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The side effects observed in various clinical trials with N-acetyl-D-glucosamine and glucosamine are few and mild. In the case of glucosamine sulphate or glucosamine hydrochloride the side effects may in part be due to the salt portion of the preparation. The salt portion of the molecule may make up as much as 40% of the administered dose. Side effects could also be due to numerous excipients in the available commercial preparations.

In the pediatric inflammatory bowel disease trial, patients were give 3 to 6 grams of N-acetyl-D-glucosamine daily in three divided doses. The authors report that in this high dose study "No adverse side-effects of treatment were noted in any patient" attributable to the N-acetyl-D-glucosamine¹.

The three year glucosamine sulphate study in osteoarthritis published in the Lancet is more detailed in its reporting of adverse events². Since this is a placebo controlled double blind study the adverse events reported by the placebo group puts these events in perspective. The proportion of patients reporting adverse events is presented in the table below.

Adverse Event (Reginater 2001)	Placebo (N=106)	Glucosamine Sulphate (N=106)
Abdominal Pain	18 (17%)	13 (12%)
Dyspepsia	8 (8%)	4 (4%)
Diarrhoea	11 (10%)	10 (9%)
Increased Blood Pressure	15 (14%)	15 (14%)
Decreased Blood Pressure	8 (8%)	2 (2%)
Cardiac Failure	7 (7%)	4 (4%)
Fatigue	7 (7%)	10 (9%)
Headache	4 (4%)	6 (6%)
Vertigo	3 (3%)	7 (7%)
Neuritis	6 (6%)	4 (4%)
Depressive Mood	7 (7%)	4 (4%)
Allergic Episode	7 (7%)	4 (4%)

In another three year trial³ the following adverse events were reported:

Adverse Event (Pavelka 2002)	Placebo (N=101)	Glucosamine Sulphate (N=101)
GI Tract and Liver	28%	25%
Musculoskeletal	22%	30%
Cardiovascular	20%	23%
Skin and Appendages	15%	10%
Respiratory Tract	7%	17%
Urinary Tract	11%	12%
Metabolic and Nutritional	8%	7%
Other	14%	14%

Most of the reported symptoms were transient and mild to moderate in severity. There was no statistical difference in adverse events between the placebo and the glucosamine sulphate groups.

Routine laboratory tests did not show any significant abnormalities in system organs or metabolic functions in the two groups during the study. There was no change in glycaemic homeostasis with fasting plasma glucose concentrations decreasing slightly in the glucosamine sulphate group.

These three clinical studies lead to the conclusion that glucosamine and N-acetyl-D-glucosamine have little if any potential for harm. This lack of potential for harm is further under scored by the fact that human breast milk contains up to 1,500 milligrams of N-acetyl-D-glucosamine per litre⁴. A newborn infant consumes up to 600 mL of breast milk per day. Thus a breast-feeding newborn may have a daily N-acetyl-D-glucosamine intake as high a 900 milligrams.

1 Salvatore, S., R. Heuschkel, et al. (2000). "A pilot study of N-acetyl glucosamine, a nutritional substrate for glycosaminoglycan synthesis, in paediatric chronic inflammatory bowel disease." Aliment Pharmacol Ther 14(12): 1567-79.

2 Reginster, J. Y., R. Deroisy, et al. (2001). "Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial." Lancet 357(9252): 251-6.

3 Pavelka, K. Gatterova, J. et al (2002) "glucosamine sulfate use and delay of progression of knee osteoarthritis." Arch Intern Med 162:2113 - 2123.

4 Miller, J. B., S. Bull, et al. (1994). "The oligosaccharide composition of human milk: temporal and individual variations in monosaccharide components." J Pediatr Gastroenterol Nutr 19(4): 371-6.

Notice: The information is intended to provide the reader with a comprehensive understanding of the science underlying the role of glucosamine and N-acetylglucosamine in the mammalian body. The scientific information on this site has been compiled from many different scientific sources. No specific therapeutic claims are made for any product. The information provided on this site is for general information purposes only and is not intended to qualify, supplement or replace that of your medical professional. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Your healthcare giver should undertake diagnosing and treating your medical condition.

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