Supplement 'eases crippling disease

Scientists have produced evidence that a food supplement can help to reduce the long-term suffering associated with the crippling disease osteoarthritis.

Osteoarthritis, or degenerative joint disease, is the most common form of arthritis, most often affecting middle-aged and older people.

The disease, which can cause severe disability and pain, tends to develop in the joints of the neck, lower back, knees, hips and fingers.

However, it may also occur in joints that have been previously injured, or subjected to prolonged heavy use.

Experts estimate that 60% of those aged 65 have moderate to severe osteoarthritis in at least one joint.

It is caused by the degeneration of the cartilage, the protective material that stops bones rubbing together in the joints.

Suffering From Joint Pain?

Joint pain can be caused by any number of things. It can be the result of an injury or overuse of the joint. If your joint pain is caused by arthritis, you will need to begin your search for an effective way to treat it. But, in order to do that, you need to know the symptoms of arthritis. All forms of arthritis share the common symptoms of severe pain, loss of range of motion, and a diminished quality of life. What you will find is that this painful, life altering condition can be found in any individual at any time of their lives. But, there are joint pain treatments that can be effective.

The first thing to do when you have joint pain is to go to a doctor. Symptoms of arthritis include severe pain in the joints and other factors as mentioned above. If your pain is accompanied with fever, the advice of a doctor is urgent because this specific type of arthritis can be deadly. Arthritis can be brought on by any number of things including overuse of the joint, sports, injury, and degeneration of the joints through time. In any case, it is important to relay to your doctor when it was first noticed, any related injuries you may have had, and what types of activities you perform on a regular basis. Your doctor will determine if the pain is arthritis through x-rays and blood tests. Once the doctor knows which type you have, treatments can begin.

For instance, the joint pain caused by rheumatoid arthritis is a function of the immune system destroying the cartilage in the joints affected. Cartilage is what keeps the bones
from grinding against each other. As your immune system eats away at your joint cartilage, pain is brought on by the formation of nerve endings in the affected area. Eventually, the pain is so sever that mobility in those joints is virtually impossible.

What is ankylosing spondylitis?

Ankylosing spondylitis is a form of chronic inflammation of the spine and the sacroiliac joints. The sacroiliac joints are located in the low back where the sacrum (the bone directly above the tailbone) meets the iliac bones (bones on either side of the upper buttocks). Chronic inflammation in these areas causes pain and stiffness in and around the spine.

Over time, chronic spinal inflammation (spondylitis) can lead to a complete cementing together (fusion) of the vertebrae, a process referred to as ankylosis. Ankylosis leads to loss of mobility of the spine.

Ankylosing spondylitis is 2-3 times more common in males than in females. In women, joints away from the spine are more frequently affected than in men. Ankylosing spondylitis affects all age groups, including children. The most common age of onset of symptoms is in the second and third decades of life.

Ankylosing spondylitis is also a systemic rheumatic disease, meaning it can affect other tissues throughout the body. Accordingly, it can cause inflammation in or injury to other joints away from the spine, as well as other organs, such as the eyes, heart, lungs, and kidneys. Ankylosing spondylitis shares many features with several other arthritis conditions, such as psoriatic arthritis, reactive arthritis, and arthritis associated with Crohn's disease and ulcerative colitis. Each of these arthritic conditions can cause disease and inflammation in the spine, other joints, eyes, skin, mouth, and various organs. In view of their similarities and tendency to cause inflammation of the spine, these conditions are collectively referred to as "spondyloarthropathies." For more information, please read the following articles; Psoriatic Arthritis, Reactive Arthritis, Crohn's Disease and Ulcerative Colitis.

Managing Musculoskeletal Injuries and Arthritis

Wayne McIlwraith, BVSc, PhD, FRCVS, DSc, DrMedVet (hc), Dipl. ACVS, Barbara Cox Anthony Chair and Director of Orthopaedic Research at Colorado State University, spoke on current and new therapeutic options to manage musculoskeletal injuries and osteoarthritis at the AAEP Focus meeting in Ft. Collins, Colo., on July 29.

He reminded the veterinary audience that interleukin-1 (a deleterious cytokine) is at the head of the inflammatory cascade, leading to a breakdown in the cartilage matrix through signaling factors that alter regulation and effect of inflammatory biochemical mediators. The goals of therapeutic intervention focus on returning a joint to normal as quickly as possible, when possible, and to prevent the occurrence and severity of osteoarthritis in an injured joint.

McIlwraith discussed intervention that targets management of capsulitis (joint capsule inflammation) and synovitis (inflammation of the synovial membrane lining the joint), since these tend to occur in advance of degenerative joint disease. One strategy that merits more investigation is physiotherapy, such as swimming or underwater treadmill therapy. This might be cutting-edge therapy, but more research and data is necessary to determine the extent of its value. One point McIlwraith made of great interest is the recent finding that two-thirds of the force across the carpus (knee) at the trot comes from muscle forces, rather than ground reaction forces as previously believed.

