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UMN Joint Support

A Phyto-Therapeutic combination of synergistic nutrients, Glucosamine Sulfate, Boswellin, and Shark Cartilage, with herbs to support healthy cartilage and joint function.

see also ( http://www.fda.gov/fdac/features/2003/103_pain.html )

Ingredients:

1. Glucosamine Sulfate 500 mg
2. Mucopolysaccharides (Shark cartilage) 100 mg
3. Boswellia Serrata 100 mg
4. Sea Cucumber 100 mg
5. Feverfew 100 mg
6. White Willow Bark 50 mg
7. Yucca 100 mg
8. Cat's Claw 200 mg
9. Bromelain enzyme 100 mg

UMN Joint Support Formula Ingredient Rationale

1. Glucosamine Sulfate

Used For / Claims: Glucosamine is a that is required for the formation of glucosamine sulfate stimulates the manufacture of cartilage around the joints, particularly in the knees, hips, spine, and hands. It reduces inflammation, and is responsible for stimulating joint repair. Numerous double-blind studies have shown glucosamine sulfate produces much better results than non-steroidal anti-inflammatory drugs (NSAIDS) (and over-the-counter pain relievers and anti-inflammatory agents: aspirin, acetaminophen, ibuprophen, etc.) in relieving the pain and inflammation of osteoarthritis. Non-steroidal anti-inflammatory drugs (NSAIDS) do temporarily relieve the pain and inflammation related to osteothritis, however, clinical studies show these chemical agents actually accelerate joint destruction.

Summary of uses:

· Osteoarthritis (DJD)
· Temporomandibular joint (TMJ) pain and degeneration
· Reduction of joint pain and inflammation
· Healing of sprains and strains

Dosage/Safety: For osteoarthritis, the normal dose is 500 mg, three times per day. Glucosamine sulfate is safe for most people. Side effects can include constipation, diarrhea, heartburn, and nausea.

References:

Barclay TS, Tsourounis C, McCart GM. Glucosamine. Ann Pharmacother 1998;32:574-9.

Pujalte, J.M., et al., Double-blind clinical evaluation of oral glucosamine sulphate in the basic treatment of osteoarthrosis. Current Medical Resident Opinion 7, 110-114, 1980.

Rindone JP, Hiller D, Collacott E, et al. Randomized, controlled trial of glucosamine for treating osteoarthritis of the knee. West J Med 2000;172:91-4.

Deal CL, Moskowitz RW. Nutraceuticals as therapeutic agents in osteoarthritis. The role of glucosamine, chondroitin sulfate, and collagen hydrolysate. Rheum Dis Clin North Am. 1999 May;25(2):379-95.

Dingle JT., Cartilage maintenance in osteoarthritis: interaction of cytokines, NSAID and prostaglandins in articular cartilage damage and repair. J Rheumatol Suppl. 1991 Mar;28:30-7.

Brandt KD., Effects of nonsteroidal anti-inflammatory drugs on chondrocyte metabolism in vitro and in vivo. Am J Med. 1987 Nov 20;83(5A):29-34.

Lopes Vaz AL. Double-blind, clinical evaluation of the relative efficacy of ibuprofen and glucosamine sulphate in the management of osteoarthrosis of the knee in out-patients. Curr Med Res Opin 1982;8:145-9.

Leeb BF, Schweitzer H, Montag K, Smolen JS. A metaanalysis of chondroitin sulfate in the treatment of osteoarthritis. J Rheumatol. 2000 Jan;27(1):205-11.

Drovanti, A, et al., Therapeutic activity of oral glucosamine sulfate in osteoarthrosis: A placebo controlled double-blind investigation. Clinical Therapy, 3, 336-343, 1981.

Source: Encyclopedia of Nutritional Supplements, Michael T. Murray, N.D. 1996. Pages 336- 42.

da Camara CC, Dowless GV. Glucosamine sulfate for osteoarthritis. Ann Pharmacother 1998;32:580-7.

Delafuente JC. Glucosamine in the treatment of osteoarthritis. Rheum Dis Clin North Am. 2000 Feb;26(1):1-11.

Thie NM, Prasad NG, Major PW. Evaluation of glucosamine sulfate compared to ibuprofen for the treatment of temporomandibular joint osteoarthritis: a randomized double blind controlled 3 month clinical trial. J Rheumatol 2001;28:1347-55.

Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulfate on osteoarthritis progression: a randomized, placebo-controlled trial. Lancet 2001;357:251-6.

Donohoe M. Efficacy of glucosamine and chondroitin for treatment of osteoarthritis. JAMA. 2000 Sep 13;284(10):1241; discussion 1242.

