Joint Builder ULTRA: A combination supplement for joint health

We recently heard from two NYBC members who have found Jarrow’s Joint Builder ULTRA very effective in supporting healthy joint function. Indeed, they were quite pleased with improvement in joint function within a few weeks to a month of starting to take this combination supplement. So we thought we’d review this formula a little more thoroughly.

First, here’s the list of ingredients, together with the supplier’s recommendation on dosage and how to take:

Ultra Joint Builder (Jarrow) Each bottle, 90 tablets. Each tablet, 500 mg glucosamine sulfate, 500 mg MSM, 167 mg Yucca juice extract (Yucca schidigera, 4:1), 34 mg ApresFLEX (Boswellia serrata extract, 20% 3-O-acetyl-11-keto-beta-boswellic acid); 13.3 mg hyaluronic acid, 1 mg boron (citrate). Suggested use is 3 tablets per day. Studies for inflammation suggest 1.5 grams per day. Start slowly and build up the dose over a few days.

Glucosamine is the most familiar part of this formula, and plays an important and well-documented role in the body’s production of the connective tissue around joints, and the production of synovial fluid (the lubricant in joints, basically). Glucosamine thus has the potential to offset the destructive effects of arthritis and osteoarthritis. MSM, a supplement providing sulfur, also plays a role in these joint supportive processes.

The Jarrow combination also includes two botanicals that have long been used for their anti-inflammatory effects. Yucca schidigera is a medicinal plant which may have beneficial effects in the prevention and treatment of arthritis. Boswellia serrata has a long tradition of use for arthritis in the Ayurvedic tradition; some recent Western study of its effectiveness has suggested benefit, but other research has been less clear.

Note that Vitamin C is another important joint-supporting supplement, since it is required for the synthesis of collagen and cartilage; be sure that your intake of this Vitamin is adequate.

For best results with Joint Builder ULTRA, some suggest also using Jarrow’s Biosil, containing the biologically active form of silicon.

See further information in the NYBC catalog:

JOINT BUILDER ULTRA (JARROW)

and

Biosil

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Broccoli compound may help prevent or slow progression of osteoarthritis

A study published in the journal Arthritis and Rheumatism concludes that sulforaphane, a compound found in broccoli and other cruciferous vegetables, may slow the progression of osteoarthritis, the most common type of arthritis. Stemming from the breakdown of cartilage and bone in the joints, osteoarthritis can cause pain in the spine, hips, knees, hands and feet, and is one of the most common kinds of debility in aging populations.

The British researchers who are authors of this study noted that, while previous studies have investigated the anti-inflammatory and anti-cancer properties of sulforaphane, theirs is the first major research into the compound’s effects on joint health. A principal achievement of their research was to identify the mechanism by which sulforaphane blocks the enzymatic processes that are linked to the destruction of cartilage in the joints. Future clinical studies can be expected to focus on the effect of sulforaphane in the diet of those susceptible to osteoarthritis.

Note that NYBC has stocked the Jarrow product Broccomax for the past several years, particularly because of ongoing scientific interest in the potential health benefits of sulforaphane:

BROCCOMAX

SAMe for osteoarthritis

We were interested to see in the recently published Mayo Clinic guide to alternative medicine a fairly strong statement supporting the use of SAMe (s-adenosylmethionine) for osteoarthrititis. So we checked with what regard as one of the best online resources for such questions, the University of Maryland Medical Center. Here’s their report, updated in 2009, which basically backs up the Mayo Clinic view:

A number of well-designed clinical trials show that SAMe may reduce pain and inflammation in the joints, and researchers think it may also promote cartilage repair, although they are not clear about how or why this works. In several short-term studies (ranging 4 – 12 weeks), SAMe supplements were as effective as nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen in adults with knee, hip, or spine osteoarthritis. SAMe was as effective as these medications in lessening morning stiffness, decreasing pain, reducing swelling, improving range of motion, and increasing walking pace. Several studies also suggest that SAMe has fewer side effects than NSAIDs. Another study compared SAMe to celecoxib (Celebrex), a type of NSAID called a COX-2 inhibitor, and found that over time SAMe was as effective as celecoxib in relieving pain.

