Tropical Oasis Joint Complete – with Hyaluronic Acid, 32 oz
Our same great Liquid Glucosamine/Chondroitin formula now enhanced with Hyaluronic Acid a natural ‘cushioner’! 32 oz size for great tasting results! This product contains: HYALURONIC ACID(HA), also known as hyaluronan, is an important disaccharide found in every tissue of the body, but in particular as an essential lubricant of healthy joints, skin and eyes. It is part of a group of macromolecules in the body labeled as glycosaminoglycans (GAGs), which are primarily in cell membranes and in the intercellular matrix of connective tissue. Along with water, HA’s unique property of high viscosity, and therefore low compressibility, provides vital shock absorption and lubrication properties. In the intercellular matrix, HA essentially operates with water to ‘bathe’ cells. GLUCOSAMINE Who is likely to be deficient? A glucosamine deficiency in humans has not been reported. Which form is best? Glucosamine is available in several forms. The glucosamine sulfate (GS) form (stabilized with a mineral salt) is the only form clearly shown in clinical trials to be effective for osteoarthritis. For this reason, it is the preferred form. GS is stabilized with one of two mineral salts: sodium chloride (NaCl) or potassium chloride (KCl).1 2 Although they both appear to effectively stabilize GS, the use of KCl as a stabilizer seems preferable since the average Western diet already provides far too much salt (NaCl) and not enough potassium. However, most of the research has been done with the NaCl-stabilized form. Glucosamine hydrochloride (GH) has been widely available as a dietary supplement for years, but only one trial has evaluated this form of glucosamine as a single remedy for OA.3 This trial found only minor significant benefits from 1,500 mg per day of GH for eight weeks, in people with osteoarthritis of the knee who were also taking up to 4,000 mg/day of acetaminophen. To more fairly evaluate the effects of GH, future research should involve people not taking pain-relieving medication. Another form of glucosamine, N-acetyl-glucosamine (NAG), has not been studied in people with osteoarthritis. How much is usually taken? Healthy people do not need to routinely supplement with glucosamine. Most research with people who have osteoarthritis, uses 500 mg three times per day of GS. Appropriate amounts for other conditions are not known. Are there any side effects or interactions? At the amount most frequently taken by adults?500 mg three times per day of GS?adverse effects have been limited to mild reversible gastrointestinal side effects. In one trial, people with peptic ulcers and those taking diuretic drugs were more likely to experience side effects.4 Animal research has raised the possibility that glucosamine could contribute to insulin resistance.5 6 This effect might theoretically result from the ability of glucosamine to interfere with an enzyme needed to regulate blood sugar levels.7 However, available evidence does not suggest that taking glucosamine supplements will trigger or aggravate insulin resistance or high blood sugar.8 Two large, 3-year controlled trials found that people taking GS had either slightly lower blood glucose levels or no change in blood sugar levels, compared with people taking placebo.9 10 Until more is known, people taking glucosamine supplements for long periods may wish to have their blood sugar levels checked; people with diabetes should consult with a doctor before taking glucosamine and should have blood sugar levels monitored if they are taking glucosamine. In 1999 the first case of an allergic reaction to oral GS was reported.11 Allergic reactions to this supplement appear to be rare. Some GS is processed with sodium chloride (table salt), which is restricted in some diets (particularly for people with high blood pressure). The theory that GS and chondroitin sulfate work synergistically in the treatment of osteoarthritis remains unproven. At the time of writing, there were no well-known drug interactions with glucosamine. CHONDROITIN Who is likely to be deficient? Because the body makes chondroitin, the possibility of a dietary deficiency remains uncertain. Nevertheless, chondroitin sulfate may be reduced in joint cartilage affected by osteoarthritis and possibly other forms of arthritis. How much is usually taken? For atherosclerosis, researchers have sometimes started therapy using very high amounts, such as 5 grams twice per day with meals, lowering the amount to 500 mg three times per day after a few months. Before taking such high amounts, people should consult a doctor. For osteoarthritis, a typical level is 400 mg three times per day. Oral chondroitin sulfate is rapidly absorbed in humans when it is