2-Amino-2-Deoxy-Glucose, 2-Amino-2-Deoxy-Beta-D-Glucopyranose, 2-Amino-2-Deoxy-D-Glucose Sulfate, 3-Amino-6-(Hydroxymethyl)Oxane-2,4,5-Triol Sulfate, Amino Monosaccharide, Chitosamine, Chlorure de Potassium-Sulfate de Glucosamine, D-Glucosamine, D-Glucosamine Sulfate, D-Glucosamine Sulphate, G6S, Glucosamine, Glucosamine Potassium Sulfate, Glucosamine Sulfate 2KCl, Glucosamine Sulfate-Potassium Chloride, Glucosamine Sulphate, Glucosamine Sulphate KCl, Glucosamine-6-Phosphate, GS, Mono-Sulfated Saccharide, Poly-(1->3)-N-Acetyl-2-Amino-2-Deoxy-3-O-Beta-D-Glucopyranurosyl-4-(or 6-) Sul, Saccharide Mono-Sulfaté, Saccharide Sulfaté, Sulfate de Glucosamine, Sulfate de Glucosamine 2KCl, SG, Sulfated Monosaccharide, Sulfated Saccharide, Sulfato de Glucosamina.
Glucosamine Hydrochloride and N-Acetyl Glucosamine are different than Glucosamine Sulfate. For information on these different products, see the Glucosamine Hydrochloride and N-Acetyl Glucosamine listings.
Glucosamine sulfate is a naturally occurring chemical found in the human body. It is in the fluid that is around joints. Glucosamine is also found in other places in nature. For example, the glucosamine sulfate that is put into dietary supplements is often harvested from the shells of shellfish. Glucosamine sulfate used in dietary supplements does not always come from natural sources. It can also be made in a laboratory.
There are different forms of glucosamine including glucosamine sulfate, glucosamine hydrochloride, and N-acetyl-glucosamine. These different chemicals have some similarities; however, they may not have the same effects when taken as a dietary supplement. Most of the scientific research done on glucosamine has been done on glucosamine sulfate. The information on this page pertains to glucosamine sulfate. For information on the other forms of glucosamine, see the specific pages for each of them.
Dietary supplements that contain glucosamine often contain additional ingredients. These additional ingredients are frequently chondroitin sulfate, MSM, or shark cartilage. Some people think these combinations work better than taking just glucosamine sulfate alone. So far, researchers have found no proof that combining the additional ingredients with glucosamine adds any benefit.
Some glucosamine sulfate products are not labeled accurately. In some cases, the amount of glucosamine actually in the product has varied from none to over 100% of the amount stated on the product's label. Some products have contained glucosamine hydrochloride when glucosamine sulfate was listed on the label.
Glucosamine sulfate is taken by mouth for osteoarthritis, glaucoma, weight loss, joint pain caused by drugs, a bladder condition called interstitial cystitis, jaw pain, joint pain including knee pain, back pain, multiple sclerosis, and HIV/AIDS.
Glucosamine is also in some skin creams used to control arthritis pain. These creams usually contain camphor and other ingredients in addition to glucosamine.
Glucosamine sulfate is used parenterally for osteoarthritis.
How does it work?
Glucosamine sulfate is a chemical found in the human body. It is used by the body to produce a variety of other chemicals that are involved in building tendons, ligaments, cartilage, and the thick fluid that surrounds joints.
Joints are cushioned by the fluid and cartilage that surround them. In some people with osteoarthritis, the cartilage breaks down and becomes thin. This results in more joint friction, pain, and stiffness. Researchers think that taking glucosamine supplements may either increase the cartilage and fluid surrounding joints or help prevent breakdown of these substances, or maybe both.
Some researchers think the "sulfate" part of glucosamine sulfate is also important. Sulfate is needed by the body to produce cartilage. This is one reason why researchers believe that glucosamine sulfate might work better than other forms of glucosamine such as glucosamine hydrochloride or N-acetyl glucosamine. These other forms do not contain sulfate.
Likely Effective for...
- Osteoarthritis. Most research shows that taking glucosamine sulfate can provide some pain relief for people with osteoarthritis, especially those with osteoarthritis of the knees. For some people, glucosamine sulfate might work as well as over-the-counter and prescription pain medications such as acetaminophen or ibuprofen; however, pain medications work quickly while glucosamine sulfate can take 4-8 weeks before it provides pain relief. Also people who take glucosamine sulfate often still need to take pain medications for pain flare-ups.
In addition to relieving pain, glucosamine sulfate might also slow the breakdown of joints and prevent the condition from getting worse if it is taken for several years. Some research shows that people who take glucosamine sulfate might be less likely to need total knee replacement surgery.
There are several kinds of glucosamine products. The most research showing benefit is for products that contain glucosamine sulfate. Products that contain glucosamine hydrochloride do not seem to work as well. Many products contain both glucosamine with chondroitin, but there is no evidence that these products work any better than glucosamine sulfate by itself.
Insufficient Evidence to Rate Effectiveness for...
- Joint pain caused by drugs that lower estrogen levels. Early research suggests that taking a combination of glucosamine sulfate and chondroitin sulfate in two or three divided doses daily for 24 weeks reduces pain in women taking drugs that lower estrogen levels for early stage breast cancer.
- Painful bladder syndrome (Interstitial cystitis). Early research suggests that taking a specific product containing glucosamine sulfate, sodium hyaluronate, chondroitin sulfate, quercetin, and rutin (CystoProtek, Tischon Corporation, Westbury, NY) four times daily for 12 months reduces symptoms of painful bladder syndrome.
- Joint pain. Research shows that taking a specific product containing glucosamine sulfate, methylsufonlylmethane, white willow bark extract, ginger root concentrate, Indian frankincense extract, turmeric root extract, cayenne, and hyaluronic acid (Instaflex Joint Support, Direct Digital, Charlotte, NC) in three divided doses daily for 8 weeks reduces joint pain. But this product doesn't seem to help joint stiffness or function.
