Buyers Guide to Joint Health Supplements

Buyer’s Guide To Joint Health

Dietary Supplements

www.wisdomandhealth.com(800) 488 1887

[email protected]: http://wisdomandhealthblog.wordpress.com/

1

Version 1.0

The information presented here is not intended to be medical advice.

Although the products discussed here are very safe, we recommend

discussing your own medical situation with your own doctor, pharmacist, or

other health care professional.

Please keep all medications out of the reach of children.

2

Who should read this?

3

Who should read this?This report is intended for multiple audiences...all of whom have something in common:

You are concerned about your joint health.

Perhaps you have the earliest stages of osteoarthritis?

Or, perhaps you have been diagnosed with osteoarthritis in the knee or hip, and are looking for something to prevent the disease from getting worse?

Maybe you are fighting chronic pain in the knee or hip, and would like to find an all-natural, drug-free way to deal with the pain?

This report is for you!

We are very fortunate to live in an era where there are so many different natural and dietary supplement options to help deal with these problems.

But...choosing a product can be a challenge!

For example, suppose you want to take a glucosamine product. Is the 1000-capsule superstore bottle good enough? Or do I need something of higher quality?

Should I take chondroitin as well?

What is MSM? Should I take that as well?

4

Who should read this?Will antioxidants help?

If so, which ones?

Are there other ingredients that could also help?

And so on…

With this report, our goal is to address these questions.

However, every person is different. What may work for you may not work for your neighbor.

So always check with your doctor, read as much information as you can, and experiment a little to see what works best for YOU.

Once you find a regimen that works, stick with it!

Hopefully, by the end of this report, you will have some ideas for changing the way you deal with your arthritis, osteoarthritis, and joint pain.

5

Why listen to me?

6

Why listen to me?I am Carlos N. Velez, the owner of www.WisdomAndHealth.com. I hold a Bachelor of Science in Pharmacy degree from the Albany College of Pharmacy, a Ph.D. in Pharmaceutical Science from the University of North Carolina at Chapel Hill, and an MBA in Finance from the Rochester Institute of Technology.

As a pharmacist and pharmaceutical scientist, I have a very strong background in the different ways to treat a variety of diseases.

I’m especially interested in helping our customers find non-prescription approaches, such as over-the-counter products, natural remedies, dietary supplements, and medical equipment.

Our goal is to find the best products available, no matter who makes them. As long as they are of excellent quality and are backed by scientific proof, then we will carry them in our store.

However, If we find something that works better, we’ll change our web site and tell you why we’ve made the change. This is why we don’t carry products under our own label. We have no bias towards one particular brand or another. We just focus on what’s best. Period.

And if you don’t see a product that you like, please let us know! We’re constantly looking for new, interesting, safe, effective products to share with others.

Thanks for reading, and for visiting

www.WisdomAndHealth.com

7

That’s me!

What is osteoarthritis?

8

What is Osteoarthritis?Osteoarthritis (OA) is the most common form of arthritis, and is the leading cause of chronic disability.

OA is thought to be caused by long-standing, persistent, mechanical stress on key joints, such as the knee or the hip.

OA is not restricted to these joints. Fingers, elbows, and wrists are also susceptible to this debilitating disease.

This constant stress leads to the breakdown of the cartilage in these joints, resulting in insufficient cushioning in the joints. This leads to bone-on-bone rubbing, which can be very painful.

OA is treated with analgesics and non-steroidal anti-inflammatory agents, such as ibuprofen, naproxen, diclofenac, and others.

These drugs work because they reduce pain and inflammation. Unfortunately, they do not affect the underlying cause of the disease, and are certainly not able to slow or reverse the disease.

Further, anti-inflammatory drugs can cause serious gastrointestinal and cardiovascular side effects.

In fact, several studies note that only 15-20% of patients will continue a given non-steroidal anti-inflammatory drug for more than a year, due to side effect issues.

