Glucosamine Sulfate Plus Chondroitin Sulfate, Bromelain, Turmeric Root, and Ginger Root by ITI (Integrative Therapeutics Inc.) - Controlled Time-Release Formula

Size: 90 Tablets

Take 1 tablet three times daily with meals or as directed by your healthcare practitioner. Use for a minimum of four weeks to obtain maximum benefits.

Glucosamine Sulfate 2KCI 500 mg

(from shrimp, crab, or lobster)

Chondroitin Sulfate (bovine) 200 mg

Proprietary Blend

Bromelain, Turmeric Root, and Ginger Root 15 mg

Other Ingredients: stearic acid, hydrogenated cotton seed oil, cellulose, silicon dioxide, magnesium stearate, and ethylcellulose.

Glucosamine sulfate is a well-absorbed source of glucosamine, an important precursor for the synthesis and maintenance of connective tissues. Chondroitin sulfate also supports formation of connective tissues, primarily joint cartilage, and helps protect existing cartilage.

Bromelain, Turmeric Root, and Ginger Root, provide powerful anti-inflammatory action and help speeding the healing of inflammed joints.

Glucosamine is a naturally occurring amino sugar found ubiquitously in glycoproteins and glycosaminoglycans. Glycosaminoglycans, formerly named mucopolysaccharides, are an integral component of all connective tissues. Connective tissue, a fibrous type of body tissue, has various functions. It supports and connects internal organs (ligaments), forms bone, cartilage, and the walls of blood vessels, attaches muscles to bones (tendons), and replaces tissues that have been damaged following injury. The two main components of connective tissue are collagen and proteoglycans. Collagen is the strong, fibrous protein that physically connects our tissues. Proteoglycans are large carbohydrate-rich structures, resembling a bottlebrush in three-dimensional structure, i.e., a central protein rod with many strings of glucosamine-containing glycosaminoglycans extending outwards. Proteoglycans hold large amounts of water forming a stiff gel by virtue of their dense negative charges from sulfates. Proteoglycans are linked to collagen fibers to help form connective tissues, and proteoglycans provide resiliency, load distribution, shock-absorbing, compressive and lubricating properties to connective tissues and joints.

Glycosaminoglycans and proteoglycans are continuously being formed and replaced in connective tissues. Remodeling of connective tissues is also continuous, albeit slowly, with turnover half-lives of almost two years in healthy human joints. Turnover is accelerated in wound healing, arthritic joints, and burns. New synthesis of glycosaminoglycans has clinical importance in skin during normal wound healing, in bone during fracture repair and osteoporosis, and in joints. In these instances, glycosaminoglycan synthesis is necessary for healing, and enhancement of glycosaminoglycan and proteoglycan deposition may improve tissue repair. Glycosaminoglycans are synthesized primarily by fibroblasts (skin, tendons, ligaments), osteoblasts (bone), and chondrocytes (cartilage). Thus, the cell’s ability to manufacture glycosaminoglycans and secrete proteoglycans is crucial during any healing or joint disease process.

The availability of glucosamine is the key, rate-limiting step in glycosaminoglycan and proteoglycan synthesis in all connective tissues, such as skin, bone, cartilage, tendons, and ligaments. Only with sufficient glucosamine, the synthesis can proceed. The body has a long metabolic pathway to synthesize a glucosamine derivative, UDP-N-acetylglucosamine, which is used for glycosaminoglycan synthesis. In addition, exogenous, i.e., dietary, glucosamine serves as an immediate precursor for glycosaminoglycan synthesis, and also stimulates incorporation of other precursors into the connective tissue matrix. Chondroitin sulfate, a glycosaminoglycan formed in the body, is also used for the synthesis and maintenance of connective tissue, primarily within the cartilage matrix. In addition, chondroitin sulfate protects existing cartilage by reducing water loss from the matrix and by inhibiting the enzymatic breakdown of the cartilage.