- Knee pain. Some research shows that taking a specific product containing glucosamine sulfate, methylsufonlylmethane, white willow bark extract, ginger root concentrate, Indian frankincense extract, turmeric root extract, cayenne, and hyaluronic acid (Instaflex Joint Support, Direct Digital, Charlotte, NC) in three divided doses daily for 8 weeks reduces joint pain in people with knee pain. But this product doesn't seem to help joint stiffness or function. Other early research shows that taking 1500 mg of glucosamine sulfate daily for 28 days does not reduce knee pain in athletes following a knee injury. However, it does seem to improve knee movement.
- Multiple sclerosis. Early research shows that taking 1000 mg of glucosamine sulfate by mouth daily for 6 months might reduce the relapse of multiple sclerosis.
- Jaw pain (Temporomandibular disorder). Some research shows that taking glucosamine sulfate works about as well as the nonsteroidal anti-inflammatory drug (NSAID) ibuprofen (Motrin, Advil, etc.) for relieving jaw pain. In some people, pain relief appears to continue for up to 90 days after glucosamine sulfate is discontinued. However, research suggests that when 1200 mg of glucosamine sulfate is taken by mouth daily for 6 months, jaw pain and the ability to open the jaw are not improved.
- Weight loss.
- Other conditions.
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).
Glucosamine sulfate is LIKELY SAFE when used appropriately by mouth in adults.
Glucosamine sulfate is POSSIBLY SAFE when injected into the muscle as a shot twice weekly for up to 6 weeks or when applied to the skin in combination with chondroitin sulfate, shark cartilage, and camphor for up to 8 weeks.
Glucosamine sulfate can cause some mild side effects including nausea, heartburn, diarrhea, and constipation. Uncommon side effects are drowsiness, skin reactions, and headache. These are rare.
Asthma: There is one report linking an asthma attack with taking glucosamine. It is not known for sure if glucosamine was the cause of the asthma attack. Until more is known, people with asthma should be cautious about taking products that contain glucosamine.
Diabetes: Some early research suggested that glucosamine sulfate might raise blood sugar in people with diabetes. However, more recent and more reliable research now shows that glucosamine sulfate does not seem to affect blood sugar control in people with type 2 diabetes. Glucosamine appears to be safe for most people with diabetes, but blood sugar should be monitored closely.
High cholesterol: Animal research suggests that glucosamine may increase cholesterol levels. In contrast, glucosamine does not seem to increase cholesterol levels in humans. However, some early research suggests that glucosamine might increase insulin levels. This might cause cholesterol levels to increase. To be cautious, if you take glucosamine sulfate and have high cholesterol. Monitor your cholesterol levels closely.
High blood pressure: Early research suggests that glucosamine sulfate can increase insulin levels. This might cause blood pressure to increase. However, more reliable research suggests that glucosamine sulfate does not increase blood pressure. To be cautious, if you take glucosamine sulfate and have high blood pressure, monitor your blood pressure closely.
Shellfish allergy: Because some glucosamine sulfate products are made from the shells of shrimp, lobsters or crabs, there is concern that glucosamine products might cause allergic reactions in people who are allergic to shellfish. However, allergic reactions in people with shellfish allergy are typically caused by the meat of shellfish, not the shell. There are no reports of allergic reactions to glucosamine in people who are allergic to shellfish. There is also some information that people with shellfish allergy can safely take glucosamine products.
Surgery: Glucosamine sulfate might affect blood sugar levels and might interfere with blood sugar control during and after surgery. Stop taking glucosamine sulfate at least 2 weeks before a scheduled surgery.
Warfarin (Coumadin)Interaction Rating: Major Do not take this combination.
Warfarin (Coumadin) is used to slow blood clotting. There are several reports showing that taking glucosamine sulfate with or without chondroitin increases the effect of warfarin (Coumadin), making blood clotting even slower. This can cause bruising and bleeding that can be serious. Don't take glucosamine sulfate if you are taking warfarin (Coumadin). Many natural medicines can interact with warfarin (Coumadin).
Medications for cancer (Antimitotic chemotherapy)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Some medications for cancer work by decreasing how fast cancer cells can copy themselves. Some scientists think that glucosamine sulfate might increase how fast tumor cells can copy themselves. Taking glucosamine sulfate along with some medications for cancer might decrease the effectiveness of these medications for cancer. Any person who is receiving chemotherapy should talk with their health provider before taking glucosamine sulfate.
Some of these medications are etoposide (VP16, VePesid), teniposide (VM26), and doxorubicin (Adriamycin).
Acetaminophen (Tylenol, others)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
There is some concern that taking glucosamine sulfate and acetaminophen (Tylenol, others) together might affect how well each works. However, more information is needed to know if this interaction is a big concern. For now, most experts say it is okay to use both together.
Medications for diabetes (Antidiabetes drugs)Interaction Rating: Minor Be cautious with this combination.Talk with your health provider.
There has been concern that glucosamine sulfate might increase blood sugar in people with diabetes. There was also the concern that glucosamine sulfate might decrease how well diabetes medications work. However, research now shows that glucosamine sulfate probably does not increase blood sugar in people with diabetes. Therefore, glucosamine sulfate probably does not interfere with diabetes medications. To be cautious, if you take glucosamine sulfate and have diabetes, monitor your blood sugar closely.
Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.
The following doses have been studied in scientific research:
- For osteoarthritis: 1500 mg once daily or 500 mg three times daily, either alone or together with 400 mg of chondroitin sulfate two or three times daily, has been used for up to 3 years. Also glucosamine sulfate 750 mg twice daily in combination with turmeric root extract 500 mg twice daily has been used for 6 weeks.
- For osteoarthritis: A cream containing 30 mg/gram of glucosamine sulfate, 50 mg/gram of chondroitin sulfate, 140 mg/gram of chondroitin sulfate, 32 mg/gram of camphor, and 9 mg/gram of peppermint oil has been applied to the skin as needed for 8 weeks.
- For osteoarthritis: 400 mg of glucosamine sulfate has been injected twice weekly for 6 weeks.
Health Solutions From Our Sponsors
Health Solutions From Our Sponsors
Adams ME. Hype about glucosamine. Lancet 1999;354:353-4. View abstract.