9

What Causes OA?There is no single, direct cause of OA. Each person may develop RA due to one or more of these causes:

Overuse, such as repeated bending of a knee for work

Injuries are a leading cause of OA in former amateur and pro athletes

Heredity, especially in people born with joint abnormalities.

10Image Source: www.WebMD.com

Wisdom for your Health: Weight gain

can place a lot of undue stress on your knees and hips, increasing the chance of

developing OA.

What is glucosamine?

11

GlucosamineMany patients take glucosamine supplements to help deal with osteoarthritis. Why are they so popular? Do they really work?

Glucosamine is a simple sugar. It is one of the key building blocks for many different tissues, such as bones, and bone marrow.

Glucosamine is also a building block of the glycosaminoglycans, which are the major component of joint cartilage.

Recall that the joint cartilage is the white material between joints. This material is the “shock absorber” between joints.

In OA, this shock absorber material is reduced, or outright missing in severe cases.

So how can we make more? By taking glucosamine in our diets, our bodies can take these building blocks and make more of the glycosaminoglycans that our joints need.

12

Glucosamine

Glucosamine ControversiesHowever, the consumption of glucosamine for the maintenance of joint health is very controversial, for several reasons:

Salt form: Glucosamine supplements come in different salt forms, such as glucosamine sulfate, glucosamine hydrochloride, and N-acetylglucosamine. Which one is the best form?

This controversy was pretty much laid to rest, thanks to a series of studies demonstrating that the sulfate form was able to enter into the blood stream and deposit in the synovial spaces of the knee after oral dosing.

(Persiani, et al., 2005; Persiani et al., 2007)

However, a number of large clinical studies showed that glucosamine hydrochloride had no benefit! This is likely because much less glucosamine was entering the circulation as the hydrochloride form, as opposed to the sulfate form.

It is clear to us that any good glucosamine supplement should use the sulfate form, and not the hydrochloride form.

13

Wisdom for your Health: Make sure your

supplement uses glucosamine sulfate, not glucosamine

hydrochloride!

Glucosamine ControversiesInflammation: There are also studies that suggest that the glucosamine supplements work in OA not because they help replace lost joint cartilage, but because they have anti-inflammatory properties.

Several studies have shown that glucosamine sulfate inhibits substances that increase inflammation. Interestingly, studies demonstrated that glucosamine may have anti-inflammatory properties in mice with rheumatoid arthritis, a different form of arthritis compared with OA

(Azuma et al., 2012).

Going overboard: As with any drug or supplement, glucosamine may not work for

some people. Or, in some cases, the effect may be so mild as to be unnoticeable.

Because of this, some folks decide to exceed recommended dosages, resulting in side effects like constipation, diarrhea, upset stomachs, and the like. Fortunately, these are mild, and disappear as the dose is reduced.

Extra Cost: There are a wide range of price levels for glucosamine supplements, from cheap 1000-capsule bottles to expensive, 30-capsule bottles.

Are the cheap products good enough? Is there a strong reason to buy the more expensive one? It can be quite confusing.

14

Glucosamine ControversiesGenerally speaking, as long as the product is manufactured by a reputable company, you should be ok.

It is more important to make sure the product has the sulfate form of glucosamine.

Also, while a glucosamine-only product may be sufficient for some people, we have to recognize that OA is a rather complex disease that demands a complex approach.

As a result, it is important to use a glucosamine sulfate supplement which has other, complimentary ingredients, such as antioxidants.

While a combination product will likely be more expensive, it will also likely be more helpful in maintaining and improving your joint health.

One ingredient which commonly appears in glucosamine supplements is chondroitin. In the next section, we take a closer look at chondroitin, and explore whether or not it is necessary for the maintenance of joint health.

15

What is chondroitin?

16

ChondroitinSome glucosamine supplements contain chondroitin, while others don’t. What is chondroitin, and is it really necessary?

Chondroitin is a glycosaminoglycan, and consists of two building blocks: N-acetyl-galactosamine and glucuronic acid.