dissolved in water prior to ingestion. Approximately 12% of chondroitin sulfate taken by mouth becomes available to the joint tissues from the blood.18 Are there any side effects or interactions? Nausea may occur at intakes greater than 10 grams per day. No other adverse effects have been reported. One doctor has raised a concern that chondroitin sulfate should not be used by men with prostate cancer. This concern is based upon two studies. In one, the concentration of chondroitin sulfate was found to be higher in cancerous prostate tissue as compared to normal prostate tissue.19 In the other study, it was shown that higher concentrations of chondroitin sulfate in the tissue surrounding a cancerous prostate tumor predict a higher rate of recurrence of the cancer after surgery.20 However, no studies to date have addressed the question of whether taking chondroitin sulfate supplements could promote the development of prostate cancer. Simply because a substance is present in or around cancerous tissue does not by itself suggest that that substance is causing the cancer. For example, calcium is a component of atherosclerotic plaques that harden the arteries; however, there is no evidence that taking calcium supplements causes atherosclerosis. To provide meaningful information, further studies would need to track the incidence of prostate cancer in men taking chondroitin supplements. Until then, most nutritionally-oriented doctors remain unconcerned about this issue. It is not known whether taking glucosamine sulfate and chondroitin sulfate in combination is a more effective treatment for osteoarthritis than taking either one by itself. At the time of writing, there were no well-known drug interactions with chondroitin sulfate. METHYLSULFONYLMETHANE (MSM) Who is likely to be deficient? Although MSM is present in food, it is not an essential nutrient, so deficiency is not likely. How much is usually taken? Some authorities report anecdotally that 250?500 mg per day has beneficial effects on a variety of health problems.6 However, the only controlled trial using MSM used over 2000 mg per day to treat osteoarthritis. More research is needed before reliable recommendations for MSM supplementation can be made. Are there any side effects or interactions? According to some anecdotal reports, MSM has been used in human research for many years in amounts above 2000 mg per day with no significant adverse effects.7 However, diarrhea, skin rash, headache, and fatigue may be experienced in less than 20% of people, according to other anecdotal reports. Detectable levels of MSM in the brain of a person taking MSM supplements have been reported,8 but the significance of this finding, if any, is unclear. At the time of writing, there were no well-known drug interactions with methylsulfonylmethane. VITAMIN C Who is likely to be deficient? Although scurvy (severe vitamin C deficiency) is uncommon in Western societies, many doctors believe that most people consume less than optimal amounts. Fatigue, easy bruising, and bleeding gums are early signs of vitamin C deficiency that occur long before frank scurvy develops. Smokers have low levels of vitamin C and require a higher daily intake to maintain normal vitamin C levels. Women with preeclampsia have been found to have lower blood levels of vitamin C than women without the condition.18 Women who have lower blood levels of vitamin C have an increased risk of gallstones.19 People with kidney failure have an increased risk of vitamin C deficiency.20 However, people with kidney failure should take vitamin C only under the supervision of a doctor. How much is usually taken? The recommended dietary allowance (RDA) for vitamin C in nonsmoking adults is 75 mg per day for women and 90 mg per day for men. For smokers, the RDAs are 110 mg per day for women and 125 mg per day for men. Most clinical vitamin C studies have investigated the effects of a broad range of higher vitamin C intakes (100?1,000 mg per day or more), often not looking for (or finding) the ‘optimal’ intake within that range. In terms of heart disease prevention, as little as 100?200 mg of vitamin C appears to be adequate.21 Although some doctors recommend 500?1,000 mg per day or more, additional research is needed to determine whether these larger amounts are necessary. Some vitamin C experts propose that adequate intake be considered 200 mg per day because of evidence that the cells of the human body do not take up any more vitamin C when larger daily amounts are used.22 Some scientists have recommended that healthy people take multi-gram amounts of vitamin C for the prevention of illness. However, little or no research supports this point of view and it remains controversial. Supplementing more results in an excretion level virtually identical to intake, meaning that consuming more vitamin C does not increase the amount that remains in the body.23 On the basis of extensive analysis of published vitamin C studies, researchers at the Linus Pauling Institute at Oregon State University have called for the RDA to be increased, but only to 120 mg.24 This same report reveals that ‘. . . 