Prescribing Advice for GPs

An NHS Prescribing Advisers' Blog

Glucosamine linked to liver failure

According to a story in the Telegraph, glucosamine has been associated with liver failure and death of a patient in Scotland.

The article gives details of a fit and healthy man aged 64 who started top take a glucosamine supplement. Shortly after starting this medication he fell ill and died of liver failure. A Consultant Gastroenterologist who treated this patient is also aware of two other cases where patients taking glucosamine have suffered reactions.

A cause and effect cannot be demonstrated but the potential for a link between the use of glucosamine and liver failure cannot yet be dismissed and is cause for concern.

Recent guidance from the National Institute for Health and Clinical Excellence (NICE) for osteoarthritis has advised clinicians that glucosamine supplements should not be prescribed.

Action: Clinicians should reflect on their prescribing practices for glucosamine. NICE do not recommend this treatment and it may not be free from risk.

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22 Comments to “Glucosamine linked to liver failure”

  1. I have been taking glucomine and chondroitin for several years, my last blood test showed I have fatty liver. They called it alkaline phosphate - 155, my doctor phoned me with some concern, that is why she arranged a second blood test. I have read the above comments and wanted to know would my liver function improve if I stop taking the glucosamine or is the damage done?

    Comment by Gill Dicker — November 13, 2017 #
    Reply

    1. @Gill

      If the Glucosamine supplement is the cause of the changed liver tests, stopping the pill should see the reuslt return to normal over time - it can be quick quick or maybe take a couple of months. However, there could be another cause in which case, stopping the glucosamine won't have any impact.

      Comment by Matthew Robinson — November 13, 2017 #
      Reply

  2. I was diagnosed with fatty liver 2014/15, I was shocked as I am so careful with my diet and would cut all fat away from my food. I followed a healthy varied diet.

    I took glucosamine for osteoporosis and arthritis/rheumatoid to get relief from joint pain. I took glucosamine twice a day for at least 2 - 3 years. After researching glucosamine and reading other people's reviews, I realised then that glucosamine is most likely the cause of my fatty liver and my blood results at present are still up and down. I instantly stopped taking this drug.

    What I would like to know is can I take a case against the manufactures that produce glucosamine? My health has deteriorated and the glucosomine could be one of the reasons for this.

    Comment by Trish — May 25, 2016 #
    Reply

    1. @Trish,

      You'd have to seek legal advice to assess whether you had a case and against whom you might be able to bring it. Some glucosamine is sold as a medicine while some is sold as a food supplement and there are several manufacturers so that will complicate things.

      Comment by Matthew Robinson — May 26, 2016 #
      Reply

      1. Thank you Matthew for your reply.

        I found myself searching this site yesterday and I noticed your reply. I was looking for this page so I could show my Dad as he has recently started taking Glucosomine. He is 80 years old and since showing him this page, he has decided not to continue taken GLM....

        Comment by Trish — June 29, 2016 #
        Reply

  3. I'm only 37 yrs old, just had my blood test 2 weeks ago, everything was ok except liver function just bit high. Doctor asking me if I have taken any herbal remedies which usually will cause it. Anyway my doctor say not to worry as it was just little bit high only. I told doctor I'd only taken glucosamine hydrochloride 500mg 3 times a day for the past 2 months. Now I wonder should I stop. I also happen to have asthma and high cholesterol (gd cholesterol) and a thalasemia anemia carrier. Any suggestion?

    Comment by Looveyable — July 24, 2013 #
    Reply

    1. @looveyable,

      Without being able to compare to liver test result before you started the glucosamine it's difficult to confirm the cause. Liver tests can comes bit a little outside 'normal' range and still be perfectly fine. If you haven't noticed any benefit from the glucosamine, I would suggest stopping them and having a repeat blood test in about a month. If you have noticed a benefit you might want to consider how large you feel the benefit has been and whether you would consider stopping the medication to have repeat tests done to see of the results normalise. If they do, then an even harder decision awaits, whether to restart the glucosamine or not.

      Comment by Matthew Robinson — July 24, 2013 #
      Reply

  4. I've also just had blood work done and my ALT and AST have doubled! My doctor was mystified but I did start taking glucosamine after my first round of blood work were my levels were on the normal/low side. I'm going to stop the glucosamine and I am scheduled for blood work again in early August. I'll let you all know the results.

    Comment by Kimmi — May 17, 2012 #
    Reply

  5. I have been taking glucosamine 1500mg tab now for more than two years and my doctor has been mystified at the slight rise in alt and ast blood tests. I only very occasionally take paracetamol and also take the odd diclofinac tab. When I do drink alcohol,(within the last five years anyway) always within safe limits and have far more alcohol free days than those not.
    I also have my tfts monitored and take thyroxine replacement.
    I wonder if it could be the glucosamine causing the problem?