It is also one of the constituents of healthy cartilage, which is the reason why it is usually combined with glucosamine.

So if chondroitin is a normal part of cartilage, and if OA is a disease where cartilage is lost, then supplements with chondroitin make sense, right?

Well, not always.

The main problem with chondroitin is that there is little evidence that combining it with glucosamine makes for a better product. While the logic of combining them is sound, evidence supporting the combination is lacking.

It also appears from the literature that using a building block like glucosamine is a more efficient way to build cartilage, as opposed

17

Chondroitin

Chondroitinto ingesting the full, intact glycosaminoglycan.

This question of whether or not to include chondroitin is undoubtably controversial. So ask 10 different people and you may receive 10 different answers!

Our advice is that if you are already taking a chondroitin-containing formula, and if it is working for you without side effects, then you should stick with it.

Ideally, a glucosamine pus chondroitin formula should also contain other ingredients to help deal with the issues associated with OA, such as pain and inflammation.

In the next section, we discuss a few other common ingredients found in joint health dietary supplements, beginning with one that is perhaps the most controversial ingredient of them all!

18

Let’s talk about MSM

19

MSMPerhaps no other ingredient in dietary supplements for joint health has triggered more controversy than MSM. What is it? And does it really help maintain joint health?

MSM is short for methylsulfonylmethane, a relatively simple compound that is present in many foods and beverages.

In 2003, the book MSM the Definitive Guide by Stanley Jacob was published. Instantly, the health care community accepted, then rejected the notion the MSM has any health benefits. Critics argued that there is no evidence that MSM does anything due to a lack of large-scale clinical trials.

Fortunately, this omission has been partially addressed. In 2011, a small clinical trial involving nearly 50 OA patients, researchers demonstrated that MSM three times daily helped with physical function and pain. However, this effect was small. Further, it was unclear if a higher dose, or if dosing for longer periods of time would yield better results (Debbi, et al. BMC Complement Altern Med. 2011 Jun 27;11:50)

20

Methylsulfonylmethane

MSMSo should you take MSM as part of

your joint health regimen?

The initial signs are very promising, given the results of the one clinical trial conducted so far.

Importantly, MSM is quite safe. A number of studies in mice have demonstrated that incredibly high daily doses for prolonged periods of time caused no ill effects. In humans, doses up to 6 grams a day have been studied, with no serious side effects noted.

One huge drawback with MSM is the dose. A number of studies suggest that for OA, a

dose of 500 milligrams three times a day is necessary to achieve any benefit.

Some clinical trials demonstrated that MSM improved symptoms of OA pain and physical function at doses of 3,000 milligrams a day! That’s a huge dose.

An interesting clinical study compared glucosamine alone with MSM alone and with the combination. The researchers found that the combination of glucosamine and MSM worked better in OA for both pain and inflammation (Usha and Naidu, Clin Drug Investig. 2004;24(6):353-63).

So, our take is that including MSM in a glucosamine supplement may help.

21

What have we learned so far?

22

Summary So FarOsteoarthritis is a painful condition of the joints, caused by a progressive loss of the shock-absorbing cartilage in between the joints.

Glucosamine-containing dietary supplements have been available for many years to deal with OA.

The clinical evidence suggests that glucosamine can help deal with the pain and loss of function associated with OA, and possibly RA as well.

Glucosamine sulfate is the preferred form to take

Adding chondroitin to the supplement is controversial. One could probably do away with it.

MSM, on the other hand, has been shown to compliment glucosamine when combined.

23

Do antioxidants have a role in

OA?

24

Antioxidants in OA?YES!

There is no question that increasing the amount of antioxidants we consume will help with OA, and likely with many other health issues.

However, this simple statement raises a few questions:

1. Which antioxidants?

2. What doses?

3. Should I combine them with glucosamine supplements?

Let’s take these one at a time.

Before tackling these questions, let’s first talk about what antioxidants are, and how they can help with our joint health.

