Glucosamine and Glaucoma Risk with Family History
Individuals with a family history of glaucoma should avoid taking glucosamine supplements as they may increase intraocular pressure and contribute to glaucoma development. 1
Risk Assessment for Glaucoma
Family history is a significant risk factor for developing primary open-angle glaucoma (POAG). According to the Rotterdam Eye Study, individuals with a first-degree relative (sibling or parent) with confirmed POAG have 9.2-fold higher odds of developing the condition 2. The risk increases further when multiple family members are affected, with odds rising to fivefold higher when two or more siblings have glaucoma 2.
Key Risk Factors for Glaucoma:
- Family history of glaucoma
- Older age
- African, Latino, or Hispanic ethnicity
- Thin central corneal thickness
- Elevated intraocular pressure (IOP)
- Myopia
- Type 2 diabetes mellitus
- Low ocular perfusion pressure
Glucosamine and Intraocular Pressure
Recent research demonstrates a concerning relationship between glucosamine supplementation and glaucoma risk:
Increased IOP: A 2024 study found that glucosamine use was associated with increased corneal compensated IOP (p=0.002) in subjects without glaucoma 1.
Heightened Glaucoma Risk: Data from FinnGen revealed that glucosamine use significantly increased the risk of primary open-angle glaucoma (hazard ratio: 2.35) and glaucoma overall (hazard ratio: 1.95) 1.
Clinical Evidence: A randomized clinical trial showed that 34.1% of patients taking glucosamine experienced a clinically significant rise in IOP (≥2 mmHg) compared to only 12.5% in the placebo group (p=0.023) 3.
Age-Related Risk: The effect was more pronounced in elderly patients, with the mean age of those experiencing significant IOP rise being 66 years versus 57.7 years in those without significant rise (p=0.034) 3.
Clinical Implications for Patients with Family History
For individuals with a family history of glaucoma, the risk factors are compounded:
- Family history already increases glaucoma risk by 9.2-fold 2
- Adding glucosamine may further increase this risk through IOP elevation 1, 3
- The combination of these risk factors creates a particularly high-risk scenario
Recommendations
Avoid glucosamine: Patients with a family history of glaucoma should avoid taking glucosamine supplements due to the increased risk of developing glaucoma.
Regular screening: Individuals with family history of glaucoma should undergo regular comprehensive eye examinations to monitor for early signs of glaucoma.
Alternative treatments: For those with osteoarthritis who are considering glucosamine, discuss alternative treatment options with their healthcare provider.
IOP monitoring: If glucosamine must be used for other medical reasons, ensure regular monitoring of intraocular pressure by an ophthalmologist.
Pitfalls and Caveats
Some research suggests glucosamine may have protective effects against oxidative stress in retinal ganglion cells 4, but this potential benefit is outweighed by the documented risk of IOP elevation in those with family history of glaucoma.
The FDA label for glucosamine does not specifically mention glaucoma risk 5, highlighting the importance of staying current with emerging research.
While temporary visual improvements have been noted with glucose in some POAG patients 6, this should not be confused with the effects of glucosamine supplements, which appear to increase glaucoma risk.