Adebowale AO, Cox DS, Liang Z, et al. Analysis of glucosamine and chondroitin sulfate content in marketed products and the Caco-2 permeability of chondroitin sulfate raw materials. JANA 2000;3:37-44.
Ajiboye R, Harding JJ. The non-enzymic glycosylation of bovine lens proteins by glucosamine and its inhibition by aspirin, ibuprofen and glutathione. Exp Eye Res 1989;49(1):31-41. View abstract.
Akarasereenont P, Chatsiricharoenkul S, Pongnarin P, Sathirakul K, Kongpatanakul S. Bioequivalence study of 500 mg glucosamine sulfate in Thai healthy volunteers. J Med Assoc Thai 2009;92(9):1234-9. View abstract.
Almada A, Harvey P, Platt K. Effects of chronic oral glucosamine sulfate on fasting insulin resistance index (FIRI) in non-diabetic individuals. FASEB J 2000;14:A750.
Alvarez-Soria MA, Largo R, Diez-Ortego E, et al. Glucosamine Inhibits IL-1ß-induced NF-kappa B Activation in Human Osteoarthritic chondrocytes. American College of Rheumatology Meeting; October 25-29, 2002. Abstract 118.
Bagasra O, Whittle P, Heins B, Pomerantz RJ. Anti-human immunodeficiency virus type 1 activity of sulfated monosaccharides: comparison with sulfated polysaccharides and other polyions. J Infect Dis 1991;164:1082-90. View abstract.
Balkan B, Dunning BE. Glucosamine inhibits glucokinase in vitro and produces a glucose-specific impairment of in vivo insulin secretion in rats. Diabetes 1994;43:1173-9. View abstract.
Barclay TS, Tsourounis C, McCart GM. Glucosamine. Ann Pharmacother 1998;32:574-9. View abstract.
Basak M, Joseph S, Joshi S, Sawant S. Comparative bioavailability of a novel timed release and powder-filled glucosamine sulfate formulation--a multi-dose, randomized, crossover study. Int J Clin Pharmacol Ther 2004;42(11):597-601. View abstract.
Bassleer C, Henrotin Y, Franchimont P. In-vitro evaluation of drugs proposed as chondroprotective agents. Int J Tissue React 1992;14(5):231-41. View abstract.
Bijlsma JWJ, Lafeber FPJG. Glucosamine sulfate in osteoarthritis: The jury is still out. Ann Intern Med 2008;148:315-6. View abstract.
Bruyère O, Cooper C, Pelletier JP, et al. A consensus statement on the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) algorithm for the management of knee osteoarthritis-From evidence-based medicine to the real-life setting. Semin Arthritis Rheum. 2016;45(4 Suppl):S3-11. View abstract.
Bruyere O, Pavelka K, Rovati LC, et al. Glucosamine sulfate reduces osteoarthritis progression in postmenopausal women with knee osteoarthritis: evidence from two 3-year studies. Menopause 2004;11:138-43. View abstract.
Bruyere O, Pavelka K, Rovati LC, et al. Total joint replacement after glucosamine sulphate treatment in knee osteoarthritis: results of a mean 8-year observation of patients from two previous 3-year, randomised, placebo-controlled trials. Osteoarthritis Cartilage 2008;16:254-60. View abstract.
Bush TM, Rayburn KS, Holloway SW, et al. Adverse interactions between herbal and dietary substances and prescription medications: a clinical survey. Altern Ther Health Med 2007;13:30-5. View abstract.
Cahlin, B. J. and Dahlstrom, L. No effect of glucosamine sulfate on osteoarthritis in the temporomandibular joints--a randomized, controlled, short-term study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112(6):760-766. View abstract.
Calamia V, Ruiz-Romero C, Rocha B, Fernández-Puente P, Mateos J, Montell E, Vergés J, Blanco FJ. Pharmacoproteomic study of the effects of chondroitin and glucosamine sulfate on human articular chondrocytes. Arthritis Res Ther 2010;12(4):R138. View abstract.
Cerda C, Bruguera M, Parés A. Hepatotoxicity associated with glucosamine and chondroitin sulfate in patients with chronic liver disease. World J Gastroenterol 2013;19(32):5381-4. View abstract.
Chesnokov V, Sun C, Itakura K. Glucosamine suppresses proliferation of human prostate carcinoma DU145 cells through inhibition of STAT3 signaling. Cancer Cell Int 2009;9:25. View abstract.
Chopra A, Saluja M, Tillu G, Sarmukkaddam S, Venugopalan A, Narsimulu G, Handa R, Sumantran V, Raut A, Bichile L, Joshi K, Patwardhan B. Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial. Rheumatology (Oxford) 2013;52(8):1408-17. View abstract.
Chopra A, Saluja M, Tillu G, Venugopalan A, Sarmukaddam S, Raut AK, Bichile L, Narsimulu G, Handa R, Patwardhan B. A Randomized Controlled Exploratory Evaluation of Standardized Ayurvedic Formulations in Symptomatic Osteoarthritis Knees: A Government of India NMITLI Project. Evid Based Complement Alternat Med 2011;2011:724291. View abstract.
Cibere J, Kopec JA, Thorne A, et al. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis. Arthritis Rheum 2004;51:738-45. View abstract.
Cibere J, Kopec JA, Thorne A, et al. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis. Arthritis Rheum 2004;51:738-45. View abstract.
Cohen M, Wolfe R, Mai T, Lewis D. A randomized, double blind, placebo controlled trial of a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor for osteoarthritis of the knee. J Rheumatol 2003;30:523-8.. View abstract.
da Camara CC, Dowless GV. Glucosamine sulfate for osteoarthritis. Ann Pharmacother 1998;32:580-7. View abstract.
Dahmer S, Schiller RM. Glucosamine. Am Fam Physician 2008;78(4):471-6. View abstract.
Danao-Camara T. Potential side effects of treatment with glucosamine and chondroitin. Arthritis Rheum 2000;43:2853. View abstract.
Does glucosamine increase serum lipid levels and blood pressure? Pharmacist's Letter/Prescriber's Letter 2001;17(11):171115.