McIlwraith mentioned that extracorporeal shock wave therapy (ESWT) significantly reduces lameness and synovial fluid parameters as compared to control horses (those not receiving treatment) in the study; these findings support a pain and inflammatory mechanism of action that elicits lameness.

The clinicians in the panel discussion were also favorably impressed with the use of ESWT, particularly for injuries at a soft tissue and bone interface, such as in the distal (lower) joints of the hock and in the rear third of the heel associated with soft tissue trauma. Back pain was another suggested use of ESWT; however, it was felt if the back could readily be injected, there was no sense in spending the money on repeated shock wave treatments. One clinician said shock wave might be especially useful to apply to capsulitis and soft tissue damage in joints that are not amenable to intra-articular (IA) treatment.

The topic of non-steroidal anti-inflammatory drugs (NSAIDs) has been one of great interest to horse owners because of their value in managing pain and inflammation, yet the well-known adverse effects of gastric ulcer syndrome preclude long-term use of NSAIDs. There has been an in vitro study from some years ago suggesting that phenylbutazone might be injurious to joint cartilage, but McIlwraith noted there is no data or clinical evidence to support this claim in the live horse. With the introduction of a new cyclooxygenase-2 (COX-2, an enzyme that causes inflammation and pain) inhibitory drug (Equioxx) on the market, some information has come to light: If COX-2 mediators are completely suppressed, it is possible to get an up-regulation of interleukin-1, this being counterproductive to managing pain and inflammation. McIlwraith stressed that we should keep an open mind about the advantages of this newly released medication.

Another common joint therapy uses intra-articular (IA) steroid injections. McIlwraith revisited the pros and cons of various corticosteroid drugs, noting that not all of these are created equal in regard to how effective they are and their role in protecting the cartilage. The use of hyaluronic acid (HA) in conjunction with IA steroid treatment has been well-applied in the veterinary world for years. HA is no longer thought to have a primary function as a joint lubricant, since its anti-inflammatory effects are more important. One study mentioned by McIlwraith was that of improvement in lameness of horses injected only with 2 mL of sterile saline, the mechanism as yet undetermined. In moderate to severe cases of osteoarthritis, intra-articular therapy should include both steroids and HA.

Intravenous (IV) treatment with HA labeled for this use (Legend) has had marked favorable effects of decreasing synovial effusion in an injured joint, with therapeutic effects persisting for 44 days following the third weekly treatment. There is common usage of IV HA as a prophylactic medication in normal horses without lameness, and data thus far has not verified this to improve a horse's gait.

McIlwraith reported that oral HA seems to have some positive effect, with some ingredient remaining active in the molecule or fragment of the molecule after it passes through the intestinal tract.

Polysulfated glycosaminoglycans (PSGAGs) are considered to be "disease-modifying osteoarthritic drugs," and although they might be slow acting, they are cartilage modifying. Most of the favorable studies in using Adequan come from its intra-articular use. Studies on IM Adequan have given equivocal effects in one study, yet positive anecdotal reports abound.

A new product called pentosan polysulfate is soon to be licensed in the United States. This substance, made from beechwood hemicelluloses, seems to be a disease-modifying osteoarthritis drug, but it's without any pain-relieving activity such as seen with NSAIDs. Lameness is not improved, but progression of cartilage deterioration might be abated by correcting biologic imbalances in an osteoarthritic joint. Pentosan polysulfate exerts anabolic effects on cartilage precursor cells to decrease erosion of cartilage.

Oral supplements and nutraceuticals have been a hot topic in the horse world for some time. McIlwraith describes these as materials that are fed to heal the lame or make a chronically unsound horse become sound. They are used with the intention of preventing joint problems from occurring. However, McIlwraith points out that if a product is not licensed as a drug, then the manufacturer of such a food product cannot make medical claims as to its efficacy. There are no criteria for licensing these products, and, hence, there is often misrepresentation of advertising. In addition, there is no regulation to ensure the ingredients claimed by the label to be in the bucket are actually present in the bucket.

More specifically, McIlwraith discussed glucosamine salts that in theory are building blocks for articular cartilage. In one Virginia study, he said less than 6% of the material fed was actually bioabsorbed from the intestinal tract. In a Canadian study, following administration of glucosamine via stomach tube, very low levels showed up in the joints. McIlwraith said in one investigative report, fewer than a third of nutraceutical products contained less glucosamine in the container than what was listed on the label. In addition, he asked the audience, how do we even know the correct dose for a horse?