The overlapping activities as well as functional differences of glucosamine and chondroitin sulfate offer several advantages for combined supplementation. Although glucosamine is a precursor for chondroitin synthesis, this process requires large amounts of metabolic energy. Dietary preformed chondroitin sulfate spares the use of glucosamine for this purpose. Instead glucosamine can be used for formation of other important glycosaminoglycans and proteoglycans. When adequate chondroitin sulfate is thus available to help protect tissues from premature breakdown, glucosamine can more readily stimulate synthesis of healthy new tissue.

Glucosamine is almost universally found in small amounts in most foods. However, bioavailability of glucosamine from foods is largely unknown. Bioavailability of oral glucosamine sulfate is excellent. It is absorbed intact, and utilized very quickly by all tissues, including connective tissues. Chondroitin sulfate is found in most animal tissues. Orally ingested chondroitin sulfate is also well absorbed and distributed to tissues. In summary, glucosamine sulfate is a well documented, highly effective source of glucosamine for glycosaminoglycan and proteoglycan synthesis in all connective tissues. Chondroitin sulfate is an excellent source of n-acetylgalactoaminoglycan for synthesis and protection of proteoglycans associated with cartilage tissues.

Last year (year 2000) a 6-month double-blind placebo-controlled study of combined glucosamine, chondroitin and manganese found evidence of significant improvement in the treated group.¹

A double-blind study compared glucosamine sulfate against placebo in 252 people with osteoarthritis of the knee.² After 4 weeks, the group that was given glucosamine experienced significantly reduced pain and improved movement, to a greater extent than the improvements seen in the placebo group.

One double-blind placebo-controlled studies involving a total of several hundred participants suggest that chondroitin can relieve symptoms of osteoarthritis. One study enrolled 85 people with osteoarthritis of the knee and followed them for 6 months.⁵ Participants received either 400 mg of chondroitin sulfate twice daily or placebo. At the end of the trial, doctors rated the improvement as good or very good in 69% of those taking chondroitin sulfate but in only 32% of those taking placebo.

Good results were seen in a 12-month double-blind trial that compared chondroitin against placebo in 104 individuals with arthritis of the knee.⁶

1. Das A Jr and Hammad TA. Efficacy of a combination of FCHG49 glucosamine hydrochloride, TRH122 low molecular weight sodium chondroitin sulfate and manganese ascorbate in the management of knee osteoarthritis. Osteoarthritis Cartilage. 2000;8:343-350.

2. Noack W, Fischer M, Forster KK, et al. Glucosamine sulfate in osteoarthritis of the knee. Osteoarthritis Cartilage. 1994;2:51-59.

3. Rovati LC. A large, randomized, placebo controlled, double-blind study of glucosamine sulfate vs. piroxicam and vs. their association, on the kinetics of the symptomatic effect in knee osteoarthritis. Osteoarthritis Cartilage. 1994;2(suppl 1):56.

4. Rovati LC. The practical development of a selective drug for osteoarthritis: glucosamine sulfate. Presented at: The Ninth EULAR Symposium; October 7-10, 1996; Madrid, Spain.

5. Bucsi L, Poor G. Efficacy and tolerability of oral chondroitin sulfate as a symptomatic slow-acting drug for osteoarthritis (SYSADOA) in the treatment of knee osteoarthritis. Osteoarthritis Cartilage. 1998;6(suppl A):31-36.

Patients who are taking the blood-thinning medication heparin -- whose molecular structure is similar to chondroitin -- should have their blood clotting activity monitored if they add chondroitin. Taking both at the same time could increase the risk of bleeding.

Diabetic patients wanting to try glucosamine (an amino sugar) should consider potential effects on their blood sugar control and monitor their blood sugar level. If you're allergic to shellfish, avoid taking glucosamine, which is made from crab, lobster, or shrimp shells.

This is a statement of nutritional support. This statement has not been evaluated by the FDA. This product is not intended to medically diagnose, treat, cure, or prevent any disease.