Sulfate could mediate the therapeutic effect of glucosamine sulfate

Hoffer LJ, Kaplan LN, Hamadeh MJ, Grigoriu AC, Baron M · Metabolism

Three findings that reframe the whole sulfur question. Glucosamine sulfate raised serum sulfate from 331 to 375 umol/L at 3 h while having no effect on serum glucosamine. Taken with acetaminophen — cleared by sulfation — serum sulfate instead FELL, from 325 to 290 umol/L. And synovial fluid sulfate tracked serum sulfate almost exactly (r = 0.99, slope 0.97), so systemic sulfate status is transmitted directly into the joint. The authors predict non-sulfate salts of glucosamine will be ineffective.

Population

7 healthy subjects for the oral-dosing arm; 15 patients undergoing diagnostic knee aspiration for the synovial arm

Intervention

1.0 g oral glucosamine sulfate, alone or with 1.0 g acetaminophen; separately, oral sodium sulfate

Limitations

Small, non-randomized, and mechanistic — the authors state plainly that these results 'do not prove that glucosamine sulfate improves osteoarthritis'. Sulfate has never been tested as an intervention with a cartilage endpoint.