Chondroitin sulfate is absorbed well, but as McIlwraith pointed out, this does not prove effectiveness in the horse. Another study showed a joint-protective effect of a combination of glucosamine and chondroitin sulfate (Cosequin by Nutramax), but no anti-inflammatory effect. Other studies looked at the use of nutraceuticals on joint health, and either the studies did not have sufficient numbers of horses to be scientifically sound, or the data was flawed. When reading the results of studies, it is important to identify who is funding the study, since a company's vested interest could skew the results.

Some research has proven efficacy of the use of omega-3 fatty acids to inhibit enzymes that break down the cartilage matrix. In a three- to four-month period, horses supplemented with omega-3 fatty acids seemed to have less stiffness and pain related to osteoarthritis.

Finally, McIlwraith touched on the supplement with unsaponified avocado and soy, which is thought to somewhat decrease interleukin-1 levels and cartilage disease scores. This might be a useful product to add to a nutraceutical supplement, and more research should be pursued.

Think of yourself young

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Find yourself ; many women put certain aspects of themselves on hold while they bring up their children ,now that the children have sorted themselves out take up those aspects that interest you . Go back to an old hobby you had or discover a new one . Try to find fulfillment so that you don't become dependent on your children for interest or entertainment.

It is time to enjoy life ; This is a time when you can have a selective memory and remember the past successes and through out any thoughts that harm your self esteem fro after all you have more confidence now and wisdom and are less impulsive.

Feel optimistic; As you get old your priorities and ambitions may change but it is still important to continue setting yourself goals to be self motivated.

Keep upto date; Take an interest in changing trends , keep in touch with a variety of people in different age groups , you may not see eye to eye with them but you can still be interested in their opinion. A continuing interest in the world and a thirst of knowledge are the keys to an ageless mind.

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Glucosamine and chondroitin—mixed results in study

Osteoarthritis sufferers will have to keep waiting for concrete findings about the effectiveness of glucosamine and chondroitin, the supplements used by so many to ease joint pain and support the maintenance of cartilage. A recent big study involving 1,583 people produced interesting good news/bad results.

First, researchers found scant scientific evidence to support the belief that the supplements work as advertised. They seemed to perform only marginally better than placebos for people with mild arthritis pain. However, for people with moderate to severe pain, the supplements, taken in combination, did offer relief to a

statistically substantial number of patients-79.2 percent, compared to 54.3 percent who took placebos. The study results were published recently in the New England Journal of Medicine.

Stuttaford answers your questions on arthritis and rheumatism

Q1: I am no longer able to make a fist due to arthritis of the middle joints of my fingers. Are there surgical options for fingers as there are for hip replacements? They are very painful and apart from Difene or Voltoral type gel rubs are there any stronger pain relief remedies? R Smith, Dublin

A: The reader hasn't told us his or her age nor whether the arthritis is the result of rheumatoid arthritis or osteoarthritis.

I would guess that the reader's troubles are the result of osteoarthritis as the middle and the terminal joints in the fingers are the ones more likely to be affected in osteoarthritis than are the first joints of the fingers. In rheumatoid arthritis it is usually the proximal finger joints between the fingers and the hands and those of the wrists that suffer most. Furthermore you have made no mention of troubles elsewhere in your body, and usually in rheumatoid arthritis the joint involvement is more widespread and doesn't often, for example, only affect the hands, feet or knees as it may do in osteoarthritis in which a joint may be subjected to some specific prolonged overuse or trauma.

Surgery is always an option but the rule is this should only be considered to relieve pain. Hip replacements when successful offer complete pain relief in well over 90 per cent of cases. Likewise knee joint replacements are usually successful in achieving this. Techniques for knee replacement are improving almost by the month. The first joint in the fingers, that between the hand and the fingers, are being successfully replaced in some cases with a plastic implant, but the decision to do this would have to be reached by your surgeon and rheumatologist. I would expect that they would be reluctant to undertake surgery in cases of osteoarthritis unless the pain couldn't be controlled by other means.

I have never been hugely enthusiastic about trying to achieve pain relief by rubbing in analgesic anti-inflammatory creams and balms and have preferred anti-inflammatory drugs taken by mouth. The problem with these NSAIDs drugs is that in older people, or those with a history of indigestion or dyspepsia, there is much higher incidence of gastro intestinal bleeding than is realised. The COX II inhibitors are excellent at relieving pain, less likely to cause gastro intestinal bleeding (that is occasionally fatal) but there is strong evidence that some of them may increase fractionally the chances of having an acute heart problem. Despite this when I have an acute attack of gout I take Arcoxia, a COX 2 inhibitor that so far has a clean bill of health as regards side effects but I wouldn't even recommend taking this COX 2 inhibitor permanently. My favourite NSAIDs is Arthrotec as it includes a constituent that is alleged to reduce the risk of gut haemorrhage or perforation.

