In this day and age we all lead busy lives at work and at home. This type of lifestyle can involve physical activity in many forms, whether you regularly work out at the gym, run around after children or have a physically demanding job.

From a very early age we put a great deal of stress onto the joints - as children playing sports, climbing trees and encountering the odd fall. Eventually, an active lifestyle and the ageing process leads to wear and tear on the whole body and can be particularly noticeable in the joints.

It’s a fact of life that as we get older our joints and spine (spinal joints – known as facet joints) are more likely to suffer aches and pains. In the UK it’s estimated that around eight million people have some form of Arthritis and that one in three people will suffer with arthritis at some point in their lives.

Did you know there are actually around 200 different kinds of arthritis, which means inflammation of the joints and spinal joints, with the most common being osteoarthritis. Other types are rheumatoid arthritis, ankylosing spondylitis, cervical spondylosis and gout.

The articulating surfaces of the bones (the ends of the bones that form the joint) are covered in articular cartilage and are bathed in Synovial Fluid – call it "joint oil". In a normal healthy joint the articular cartilage is smooth and the synovial fluid is of sufficient high quality to provide adequate lubrication.

Unfortunately as we get older this lubrication becomes less efficient, therefore the aiding of everyday mobility and smooth working of joint cartilage, tendons and ligaments lessens.

Glucosamine and Chondroitine are thought to be a safe and natural approach for healthy joints and spine.

… BUT CAN THESE SUPPLEMENTS LIVE UP TO THE HYPE?


An introduction to Glucosamine and Chondroitine

Glucosamine Sulphate is a naturally occuring substance in our body. It is a sugar, produced from glucose, and is used in the maintenance and regeneration of healthy cartilage in joints and spinal joints and preserve joint integrity in the face of heavy training.

Glucosamine is a major building block of glycosaminoglycans, complex proteins that form part of the structure of cartilage, and is therefore essential for the production of new cartilage in the joints. Glucosamine is also needed for the synthesis of synovial fluid - a vital cushioning substance that protects the joints from the damaging effects of friction.

All of the Glucosamine forms originated from shellfish, and has been shown since the first clinical studies in 1980 to be effective at easing discomfort associated with arthritis - at least - if not more effectively than common non-steroidal anti-inflammatory drugs (NSAIDS) such as Ibuprofen or Aspirin.

Chondroitin Sulphate is a sulphated glycosaminoglycan (GAG) composed of a chain of alternating sugars (N-acetylgalactosamine and glucuronic acid). It is usually found attached to proteins as part of a proteoglycan. A chondroitin chain can have over 100 individual sugars, each of which can be sulphated in variable positions and quantities. Understanding the functions of such diversity in chondroitin sulphate and related glycosaminoglycans is a major goal of glycobiology. Chondroitin sulphate is an important structural component of cartilage and provides much of its resistance to compression. Along with glucosamine, chondroitin sulphate has become a widely used dietary supplement for treatment of osteoarthritis.
Chondroitin sulphate that we can by as a supplement is taken from animal cartilage, such as tracheas or shark cartilage. Maybe I should have not mentioned this as it may put you off from taking it.

Glucosamine and chondroitin (chondroitin sulphate) supplements have grown enormously in popularity in the UK, because the two compounds are thought to help painful joints and decrease the risk of osteoarthritis. Sales of the two compounds are brisk, reaching an estimated one billion dollars in the United States alone.


…Another popular form of Glucosamine is known as Glucosamine HCL, or hydrochloride. Some studies have shown the HCL to be more effective and some have shown the sulphate to be more effective, so it would be prudent to either try both individually (probably not the most cost effective option) and see which one works better for you, or ideally simply find a product that contains both HCL and Sulphate.
It is proven though that Glucosamine HCL is 99% pure and Glucosamine Sulphate is only 80% pure. This means that the HCL form is easier to absorb by the body, but further studies need to be done to find out which of the 2 forms will be the one that survives the time.