Drovanti A, Bignamini AA, Rovati AL. Therapeutic activity of oral glucosamine sulfate in osteoarthrosis: a placebo-controlled double-blind investigation. Clin Ther 1980;3:260-72. View abstract.
Du XL, Edelstein D, Dimmeler S, et al. Hyperglycemia inhibits endothelial nitric oxide synthase activity by post-translational modification at the Akt site. J Clin Invest 2001;108:1341-8. View abstract.
Eriksen P, Bartels EM, Altman RD, Bliddal H, Juhl C, Christensen R. Risk of bias and brand explain the observed inconsistency in trials on glucosamine for symptomatic relief of osteoarthritis: a meta-analysis of placebo-controlled trials. Arthritis Care Res (Hoboken). 2014;66(12):1844-55. View abstract.
Foerster KK, Schmid K, Rovati LC. Efficacy of glucosamine sulfate in osteoarthritis of the lumbar spine: a placebo-controlled, randomized, double-blind study. Am Coll Rheumatol 64th Ann Scientific Mtg, Philadelphia, PA: 2000;Oct 29- Nov 2:abstract 1613.
Forster K, Schmid K, Rovati L, et al. Longer-term treatment of mild-to-moderate osteoarthritis of the knee with glucosamine sulfate- a randomized controlled, double-blind clinical study. Eur J Clin Pharmacol 1996;50:542.
Fox BA, Stephens MM. Glucosamine hydrochloride for the treatment of osteoarthritis symptoms. Clin Interv Aging 2007;2(4):599-604. View abstract.
Fransen M, Agaliotis M, Nairn L, Votrubec M, Bridgett L, Su S, Jan S, March L,Edmonds J, Norton R, Woodward M, Day R; LEGS study collaborative group. Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens. Ann Rheum Dis 2015;74(5):851-8. View abstract.
Frestedt, J. L., Walsh, M., Kuskowski, M. A., and Zenk, J. L. A natural mineral supplement provides relief from knee osteoarthritis symptoms: a randomized controlled pilot trial. Nutr J 2008;7:9. View abstract.
Ganu VA, Hu SI, Strassman J, et al. Inhibitors of N-glycosylation Reduce Cytokine-induced Production of Matrix Metalloproteinases, Nitric oxide, and PGE2 from Articular Chondrocytes: A Candidate Mechanism for the Chondroprotective Effects of d-Glucosamine. American College of Rheumatology Meeting; October 25-29, 2002. Abstract 616.
Giaccari A, Morviducci L, Zorretta D, et al. In vivo effects of glucosamine on insulin secretion and insulin sensitivity in the rat: possible relevance to the maladaptive responses to chronic hyperglycaemia. Diabetologia 1995;38:518-24. View abstract.
Giordano N, Fioravanti A, Papakostas P, et al. The efficacy and tolerability of glucosamine sulfate in the treatment of knee osteoarthritis: a randomized, double-blind, placebo-controlled trial. Curr Ther Res Clin Exp 2009;70(3):185-196. View abstract.
Graeser AC, Giller K, Wiegand H, Barella L, Boesch Saadatmandi C, Rimbach G. Synergistic chondroprotective effect of alpha-tocopherol, ascorbic acid, and selenium as well as glucosamine and chondroitin on oxidant induced cell death and inhibition of matrix metalloproteinase-3--studies in cultured chondrocytes. Molecules. 2009;15(1):27-39. View abstract.
Gray HC, Hutcheson PS, Slavin RG. Is glucosamine safe in patients with seafood allergy (letter)? J Allergy Clin Immunol 2004;114:459-60. View abstract.
Greenlee H, Crew KD, Shao T, Kranwinkel G, Kalinsky K, Maurer M, Brafman L, Insel B, Tsai WY, Hershman DL. Phase II study of glucosamine with chondroitin on aromatase inhibitor-associated joint symptoms in women with breast cancer. Support Care Cancer 2013;21(4):1077-87. View abstract.
Guillaume MP, Peretz A. Possible association between glucosamine treatment and renal toxicity: comment on the letter by Danao-Camara. Arthritis Rheum 2001;44:2943-4. View abstract.
Herrero-Beaumont G, Ivorra JA, Del Carmen Trabado M, et al. Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator. Arthritis Rheum 2007;56:555-67. View abstract.
Hoffer LJ, Kaplan LN, Hamadeh MJ, et al. Sulfate could mediate the therapeutic effect of glucosamine sulfate. Metabolism 2001;50:767-70.. View abstract.
Holmang A, Nilsson C, Niklasson M, et al. Induction of insulin resistance by glucosamine reduces blood flow but not interstitial levels of either glucose or insulin. Diabetes 1999;48:106-11. View abstract.
Hong H, Park YK, Choi MS, Ryu NH, Song DK, Suh SI, Nam KY, Park GY, Jang BC. Differential down-regulation of COX-2 and MMP-13 in human skin fibroblasts by glucosamine-hydrochloride. J Dermatol Sci 2009;56(1):43-50. View abstract.
Hughes R, Carr A. A randomized, double-blind, placebo-controlled trial of glucosamine sulphate as an analgesic in osteoarthritis of the knee. Rheumatology (Oxford) 2002;41:279-84. . View abstract.
Hwang MS, Baek WK. Glucosamine induces autophagic cell death through the stimulation of ER stress in human glioma cancer cells. Biochem Biophys Res Commun 2010;399(1):111-6. View abstract.
Ilic MZ, Martinac B, Samiric T, Handley CJ. Effects of glucosamine on proteoglycan loss by tendon, ligament and joint capsule explant cultures. Osteoarthritis Cartilage 2008;16(12):1501-8. View abstract.
Imagawa K, de Andrés MC, Hashimoto K, Pitt D, Itoi E, Goldring MB, Roach HI, Oreffo RO. The epigenetic effect of glucosamine and a nuclear factor-kappa B (NF-kB) inhibitor on primary human chondrocytes--implications for osteoarthritis. Biochem Biophys Res Commun 2011;405(3):362-7. View abstract.