First, antioxidants are compounds such as Vitamin C or Vitamin E that block oxidation. Oxidation is a type of important chemical reaction that takes place in all of the cells in our body. However, excessive oxidation, or exposure to oxidants in the environment, can lead to health issues.

Oxidation is known to play a key role in a number of diseases, such as Alzheimer’s, heart disease, and certain types of cancer.

25

Vitamin C & OAAntioxidants are part of the reason why we need to eat plenty of fruits and vegetables. These foods are rich in Vitamin C, which is an excellent antioxidant.

Critically, vitamin C is essential for the synthesis of collagen and glycoaminoglycans, the building blocks of many tissues, including joint cartilage.

But can taking antioxidants like vitamin C really help in OA?

Again, there are mixed results in the clinical literature. One of the more interesting studies states:

“...these data suggest that vitamin C supplementation may indeed be beneficial in

preventing incident knee OA.”

(Peregoy & Wilder, Public Health Nutr. 2011 Apr;14(4):709-15.)

In our view, Vitamin C has benefits beyond any potential benefit in OA. Importantly, Vitamin C is very safe. So we view having Vitamin C in a glucosamine supplement as a bonus.

If your supplement does not have Vitamin C, we believe it is not harmful, and potentially beneficial, to take an extra 50-100 milligrams of Vitamin C every day.

26

Other Antioxidants in OAAre there other antioxidants that may help with joint health?

If you review the literature like we have, you will find a number of in vitro, animal, and human studies exploring the use of antioxidants in OA or other forms of arthritis. Here are a few that we found most interesting:

Ventol, an antioxidant derived from Ecklonia cava (a brown algae found in Asia), has been shown to slow the degradation of proteoglycans in models of OA.

(Kang, et al. Res Commun Mol Pathol Pharmacol. 2004;115-116:77-95.)

Fruit peel extracts, such as passion fruit peel

extract, have demonstrated positive results in clinical trials in patients with OA. Similar results have been shown with other fruit-derived extracts.

(Farid, et al. Nutr Res. 2010 Sep;30(9):601-6.

Alkaloids such as berberine, which are found in a variety of fruit, have demonstrated efficacy in rat models of OA

(Hu, et al. Phytother Res. 2011 Jun;25(6):878-85).

Proanthocyanidins, derived from grape seed, has been shown to ameliorate OA in rats. Proanthocynidin is unusual in that it may have pain killing properties as well

(Woo et al,. Exp Mol Med. 2011 Oct 31;43(10))

27

More on ProanthocyanidinsWe believe proanthocyanidins are especially interesting, and merit a closer look.

Proanthocyanidins started coming into focus as more people started believing in the health benefits of red wine. The so called “French Paradox” arose when scientists began to notice that consumers of high-fat diets tended to live longer, and this was related to their daily consumption of red wine.

Initially, the compound known as resveratrol in red wine was thought to be the reason why red wine provides a health benefit. However, later studies found that the levels of resveratrol in red wine are much to low to provide any health benefit.

Procyanidins, of which the proanthocynadins are one subtype, are a more likely candidate for the red wine benefit. This is because they are present in red wine at much higher levels in red wine compared to resveratrol.

In fact, in a groundbreaking study published in Nature, researchers from the Queen Mary’s School of Medicine in London

28

More on Proanthocyanidinsnoted the following:

“Regular, moderate consumption of red wine is linked to a reduced risk of coronary

heart disease and to lower overall mortality, but the relative contribution of

wine's alcohol and polyphenol components to these effects is unclear. Here we identify

procyanidins as the principal vasoactive polyphenols in red wine and show that they

are present at higher concentrations in wines from areas of southwestern France and Sardinia, where traditional production methods ensure that these compounds are

efficiently extracted during vinification. These regions also happen to be associated with increased longevity in the population.”

In other words, it’s the procynidins, of which proanthicyanidin is one, which are the beneficial components found in red wine.

And why are they beneficial in the first place?

Because they are incredibly powerful antioxidants!