What research suggests

Non-steroidal anti-inflammatory drugs (NSAIDs) are the 'classic' treatment for osteoarthritis, in part because they tend to tone down the inflammation. However, NSAIDS do nothing to arrest the basic source of the disease, and thus there is increased interest in Glucosamine and Chondroitin sulphate. As mentioned earlier, it is often hypothesised that the two compounds might actually prevent the breakdown of cartilage and/or stimulate the production of new cartilage, in effect stopping osteoarthritis in its tracks.

A lot studies have been performed on this subject. At least 18 clinical studies involving over 3000 individuals have been carried out with Glucosamine Sulphate, and eight Chondroitin Sulphate studies with almost 800 subjects have been published. The studies suggest that either Glucosamine or Chondroitin Sulphate is better than a placebo at relieving joint pain. There is no strong evidence that they are better than NSAID’s, but they have a much lower toxicity than NSAIDS, with far fewer negative side effects.
Strangely enough, although the two compounds are often sold together, there are no clinical studies in humans in which Glucosamine and Chondroitin Sulphate have been administered together. In addition, Glucosamine and Chondroitin Sulphate have a slower 'response time' and do not offer the immediate pain relief associated with NSAID’s (the effects of Glucosamine and Chondroitin are probably longer-lasting; some studies indicate that the effects of Glucosamine and Chondroitin Sulphate may persist for up to four weeks after withdrawal (Delafuente JC, 'Glucosamine in the treatment of osteoarthritis’, Rheumatic Disease Clinics of North America. 2000)

Types of Glucosamines to Avoid

Glucosamine Sulphate alone is perfectly ok, but you should avoid Glucosamine Sulphate * NaCL (or KCl) (or if the ingredients list says potassium or salt after the sulphate). Some companies are very tricky about this - unless it just says Glucosamine Sulphate or HCL, you likely are getting an inferior product. It is easy for people to see the Glucosamine Sulphate and simply ignore the ‘KCl’ on the end. We are not all molecular scientists after all.

Glucosamine & Chondroitin are available in the following forms:

• Pure Capsules
• Tablets (pills)
• Pure Powder
  
• Liquid (Joint Formulas)

Pure Capsules
Capsules without any bulking ingredients or flow agents are good.

Tablets
Tablets always contain binding and bulking agents so usually contain much less of the actual working ingredient and are often aggressive to the stomach lining.

Pure Powder and Liquids (Joint formulations)
Pure Powder is the most bio available and economical form of Glucosamine Sulphate and Chondroitin Sulphate. Simply add the powder to juice or water.

Liquid joint formulations are good however you are often paying for the suspension liquid when it's the Glucosamine that does the job! So it's best to buy pure powder and add it to a liquid of your choice!
The Powerful Benefits of Liquids

Liquids, aside from offering the obvious benefit of being easy to swallow, have another very important trait. Unlike tablets and capsules, liquid starts to be absorbed as soon as it enters the stomach. It is not uncommon to have capsules pass right through the body in a way that the product name is still visible after the capsule has left the body completely. This does not happen with liquids, as they are absorbed almost 100% and are not wasted.
Tablets and capsules may cost less, but in reality you get far less absorption for your money. No wonder they cost less! Liquids are fast - you do not even have to wait for them to dissolve. They start working as soon as you swallow and many have fairly pleasant flavors.

Beneficial Complementary Ingredients -

MSM(Methyl-Sulphonyl-Methane) Hydrolysed Collagen Celadrin Omega 3 Fatty Acids Manganese Ascorbate Boswellia (Boswellin) Serrata Vitamin A Vitamin C Vitamin E Bromelaine Yucca Niacinamide Aloe Vera Gel

The important ones to look for on the label are - Hydrolysed Collagen, MSM, Vitamin C, Celadrin

…Why Collagen?
Collagen is a protein that naturally occurs in your body and is a component of white fibers contained in skin, bones, tendons and other connective tissues. The collagen works as a building block giving these tissues their form, strength and flexibility.

