
Glucosamine Supplementation Reduces All-Cause Mortality: Study - mrfusion
https://www.lifespan.io/news/glucosamine-supplementation-reduces-all-cause-mortality/
======
evo_9
If you are interested in digging into this stuff, and what really works
medically/scientifically based on reviewed evidence and sources such as
Cochrane Reviews, I can't recommend Dr Stanfields youtube channel high enough:
[https://www.youtube.com/c/DrBradStanfield/videos](https://www.youtube.com/c/DrBradStanfield/videos)

Also here is his video on Sulforaphane which Glucosamine activates. He goes
into detail as to how this mechanism works. Because of his video/latest
research presented I changed to taking Broccomax because you need Myrosinase
to actvite the SGS for it's full effect, he goes into detail on this here:
[https://www.youtube.com/watch?v=qAb1eQbRAe0](https://www.youtube.com/watch?v=qAb1eQbRAe0)

Cochrane Review he uses as his primary source:
[https://www.cochrane.org/CD007176/LIVER_antioxidant-
suppleme...](https://www.cochrane.org/CD007176/LIVER_antioxidant-supplements-
for-prevention-of-mortality-in-healthy-participants-and-patients-with-various-
diseases)

~~~
hkt
Is a Cochrane review really a primary source? They're meta-analysis, which I'd
think of as secondary.

In the case linked, the analysis seems pretty unequivocally to not support
supplementing:

"We found no evidence to support antioxidant supplements for primary or
secondary prevention. Beta-carotene and vitamin E seem to increase mortality,
and so may higher doses of vitamin A. Antioxidant supplements need to be
considered as medicinal products and should undergo sufficient evaluation
before marketing."

Did I miss something?

~~~
JamesBarney
The op talks about sulforaphane but then links to an article about vitamin a
and e(I don't know why) They're totally different chemicals that work through
completely different pathways.

And a study on vitamin a and e etc doesn't tell you much about other
supplements. Just like how a study on does whether or not statins are
associated with reduced mortality tells you little about whether or not ACE
inhibitors are associated with reduced mortality.

Also I don't think op meant primary source as in primary vs secondary sources
but meant in the sense of "this doctor primarily uses Cochrane as his source
for information"

------
andrewem
The paper this is based on, which might be a better link:
[https://ard.bmj.com/content/79/6/829](https://ard.bmj.com/content/79/6/829)

~~~
faitswulff
The study says the participants were 62% female, overwhelmingly ate more
vegetables and supplements, exercised more than the control group, were mostly
white, as well as self reported glucosamine supplementation - without dosage
information. Overall it might be more indicative of wealth, education, and
fitness than the effect of glucosamine. The paper itself says it’s not able to
differentiate the effect from lifestyle changes:

> Third, regular glucosamine use may be a marker for a healthy lifestyle, but
> it is hard to distinguish the confounding effects of a healthy lifestyle
> from the impact of regular supplementations in an observational study.
> Although we had carefully adjusted for potential confounding lifestyle-
> related factors in our analyses, we could not exclude the possibility that
> the results were confounded by unmeasured lifestyle-related factors. In
> general, with the current observational study design the possibility of
> residual confounding due to imprecise measurements or unknown factors cannot
> be excluded for all findings in our study, despite our careful adjustment of
> all measured confounders.

~~~
m0llusk
That is possible but the large sample size may help. The study involved
roughly a half million people with around one hundred thousand supplementing
with glucosamine. With that many people and these big numbers the results are
rather strong.

~~~
Obi_Juan_Kenobi
Sampling addresses variance, not confounding factors.

If the sample is not representative of the broader population, then in no way
will any amount of sampling correct that error.

Observational studies often involve quite large samples, but they remain
unreliable because it is extremely difficult to address all possible
confounding factors. Experimental intervention is the gold standard for a
reason, and absent the ethical or practical impossibility of experimentation,
should be used here.

------
ve55
I've been supplementing glucosamine along with a large amount of other things
for awhile now. I'm not too bullish on it in humans, but it doesn't seem like
it hurts, and is definitely cheap:
[https://nearcyan.com/supplements](https://nearcyan.com/supplements)

My latest favorites that I'm a bit more hopeful for are glycine, spermadine,
and rapamycin.