Rindone JP, Hiller D, Collacott E, Nordhaugen N, Arriola G. Randomized, controlled trial of glucosamine for treating osteoarthritis of the knee. West J Med. 2000 Feb;172(2):91-4.

Braham R, Dawson B, Goodman C. The effect of glucosamine supplementation on people experiencing regular knee pain. Br J Sports Med 2003;37:45-9.

2. Mucopolysaccharides (Shark cartilage)

Used For / Claims: Mucopolysaccharides are components of tendons, ligaments, cartilage, synovial fluid, mucous membranes, structures in the eye, blood vessels, and heart valves. Cartilage, derived from shark and bovine (cow) sources, is a type of connective tissue comprised of mucopolysaccharides, protein substances, calcium, sulfur, and collagen,

Mucopolysaccharides are used for:

· Wound healing
· Reducing inflammation
· Relieving the pain and stiffness associated with degenerative joint conditions.
· Aiding in the repair of cartilage
· Assisting in the formation of lubricating fluids in the body

Mucopolysaccharides are known to have powerful anti-inflammatory properties, help with repair of damaged cartilage and also aid in the production of lubricating fluids in the body.

Dosage/Safety: Mucopolysaccharides derived from shark cartilage are safe for most people. It has been given to people at up to one gram per day without side effects.

References:

Prudden JF, Allen J. The clinical acceleration of healing with a cartilage application. JAMA 1965;192:352–6.

Felzenszwalb I, Pelielo de Mattos JC, Bernardo-Filho M, Caldeira-de-Araujo A. Shark cartilage-containing preparation: protection against reactive oxygen species. Food Chem Toxicol. 1998 Dec;36(12):1079-84.

Lane, I.W., M.D. "Shark Cartilage and the Pain of Arthritis.", Explore! 3 no. 6 (1992):23.

Prudden JF, Wolarsky E. The reversal by cartilage of the steroid-induced inhibition of wound healing. Surg Gynecol Obstet 1967;125:109–13.

Fontenele JB, Viana GS, Xavier-Filho J, de-Alencar JW. Anti-inflammatory and analgesic activity of a water-soluble fraction from shark cartilage. Braz J Med Biol Res. 1996 May;29(5):643-6.

Alternative Medicine, The Definitive Guide, Future Medicine Publishing, 1993. Page 535.

3. Boswellia Serrata

Used For / Claims: Boswellia serrata is a large branching tree native to India which yields a gum resin known as salai guggul, used for centuries to treat osteoarthritis.
The active constituents of Boswellia Serrata are boswellic acid and alpha-boswellic acid, which have anti-inflammatory properties. Boswellic acid (active ingredient) has demonstrated anti-arthritic effects in a variety of studies. Mechanism of actions include reduction of inflammation, and improved blood supply to joints. Boswellia Serrata has also been shown to be beneficial for asthma and ulcerative colitis.

Dosage/Safety: Boswellia serrata is safe for most people. It has been given to people at up to one gram per day without side effects.

References:

Reddy, C.K., Chandrakasan, G., Dhar, S.C., Studies on the metabolism of glycosaminoglycans under the influence of new herbal anti-inflammatory agents. Biochemical Pharmacology, 20:3527-34, 1989

Ammon HP, Safayhi H, Mack T, Sabieraj J. Mechanism of antiinflammatory actions of curcumine and boswellic acids. J Ethnopharmacol 1993;38(23):1139.

Singh, G.B., Atal, C.K., Pharmacology of an extract of Boswellia serrata, a new non-steroidal anti-inflammatory agent, Agents Action, 18:407-12, 1986.

Gupta I, Gupta V, Parihar A, et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study. Eur J Med Res 1998;3(11):511-4.

Botanical Influences on Illness, A sourcebook of Clinical Research, Melvyn R. Werbach, M.D., Assistant Clinical Professor, UCLA School of Medicine. 1994. Page 252.

Gupta I, Parihar A, Malhotra P, et al. Effects of Boswellia serrata gum resin in patients with ulcerative colitis. Eur J Med Res 1997;2(1):37-43.