But, here is the really interesting thing about proanthocyanidin.

A number of studies using different tissues have demonstrated that proanthocyanidin can “stick” to collagen and other connective tissues., delivering antioxidant power directly where it’s needed!

29

Examples of Proanthocyanidins

30

Proanthocyanidin A1 Proanthocyanidin A2 Procyanidin C1

As one can see from these structures, procyanidins and proanthocyanidins are rather complex molecules. They have multiple aromatic areas on the molecule which gives them

their anti-oxidation power.

More on ProanthocyanidinSo, as you ingest proanthocynadins, they are absorbed and distributed throughout your bodies. However, they prefer to stick to connective tissues, delivering powerful antioxidant power directly to these tissues, such as joints!. Let’s look at the scientific proof.

First, a study in mice with rheumatoid arthritis demonstrated that grape seed proanthocynadin extract reduced a variety of markers of inflammation.

(See Cho et al., Immunol Lett. 2009 Jun 4;124(2):102-10).

A number of studies have demonstrated that proanthocynadins can bind to collagen throughout the body.

This is important because collagen is one of the major components of joint cartilage. So having an antioxidant “stick” to your joint cartilage is a beautiful way to reduce the amount of damage caused by oxidation.

(See Castellan, et al. Dent Mater. 2010 Oct;26(10):968-73; Ku et al., Chemosphere. 2007 Apr;67(8):1618-27, and many others).

In summary, there is little doubt that anti-oxidants can help maintain joint health and function. Vitamins such as C and E are good choices, and they are very safe for daily use, but they may not be potent enough to help much with OA. Powerful antioxidants such as proanthocynidins which can bind to connective tissues may have a tremendous benefit in connective tissue diseases such as OA.

31

Enzyme Therapy in OA

32

Enzymes and OA

33

Enzymes are complex proteins that make chemical reactions go faster than they would otherwise. For examples, various enzymes are present in the stomach which begin the process of digesting foods. The process by which yeast converts sugars to alcohol during the brewing process is also driven by various yeast enzymes.

Various enzymes are also used for health purposes, such as treating various diseases, wound healing, and as digestion aids. In 2006, an interesting paper from Germany looked at a blend of enzymes in OA patients, and compared the blend of enzymes to diclofenac, a non-steroidal anti-inflammatory prescription drug which is commonly used in OA.

Klein et al. Clin Exp Rheumatol. 2006 Jan-Feb;24(1):25-30.

The results were quite interesting. The researchers found there was no difference between the enzymes and the diclofenac.

What strikes us about this result is that drugs like diclofenac are known to cause serious stomach side effects when taken regularly over time. So to take something like an enzyme, which is very safe, and have it work just as well as a prescription drug, is really an interesting finding.

Enzymes and OA

34

One of the enzymes in this study is bromelain. Now fans of WisdomAndHealth. are already familiar with bromelain, as it is one of the ingredients in our popular Tush MD product. In Tush MD, bromelain acts as a digestive aid and as an anti-inflammatory agent.

http://www.wisdomandhealth.com/tush-md/

The anti-inflammatory properties of bromelain have been explored in multiple studies and multiple diseases. In mice with colitis, for example, bromelain decreases pro-inflammatory proteins called cytokines.

Hale, et al. Inflamm Bowel Dis. 2010 Dec;16(12):2012-21.

Bromelain may have benefits in other diseases where inflammation is present, such as asthma, inflammatory bowel disease, and skin inflammation.

Wisdom for your Health:

Bromelain is extracted from pineapple stems, though there is quite a bit in the fruit as well.

Bromelain and OA

35

But does bromelain help in OA? Well, we already mentioned the study in which bromelain was demonstrated to be equivalent to prescription-strength diclofenac in OA patients.

Other studies have demonstreated bromelain benefits against pain and/or inflammation. As another example, a study by Walker et al. The authors concluded “...that bromelain may be effective in ameliorating physical symptoms and improving general well-being in otherwise healthy adults suffering from mild knee pain…”

Walker, et al. Phytomedicine. 2002 Dec;9(8):681-6.

