Thursday, June 7, 2012
I feel like I should start this blog with "forgive me Father, for I have sinned, it has been almost 3 months since my last blog". I am sorry for not blogging...if only I could explain the level of intensity that has consumed my life for the past couple months. I will just say, WOW. Now that I'm past that drama, let's talk about joint supplements. This is one topic I am asked about frequently and I do believe my reply is always the same..."uggghhhh". The scientist in me struggles severely with research related to this topic. I read a recent article this week from the Journal of Veterinary Internal Medicine (Vandeweerd, et al., 2012) that did a really nice job of evaluating the nutraceutical research in dogs, cats, and horses. They started off with 67 published studies and after ruling out those that didn't have any connection with the subjects (relied on completely subjective reported opinions), in vitro studies (test tube), no evaluation of clinical signs of pain or locomotion (not sure what the heck they measured), and those that were not controlled, the researchers wound up with only 22 of the original 67. That is why I respond with "ugggghhhhh". If I had been included on that paper, I would have included the in vitro studies (14) because it's those studies that often tell us more about what is going on at the cellular and molecular level. Since our animal companions cannot tell us what hurts, at least knowing we may be eliminating some pain and inflammation is useful. So, I decided to basically review some of the big name products and specifically review what the main ingredients do. Glucosamine: This is the main ingredient in the vast majority of joint health supplements. I look for a dose between 10-20 mg per pound of body weight. So, for Karma, my little border collie (25 Lb), I want to make sure she is getting about 250 mg daily. Glucosamine is a natural compound, more specifically an amino sugar found in cartilage and in fact is in high concentrations in trachea. Chondroitin : This compound is a complex carbohydrate found in healthy cartilage that helps retain water. This compound has almost exclusively been researched in conjunction with glucosamine in animals; therefore, coming up with a specific dose is not feasible. Fish oil: This might surprise everyone; however, the research surrounding fish oil, in particular the 2 omega 3 fatty acids known as EPA and DHA have the most definitive benefits in regard to inflammation and joints. I typically suggest 1,000 mg for a 40 Lb dog. MSM (Methylsulfonylmethane): This is a cool compound! I kind of like it a lot because it's just useful. It is a natural compound found in most living tissue, both animal and plant and helps to reduce pressure in cells. This is one of those compounds whose efficacy in reducing symptoms is difficult to determine; however, in vitro studies at the molecular and cellular level do indicate it is useful for inflammatory conditions. You will see doses typically ranging from 10 - 30 mg per pound of body weight. Green Lipped Mussel: This ingredient contains a unique omega 3 fatty acid that prevents oxidative stress. Avocado and soybean unsaponifiables (one of the active ingredients found in Dasuquin): There are several good in vitro studies that indicate this compound actually can improve structural components of joint cartilage; however, there is no dose range for inclusion. There certainly are other ingredients that get included in joint supplements that are of value including Vitamins E and C, milk proteins (active ingredients in Duralactin), Cetyl myristoleate (active ingredient in Cetyl-M), and manganese. These compounds have either structural(manganese), anti-inflammatory or antioxidative properties. So, you may be guessing where I'm going here but when it comes to selecting a joint supplement, I want one that includes as much structural, antioxidative, and anti-inflammatory potential as possible. In my opinion the 3 best products that reach those goals are: Dasuquin, Synovi G3, and Glyco-Flex III. All 3 of those products contain ingredients that address all 3 concerns related to joints (structure, inflammation, and reduction of oxidation). I'd like to thank one of my interns this summer (Cam Bexten) for researching the commercial products and listing out all of their ingredients and doses. Without her, this blog post wouldn't have been written. Vandeweerd et al. 2012. Systematic review of efficacy of nutraceuticals to alleviate clinical signs of osteoarthritis. J. Vet. Intern. Med. 26: 448-456.