From: http://www.umm.edu/altmed/articles/s-adenosylmethionine-000324.htm

Read more at the NYBC entry for SAMe:
http://nybcsecure.org/product_info.php?cPath=57&products_id=207

SAMe (S-adenosyl-methionine) for osteoarthritis

We’ve discussed SAMe’s use as an anti-depressant on this Blog, as well as its potential to support liver health. But over the past twenty years there has also been much research into SAMe to counter osteoarthritis pain. In a number of trials in Europe and in the US, SAMe has equalled the effect of nonsteroidal anti-inflammatory drugs (NSAIDS) like ibuprofen in decreasing pain and improving function. Furthermore, it is better tolerated than NSAIDS, which cause clinical concern about side effects especially when taken at high doses over long periods of time.

Here’s one drawback to SAMe for osteoarthritis: trials have shown this supplement to have a slower onset of action than NSAIDs–an initial starting use of about 4 weeks is needed for full effectivesness. In the meantime, some patients may continue to take NSAIDS, gradually reducing the dose.

See the NYBC description of SAMe for additional information, including our recommendation to take adequate B-complex along with this supplement.

For further reading and references on SAMe for osteoarthritis, we recommend Natural Products: A Case-Based Approach for Health Professionals (American Pharmacists’ Assoc., Washington, DC: 2006), pp. 37-49

Arthritis Supplements reviewed in the journal “American Family Physician”

Our local paper, The New York Times, has just brought us a piece on “Making Sense of Arthritis Supplements” in its Jan. 21, 2008 issue.  It’s motivated by a recent medical journal review, and has already attracted a long string of reader comments.
No surprise, given that arthritis is the leading condition for which Americans use alternative therapies, including dietary supplements. At this point there has been a lot of scientific research on supplements for osteoarthritis; the review in the journal “American Family Physician,” which is the starting point for the NYT piece,  attempts to help people sort through the studies and come to some conclusions about what the best bets are.
Some of our own thoughts on the topic:
Glucosamine sulfate is the acknowledged front-runner, both for symptom relief and on account of evidence that it may have disease-modifying effects. Especially when side effects of ibuprofen or prescription medications cause concern, there’s reason to think about glucosamine sulfate as an alternative.
In 2005, results were made available for the NIH-sponsored “Glucosamine-Chondroitin Arthritis Intervention Trial” (GAIT), which looked at almost 1600 US patients with moderate-to-severe knee osteoarthritis pain. In the glucosamine-chondroitin combination group, 79.2% had pain relief, as opposed to 69.4% in the celecoxib (tradename you might know: Celebrex) group. The competition to interpret this trial to favor supplements or prescription drugs still rages pretty fiercely–see the comment from Dr Jason Theodosakis following the NYT review. (He was on oversight committee of the GAIT study, and is a well-known proponent of glucosamine.)
There is another supplement, more expensive than glucosamine, that has been extensively researched for osteoarthritis: SAM-e (S-Adenosyl-methionine). Below we simply reproduce the abstract of a frequently-cited review of this supplement, with Conclusion highlighted. (BTW, the caution raised in the NYT review about the stability of this product on the shelf is a point well taken.)
Safety and efficacy of S-adenosylmethionine (SAMe) for osteoarthritis
Soeken KL, Lee WL, Bausell RB, Agelli M, Berman BM.
University of Maryland, School of Nursing, Baltimore, MD.
OBJECTIVE: We assessed the efficacy of S-adenosylmethionine (SAMe), a dietary supplement now available in the Unites States, compared with that of placebo or nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of osteoarthritis (OA). STUDY DESIGN: This was a meta-analysis of randomized controlled trials. DATA SOURCES: We identified randomized controlled trials of SAMe versus placebo or NSAIDS for the treatment of OA through computerized database searches and reference lists. OUTCOMES MEASURED: The outcomes considered were pain, functional limitation, and adverse effects. RESULTS: Eleven studies that met the inclusion criteria were weighted on the basis of precision and were combined for each outcome variable. When compared with placebo, SAMe is more effective in reducing functional limitation in patients with OA (effect size [ES] =.31; 95% confidence interval [CI],.099-.520), but not in reducing pain (ES =.22; 95% CI, -.247 to.693). This result, however, is based on only 2 studies. SAMe seems to be comparable with NSAIDs (pain: ES =.12; 95% CI, -.029 to.273; functional limitation: ES =.025; 95% CI, -.127 to.176). However, those treated with SAMe were less likely to report adverse effects than those receiving NSAIDs. CONCLUSIONS: SAMe appears to be as effective as NSAIDs in reducing pain and improving functional limitation in patients with OA without the adverse effects often associated with NSAID therapies.
Citation: J Fam Pract. 2002 May;51(5):425-30.