4. Sea Cucumber

Used For / Claims: Beche de Mer (Sea Cucumber) is a marine animal related to starfish and sea urchins, rich in naturally-occurring carbohydrates, calcium, chondroitins, iron, magnesium, mucopolysaccharides, niacin, protein, riboflavin, sodium, vitamins A & C, and zinc. Sea cucumber has a body composed mainly of cartilage that serves as a rich source of mucopolysaccharides; mainly chondroitin sulfate. Sea Cucumber modulates prostaglandins, which regulate the inflammatory process in the body. Mitchell Kurk, M.D., D.O., O.D., Medical Director of the Biomedical Revitalization Center of Lawrence, New York, has found that the conditions of approximately 70% of arthritic patients have improved with the use of sea cucumber. Sea cucumber has been approved by the Australian Department of Health as an effective arthritis treatment. A six month placebo-controlled, double-blind trial conducted at the University of Oueensland, Australia concluded that patients receiving two 500 mg. Capsules daily of sea cucumber had a marked decrease in symptomology. Study director R.A. Hazelton. M.D noticed improvement such as increased grip strength, diminished morning stiffness, and significant pain reduction. No adverse reactions, side-effects, or toxicity were noted.

Sea cucumber is used for:

· Inflammatory conditions
· Osteoarthritis
· Rheumatoid arthritis
· Joint injuries or trauma
· Tendinitis

Howard Benedikt, MS, DC has been a chiropractor for over 18 years. He obtained an MS in nutrition from Long Island University, and has taught on both the graduate and undergraduate level at several chiropractic colleges. He is host to a weekly radio talk show, "Alternatives," in New York City.

Dr. Benedikt offers the following case studies where sea cucumber has been shown to be effective:

Patient #1: 63-year-old white male teacher with 15 year history of bilateral knee pain. Unable to stand long periods of time or walk without extreme pain. Some swelling found bilaterally, tender to touch. Patient had been on anti-inflammatory medications on and off, presently taking Tylenol as per need. No other supplementation except a daily multiple. Placed on sea cucumber (4x/day), within 14 days, patient reported 50 percent improvement in symptoms, able to walk 15 blocks without pain. Notes decreased swelling and increased range of motion.

Patient #2: 58-year-old female with right-sided hand and finger pain. Unable to clench hand or hold anything in the hand without pain. Some weakness in the hand. Redness and swelling in several fingers of the hand. She had been taking a wide variety of pain medications to include NSAIDs at the time of her visit. Previous diagnosis of rheumatoid arthritis with DJD at C4, C5. She was placed on a rotational diet which included the removal of wheat and dairy from here diet, and taking sea cucumber 4x/day. I'm glad to say that as of this writing she reports a 75 percent improvement in her pain. Dynamometer grip strength shows a marked improvement.

Patient #3: 27-year-old-male, executive banker, works out a least three times a week at local health club; jogs, loves to bike. Presented with lower back pain with right sided sciatica. X-rays indicate early DJD at L4, L5. Sea cucumber was added to his regime of spinal manipulation. Pain free within four days of taking the sea cucumber.

It is my opinion that sea cucumber offers pain relief in a fast, nontoxic way. It should be considered by all physicians who not only treat musculoskeletal conditions, but deal with people in pain.

Howard Benedikt, DC, MS
New York, New York

Dosage/Safety: Studies using Sea Cucumber have used up to 500 mg. per day, with little side effects.

References:

Walker, M., "Biochemical Components of Sea Cucumber for Human Benefit." Explore! 3 no. 6 (1992): 12-17. Source: Alternative Medicine, The Definitive Guide, Future Medicine Publishing, 1993. Page 534

Howard Benedikt, MS, DC., http://www.chiroweb.com/hg/14/10/03.html

5. Feverfew

Used For / Claims: Feverfew is an herb that has a long history in the treatment of arthritis, headache, and fever. Research has shown extracts of feverfew have greater anti-inflammatory action than aspirin in experimental studies. The net effect of feverfew's action is a significantly decreased inflammatory response.

Feverfew is used for:

· Preventing migraine headaches
· Decreasing the pain associated with arthritis

Dosage/Safety: For migraine headaches, clinical studies have used 50 to 100 mg of feverfew extract daily.

References:

Petry JJ, Hadley SK., Medicinal herbs: answers and advice, part 1. Hosp Pract (Off Ed). 2001 Jul 15;36(7):57-60.

Ernst E, Pittler MH., The efficacy and safety of feverfew (Tanacetum parthenium L.): an update of a systematic review. Public Health Nutr. 2000 Dec;3(4A):509-14.

Pittler M, Ernst E., Feverfew for preventing migraine. Cochrane Database Syst Rev. 2004;1:CD002286.

Prusinski A, Durko A, Niczyporuk-Turek A., Feverfew as a prophylactic treatment of migraine. Neurol Neurochir Pol. 1999;33 Suppl 5:89-95.

Kwok BH, Koh B, Ndubuisi MI, Elofsson M, Crews CM., The anti-inflammatory natural product parthenolide from the medicinal herb Feverfew directly binds to and inhibits IkappaB kinase. Chem Biol. 2001 Aug;8(8):759-66.

