, and the product is the potassium chloride salt.
• You're pregnant or breastfeeding, where no Schedule 1 warning exists but no data was located either.

• Glucosamine sulfate (item 2368). Best known for: The salt the long-term trials used. Absorption: Permitted listed with no conditions. Typical use: The form to pick if you're following the evidence that favours glucosamine.
• Glucosamine sulfate potassium chloride (item 2369). Best known for: A stabilised sulfate salt, very common on shelf. Absorption: Potassium chloride is a mandatory component. Typical use: Carries a kidney and heart warning, and a 550 mg potassium limit for oral use.
• Glucosamine sulfate sodium chloride (item 2370). Best known for: The sodium-stabilised equivalent. Absorption: Permitted listed with no conditions. Typical use: An alternative if potassium is a concern for you.
• Glucosamine hydrochloride. Best known for: A different salt with a different evidence picture. Absorption: Not interchangeable with the sulfate evidence. Typical use: Check which salt a product actually uses.
• Corn-fermented glucosamine. Best known for: Made without crustacean shell. Absorption: The route around the shellfish question. Typical use: The option if allergy or a vegetarian diet rules out shellfish-derived.

Reference values. There's no Nutrient Reference Value for glucosamine, because it's not a nutrient.

Typical supplemental range. Australian labels usually sit around 1,500 mg a day, which is the dose most trials used, taken as one dose or split. Trials in the long-term analyses ran from one to four years, and the register notes the highest dose in a cached human trial was 3,000 mg a day of corn-fermented glucosamine.

Upper level. There's no upper limit in Schedule 1 for any glucosamine salt and no NHMRC reference value. The one hard number is on glucosamine sulfate potassium chloride: for oral use it's only permitted in medicines containing less than 550 mg of potassium chloride.

Worth knowing. Give it months rather than weeks if you're going to try it. The trials that found anything ran a year or longer. Your needs depend on your age, diet and health circumstances. Talk to one of our naturopaths.

Food first, where the diet allows it.

• None meaningful: glucosamine isn't obtained in useful amounts from food; supplements are manufactured

This list is the part of the page we will not shorten. If any of it applies to you, talk to one of our naturopaths or your doctor before starting.

• Shellfish allergy. Most glucosamine is made from crustacean shell. Of 366 Australian adverse reaction reports on glucosamine and chondroitin preparations between 2000 and 2011, 263 (71.85%) were hypersensitivity reactions.
• Asthma. Named alongside shellfish allergy as a caution group.
• Warfarin. Caution advised, though the same review states no significant supplement-drug interaction was found. Evidence is not settled.
• Diabetes medicines. Named as a caution group, though 90 days of glucosamine hydrochloride with chondroitin was reassuring on glycaemic control.
• Kidney disease, or taking heart or blood pressure medicines. Mandatory Schedule 1 warning on glucosamine sulfate potassium chloride (item 2369).
• Pregnancy and breastfeeding. No warning is recorded against any glucosamine item in Schedule 1, and no safety data was located either.
• Children. No paediatric restriction on glucosamine items, but sodium chondroitin sulfate (item 4582) mandates "Adults only", and joint indications commonly carry age restrictions.
• Non-pharmaceutical-grade product. Post-marketing surveillance lists adverse events specifically for non-pharmaceutical-grade glucosamine and chondroitin.
• If you take prescription medicines, check with your doctor, pharmacist or our naturopaths before starting.