Alternative Joint-Health Ingredients Are on the Rise

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By now, the notion that glucosamine and chondroitin sulfate sales are declining in the U.S., or at least leveling off, should not come as a big surprise. After all, some market researchers (not all) have reported net losses for these joint-health giants for a few years now.¹ Although glucosamine and chondroitin still make up the whopping majority of the market, consumer concerns over issues like adulteration, reports of some poor-quality products^2,3, allergies related to shellfish sources, plus the not-so-natural state of some highly processed ingredients have all contributed to diminishing sales-in spite of the fact that there is modern data suggesting that these ingredients may alleviate conditions such as osteoarthritis.⁴

Some of those lost dollars are now being taken up both by other familiar joint-health ingredients and lesser-known alternatives (like botanicals). There are many options, and research is expanding around these ingredients.

Vegetarian Alternatives

If there’s one bright spot for glucosamine and chondroitin right now, it may just be vegetarian versions of these ingredients. These options not only open channels to vegetarian consumers; they also eliminate any animal-source concerns, such as shellfish allergies.

Gnosis S.p.A. (Desio, Italy), for instance, is stepping into the chondroitin sulfate arena with its latest ingredient, Mythocondro, launched at this year’s SupplySide West trade show. Produced through a non-animal fermentation process, Mythocondro is said to be structurally and functionally similar to traditional chondroitin sulfate.

Because cow, pig, chicken, and fish species can all be used as raw material for chondroitin sulfate, Gnosis product-support specialist Lorena Carboni says it’s possible that products may include a blend of all of these sources. According to Carboni, the result may be “a chondroitin sulfate final product [with] mixed characteristics and not-well-defined activities.” By providing a traceable and consistent product, she adds, Mythocondro can avoid product-of-origin and adulteration questions that plague the modern chondroitin sulfate market.

Chondroitin isn’t the only ingredient going vegetarian; multiple ingredient suppliers offer glucosamine ingredients created from plant sources using fermentation and fungal processes. Some of the most famous of these ingredients are Cargill’s (Minneapolis) Regenasure ingredient, TSI USA’s (Missoula, MT) GlucosaGreen and its brand new GlucosaGreenDF, and Ethical Naturals’ (San Anselmo, CA) GreenGrown glucosamine.

Although these ingredients have been on the market for years, suppliers like Cargill say they are now seeing renewed interest in them, from both new and existing joint-health product manufacturers, some of whom may have once been formulating with animal sources.

Collagen

Collagen sales continue to impress with an estimated 123% sales boost over the last year, according to SPINS data. These building blocks of connective tissue are well studied, and, in some cases, they’re found with innate glycosaminoglycans and other useful compounds.

Not all collagen is the same, however.

BioCell Technology LLC (Newport Beach, CA), for instance, supplies a collagen composition of type II collagen, hyaluronic acid, and chondroitin sulfate. BioCell has already completed significant amounts of joint-health research on this ingredient, BioCell Collagen. Recent clinical-trial findings indicate that, by supporting joint health, the ingredient may lead to improvement not only in daily activities but also functional recovery from exercise.^5,6

Rousselot (Son, Netherlands), on the other hand, offers a collagen peptide, Peptan, based on type I collagen. When put to the test earlier this year, Peptan generated more cartilage and protein synthesis in animal subjects, while also significantly reducing joint-related inflammation markers.⁷

Type I and type II collagen aren’t the only collagen types making news. Thanks to a patented processing method, Certified Nutraceuticals’ (Murrieta, CA) KollaGen IVX ingredient, derived from eggshell membrane, contains significant levels of type I collagen, but also type V and type X collagen. While these obscure collagens are found in extremely lower amounts, they are believed to play important roles in the regeneration of type I collagen and the protection of tissues. The company also offers another joint-health product, TendoGuard, that combines types I, II, V, and X with glycosaminoglycans, plus hyaluronic acid and chondroitin sulfate.

As the research piles up on collagen ingredients and joint health, companies are actively seeking global health claims to back their collagen ingredients.

Gelita (Sergeant Bluff, IA) filed for European health claims relating to its Fortigel gelatin peptides back in July 2015, but then EFSA announced new guidelines for health claims in January 2016. The new guidelines included new recommendations for scientific substantiation, leading Gelita to withdraw its original applications. The company told Nutritional Outlook that it is already working on new studies and intends to refile its applications to meet the new recommendations.

Collagen ingredients can be derived from a variety of animal byproducts, including cartilage from cattle, pig, fish, and chicken. Eggshell membrane is another such byproduct. Byproducts enable companies to reuse materials that otherwise would be discarded, and by doing so, create an appealing sustainability story.