Heptinstall, S., White, A., Williamson, L., and Mitchell, J.R.A., ‘Extracts of feverfew inhibit granule secretion in blood platelets and plymorphoneuclear leukocytes', Lancet, 1985, i, pp. 1,071-4.

Encyclopedia of Natural Medicine, Michael Murray, N.D., Joseph Pizzorno, N.D., 1991. Page 497.

6. White Willow Bark

Used For / Claims: The bark of the white willow tree has been used for hundreds of years to combat the pain of rheumatism, arthritis, and headache. Extracts of the bark were synthesized into salicylic acid in 1838. This new product became known as aspirin in 1897. Willow bark constituents include flavonoids, tannins, and salicylates. A majority of the benefits attributed to willow bark are based on the pharmacology documented for salicylates. These include fever-reducing and anti-inflammatory properties.

Research show that white willow bark can relieve pain associated with:
· Rheumatism
· Arthritis
· Joint pain
· Muscle pain
· Tendonitis

Dosage/Safety: For back pain, willow bark extract providing up to 240 mg salicin per day has been used. Avoid use by individuals with aspirin hypersensitivity. Willow bark may cause serious allergic reactions, including anaphylaxis, in people who are allergic to aspirin, and may contribute to Reye’s syndrome in chidren.

References:

Blumenthal M, editor. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein. Boston, MA: American Botanical Council, 1998.

Vane JR, Botting RM., The mechanism of action of aspirin. Thromb Res. 2003 Jun 15;110(5-6):255-8.

Thompson, W.R., ‘Herbs That Heal, Charles Scribner's Sons. New York, 1976, pp. 81-82.

Fiebich BL, Appel K., Anti-inflammatory effects of willow bark extract. Clin Pharmacol Ther. 2003 Jul;74(1):96; author reply 96-7.

Chrubasik S, Eisenberg E, Balan E, et al. Treatment of low back pain exacerbations with willow bark extract: a randomized double-blind study. Am J Med 2000;109:9-14.

The Scientific Validation of Herbal Medicine, Daniel B. Mowrey, Ph.D.1986. Page 224.

Chrubasik S, Pollak S, Black A., Willow bark extract, a useful alternative for the treatment of osteoarthritis: comment on the editorial by Marcus and Suarez-Almazor. Arthritis Rheum. 2003 Jan;48(1):278-80; author reply 280.

Newall CA, et al. Herbal Medicines: A Guide for Health-Care Professionals, 1st ed. London: Pharmaceutical Press; 1998.

Marz RW, Kemper F.Willow bark extract--effects and effectiveness. Status of current knowledge regarding pharmacology, toxicology and clinical aspects. Wien Med Wochenschr. 2002;152(15-16):354-9.

Thompson, W.A.R., ‘Medicines from the Earth', McGraw Hill Book Co., Limited, Maidenhead, England, 1978.

Chrubasik S, Pollak S., Pain management with herbal antirheumatic drugs. Wien Med Wochenschr. 2002;152(7-8):198-203.

7. Yucca

Used For / Claims: The Yucca plant is rich in naturally occurring saponins, which give it anti-inflammatory properties. Yucca root acts as a blood purifier, beneficial in the treatment of arthritis and inflammatory disorders. Yucca has shown positive therapeutic effect on osteoarthritis.149 osteoarthritis patients were randomly given either yucca saponin extract or placebo in periods ranging from 1 week to 15 months before re-evaluation. Results: 61% of the patients given yucca noted less swelling, pain and stiffness.

Yucca is used for:

· Chronic inflammation
· May reduce pain, stiffness, and swelling associated with arthritic conditions
· May be beneficial for migraine headaches, poor blood circulation, and skin conditions

Dosage/Safety: Research shows people have used up to 500 mg of powdered Yucca two to three times per day. No evidence of toxicity in laboratory studies was reported.

References:

Gruenwald J, et al. PDR for Herbal Medicines. 1st ed. Montvale, NJ: Medical Economics Company, Inc., 1998.

Bingham, R, et al, ‘Yucca plant saponin in the management of arthritis', Journal of Applied Nutrition, 27:45-50, 1975.

Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. Terry C. Telger, transl. 3rd ed. Berlin, GER: Springer, 1998.

Botanical Influences on Illness, A sourcebook of Clinical Research, Melvyn R. Werbach, M.D., Assistant Clinical Professor, UCLA School of Medicine. 1994. Page 330.