    Comment by Barbara — July 19, 2011 #
    Reply

    1. @Barbara,

      It is a possibility and one worth exploring. Speak to your doctor first about stopping the glucosamine and see if your liver tests return to normal. Then to be even more sure you could restart the glucosamine and see if the liver tests rise for a second time. If this does happen it should be reported to your regulatory agency in your home country.

      Comment by Matthew Robinson — July 20, 2011 #
      Reply

  6. @Michael,

    I'm glad that you are recovered and now free from pain. If you have had blood tests showing liver problems and these have now also returned to normal then this is good news. I would encourage you to report this to you doctor so that regulatory authorities can be made aware of these events, such reporting helps to ensure drug safety as we learn from occurrences such as this.

    Comment by Matthew Robinson — July 15, 2011 #
    Reply

  7. I am a 50 year old male. I have never drank or smoked and am in pretty good health.
    I was taking glucosamine every day for joint pain. It was wonderful.
    I began to have over the course of 2 years severe liver pain. I was told by my doctor that I probably had a fatty liver, but no diet would help it.
    I ran out of glucosmine and had no time to refill for about 1 month.
    Suddenly one day I noticed that I had experiencec NO PAIN in my liver at all!
    I have not taken glucosamine for over 1 year now and have had NO further problems with my liver.
    I am convinced that Glucosamine was irritating and inflaming my liver.
    I now simply take MSM 1500. not as effective, but I must protect my liver.

    Comment by Michael — July 15, 2011 #
    Reply

  8. Hi Matthew I am very impressed with the prompt reply, thankyou so much for your expert advice, we will follow your recommendation & let you know the outcome.

    Kind regards

    Comment by Sue Leadbitter — September 29, 2010 #
    Reply

    1. @Sue,

      I'd like to know the outcome if you can find the time to let me know. Either way I hope your husband's liver tests return to normal range very soon.

      Comment by Matthew Robinson — September 29, 2010 #
      Reply

  9. My Husbands is 58 years old & liver function is 240, he is a very social drinker but had not had a drink for 3 weeks prior to blood test, after it was discovered on a routine blood test previously that it was over 300. He has been taking 1 Glucosamine 750 with Chondroitin 400 twice a day, could this be causing elevation of liver function?

    Comment by Sue Leadbitter — September 28, 2010 #
    Reply

    1. @Sue,

      I guess it is possible. Stop the glucosamine and have the liver function tests repeated after about a month. If they return to normal then the real test would be to restart the glucosamine and see if the levels rise again. Then you can be sure that the glucosamine is the cause.

      Comment by Matthew Robinson — September 28, 2010 #
      Reply

  10. @John

    I haven't seen anything further since this story broke in 2008. It may have been coincidence or it may be an extremely rare side effect.

    If you still have concerns ask your GP to do a blood test to check your liver so that you can get some reassurance.

    Comment by Matthew Robinson — January 10, 2010 #
    Reply

  11. I am a bit concerned with these reports on liver problems and taking G. I had a liver transplant in 2004 over a seperate health issue. My doctor prescribed G for me about 12 months ago due to pains in the knees Ostherisisis (whatever it is called), I really hope it will nor cause any problems with my new liver. I spoke with my doctor and he said nor to worry as there is no medical evidence to support any bad effects it would have on my liver. However I am bothered about it and u really don't want to stop taking G on unsupported evidence as it really helps my knee joints. I know this article is quite old, anyone know if there has been any further news on this issue since it's been posted?

    Comment by John Woj — January 10, 2010 #
    Reply

  12. [...] Prescribing Advice for GPs Glucosamine linked to liver failure Posted by root 12 minutes ago (http://www.prescriber.org.uk) Mar 6 2008 comment by matthew robinson march 10 2008 glucosamine supplement called chondromax containing 400mg marine chondroitin and 500mg optiflex glucosamine hci prescribing advice for gps is powered by wordpress Discuss  |  Bury |  News | Prescribing Advice for GPs Glucosamine linked to liver failure [...]

    Pingback by Prescribing Advice For GPs Glucosamine Linked To Liver Failure | Joint Pain Relief — June 8, 2009 #
    Reply

  13. Following recent blood tests while suffering severe headaches it was discovered there was a problem with my liver. This co-incided with me changing to a new Glucosamine supplement called ChondroMax containing 400mg Marine Chondroitin and 500mg Optiflex Glucosamine HCI.
    Cynthia Lawson - 21 April 2008

    Comment by Cynthia Lawson — April 21, 2008 #
    Reply

  14. It may be either medication or the combination. Stopping the anti-inflammatories is a reasonable step but I think I would also consider stopping the glucosamine given this recent information.

    Comment by Matthew Robinson — March 10, 2008 #
    Reply

  15. I have been taking glucosamine for a while, with consultants knowledge, after being diagnosed with arthritis in one knee, and a cartilage problem in the other. After a recent routine blood test, it was discovered I had a liver problem (I do not know specific details) but was advised to stop taking the anti-inflammatory medication. It would appear it may well be my glucosamine supplement, not the anti inflammatories that are to blame.

    Comment by JS — March 8, 2008 #
    Reply

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