Ju Y, Hua J, Sakamoto K, Ogawa H, Nagaoka I. Glucosamine, a naturally occurring amino monosaccharide modulates LL-37-induced endothelial cell activation. Int J Mol Med 2008;22(5):657-62. View abstract.
Ju Y, Hua J, Sakamoto K, Ogawa H, Nagaoka I. Modulation of TNF-alpha-induced endothelial cell activation by glucosamine, a naturally occurring amino monosaccharide. Int J Mol Med 2008;22(6):809-15. View abstract.
Kim CH, Cheong KA, Park CD, Lee AY. Glucosamine improved atopic dermatitis-like skin lesions in NC/Nga mice by inhibition of Th2 cell development. Scand J Immunol 2011;73(6):536-45. View abstract.
Kim DS, Park KS, Jeong KC, Lee BI, Lee CH, Kim SY. Glucosamine is an effective chemo-sensitizer via transglutaminase 2 inhibition. Cancer Lett 2009;273(2):243-9. View abstract.
Knudsen J, Sokol GH. Potential glucosamine-warfarin interaction resulting in increased international normalized ratio: Case report and review of the literature and MedWatch database. Pharmacotherapy 2008;28:540-8. View abstract.
Lee, Y. H., Woo, J. H., Choi, S. J., Ji, J. D., and Song, G. G. Effect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis. Rheumatol Int 2010;30(3):357-363. View abstract.
Levin RM, Krieger NN, and Winzler RJ. Glucosamine and acetylglucosamine tolerance in man. J Lab Clin Med 1961;58(6):927-932.
Liang CM, Tai MC, Chang YH, Chen YH, Chen CL, Chien MW, Chen JT. Glucosamine inhibits epidermal growth factor-induced proliferation and cell-cycle progression in retinal pigment epithelial cells. Mol Vis 2010;16:2559-71. View abstract.
Lin YC, Liang YC, Sheu MT, Lin YC, Hsieh MS, Chen TF, Chen CH. Chondroprotective effects of glucosamine involving the p38 MAPK and Akt signaling pathways. Rheumatol Int 2008;28(10):1009-16. View abstract.
Lopes Vaz A. Double-blind, clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulphate in the management of osteoarthrosis of the knee in out-patients. Curr Med Res Opin 1982;8:145-9. View abstract.
Madhu K, Chanda K, Saji MJ. Safety and efficacy of Curcuma longa extract in the treatment of painful knee osteoarthritis: a randomized placebo-controlled trial. Inflammopharmacology 2013;21(2):129-36. View abstract.
Marti-Bonmati, L., Sanz-Requena, R., Rodrigo, J. L., Alberich-Bayarri, A., and Carot, J. M. Glucosamine sulfate effect on the degenerated patellar cartilage: preliminary findings by pharmacokinetic magnetic resonance modeling. Eur Radiol 2009;19(6):1512-1518. View abstract.
McAlindon T, Formica M, LaValley M, et al. Effectiveness of glucosamine for symptoms of knee osteoarthritis: results from an internet-based randomized double-blind controlled trial. Am J Med 2004;117:643-9. View abstract.
McAlindon T. Why are clinical trials of glucosamine no longer uniformly positive? Rheum Dis Clin North Am 2003;29:789-801. View abstract.
McAlindon TE, LaValley MP, Gulin JP, Felson DT. Glucosamine and chondroitin for treatment of osteoarthritis: a systematic quality assessment and meta-analysis. JAMA 2000;283:1469-75. View abstract.
Monauni T, Zenti MG, Cretti A, et al. Effects of glucosamine infusion on insulin secretion and insulin action in humans. Diabetes 2000;49:926-35. View abstract.
Muller-Fassbender, H., Bach, G. L., Haase, W., Rovati, L. C., and Setnikar, I. Glucosamine sulfate compared to ibuprofen in osteoarthritis of the knee. Osteoarthritis Cartilage 1994;2(1):61-69. View abstract.
Muniyappa R, Karne RJ, Hall G, et al. Oral glucosamine for 6 weeks at standard doses does not cause or worsen insulin resistance or endothelial dysfunction in lean or obese subjects. Diabetes 2006;55:3142-50. View abstract.
Murphy RK, Ketzler L, Rice RD, Johnson SM, Doss MS, Jaccoma EH. Oral glucosamine supplements as a possible ocular hypertensive agent. JAMA Ophthalmol 2013;131(7):955-7. View abstract.
Naito K, Watari T, Furuhata A, Yomogida S, Sakamoto K, Kurosawa H, Kaneko K,Nagaoka I. Evaluation of the effect of glucosamine on an experimental rat osteoarthritis model. Life Sci 2010;86(13-14):538-43. View abstract.
Nandhakumar J. Efficacy, tolerability, and safety of a multicomponent antiinflammatory with glucosamine hydrochloride vs glucosamine sulfate vs an NSAID in the treatment of knee osteoarthritis--a randomized, prospective, double-blind, comparative study. Integr Med Clin J 2009;8(3):32-38.
Nieman DC, Shanely RA, Luo B, Dew D, Meaney MP, Sha W. A commercialized dietary supplement alleviates joint pain in community adults: a double-blind, placebo-controlled community trial. Nutr J 2013;12(1):154. View abstract.
Noack, W., Fischer, M., Forster, K. K., Rovati, L. C., and Setnikar, I. Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis Cartilage 1994;2(1):51-59. View abstract.
Nowak A, Szczesniak L, Rychlewski T, et al. Glucosamine levels in people with ischaemic heart disease with and without type II diabetes. Pol Arch Med Wewn 1998;100:419-25. View abstract.
Olszewski AJ, Szostak WB, McCully KS. Plasma glucosamine and galactosamine in ischemic heart disease. Atherosclerosis 1990;82:75-83. View abstract.
Ostergaard, K., Hviid, T., and Hyllested-Winge, J. L. [The effect of glucosamine sulphate on the blood levels of cholesterol or triglycerides--a clinical study]. Ugeskr Laeger 2007;169(5):407-410. View abstract.