From about the age of 25 the body’s natural collagen levels begin to deplete and continue to do so at a rate of 1.5 per cent each year after. (you know when get the sagging bags underneath your eyes, …just kidding).
This and decreased ability to restore and synthesize normal collagen structures can result in general wear and tear of the body’s tissues. It is possible to combat this depletion supplementing your body with collagen and other nutrients in your diet.

…Why MSM?
This is a source of organic Sulphur that acts as a anti-inflammatory. The MSM encourages the cells to be more youthful and it does this by making then more flexible and allowing toxins to be removed. This enables the cells to absorb more nutrients. Sulphur is known to be a vital element for the body to produce and regenerate cartilage and as we get older the levels of MSM diminish.

…Why Vitamin C?
We all know about the use of Vitamin C for the common cold etcetera, but did you know that it is required for the maintenance of normal connective tissue. Vitamin C is a potent antioxidant and is instrumental in collagen production and maintenance of the strength and togetherness of the collagen fibers. (most of us have far too low levels Vitamin C in our bodies, due to poor diets and further depletion because of stress etcetera). Vitamin C helps us to assimilate collagen and helps us to assist in natural collagen synthesis and wound healing).

…Why Celadrin?
This a new natural proprietary ingredient, that has clinically proven itself to reduce pain and swelling and rapidly promote joint health, whilst improving flexibility and mobility. Celadrin is a patented blend of estified fatty acid carbons which have been scientifically arranged to achieve maximum efficacy for joint mobility and health. Celadrin is an anti-inflammatory which reduces pain quickly with no known side effects and has been published twice in the internationally acclaimed ‘Journal of Rheumatology’.


How much should I take?

The majority of studies suggest a daily intake of 1,500mg of Glucosamine Sulphate and 1,200mg of Chondroitin Sulphate. After 60 days, a daily maintenance dosage of 750mg Glucosamine Sulphate and 600mg of Chondroitin Sulphate is recommended.
Sadly, no 'dosage-response' studies have been published in the scientific literature to gain a better understanding of how much of each compound might really be needed for maximum benefit. Most clinical studies use 1,500mg of Glucosamine Sulphate and 1,200mg of Chondroitin Sulphate daily over 4 to 12 week periods and these dosages have been used to judge short-term safety of the compounds.
A problem has been that certain brands of the supplements are 'cheating', some products have been independently tested and found to have high potency, whilst other brands have significantly less of the compound, compared with what is stated on the label (you can check this out at www.consumerlab.com).
Even though in Europe Glucosamine Sulphate and Chondroitin Sulphateis are prescription drugs, therefore need to meet quality-control standards, there is still a great difference between the quality of the various brands out there so check carefully what you buy.

What Kind of Glucosamine & Chondroitin Sulphate should I Buy?

There are so many different forms and types and brands of Glucosamine & Chondroitin Sulphate out there and the quality varies widely. It is often advised that one seek out a reputable manufacturer - one that offers a full, no questions asked, money back guarantee – but I have found it hard to find a manufacturer that provides you with that kind of quarantee. From the ones that provide a product that adheres to the latest research findings, only one is providing such a guarantee. It may be best to follow the old saying that you get what you pay for.
It can also be helpful to look at the label before you buy or get recommendations from other people you know that use Glucosamine & Chondroitin. A good liquid brand should cost you about one pound a day or slightly more and include Glucosamine Sulphate or HCL or both, Chondroitin Sulphate and other "synergistic" (effective in combination) ingredients as well. Again, Glucosamine & Chondroitin in tablet form is not recommended due to low absorption issues. Some of the better formulas will also contain some or all of the following, Hydrolised Collagen, MSM, Celadrin and Vitamin C.

So the supplement does live up to it’s hype …or does it?