90?100 mg vitamin C per day is required for optimum reduction of chronic disease risk in nonsmoking men and women.’ Thus, the multiple gram amounts of vitamin C taken by many healthy people may be superfluous. The studies that ascertained approximately 120?200 mg daily of vitamin C is correct for prevention purposes in healthy people have typically not investigated whether people suffering from various diseases can benefit from larger amounts. In the case of the common cold, a review of published trials found that amounts of 2 grams per day in children appear to be more effective than 1 gram per day in adults, suggesting that large intakes of vitamin C may be more effective than smaller amounts, at least for this condition.25 Are there any side effects or interactions? Some people develop diarrhea after as little as a few grams of vitamin C per day, while others are not bothered by ten times this amount. Strong scientific evidence to define and defend an upper tolerable limit for vitamin C is not available. A review of the available research concluded that high intakes (2?4 grams per day) are well-tolerated by healthy people.26 However, intake of large amounts of vitamin C can deplete the body of copper27 28 ?an essential nutrient. People should be sure to maintain adequate copper intake at higher intakes of vitamin C. Copper is found in many multivitamin-mineral supplements. Vitamin C increases the absorption of iron and should be avoided by people with iron overload diseases (e.g., hemochromatosis, hemosiderosis). Vitamin C helps recycle the antioxidant, vitamin E. It is widely (and mistakenly) believed that mothers who consume large amounts of vitamin C during pregnancy are at risk of giving birth to an infant with a higher-than-normal requirement for the vitamin. The concern is that the infant could suffer ‘rebound scurvy,’ a vitamin C deficiency caused by not having this increased need met. Even some medical textbooks have subscribed to this theory.29 In fact, however, the concept of ‘rebound scurvy’ in infants is supported by extremely weak evidence.30 Since the publication in 1965 of the report upon which this mistaken notion is based, millions of women have consumed high amounts of vitamin C during pregnancy and not a single new case of rebound scurvy has been reported.31 A preliminary study found that people who took 500 mg per day of vitamin C supplements for one year had a greater increase in wall thickness of the carotid arteries (vessels in the neck that supply blood to the brain) than those who did not take vitamin C.32 Thickness of carotid artery walls is an indicator of progression of atherosclerosis. Currently, no evidence supports a cause-and-effect relationship for the outcome reported in this study. The vast preponderance of research suggests either a protective or therapeutic effect of vitamin C for heart disease, or no effect at all. People with the following conditions should consult their doctor before supplementing with vitamin C: glucose-6-phosphate dehydrogenase deficiency, iron overload (hemosiderosis or hemochromatosis), history of kidney stones, or kidney failure. It has been suggested that people who form calcium oxalate kidney stones should avoid vitamin C supplements, because vitamin C can be converted into oxalate and increase urinary oxalate.33 34 Initially, these concerns were questioned because of potential errors in the laboratory measurement of oxalate.35 36 However, using newer methodology that rules out this problem, recent evidence shows that as little as 1 gram of vitamin C per day can increase the urinary oxalate levels in some people, even those without a history of kidney stones.37 38 In one case, 8 grams per day of vitamin C led to dramatic increases in urinary oxalate excretion and kidney stone crystal formation causing bloody urine.39 People with a history of kidney stones should consult a doctor before taking large amounts (1 gram or more per day) of supplemental vitamin C. Despite possible therapeutic effects of vitamin C in people with diabetes at lower intakes, one case of increased blood sugar levels was reported after taking 4.5 grams per day.40 Are there any drug interactions? Certain medicines may interact with vitamin C. Refer to drug interactions for a list of those medicines. Copyright ? 2004 Healthnotes, Inc. All rights reserved. www.healthnotes.com
