Death sparks safety concern over popular pain remedy
Liver expert tells inquiry three similar cases have emerged in Tayside area
A STRONG and healthy man died of catastrophic liver failure after taking an alternative medicine made from crab and lobster shells, an inquiry heard yesterday.
Norman Ferrie, 64, died within weeks of starting a course of glucosamine, the popular over-the-counter remedy, to tackle pain in his arthritic joints.
A liver expert told a fatal accident inquiry it was one of three similar cases that showed up at the same time in the Tayside area.
Ninewells Hospital consultant gastroenterologist, Dr John Dillon, 44, said the public should be warned about the potential danger of alternative remedies.
He said there was a public perception that alternative remedies were safe, despite them not undergoing strict clinical testing like prescribed medication.
Dr Dillon told the inquiry at Perth Sheriff Court: “We were confident the liver had been normal and that something had attacked it. It was an illness of weeks’ duration.
“He had been taking glucosamine to help with pain and arthritis in his joints. The dating of his illness was within a very short time frame of starting to take that.
“We had two other cases where the patient became ill after taking this. We were becoming suspicious of glucosamine causing a reaction and causing liver failure.
“He had stopped taking the glucosamine by the time we saw him. Our advice to him was not to re-start taking it,” Dr Dillon said.
Glucosamine is an aminomonosaccharide that occurs naturally in the body and is involved in the maintenance of connective tissue such as the cartilage. Most supplements are a manufactured, synthetic form of this compound or derived from shellfish shells, which means it may precipitate allergy in suscepti- ble individuals.
It is believed to be the first time that serious health concerns have been raised over glucosamine, which has been widely tested by mainstream medical authorities, with varying views as to its effectiveness.
The main hazards noted by the Medicines and Healthcare Products Regulatory Agency and the UK Commission on Human Medicines are over those who have seafood allergies and interactions with the blood-thinning drug warfarin.
Dr Kate McLintock, a GP and adviser to the Arthritis Research Campaign, said glucosamine was thought of by some researchers as better than ibuprofen in offering pain relief for people suffering from osteoarthritis.
She added: “No serious adverse reactions are known, but allergy to shellfish should be borne in mind. Some people may experience reversible problems such as stomach upset, headache, rash, itch, f lushing, drowsiness and insomnia.”
Mr Ferrie, from Invergowrie, started taking the glucosamine tablets in April or May 2004 and had become extremely ill by mid-June.
He was admitted to Ninewells Hospital in Dundee on June 30, but suffered liver failure and died in Edinburgh Royal Infirmary on July 3, 2004.
Dr Dillon said: “He didn’t respond to the therapy they used to treat the infection. The infection became so severe that it led to his ultimate demise.
“We have an association between glucosamine and this event and that is clearly very worrying.
“My advice would be that if a patient became aware of a difficulty after taking glucosamine then they should stop taking it immediately.”
Dr Dillon said i t wa s possible the case had been a “statistical fluke” but he hopes to publish a paper on the subject to raise the issue worldwide.
One of the most authoritat i ve t r i a l s w a s t h e G l u - cosamine/chondroitin Arthritis Intervention Trial (Gait) study, backed by the US National Institutes for Health, which concluded that overall, there were no significant differences between (glucosamine and chondroitin) and placebo.
However, for a subset of participants with moderate-tosevere pain, the treatment provided statistically significant pain relief.
There were 77 reports of serious adverse effects during the study, but only three were attributed to treatments. Most side effects were mild, such as upset stomach, and were spread evenly across the different treatment groups.
Mr Ferrie’s sister, Elaine, 59, had previously told the inquiry her engineer brother was generally a “strong and healthy” man.
“It seems incredible that a very strong and healthy man can die so quickly and the only unusual thing was he had taken glucosamine,” she said.