If you have ever tried Glucosamine & Chondroitin Sulphate you will probably have found the benefit from this. However, it is also suggested that Glucosamine & Chondroitin Sulphate have a large and complex molecular structure - too large to pass easily through the small pores in the capillary walls. This means that the substance can’t be absorbed properly and therefore does not get to where it's needed most, the joints and spine. It stays in the blood only to be filtered out by the body's waste system! Most Glucosamine & Chondroitin Sulphate supplements do work, but only in a limited way according this theory. Most manufacturers   
combat this problem by adding
higher and higher levels and
concentrations of Glucosamine
& Chondroitin Sulphate into the
supplements… Just overload the
body with huge amounts of
Glucosamine & Chondroitin
Sulphate and you will get more
to where it is needed (Duh!)
Al this does is wasting an expensive
product, but also puts an unhealthy
pressure on the digestive and waste
systems of the body – not good if you
are seeking "natural" and "safe" remedies!

The Solution

The science and technology of nutraceutical supplementation has moved on. One company has come up with a supplement that has surprisingly little actual Glucosamine & Chondroitin Sulphate in it. In this supplement the ingredients have been broken down into the smaller molecular sized base compounds which, when combined together, form Glucosamine & Chondroitin. These base compounds are pure amino acids and aminosaccharides and are much easier absorbed into the cells which triggers them to produce their own Glucosamine and Chondroitin. This looks to be a far better and more effective option than trying to move higher levels through the digestive system – not really a "natural" option!
The product is known as Cortaflex, which is not really new. The reason why probably most people have not heard of this product is because it was initially made for race horses and horses involved in jumping competitions (Equine Cortaflex) – for a study on the effectiveness for horses please visit www.jointsupplementresearch.com
The company has now produced a similar product for humans too. Before you know it you will be jumping higher then ever.
The company has also released Cortaflex HA Capsules which are double the strength of the regular capsules and have the addition of Hyaluronic Acid - a major component of Synovial Fluid (joint lubricating fluid).


CONFUSED?

Research has proven that a Glucosamine & Chondroitin supplement helps in reducing pain and stiffness in osteo-arthritic joints and spine, so it is worth investing money in this supplement.
People who have NO problems with their joints (or maybe some slight intermittend aches) they also benefit enormously from this supplement as it is proven in research to minimize the effects of aging / wear and tear of the joints and spine. So do not wait for the problems to start but prevent your joints and spine from wearing out excessively!

Personally I have not had the change yet to try Cortaflex, so I cold not comment on the benefits of this product. However I will do a trial in the Clinic and also will personally use it. When I have the findings ready I will let you know.
I have managed to arrange sachets from Cortaflex – the company owner has informed me that this product starts to show it’s benefits within 7 days! If you wish to try this for yourself then please collect a supply for seven days for FREE and all I ask is to provide me your testimonial of your experience with the 7 day trial.
Only as long the supply lasts.

Below you will find a short list of the brands / products that I know from personal use and trials in the Clinic that they are effective (my personal favorite is Joint Therapy). Patients often ask me what brand to buy and if they can buy it in the Clinic. On numerous requests I decided to stock the products in the Clinic for the convenience of the patients, but you may prefer to visit your favorite health food shop. Knowing what product(s) to ask for I have listed the better product/brands available and have included the price (As you probably have noticed I use the term investment and not price or fee. It is an investment in the health of your spine and joints and not a cost) this to make sure you are not being charged too much.
                   
 
     BRAND        INVESTMENT      FORM        COLLAGEN INCLUDED    
Joint Therapy       £ 34.97     Pure Powder             Yes
(28 SERVINGS)       

Collagen Plus
(30 SERVINGS)        £ 24.97     Pure Powder             Yes      

Cortaflex
(60 SERVINGS)          £ 24.97     Pure Powder              N/A

Cortaflex HA
(30 SERVINGS)        £ 24.97     Pure Powder              N/A


If you wish you can order the products over the phone on 01244 852545 or 851449 or just pop in the Clinic, this may give you the opportunity to ask me any questions in person.
We will soon provide the online buying option as well, so until then the ‘good old - fashioned’ way of buying.

Please do not hesitate to contact me via the phone or email with any questions you may have so I may be able to help you. Our personal support comes at no extra charge.


Wishing you good Health

Arjen Bootsma  BSc(Hons) MCSP SRP
Founder ChesterPhysio
.