~~~
jiggawatts
On Rapamycin: "The known adverse effects caused by sirolimus and marketed
analogs at the doses used in transplant regimens, especially the increased
risk of infection due to immunosuppression, as well as dose-dependent
metabolic impairment, make it unlikely that chronic, long-term treatment with
sirolimus could become a widely used anti-aging agent."

Sounds more than a little dangerous, unless you have an illnes like Lupus that
activates mTOR, and _even then_ I'd be nervous taking this drug without expert
medical supervision!

On the upside, my partner has a Lupus-like autoimmune disease, so this drug
will be an interesting one to track.

~~~
ve55
Yeah, I have it in a different section on my page mostly for that reason. It's
not something I'd ever encourage people to 'just take', in the way I might
some simple vitamins or minerals or so on that they might need.

Personally, I do think it can likely be taken pretty safely if monitored
reasonably, and I am pretty hopeful for it as well. But it's true it's a
serious drug so it shouldn't be messed around with as if it's a game.

------
hirenj
I wonder why we need to supplement glucosamine (e.g. to treat arthritis) when
it is synthesised by the body from glucose in one of our basic metabolic
pathways. I could only imagine this becomes a problem unless a) the enzymes
responsible stop working or b) if the glucose gets shunted off to some other
purpose.

It’s also funny that chondroitin supplementation does the job too, because it
actually contains no glucosamine, but contains monosaccharides that are
derived from glucosamine (N-acetyl Galactosamine).

I think there’s probably a very interesting answer to these metabolic
questions that could shed a lot of light onto the phenotypes of aging. That
said, I don’t know what evidence is out there for systemic lack of e.g.
glycosaminoglycans in aged populations, or even in arthritic cohorts.

~~~
hhas01
In absence of good, hard, scientific evidence of effects above and beyond
placebo, I’m gonna go with “Cos it’s easy to bottle and it’s easy to sell”.

And profitable too, I have no doubt. Thanks to Orrin Hatch, US supplement
peddlers don’t even have to prove their products are _safe_ , never mind
effective:

[https://en.wikipedia.org/wiki/Dietary_Supplement_Health_and_...](https://en.wikipedia.org/wiki/Dietary_Supplement_Health_and_Education_Act_of_1994)

I bet the oft-reviled Big Pharma (who, amusingly enough, are some of the
biggest manufactures of supplements too) just wish _all_ their products could
enjoy such lax standards of regulation. Meanwhile, to everyone else, I
wholeheartedly recommend The Poison Squad:

[https://www.pbs.org/wgbh/americanexperience/films/poison-
squ...](https://www.pbs.org/wgbh/americanexperience/films/poison-squad/)

[https://www.penguinrandomhouse.com/books/312067/the-
poison-s...](https://www.penguinrandomhouse.com/books/312067/the-poison-squad-
by-deborah-blum/)

------
nazca
I've given glucosamine to my dogs for years, and I can clearly notice a
difference in their joint health and how stiff and sore they are after long
runs ('long-run': 15-25 miles, measured on GPS collars). When I run out of
glucosamine, or just drop off of giving it to them for whatever reason, I see
them fall back pretty quickly. And when I restart them on it, I notice a
response in a few days.

I also give give them fish oil pills, but I've never been able to notice a
difference.

~~~
GloriousKoji
Purely anecdotal data but a I know a good number of dogs and cats that had
really good results supplementing with glucosamine. As for me personally and
few other friends and family, glucosamine supplements didn't have much of a
noticeable effect.

~~~
xvilka
Probably because we, humans, don't move as much as cats and dogs.

------
Fezzik
Like others, I give my dogs glucosamine and it seems to have clear health
benefits, but I have tried numerous dosages for myself and when I consume any
meaningful amount it gives me absolutely wretched headaches about a day or two
after consumption. Something to be aware if you start taking glucosamine and
get headaches, it’s probably the glucosamine.

~~~
beagle3
Perhaps you have some undiagnosed shellfish allergy?

FWIW, I've noticed iHerb has started selling shellfish-free glucosamine.