Together with its manufacturing partner ESM Technologies, ingredient distributor Stratum Nutrition (St. Charles, MO), which markets the NEM brand of eggshell membrane, says the NEM business has already diverted over 11,000 metric tons of raw, broken eggshells from landfills to the ingredient supply.

MSM

As a naturally occurring sulfur compound in plants, methylsulfonylmethane (MSM) continues to gain the backing of positive clinical results in studies testing MSM’s use alone or in combination with other ingredients intended for joint health.

In recent trials, MSM combined with ingredients like boswellic acid, chondroitin sulfate, curcumin, collagen, hyaluronic acid, and numerous other ingredients appeared to relieve pain and improve functionality in various joint-related disorders.^8,9,10

While noting that MSM is highly effective on its own, “many of our customers use it in combination with other ingredients,” says Tim Hammond, vice president of sales and marketing at Bergstrom Nutrition (Vancouver, WA), purveyor of the OptiMSM brand. Hammond adds that additional areas of interest for MSM include uses in post-workout recovery. Already, positive studies are starting to emerge in this area.

Turmeric

A host of botanical ingredients have also shown therapeutic promise for joint health.

The botanical superstar turmeric (Curcuma longa) is probably one of the most famous in this area. Latest sales numbers out of the American Botanical Council’s HerbalGram journal indicate that in 2015 alone, turmeric sales grew 32.2% in the natural channel. According to another market report from SPINS, turmeric sales in U.S. health channels increased 156% in the past year.

As turmeric suppliers fight for their share of the joint-health space, one supplier, Sabinsa (East Windsor, NJ), believes its unique approach to turmeric and joint health is best for yielding results. For nearly a decade now, the company has promoted the ingredient turmeric in Arthriblend-SR, a sustained-release combination of curcumin (a primary bioactive in turmeric), boswellic acid, glucosamine, and piperine. Each component of Arthriblend-SR has been evaluated in its own right for joint health, and each works through a different mechanism of action.

Arthriblend-SR’s unique delivery system ensures sustained release of the actives over an eight-hour period. This can be reassuring when one considers the relatively short half-life of curcumin and boswellic acids in the body. Put simply, by extending release, Arthriblend-SR gives these active ingredients a better chance of efficacy, Sabinsa suggests.

Clinical improvements seen with Arthriblend-SR include reduced use of painkillers and improvements in musculoskeletal movement and WOMAC scores.

Research also continues to support curcumin’s potential role in alleviating joint-health problems on its own.^11,12

Hops

A unique, alternative botanical for joint health may be had in hops (Humulus lupulus). Its flowers are most often used for beer making, but a couple of companies have harnessed a pain-relieving extract from it.

Soft Gel Technologies (Commerce, CA) says its Perluxan hops extract has proven to be as effective as ibuprofen as a COX-2 inhibitor, and humans in clinical trials have reported pain relief from Perluxan just two hours after ingestion. More research is still needed to determine the lowest dose needed for efficacy, though.

Soft Gel markets Perluxan in a resin format, but ingredient distributor Pharmachem Laboratories (Kearny, NJ), responsible for much of the research on this ingredient, supplies it in a powder material. Both parties say that Perluxan’s pain relief is largely (though not entirely) a result of its content of alpha acids, so the ingredient is standardized for this purpose.

Chebulic Myrobalan

Throughout South Asia, the Ayurvedic plant chebulic myrobalan (Terminalia chebula) is regarded for its fruit’s healing properties-so much so that it is sometimes referred to in Tibet as “King of Medicine.”¹³ Seeing a financial opportunity in this, Natreon (New Brunswick, NJ) recently introduced AyuFlex, an aqueous extract of chebulic myrobalan that can be sold as a dietary supplement.

Earlier this year, researchers reported clinical improvements in stiffness and WOMAC scores, along with a decreased need for painkillers, when AyuFlex supplementation was compared with placebo supplementation in osteoarthritis subjects after 12 weeks.¹⁴ Results of an additional study, this time on joint mobility in overweight subjects, were revealed at this year’s SupplySide West show but were not available at press time.

Horsetail

Although it may come as a surprise to some of us, horsetail (Equisetum arvense) was a big earner in joint-health supplements last year, according to SPINS data. The species of rush plant pulled in an 18% increase in industry sales. Horsetail supplier Draco Natural Products (San Jose, CA) confirms the success, having seen its own recent increase in horsetail powder sales and turnover of inventory.