Ostojic, S. M., Arsic, M., Prodanovic, S., Vukovic, J., and Zlatanovic, M. Glucosamine administration in athletes: effects on recovery of acute knee injury. Res Sports Med 2007;15(2):113-124. View abstract.
Park JY, Park JW, Suh SI, Baek WK. D-glucosamine down-regulates HIF-1alpha through inhibition of protein translation in DU145 prostate cancer cells. Biochem Biophys Res Commun 2009;382(1):96-101. View abstract.
Pavelka K, Gatterova J, Olejarova M, et al. Glucosamine sulfate use and delay of progression of knee osteoarthritis: A 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med 2002;162:2113-23. View abstract.
Persiani S, Rotini R, Trisolino G, et al. Synovial and plasma glucosamine concentrations in osteoarthritic patients following oral crystalline glucosamine sulphate at therapeutic dose. Osteoarthritis Cartilage 2007;15:764-72. View abstract.
Petersen, S. G., Beyer, N., Hansen, M., Holm, L., Aagaard, P., Mackey, A. L., and Kjaer, M. Nonsteroidal anti-inflammatory drug or glucosamine reduced pain and improved muscle strength with resistance training in a randomized controlled trial of knee osteoarthritis patients. Arch Phys Med Rehabil 2011;92(8):1185-1193. View abstract.
Pham T, Cornea A, Blick KE, et al. Oral glucosamine in doses used to treat osteoarthritis worsens insulin resistance. Am J Med Sci 2007;333:333-9. View abstract.
Phitak T, Pothacharoen P, Kongtawelert P. Comparison of glucose derivatives effects on cartilage degradation. BMC Musculoskelet Disord 2010;11:162. View abstract.
Poolsup N, Suthisisang C, Channark P, Kittikulsuth W. Glucosamine long-term treatment and the progression of knee osteoarthritis: systematic review of randomized controlled trials. Ann Pharmacother 2005;39:1080-7. View abstract.
Pouwels MJ, Jacobs JR, Span PN, et al. Short-term glucosamine infusion does not affect insulin sensitivity in humans. J Clin Endocrinol Metab 2001;86:2099-103. View abstract.
Provenza JR, Shinjo SK, Silva JM, Peron CR, Rocha FA. Combined glucosamine and chondroitin sulfate, once or three times daily, provides clinically relevant analgesia in knee osteoarthritis. Clin Rheumatol 2015;34:1455-62.View abstract.
Pujalte JM, Llavore EP, Ylescupidez FR. Double-blind clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis. Curr Med Res Opin 1980;7:110-4. View abstract.
Pujalte JM, Llavore EP, Ylescupidez FR. Double-blind clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis. Curr Med Res Opin 1980;7(2):110-14. View abstract.
Qiu GX, Gao SN, Giacovelli G, et al. Efficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis. Arzneimittelforschung 1998;48:469-74. View abstract.
Qiu GX, Weng XS, Zhang K, et al. [A multi-central, randomized, controlled clinical trial of glucosamine hydrochloride/sulfate in the treatment of knee osteoarthritis]. Zhonghua Yi Xue Za Zhi 2005;85:3067-70. View abstract.
Qiu W, Su Q, Rutledge AC, Zhang J, Adeli K. Glucosamine-induced endoplasmic reticulum stress attenuates apolipoprotein B100 synthesis via PERK signaling. J Lipid Res 2009;50(9):1814-23. View abstract.
Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulfate on osteoarthritis progression: a randomised, placebo-controlled trial. Lancet 2001;357:251-6. View abstract.
Reginster, J. Y. The efficacy of glucosamine sulfate in osteoarthritis: financial and nonfinancial conflict of interest. Arthritis Rheum 2007;56(7):2105-2110. View abstract.
Reichelt A. Efficacy and safety of intramuscular glucosamine sulfate in osteoarthritis of the knee. A randomised, placebo-controlled, double-blind study. Arzneimittelforschung 1994;44:75-80. View abstract.
Richy F, Bruyere O, Ethgen O, et al. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis. Arch Intern Med 2003;163:1514-22. View abstract.
Rindone JP, Hiller D, Collacott E, et al. Randomized, controlled trial of glucosamine for treating osteoarthritis of the knee. West J Med 2000;172:91-4. View abstract.
Rossetti L, Hawkins M, Chen W, et al. In vivo glucosamine infusion induces insulin resistance in normoglycemic but not in hyperglycemic conscious rats. J Clin Invest 1995;96:132-40. View abstract.
Rovati LC, Giacovelli G, Annefeld N, and et al. A large, randomized, placebo-controlled, double-blind study of glucosamine sulfate vs piroxocam and vs their association on the kinetics of the symptomatic effect in knee osteoarthritis. Osteoarth Cartilage 1994;2(suppl 1):56.
Rozendaal RM, Koes BW, van Osch GJVM, et al. Effect of glucosamine sulfate on hip osteoarthritis: A randomized trial. Ann Intern Med 2008;148:268-77. View abstract.
Rozendaal, R. M., Uitterlinden, E. J., van Osch, G. J., Garling, E. H., Willemsen, S. P., Ginai, A. Z., Verhaar, J. A., Weinans, H., Koes, B. W., and Bierma-Zeinstra, S. M. Effect of glucosamine sulphate on joint space narrowing, pain and function in patients with hip osteoarthritis; subgroup analyses of a randomized controlled trial. Osteoarthritis Cartilage 2009;17(4):427-432. View abstract.
Rozenfeld V, Crain JL, Callahan AK. Possible augmentation of warfarin effect by glucosamine-chondroitin. Am J Health Syst Pharm 2004;61:306-307. View abstract.
Russell RL, Pacelli KA, Kennedy KA. The development of multiple drug resistance in EMT6 cells after treatment with Brefeldin A (B), Tunicamycin (T), Hypoxia (H), 2-deoxyglucose (D), or Glucosamine (G). FASEB J 1993;7:A690.
Sakai S, Sugawara T, Kishi T, Yanagimoto K, Hirata T. Effect of glucosamine and related compounds on the degranulation of mast cells and ear swelling induced by dinitrofluorobenzene in mice. Life Sci 2010;86(9-10):337-43. View abstract.