~~~
Fezzik
I had that thought but have never formally tested it. I do eat an above-
average amount of crab, clams, scallops, shrimp (tail on), etc... and I always
feel great afterwards. Obviously a glucosamine tablet is far more
concentrated, so I could very well be allergic.

I’ll definitely checkout that brand though!

------
CyberDildonics
This title is not the title of the study.

"Associations of regular glucosamine use with all-cause and cause-specific
mortality: a large prospective cohort study"

This does not mean it reduces all cause mortality. This is correlation, not
causation.

To take this further, there might be no limit to what you could correlate to
some degree with all-cause mortality, especially since it might be heavily
correlated to financial status, which would correlate to an enormous amount of
other behaviors (eating avocados, owning a swimming pool, having a high
ceiling, having your own bathroom, having a gym membership, organic food, name
brand laundry soap, not taking public transportation, better healthy
insurance, smoking habits, coffee quality, living in a low crime area, etc
etc). Determining cause and effect takes a lot of control variables.

~~~
bernie_simon
"The UK Biobank used a baseline touch screen questionnaire to assess several
potential confounders: sociodemographic characteristics (age, sex, ethnicity,
Townsend Deprivation Index, education and average total annual household
income), lifestyle behaviours (smoking status, alcohol consumption, physical
activity, body mass index (BMI) and vegetable and fruit consumption), health
conditions (CVD (myocardial infarction, angina or stroke), respiratory disease
(chronic obstructive pulmonary disease or emphysema), cancer, digestive
disease (liver failure, cirrhosis or alcoholic liver disease), dementia,
depression, longstanding illness, hypertension, diabetes and high
cholesterol), drug use (chondroitin, aspirin and other non-steroidal anti-
inflammatory drug (NSAID) use), vitamin supplementation (vitamin A, vitamin B,
vitamin C, vitamin D, vitamin E, multivitamin and folic acid) and mineral and
other dietary supplementation (calcium, iron, zinc, selenium and fish oil)). "

~~~
richdougherty
Still, the authors accept correlation as a potential objection, despite doing
their best to control for it. I suppose they need a randomised controlled
study or something to be more certain.

"Third, regular glucosamine use may be a marker for a healthy lifestyle, but
it is hard to distinguish the confounding effects of a healthy lifestyle from
the impact of regular supplementations in an observational study. Although we
had carefully adjusted for potential confounding lifestyle-related factors in
our analyses, we could not exclude the possibility that the results were
confounded by unmeasured lifestyle-related factors. In general, with the
current observational study design the possibility of residual confounding due
to imprecise measurements or unknown factors cannot be excluded for all
findings in our study, despite our careful adjustment of all measured
confounders."

------
shawncampbell
> This population-based prospective cohort study included 495 077 women and
> men (mean (SD) age, 56.6 (8.1) years) from the UK Biobank study.
> Participants were recruited from 2006 to 2010 and were followed up through
> 2018. We evaluated all-cause mortality and mortality due to cardiovascular
> disease (CVD), cancer, respiratory and digestive disease. HRs and 95% CIs
> for all-cause and cause-specific mortality were calculated using Cox
> proportional hazards models with adjustment for potential confounding
> variables.

> Regular glucosamine supplementation was associated with lower mortality due
> to all causes, cancer, CVD, respiratory and digestive diseases.

~~~
throw1234651234
I am guessing they didn't control for lifestyle, etc. Someone who takes
glucosamine either works out heavily and supplements (and probably watches
their diet), or had joint surgery, and falls into the first group to some
degree.

Edit: Yea, reading the study, I don't see anything about controlling for
fitness level. Running and caring about one's diet alone would account for
this effect without glucosamine.

~~~
brownbat
> Edit: Yea, reading the study, I don't see anything about controlling for
> fitness level.

They specifically control for the following lifestyle factors: "smoking
status, alcohol consumption, physical activity, body mass index (BMI) and
vegetable and fruit consumption."

(Ctrl+f for "covariates")

In the conclusion, they acknowledge: "Although we had carefully adjusted for
potential confounding lifestyle-related factors in our analyses, we could not
exclude the possibility that the results were confounded by unmeasured
lifestyle-related factors."