No serious adverse events have been reported with the consumption of either bromelain or pineapples in these clinical studies.

Adverse events that have been reported are mainly gastrointestinal (i.e. diarrhea, nausea and flatulence), but have also included headache, dry mouth, and skin rash.

Wisdom for your Health: The

proof is there, folks!

Putting it all together...

36

Summary So FarAntioxidants appear to have a role to play in osteoarthritis

Vitamin C is a common, safe antioxidant which may help with osteoarthritis

Other antioxidants, such as proanthocyanidins, are very interesting because they have been shown to “stick” to collagen, delivering antioxidant power right to where it is most needed

Bromelain, an enzyme extracted from pineapples, may have anti-inflammatory properties, and is already present in a number of dietary supplements geared towards inflammatory conditions

37

What we can offer you...

38

Glucosamine Sulfate

39

Perhaps you are not certain if glucosamine is right for you?

For you, we suggest starting with a basic glucosamine sulfate formula.

The large bottle contains 250 capsules, or a mere 25 cents a day for glucosamine sulfate.

Available in 60 and 250 capsules per bottle.

Wisdom for your Health: This is a good starting point if you

simply want to try glucosamine for a few months.

Each capsule contains:

Glucosamine Sulfate.................................……..500 mg

© Douglas Laboratories, Inc. All Rights Reserved

These statements have not been evaluated by the Food and Drug Administration.

This product is not intended to diagnose, treat, cure, or prevent any disease.

http://www.wisdomandhealth.com/glucosamine-sulfate-500-mg-capsules/

Glucosamine + MSM Forte

40

This is a sophisticated formula perfectly suited for folks who want to maintain connective tissues, such as cartilage, bone, tendons, ligaments, and skin.

The large bottle contains 250 capsules, or a mere 32 cents a day for this terrific formula!

Available in 60, 120, and 250 capsules per bottle.

Wisdom for your Health: This is a great product...a good blend of ingredients at a very reasonable

price.


Vitamin C (Ascorbic Acid)..............……...........50 mg Glucosamine Sulfate.................................……..500 mg Methylsulfonylmethane (MSM®) ................….250 mg Proanthocyanidins (red wine) ....................….10 mg Bromelain ..............................................………..10 mg




www.wisdomandhealth.com/glucosamine-msm-forte/

Bromelain-5000

41

Perhaps you are already happy with your glucosamine formula, but you would like to add bromelain to your regimen.

Our Bromelain-5000 is a simple, inexpensive way to add bromelain to your OA dietary supplement routine.

Each bottle contains 60 capsules or bromelain, with no artificial colors or preservatives.

This is a great way to try bromelain for 3-6 months without committing to a more complicated formula.

Wisdom for your Health: A simple, single-ingredient

product is a good way to experiment. Try it for 3-6 months and see if it

works for you!


Bromelain..............……...........5,000 units




http://www.wisdomandhealth.com/bromelain-5000-60-capsules/

Which Product Is Best For ME?

42

This is always a difficult question to answer. And, there is no guarantee that they will work for YOU specifically. Fortunately, these products are very safe, and fairly inexpensive. So if you have osteoarthritis, or are concerned about joint health, trying one of these products for 3-6 months may be worth it.

If you have never taken a glucosamine product, this is a clean, simple, inexpensive product with which to start.

Our Glucosamine + MSM Forte is a sophisticated blend of glusocamine, MSM, and powerful antioxidants. This blend may provide incremental benefits to existing glucosamine formulas.

Bromelain-5000 is a great way to add this fruit-derived enzyme to your existing dietary supplement regimen.

Want to know more?

Contact us!

www.wisdomandhealth.com(800) 488 1887

[email protected]://wisdomandhealthblog.wordpress.com/

43

Health & Medicine

Buyers Guide to Joint Health Supplements