Satia JA, Littman A, Slatore CG, Galanko JA, White E. Associations of herbal and specialty supplements with lung and colorectal cancer risk in the VITamins and Lifestyle study. Cancer Epidemiol Biomarkers Prev 2009;18(5):1419-28. View abstract.
Scotto d'Abusco A, Politi L, Giordano C, Scandurra R. A peptidyl-glucosamine derivative affects IKKalpha kinase activity in human chondrocytes. Arthritis Res Ther 2010;12(1):R18. View abstract.
Scroggie DA, Albright A, Harris MD. The effect of glucosamine-chondroitin supplementation on glycosylated hemoglobin levels in patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized clinical trial. Arch Intern Med 2003;163:1587-90. View abstract.
Setnikar I, Cereda R, Pacini MA, Revel L. Antireactive properties of glucosamine sulfate. Arzneimittelforschung 1991;41(2):157-61. View abstract.
Setnikar I, Giacchetti C, Zanolo G. Pharmacokinetics of glucosamine in the dog and in man. Arzneimittelforschung 1986;36(4):729-35. View abstract.
Setnikar I, Pacini MA, Revel L. Antiarthritic effects of glucosamine sulfate studied in animal models. Arzneimittelforschung 1991;41(5):542-5. View abstract.
Setnikar I, Palumbo R, Canali S, et al. Pharmacokinetics of glucosamine in man. Arzneimittelforschung 1993;43:1109-13. View abstract.
Setnikar I, Rovati LC. Absorption, distribution, metabolism and excretion of glucosamine sulfate. A review. Arzneimittelforschung 2001;51:699-725. View abstract.
Shankar RR, Zhu JS, Baron AD. Glucosamine infusion in rats mimics the beta-cell dysfunction of non-insulin-dependent diabetes mellitus. Metabolism 1998;47:573-7. View abstract.
Shaygannejad, V., Janghorbani, M., Savoj, M. R., and Ashtari, F. Effects of adjunct glucosamine sulfate on relapsing-remitting multiple sclerosis progression: preliminary findings of a randomized, placebo-controlled trial. Neurol Res 2010;32(9):981-985. View abstract.
Shikhman AR, Brinson DC, Valbracht J, Lotz MK. Differential metabolic effects of glucosamine and N-acetylglucosamine in human articular chondrocytes. Osteoarthritis Cartilage 2009;17(8):1022-8. View abstract.
Simon RR, Marks V, Leeds AR, Anderson JW. A comprehensive review of oral glucosamine use and effects on glucose metabolism in normal and diabetic individuals. Diabetes Metab Res Rev 2011;27(1):14-27. View abstract.
Smidt D, Torpet LA, Nauntofte B, Heegaard KM, Pedersen AM. Associations between labial and whole salivary flow rates, systemic diseases and medications in a sample of older people. Community Dent Oral Epidemiol 2010;38(5):422-35. View abstract.
Sobal G, Menzel J, Sinzinger H. Optimal 99mTc radiolabeling and uptake of glucosamine sulfate by cartilage. A potential tracer for scintigraphic detection of osteoarthritis. Bioconjug Chem 2009;20(8):1547-52. View abstract.
Stumpf JL, Lin SW. Effect of glucosamine on glucose control. Ann Pharmacother 2006;40:694-8. View abstract.
Sumantran VN, Chandwaskar R, Joshi AK, Boddul S, Patwardhan B, Chopra A, Wagh UV. The relationship between chondroprotective and antiinflammatory effects of Withania somnifera root and glucosamine sulphate on human osteoarthritic cartilage in vitro. Phytother Res 2008;22(10):1342-8. View abstract.
Swinburne LM. Glucosamine sulphate and osteoarthritis. Lancet 2001;357(9268):1617. View abstract.
Tallia AF, Cardone DA. Asthma exacerbation associated with glucosamine-chondroitin supplement. J Am Board Fam Pract 2002;15:481-4.. View abstract.
Tannis AJ, Barban J, Conquer JA. Effect of glucosamine supplementation on fasting and non-fasting plasma glucose and serum insulin concentrations in healthy individuals. Osteoarthritis Cartilage 2004;12:506-11. View abstract.
Tannock LR, Kirk EA, King VL, et al. Glucosamine supplementation accelerates early but not late atherosclerosis in LDL receptor-deficient mice. J Nutr 2006;136:2856-61. View abstract.
Tapadinhas MJ, Rivera IC, Bignamini AA. Oral glucosamine sulphate in the management of arthrosis: report on a multi-centre open investigation in Portugal. Pharmatherapeutica 1982;3(3):157-68. View abstract.
Theodosakis J. A randomized, double blind, placebo controlled trial of a topical cream containing glucosamine sulfate, chondroitin sulfate, and camphor for osteoarthritis of the knee. J Rheumatol 2004;31:826. View abstract.
Theoharides, T. C., Kempuraj, D., Vakali, S., and Sant, G. R. Treatment of refractory interstitial cystitis/painful bladder syndrome with CystoProtek--an oral multi-agent natural supplement. Can J Urol 2008;15(6):4410-4414. View abstract.
Thie NM, Prasad NG, Major PW. Evaluation of glucosamine sulfate compared to ibuprofen for the treatment of temporomandibular joint osteoarthritis: a randomized double blind controlled 3 month clinical trial. J Rheumatol 2001;28:1347-55. View abstract.
Tiku ML, Narla H, Karry SK, et al. Glucosamine Inhibits Advanced Lipoxidation Reaction and Chemical Modification of Lipoproteins by Scavenging Reactive Carbonyl Intermediates. American College of Rheumatology Meeting; October 25-29, 2002. Abstract 11.
Towheed TE, Anastassiades TP, Shea B, et al. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev 2001;1:CD002946. View abstract.
Towheed TE, Maxwell L, Anastassiades TP, et al. Glucosamine therapy for treating osteoarthritis. Cochrane Database Syst Rev 2005;(2):CD002946. View abstract.