But if someone "works out heavily and supplements," that should show up in
self reported physical activity, and indirectly in BMI.

~~~
NickM
_But if someone "works out heavily and supplements," that should show up in
self reported physical activity, and indirectly in BMI._

Well, not to nitpick, but people with high muscle mass can easily end up with
an "obese" BMI even if they have very low body fat. And it also doesn't take
very many hours of working out per week to get jacked if you're doing heavy
weightlifting and supplementing.

No idea if such people are common enough to skew the results of this study
significantly, but it still makes me wonder a bit.

~~~
dogma1138
Even body builders will have a hard time of getting to obese levels of BMI
most of them are in the “overweight” range usually around 26-27.

And no people like this aren’t common at all.

------
nikolay
I've been a big fan of N-Acetyl Glucosamine (aka NAG), which is one of the
most underlooked safe supplement to deal with autoimmune disease. Could it be
the same as the mobility supplements with Glucosamine?

------
llama9000
The bit questioning its usefulness in addressing arthritis is pretty much
bullshit, as it's working for my parents and even my cat - Who went from
dragging himself around to going all jumpy within DAYS of having it mixed in
with the food.

Glucosamine + Chondrotin + MSM - This supplement combination is ideal.

~~~
MMTP
The evidence for Glucosamine alone to do much about arthritis is poor.
Glucosamine + Chondrotin + MSM is a different matter entirely and is not the
same as what the author is speaking about.

------
GekkePrutser
I do indeed note that my minor (RSI related) joint issues almost immediately
disappear when I take that stuff. It seems indeed quite beneficial.

~~~
gootdude
What dosage do you take and how long does the pain relief last?

~~~
GekkePrutser
I take Glucosamine / Chondroitine Complex 500/100mg. One or 2 per day.

It's hard to say how long, it does take a day or 2 to kick in (when I said
"immediately" I meant within a couple days when I start taking it. I probably
shouldn't have used that term.)

I'm not very strict with medication so I tend to stop it when I don't have
issues.

But especially in my elbows where I only have mild pain it seems to help a
lot. In my wrists it doesn't as much, but I think the pain there is not
totally joint-related.

------
viburnum
I wonder if humans used to eat more bones ... I had a physical anthropology
professor who studied an ancient site in east Africa where it appeared humans
got a fair amount of food from eating leftovers from lions and whatnot,
breaking open bones and eating marrow. Basically humans were in between the
predators and the vultures.

~~~
jdhawk
Yes, and even more recently, the stew pot extracted a lot more than the
boneless chicken breast of today.

------
Abaqus49
I was suffering from severe knee pain due to cartilage wear and started taking
liquid Glucosamine supplement as per doctor advice since 4 years. Now I'm
perfectly OK and run daily.

------
shadykiller
Quote: "Glucosamine is a polysaccharide that is found naturally in
cartilaginous joint tissues, bones, skin, ligaments, and nails"

Why not just eat natural sources like cartilage, bone broth, skin etc ?

~~~
jiofih
Interestingly most sources I could find on the web say categorically that “No
natural food sources of glucosamine exist”, while the the supplement is made
from sea shells. All resources related to canine health on the other hand
mention cartilage, bone marrow and beef trachea as rich in glucosamine...
someone is being dishonest there.

~~~
jagannathtech
Natural source means made by plants.

------
amasad
I wonder if you get enough of it on a highly carnivorous diet -- bone broth,
bone marrow etc.

~~~
GekkePrutser
I doubt it as many people mention it has great benefit on dogs, and their diet
is pretty much all that.

------
lettergram
Probably because those who are old start moving again with lower joint pain.

My 80 year old grandfather is the most fit person I know. Super healthy, but
literally lifts rocks and gardens every day.

To contrast other family members are in their 50s with diabetes and heart
conditions.

Keeping active is key. Remove peoples joint pain (which is what this
supplement is used for) and of course they reduce mortal across the board.

~~~
tomcam
Props to your grandfather. I can barely lift even a small garden.

~~~
jagannathtech
lol

------
hrishios
This is an impossible field to be working in - I know - and it's to do with
the way our medical research and treatment systems are set up.

We began as a species focused on making sick people healthy, and it's the way
the entire system works. It's near impossible to get studies approved that
tackle aging and proactive healthcare with drugs, as they will largely need to
look at the effects on people who are healthy now, but will almost assuredly
die from dementia, Alzheimer's and heart disease.

I understand why it is the way it is, but it's frustrating to see the system
wait until you have heart disease in your 70s before doing something about it.