8. Cat's Claw (Uncaria tomentosa)

Used For / Claims: Cat's Claw is an herb which has been used for hundreds, if not thousands, of years by the native Indians of Peru, and presently by natural therapists around the world to stimulate the immune system and treat arthritis, inflammation, rheumatism, and immune related conditions. Cat's Claw is known to be a powerful antioxidant nutrient. Clinical studies on Cat’s Claw show that its pentacyclic oxindole alkaloids enhance phagocytosis, display immunomodulatory properties, and alleviate inflammation.

Cat’s Claw is used for:

· Antioxidant protection
· Modulation of the immune system
· Reduction of inflammation
· Reduction of symptoms in arthritic conditions

Dosage/Safety: For general health and immune system benefits, 500 mg to 1000
mg per day of cat's claw is recommended. In studies for osteoarthritis and
rheumatoid arthritis, between 100 mg and 5 grams per day of Cat's claw has
been used. Higher doses (3-4 grams) can cause dizziness, headache, and/or
vomiting in some people.

References:

Cats Claw: "Medicinal Properties of this Amazon Vine", Nutrition Science, July-August 1995.

Wirth C, et al. Pharmacologically active procyanidines from the bark of Uncaria tomentose. Phytomedicine 1997;4:265-6.

Hemingway SR, Phillipson JD. Proceedings: alkaloids from south American species of Uncaria (Rubiaceae). J Pharm Pharmacol 1974;26(suppl):113.

Rizzi R, et al. Mutagenic and antimutagenic activities of Uncaria tomentosa and its extracts. J Ethnopharmacol 1993;38:63-77.

Sandoval M, et al. Cat's claw inhibits TNFalpha production and scavenges free radicals: role in cytoprotection. Free Radic Biol Med 2000;29:71-8.

Mur E, et al. Randomized double blind trial of an extract for the pentacyclic alkaloid-chemotype of Uncaria tomentosa for the treatment of rheumatoid arthritis. J Rheumatol 2002;29:678-81.

Paulsen SM. Use of herbal products and dietary supplements by oncology patients--Informed decisions? Highlights Oncol Pract 1998;15:94-106.

Chrubasik S, Pollak S.Pain management with herbal antirheumatic drugs. Wien Med Wochenschr. 2002;152(7-8):198-203.

Sandoval M, et al. Anti-inflammatory and antioxidant activities of cat's claw (Uncaria tomentosa and Uncaria guianensis) are independent of their alkaloid content.
Aquino R, et al. Plant metabolites: New compounds and anti-inflammatory activity of Uncaria tomentosa. J Nat Prod 1991;54:453-9.

Keplinger K, et al. Uncaria tomentosa: ethnomedicinal use and new pharmacological, toxicological and botanical results. J Ethnopharmacol 1999; 64:23-34.

9. Bromelain enzyme

Used For / Claims: Bromelain is an enzyme derived from pineapples known for its anti-inflammatory and anti- edema (swelling) properties. Clinical studies show bromelain’s ability to prevent edema formation and reduce existing edema. It reduces blood levels of fibrinogen and support fibrinolysis and has been investigated for its positive effects on burn wounds. In one study, 25 patients with advanced rheumatoid and osteoarthritis, 2 patients with osteoarthritis alone, and 1 patient with gouty arthritis who all had residual joint swelling and impairment in mobility following long-term corticosteroid therapy were given bromelain daily. Results: A majority of the patients reported significant reduction of joint swelling and that joint mobility was increased soon after supplementation was started. After 3 weeks 73% of the patients reported good to excellent results. There were no side-effects.

Bromelain is used for:

· Inflammation
· Edema
· Joint pain
· Improved recovery from burns and surgery

Dosage/Safety: For arthritic and muscular conditions, up to 900 mg of Bromelain per day has been used. In higher doses, bromelain can cause diarrhea and/or gastrointestinal disturbances in some people.

References:

Walker AF, et al. Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults. Phytomedicine 2002 Dec;9(8):681-6.

Klein G, Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes. Clin Drug Invest 2000;19:15-23.

Taussig SJ, Batkin S. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application. An update. J Ethnopharmacol 1988;22:191-203.

Cohen, A., Goldman, J., ‘Bromelain's therapy in rheumatoid arthritis', Pennsylvania Medical Journal, 67:27-30, June 1964.

Masson M., Bromelain in blunt injuries of the locomotor system. A study of observed applications in general practice. Fortschr Med 1995;113:303-6.

Petry JJ. Surgically significant nutritional supplements. Plast Reconstr Surg 1996;97:233-40.

Nutritional Influences on Illness, A sourcebook of Clinical Research, Melvyn R. Werbach, M.D., Assistant Clinical Professor, UCLA School of Medicine. Page 386.

Klasen HJ. A review on the non-operative removal of necrotic tissue from burn wounds. Burns 2000;26:207-22.