Towheed TE. Current status of glucosamine therapy in osteoarthritis. Arthritis Rheum 2003;49:601-4. View abstract.
Towheed, T. E. and Anastassiades, T. P. Glucosamine therapy for osteoarthritis. J Rheumatol 1999;26(11):2294-2297. View abstract.
Tsai CY, Lee TS, Kou YR, Wu YL. Glucosamine inhibits IL-1beta-mediated IL-8 production in prostate cancer cells by MAPK attenuation. J Cell Biochem 2009;108(2):489-98. View abstract.
Uitterlinden EJ, Koevoet JL, Verkoelen CF, Bierma-Zeinstra SM, Jahr H, Weinans H, Verhaar JA, van Osch GJ. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants. BMC Musculoskelet Disord 2008;9:120. View abstract.
Vetter G. [Topical therapy of arthroses with glucosamines (Dona 200)]. Munch Med Wochenschr 1969;111(28):1499-502. View abstract.
Villacis, J., Rice, T. R., Bucci, L. R., El-Dahr, J. M., Wild, L., Demerell, D., Soteres, D., and Lehrer, S. B. Do shrimp-allergic individuals tolerate shrimp-derived glucosamine? Clin Exp Allergy 2006;36(11):1457-1461. View abstract.
Vlad, S. C., LaValley, M. P., McAlindon, T. E., and Felson, D. T. Glucosamine for pain in osteoarthritis: why do trial results differ? Arthritis Rheum 2007;56(7):2267-2277. View abstract.
von Felden J, Montani M, Kessebohm K, Stickel F. Drug-induced acute liver injury mimicking autoimmune hepatitis after intake of dietary supplements containing glucosamine and chondroitin sulfate. Int J Clin Pharmacol Ther 2013;51(3):219-23. View abstract.
Wangroongsub Y, Tanavalee A, Wilairatana V, Ngarmukos S. Comparable clinical outcomes between glucosamine sulfate-potassium chloride and glucosamine sulfate sodium chloride in patients with mild and moderate knee osteoarthritis: a randomized, double-blind study. J Med Assoc Thai 2010;93(7):805-11. View abstract.
Weimann G, Lubenow N, Selleng K, et al. Glucosamine sulfate does not crossreact with the antibodies of patients with heparin-induced thrombocytopenia. Eur J Haematol 2001;66:195-9. View abstract.
Wilkens, P., Scheel, I. B., Grundnes, O., Hellum, C., and Storheim, K. Effect of glucosamine on pain-related disability in patients with chronic low back pain and degenerative lumbar osteoarthritis: a randomized controlled trial. JAMA 2010;304(1):45-52. View abstract.
Wu D, Huang Y, Gu Y, Fan W. Efficacies of different preparations of glucosamine for the treatment of osteoarthritis: a meta-analysis of randomised,double-blind, placebo-controlled trials. Int J Clin Pract 2013;67(6):585-94. View abstract.
Wu YL, Kou YR, Ou HL, Chien HY, Chuang KH, Liu HH, Lee TS, Tsai CY, Lu ML. Glucosamine regulation of LPS-mediated inflammation in human bronchial epithelial cells. Eur J Pharmacol 2010;635(1-3):219-26. View abstract.
Xu HT, Chen Y, Chen LK, Li JY, Zhang W, Wu B. [Effect of various intervention factors on MMP-3 and TIMP-1 level in synovial fluid in knee joints with osteroarthritis]. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2008;33(1):47-52. View abstract.
Yamamoto, T., Kukuminato, Y., Nui, I., Takada, R., Hirao, M., Kamimura, M., Saitou, H., Asakura, K., and Kataura, A. [Relationship between birch pollen allergy and oral and pharyngeal hypersensitivity to fruit]. Nippon Jibiinkoka Gakkai Kaiho 1995;98(7):1086-1091. View abstract.
Yomogida S, Hua J, Sakamoto K, Nagaoka I. Glucosamine suppresses interleukin-8 production and ICAM-1 expression by TNF-alpha-stimulated human colonic epithelial HT-29 cells. Int J Mol Med 2008;22(2):205-11. View abstract.
Yomogida S, Kojima Y, Tsutsumi-Ishii Y, Hua J, Sakamoto K, Nagaoka I. Glucosamine, a naturally occurring amino monosaccharide, suppresses dextran sulfate sodium-induced colitis in rats. Int J Mol Med 2008;22(3):317-23. View abstract.
Yu JG, Boies SM, Olefsky JM. The effect of oral glucosamine sulfate on insulin sensitivity in human subjects. Diabetes Care 2003;26:1941-2. View abstract.
Yue QY, Strandell J, Myrberg O. Concomitant use of glucosamine may potential the effect of warfarin. The Uppsala Monitoring Centre. Available at: www.who-umc.org/graphics/9722.pdf (Accessed 28 April 2008).
Yun J, Tomida A, Nagata K, Tsuruo T. Glucose-regulated stresses confer resistance to VP-16 in human cancer cells through a decreased expression of DNA topoisomerase II. Oncol Res 1995;7:583-90. View abstract.
Zhang W, Doherty M, Arden N, et al. EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2005;64:669-81. View abstract.
Zhang, W., Nuki, G., Moskowitz, R. W., Abramson, S., Altman, R. D., Arden, N. K., Bierma-Zeinstra, S., Brandt, K. D., Croft, P., Doherty, M., Dougados, M., Hochberg, M., Hunter, D. J., Kwoh, K., Lohmander, L. S., and Tugwell, P. OARSI recommendations for the management of hip and knee osteoarthritis: part III: Changes in evidence following systematic cumulative update of research published through January 2009. Osteoarthritis Cartilage 2010;18(4):476-499. View abstract.
Zhu, Y., Zou, J., Xiao, D., Fan, H., Yu, C., Zhang, J., Yang, J., and Guo, D. Bioequivalence of two formulations of glucosamine sulfate 500-mg capsules in healthy male Chinese volunteers: an open-label, randomized-sequence, single-dose, fasting, two-way crossover study. Clin Ther 2009;31(7):1551-1558. View abstract.