~~~
hhas01
You do realize the reason people now die of dementia is because medical
science and improved standards of living have largely eliminated all the
things that used to kill them before they got old enough to develop it? The
same goes for cancers.

As for heart disease, that’s largely a product of lifestyle choices: smoking,
obesity, inactivity. And doctors already tell their patients to eat healthily
and exercise daily, but who wants to hear that when they’re young enough not
to feel the consequences, or old enough not to want to change their ways now?

Hence the eternal market for easy, quick magical pills and their silver-
tongued salesmen that promise to cure it all.

We began as a species programmed to spot the difference between a zebra and
lion on the plains of the Serengeti, and we’ve barely evolved since—if
anything, we’re even easier to hack now. Just ask the vampires.

------
matsemann
[https://examine.com/supplements/glucosamine/](https://examine.com/supplements/glucosamine/)

Always used this site when trying to find unbiased information, and also not
be to hyped about a single study. However now the effect matrix is hidden
behind a paywall.

When talking about joint health: As a young and very active person my biggest
problem is overtraining injuries. Wish I knew how to be able to train as much
as I would like to, with just a simple supplement or so...

~~~
adrr
There's always peptides that do work with mouse models but there aren't any
decent safety studies on them with humans. I really wish there was a push to
get safety and efficacy studies around BPC-157 and other peptides.

------
bhopballooo
Is it a simple case of pain-free joints enabling one to exercise more?

~~~
autisticcurio
Every time you move, the body releases adrenaline, so you are not far wrong in
your line of thought. The adrenal glands produces around 180 different
hormones including adrenaline, so protecting or even attempting to improve
their function would be a logical natural pain killing route to take. Hint
they are layer upon layer of epithelial cells. Of course other factors like
the body attacking itself is also a problem which the adrenal glands alone
cant "fix", for example too much sodium increases the Th17 cells to the point
they start attacking the body. T cells from Thymus, B cells from bone marrow.
However considering civilisations & Religions have existed for over
10,000years dating back to Sumerian times, observation was the only
"scientific" methods available at the time, and Religions had to keep their
followers healthy for the next attack, so looking into different religious
fasting methods could also improve health outcomes. The world record for a
water only fast, still in the Guinness book of world records is 382days,
carried out in 1971 at the University of Dundee. Having done an 18day water
only fast myself and felt like a teenager again, I'd highly recommend
investigating it to others. A US movement in the 1950's called the Hygienists
and Shelton were big advocates. Also consider the immune system attacks the
food we eat, so as our immune cell count falls during a fast, are there still
more immune cells now working solely removing damaged cells from the body? Its
suggested viruses need carbs as noted by the use of the Keto BCAA Lysine for
Cold Sores, bacteria builds biofilms when they go dormant in the body but are
not impenetrable to the attacking immune system either. So there seems to be
some merit with a water only fast for some, however sudden death is a risk to
those with undiagnosed conditions, a bit like we see with some seemingly
healthy people dying of covid. Either way, the human body, in fact any
lifeform is an extremely complex biochemical and electrical real time puzzle
where many chemicals play their part in lengthening life spans or shortening
life spans. I wouldnt bet my life on just one supplement, unlike Linus Pauling
and Vit C, its effects like all supplements, need to be put in context in the
scheme of things keeping us alive, healthy and happy.

------
hhas01
Article title is gross overreach, if not outright wrong.

IANAS, but even I know Correlation does not mean Causation. The paper itself
only says “associated with”, _not_ “responsible for”. Being an observational
study of self-selecting cohorts, even with the authors’ attempts to control
the confounders will be massive.

Honestly, this is the standard of reporting I’d expect from yellow-bellied
fish wrappers like the Daily Mail. Please do better.

------
ibobev
All-Cause Mortality? Is it make you also somehow immune to fire arms for
example? Just the title makes the article to view unserious.

~~~
jdhn
>Is it make you also somehow immune to fire arms for example?

No, you have to start off with daily injections of small arms fires (think .22
caliber) in order to begin building immunity. Over time you gain immunity and
then can work your way up to larger calibers.

