Smart Supplementation

Beyond Glucosamine & Chondroitin: Supplements for Arthritis

When you think of dietary supplements for the joints and arthritis, chances are that you're thinking of glucosamine and chondroitin sulfate--which makes sense since there is good research to support the use of these nutraceuticals for this purpose.  What many people don't know, however, is that there are other nutraceuticals which also can be used effectively for arthritis.  Three of these are hyaluronic acid, calcium fructoborate and bromelain.

Hyaluronic acid

Hyaluronic acid (HA) is a naturally occuring substance found outside of cells, in the tissues and body fluids of all vertebrates. HA is a polysaccharide (long-chain sugar) chain found most primarily in cartilage, synovial fluid, skin, and the aqueous humor in the eye [1]--areas in the body where it serves as part of the supporting structure, cushioning and lubricating.

Research suggests that hyaluronic acid may prevent the breakdown of natural cushioning barriers in joint [2]. It seems that hyaluronic acid binds to cellular receptors on the surface membrane of cartilage and other cell types, supporting wound healing as well as reducing the enzymes that contribute to cartilage breakdown [3-4]. In randomized double-blind placebo-controlled study, 20 subjects with arthritis of the knee received either an oral form of hyaluronic acid or placebo for 8 weeks. The results were that daily supplementation with hyaluronic acid was useful to enhance several markers of quality of life in adults with knee arthritis, including improving pain and discomfort [5]. 

One form of hyaluronic acid that is significantly more effective than other forms is Hyal-Joint.  Hyal-Joint is 2 to 4 times more active in nourishing synovial fluid and supporting its health than regular hyaluronic acid. The increased activity comes from the unique (patent pending) composition of Hyal-Joint which naturally contains hyaluronic acid, as well as collagen and other proteoglycan which together create a special synergistic effect [6].

Fruitex-B® (aka, Calcium Fructoborate)

Fruitex-B®, which is also known as calcium fructoborate, is a form of the mineral boron. In research involving subjects with arthritis, 50% of the patients who received a daily supplement of 6 mg of boron noted improvements in joint pain associated with movement, while only 10% of subjects given a placebo experienced similar improvement [7]. Clinical studies demonstrate that Fruitex-B® especially effective in reducing pain in patients with arthritis [8]. The reason for the improvements in pain may be the result of boron helping to reduce joint inflammation [9-11].

Bromelain

Bromelain is a proteolytic (i.e., protein-digesting) enzyme found in pineapples.  Bromelain has proteolytic action on a variety of proteins, breaking them down into smaller peptides and amino acids [12].  Beyond its protein digesting capacity, research has shown that bromelain helps reduce inflammation. This was seen in a study where bromelain helped patients with arthritis, 73% of whom had good to excellent results [13].

References

1. Goa KL, Benfield P. Hyaluronic acid. A review of its pharmacology and use as a surgical aid in ophthalmology, and its therapeutic potential in joint disease and wound healing. Drugs 1994;47:536-66.
2. Dougados M. Sodium hyaluronate therapy in osteoarthritis: arguments for a potential beneficial structural effect. Semin Arthritis Rheum 2000;30(2 Suppl 1):19-25.
3. Chen WY, Abatangelo G. Functions of hyaluronan in wound repair. Wound Repair Regen 1999;7:79-89.
4. Petrella RJ, DiSilvestro MD, Hildebrand C. Effects of hyaluronate sodium on pain and physical functioning in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled clinical trial. Arch Intern Med 2002;162:292-8.
5. Available at: http://www.hyal-joint.com/doc.php?op=uniqueness&tit=The%20uniqueness%20of%20Hyal-Joint. Accessed October 5, 2009.
6. Travers RL, Rennie GC, Newnham RE. Boron and arthritis: the result of a double-blind pilot study. J Nutr Med. 1990;1:127-32.
7. Available at: www.futureceuticals.com/proprietary/pdf/FruitexBBrochure.pdf. Accessed June 1, 2006
8. Hall IH, Rajendran KG, Chen SY, et al. Anti-inflammatory activity of amine-carboxyboranes in rodents. Arch Pharm (Weinheim). 1995 Jan;328(1):39-44.
9. Rajendran KG, Chen SY, Sood A, Spielvogel BF, Hall IH. The anti-osteoporotic activity of amine-carboxyboranes in rodents. Biomed Pharmacother. 1995;49(3):131-40.
10. Hall IH, Starnes CO, McPhail AT, et al. Anti-inflammatory activity of amine cyanoboranes, amine carboxyboranes, and related compounds. J Pharm Sci. 1980 Sep;69(9):1025-9.
11. Osol A, Robertson, P. The United States Dispensatory, 27th edition. Philadelphia: J.P. Lippincott Company; 1973: 201.
12. Cohen A, Goldman J. Bromelains therapy in rheumatoid arthritis. Pennsylvania Med J 1964; 67:27-30.