Glucosamine Chondroitin: interpreting the research

When interpreting research on dietary supplements, it sometimes pays to look between the lines and recognize that pharmaceutical companies don’t have much interest in letting people know that over-the-counter dietary supplements are at times a reasonable option for addressing a medical condition. Yes, it’s true, the pharmaceutical companies and their researchers can display, shall we say, bias in assessing the relative merits of prescrpiton drugs and supplements.

Here’s a brief case study from the NYBC archives:

…a good illustration of the dangers of the influence of The Media and Big Business on our healthcare system was recently discussed by New York Buyers’ Club’s Treatment Director, George M. Carter: this past year, the National Institutes of Health released the results of a study that the popular media interpreted as decrying the effectiveness of the popular supplement, glucosamine-chondroitin. However, read in its entirety, the study found that the combination didn’t work well specifically for mild arthritis of the knee but neither did the prescription drug Celebrex, also included in the study. It is interesting to note that many of the researchers involved had received monies from Pfizerthe makers of Celebrex. It is also worth noting that for moderate to severe arthritic pain, the glucosamine-chondroitin combination actually worked much better than Celebrex – and that the researchers didn’t even use its most potent form (glucosamine sulfate) in the study.

For more on this issue, see the NYBC website:

Interpreting the research on glucosamine chondroitin

When FDA-Approved Drugs Stumble, Shouldn’t Patients and Healthcare Providers Consider Dietary Supplements Instead?

Our friends at the FDA have come under a lot of criticism lately.

It seems that every time you open a newspaper (OK, we actually open our browser these days), there’s a new revelation about problems with an FDA-approved drug:

• Vioxx: approved by the FDA in 1999 to treat arthritis pain; withdrawn by manufacturer Merck in 2004 because of concerns about increased risk of heart attack and stroke associated with long-term, high-dosage use

• Statins: a class of FDA-approved drugs to lower cholesterol, including such well-known names as Lipitor; studies have found statin therapy may be associated with heart problems and myopathy (muscle weakness)

• Procrit: one of several drugs for anemia that now carry FDA-mandated “black-box” warnings indicating that they can increase risk of death or serious medical complication, especially when used at high dosage. Procrit and other red blood cell-stimulating drugs had been advertised as “improving quality of life,” but can worsen cancer and increase the risk of blod clots

• Avandia: in May, 2007 the New England Journal of Medicine published a report concluding that this FDA-approved diabetes drug is associated with increased heart attack risk; federal drug reviewers agreed, and said that Avandia is particularly dangerous for people also taking insulin

These and other revelations led Congress to pass legislation this year aimed at improving the FDA’s ability to force follow-up studies on approved drugs, so that serious problems could be detected earlier. (There’s a lot to say about how the FDA approval process has been corrupted by its dependence on funding from pharmaceutical companies, but for the moment we’ll pass by that topic!)

Here we’d just like to ask whether it doesn’t make sense–given such issues as these with prescription drugs—-for patients and their healthcare providers to consider dietary supplements and nutritional strategies as an alternative whenever possible.

Some specific alternatives to the drugs above:

• Glucosamine and chondroitin for osteoarthritis pain; SAMe also effective for this purpose in some trials.

• Niacin and/or fish oil to manage cholesterol; CoQ 10 to offset statin-related side effects. (See the studies on CoQ 10 in this Blog for evidence about how this supplement can counter statin-related muscle pain and diastolic function impairment.) 

• Marrow Plus to counter anemia; may be useful for chemotherapy-associated anemia. See this comment on Marrow Plus from one NYBC member who used it to maintain blood counts during six months of Pegasys/Ribavirin combination therapy for Hep C.

• Chromium supplementation may improve insulin function in diabetics; dietary supplements such as Glycemic Balance may also be useful.

–EXCERPTED FROM THE FORTHCOMING FALL, 2007 NEWSLETTER OF THE NEW YORK BUYERS’ CLUB, THE SUPPLEMENT.

FOR MORE INFORMATION ON THE DIETARY SUPPLEMENTS MENTIONED HERE, OR TO READ PAST ISSUES OF THE SUPPLEMENT, PLEASE VISIT

www.newyorkbuyersclub.org