~~~
tomcam
That was one of the low key funniest things I’ve ever read on hacking news

~~~
tomcam
Hacker News. I’m an idiot. But I stand by the rest!

------
oehtXRwMkIs
It's interesting to see that even on HN people don't know the difference
between correlation and causation.

~~~
Dayshine
Have you read the paper? They adjust for damn near everything including
reverse causation. What confounders do you believe the UK biobank data can't
account for?

~~~
oehtXRwMkIs
It doesn't matter if you eliminate 10 million confounds. No matter how good
your correlation study is, it cannot establish a causation. To do that you
need random assignment at the very least.

~~~
ncmncm
... and even that gives you the wrong answer if your diagnostic specificity is
faulty.

This last is why we keep seeing muddled reports that "antidepressants don't
work". Diagnosis of "depression" is a snakepit; the only known way to discern
which among at least six conditions you might have, all labeled "depression",
is to see what medications work, if any. Imagine trying to conduct a plausible
RCT for that.

"Gold standard"? Ha.

~~~
oehtXRwMkIs
Did you reply to the wrong comment?

~~~
ncmncm
I replied to "...it cannot establish a causation. To do that you need random
assignment at the very least."

~~~
oehtXRwMkIs
Oh, your quoting of "gold standard" really threw me off.

------
TedDoesntTalk
What dosage is recommended?

~~~
gniv
This other study suggests 2000mg per day:
[https://bjsm.bmj.com/content/37/1/45.short](https://bjsm.bmj.com/content/37/1/45.short)

------
lgats

       Regular glucosamine supplementation was associated with lower mortality due to all causes, cancer, CVD, respiratory and digestive diseases.
    

associated, not direct causation

------
bigpumpkin
are there dietary sources of glucosamine?

~~~
throw1234651234
Yes - cartilage. If you eat chicken or something like that, eat the cartilage.
You can do this on pre-cooked chickens you get from Sam's Club / Costco. If
you eat chicken breasts only (which a lot of health-conscious people do), you
don't get this benefit.

I talked to Dr.Yang Jwing Ming (one of the few Kung Fu practioners with a
Western phd and he said eating cartilage is one of the best ways to help
reduce the risk of arthritis. Oh, and pig ears too, but I never tried that,
being a Westerner and all.

~~~
lottin
Westerners have eaten pig ears for centuries.

~~~
hombre_fatal
I would be surprised if I've met anyone in the US who has eaten pig ear nor
the chicken feet you see next to them in the hispanic market. And just about
everyone would react to the ick factor.

I don't think it's as common as you think:
[https://en.wikipedia.org/wiki/Pig%27s_ear_(food)](https://en.wikipedia.org/wiki/Pig%27s_ear_\(food\)).

~~~
hellotomyrars
I don't really know of anyone who eats pig ears but chicken feet aren't that
weird for the American South.

------
m0zg
To people who put too much stock in these "studies", consider this: as of July
2020 we _still_ have no conclusive answer if _eggs_ are good for you or not.
What makes you believe this is any different?

~~~
fragmede
Why would eggs, for which there isn't a chemical formula, nor a standard
preparation, be _easier_ to study? What even does "good for you" mean?

Don't get confused between mass-media popular "science" and things science can
actually do - like measure whether a dozen eggs a day will raise your LDL and
HDL (cholesterol) and cause heart disease - and drawing wild conclusions
(especially right now) from pre-print articles that are used to sell magazine
articles to use as justification to eat chocolate and drink wine under the
guise of "it's good for you".

------
ryanmarsh
People who take glucosamine often do so BECAUSE of their active lifestyle,
most don't have a use for it otherwise.

This study did not control for lifestyle.

In other news, people who own Peloton shoes likely to live longer...

~~~
madacol
> Covariates

> The UK Biobank used a baseline touch screen questionnaire to assess several
> potential confounders: ..., lifestyle behaviours (smoking status, alcohol
> consumption, physical activity, body mass index (BMI) and vegetable and
> fruit consumption),

You seem to not have read other comments, where the same complaint is made,
and its answers.