Clinical research on horsetail consumption is still lacking, but some studies suggest that horsetail may be a useful supplement for bone nutrients and pain relief.^15,16 Horsetail is believed to be a bioavailable source of silicon. Silicon performs an important role in connective tissues, such as cartilage and bone.

A considerable body of research exists for silicon. And the horsetail supply is ripe, too. Draco Natural Products, for instance, can and does source horsetail powder from virtually every province in China.

Also read:

NEM Eggshell Membrane May Improve Joint Health in Dogs

New Joint-Health Chewable Offers Alternative to Glucosamine and Chondroitin

Shilajit Extract May Upregulate Genes Responsible for Collagen Synthesis

References:

1. SPINS recorded a $23.8 million loss in cross-channel aggregate U.S. sales for glucosamine–chondroitin combination products in the 52 weeks ending July 10, 2016, and a $14 million loss for solo glucosamine supplements.
2. N Volpi, “Quality of different chondroitin sulfate preparations in relation to their therapeutic activity,” Journal of Pharmacy and Pharmacology, vol. 61, no. 10 (October 2009): 1271–1280
3. J Martel-Pelletier et al., “Discrepancies in composition and biological effects of different formulations of chondroitin sulfate,” Molecules, vol. 20, no. 3 (March 2015): 4277–4289
4. MC Hochberg et al., “Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicenter, randomized, double-blind, non-inferiority trial versus celecoxib,” Annals of the Rheumatic Diseases, vol. 75, no. 1 (January 2016): 37–44
5. AG Schauss et al., “Effect of the novel low molecular weight hydrolyzed chicken sternal cartilage extract, BioCell Collagen, on improving osteoarthritis-related symptoms: a randomized, double-blind, placebo-controlled trial,” Journal of Agricultural and Food Chemistry, vol. 60, no. 16 (April 25, 2016): 4096–4101
6. HL Lopez et al., “Evaluation of the effects of BioCell Collagen, a novel cartilage extract, on connective tissue support and functional recovery from exercise,” Integrative Medicine, vol. 14, no. 3 (June 2015): 30–38
7. QA Dar et al., “Oral hydrolyzed type 1 collagen induces chondroregeneration and inhibits synovial inflammation in murine posttraumatic osteoarthritis,” Osteoarthritis and Cartilage, vol. 24, supplement 1 (April 2016): S532–S533
8. A Notarnicola et al., “The ‘MESACA’ Study: methylsulfonylmethane and boswellic acids in the treatment of gonarthrosis,” Advances in Therapy, vol. 28, no. 10 (October 2011): 894–906
9. G Merolla et al., “Co-analgesic therapy for arthroscopic supraspinatus tendon repair pain using a dietary supplement containing Boswellia serrata and Curcuma longa: a prospective randomized, placebo controlled study,” Musculoskeletal Surgery, 99 (September 2015), supplement 1: S43–S52
10. A Notarnicola et al., “Methylsulfonylmethane and boswellic acids versus glucosamine sulfate in the treatment of knee arthritis: randomized trial,” International Journal of Immunopathology & Pharmacology, vol. 29, no. 1 (March 2016): 140–146
11. K Perkins et al., “Efficacy of Curcuma for treatment of osteoarthritis,” Journal of Evidence-Based Complementary & Alternative Medicine. Published online March 14, 2016
12. JW Daily et al., “Efficacy of turmeric extracts and curcumin for alleviating the symptoms of joint arthritis: a systematic review and meta-analysis of randomized clinical trials,” Journal of Medicinal Food, vol. 19, no. 8 (August 2016): 717–729
13. B Anwesa et al., “The development of Terminalia chebula Retz. (Combretaceae) in clinical research,” Asian Pacific Journal of Tropical Biomedicine, vol. 3, no. 3 (March 2013): 244–252
14. N Chandrasekhar et al., “A randomized, double-blind, placebo-controlled, parallel group clinical study to evaluate the analgesic effect of aqueous extract of Terminalia chebula, a proprietary chromium complex, and their combination in subjects with joint discomfort,” Asian Journal of Pharmaceutical and Clinical Research, vol. 9, no. 3 (February 2016): 264–269
15. SD Kotwal et al., “Anabolic therapy with Equisetum arvense along with bone mineralizing nutrients in ovariectomized rat model of osteoporosis,” Indian Journal of Pharmacology, vol. 48, no. 3 (May–June 2016): 312–315
16. A Asgharikhatooni et al., “The effect of Equisetum arvense (horse tail) ointment on wound healing and pain intensity after episiotomy: a randomized placebo-controlled trial,” Iran Red Crescent Medical Journal, vol. 17, no. 3 (March 3, 2015): e25637