Study Finds Glucosamine Associated with the Highest Number of Adverse Events in Complementary Health Products

The Singapore Health Sciences Authority (HSA) received 727 adverse event reports associated with CHPs.
CHPs encompass Chinese Proprietary Medicines, health supplements, and traditional medicines (e.g., Malay traditional medicine, Jamu, and Ayurvedic medicine).
The primary motivations for using CHPs were:
- Pain relief: 33%
- General health and well-being: 21%
- Weight management: 9%

Skin reactions accounted for nearly 60% of adverse events, with symptoms like rash, itching, and facial swelling.
Glucosamine-containing products were linked to about 65% of skin reactions, followed by melatonin and dried ivy leaf extract products.
General disorders (e.g., pain, fever) and liver disorders (e.g., hepatitis, jaundice) were also reported, along with endocrine issues primarily related to corticosteroid adulteration.

68.1% of adverse events stemmed from health supplements, while 10.7% were linked to Chinese Proprietary Medicines.
Accessibility of these products contributes to usage without adequate oversight, increasing potential risks.

Only 10% of the 727 products were tested for adulteration:
- 77% of those tested contained undeclared drugs, sometimes with multiple adulterants.
Common adulterants found include NSAIDs and steroids, posing risks like cardiovascular complications and diabetes.
Notable examples of adulterated products:
- Traditional Herbs Preparation XPE – contained steroids, antihistamines, and antibiotics.
- CHONG CAO DAN – linked to Cushing’s syndrome after prolonged use.

Despite the general safety of CHPs, there remains a risk of serious adverse events due to adulteration.
The findings underscore the need for enhanced post-market surveillance and increased consumer awareness to protect public health.

For more information, refer to the publication in Frontiers in Medicine: DOI: 10.3389/fmed.2026.1872698.