The disadvantage of all joint replacements is that not only may they become loose and painful so that in time they inevitably fail but there is always the danger of infection. Finger replacements that I have seen carried out successfully have usually been done because of rheumatoid rather than osteo-arthritis.

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Rating Your Pain From 0 To 10 Might Not Help Your Doctor

The most commonly used measure for pain screening may only be modestly accurate, according to researchers from the Indiana University School of Medicine and the University of North Carolina. In a study that appears in the October issue of the Journal of General Internal Medicine, they evaluate the usefulness of a scale that asks patients in primary care to rate their current pain from 0 (no pain) to 10 (worst pain).

Universal pain screening is an increasingly common practice, largely because of the Joint Commission on Accreditation of Healthcare Organization's requirement that accredited hospitals and clinics routinely assess all patients for pain. JCAHO is the nation's predominant standards-setting and accrediting body in health care.

"Our study is the first to evaluate the accuracy of the widely-used numeric rating scale [NRS] as a screening test to identify primary care patients with clinically important pain. Accurate screening is important because pain symptoms, both serious and not so serious, are among the most common complaints in primary care," said Erin E. Krebs, M.D., M.P.H., assistant professor of medicine at the IU School of Medicine and a Regenstrief Institute research scientist. "To be helpful, a screening test needs to provide accurate information that doctors can use to improve care. If a test isn't very accurate or useful, doctors learn to tune out the numbers."

The authors found that, while the NRS is easy to administer, it fails to identify about a third of patients with pain serious enough to impair day-to-day functioning. Most patients in this study had long-standing pain, and many had more than one pain problem. The authors did not evaluate the accuracy of pain ratings in settings where short-term pain is more common, such as after surgery. The researchers noted that because it focuses on current pain, the NRS may miss intermittent symptoms. They also reported that "pain" was not the preferred word for some patients. For example, one study participant indicated that he felt discomfort, but not pain.

Health campaigner's hospital vigil

A "LAST stand" protest to hit out at massive cuts in Burnley's hospital services will be made on Wednesday.
From 8 a.m. until 8 p.m., hospital campaigner and leader of Burnley Council Coun. Gordon Birtwistle will stand outside Burnley General Hospital.

"This is the 'last stand' over the decimation of our hospital," he said.

His decision to resurrect the Express-backed Save Our Hospital campaign comes as news that Burnley could lose its fracture clinic – despite it being a feature in the plan chosen by county councillors and the East Lancashire Primary Care Trust.

Coun. Birtwistle, instrumental in the fight to stop the transfer of services to Blackburn, will put up banners and campaign posters outside the hospital's Casterton Avenue entrance.

He is hoping supporters and well-wishers will turn up throughout the day.

"I would like people to come and shake my hand or stand for 10 minutes, but this is not a mass demonstration. It is more of a symbolic protest, a continuation of the Save Our Hospitals campaign," he said.

Online pharmacies can seriously damage health

Dubious online pharmacies are putting the health and wealth of customers at risk by operating without proper credentials and lacking even the most basic e-commerce security features.

The claims were made in online brand management company MarkMonitor's latest Brandjacking Index report, a quarterly study which measures the effect of online threats to brands.

Research was based on electronic analysis of 3,160 online pharmacies and 60 million email solicitations from a variety of sources, captured over a four-week period in June.

"The data shows that 'brandjackers' are profoundly exploiting brands, using increasingly sophisticated tactics," said Irfan Salim, president and chief executive at MarkMonitor.

"In the case of the pharmaceutical industry, this poses an outright danger to consumers through questionable practices that indicate counterfeiting and grey markets.

"Caveat emptor on the part of consumers is not a sufficient response. Brand holders must shoulder the responsibility of protecting their brands online from the highly-developed and ever-evolving threats that 'brandjackers' pose."

Researchers found that only four of the 3,160 online pharmacies studied were accredited as Verified Internet Pharmacy Practice Sites, the industry credential that assures consumers of legitimate online pharmacy operations.

Glucosamine Sulphate

Glucosamine is an amino sugar produced from the shells of chitin (shellfish) and is a key component of the extra cellular matrix of cartilage. Glucosamine works to stimulate joint function and repair. Glucosamine has been clinically proven to slow the progression of osteoarthritis in humans with arthritis and hip dysplasia in pets. It has been proven effective in easing osteoarthritis pain, aid in rehabilitating cartilage, renewing synovial fluid, and repairing joints that have been damaged from osteoarthritis.

Our bodies produce Glucosamine naturally. However, as we grow older we lose the ability to produce sufficient quantities. Having enough Glucosamine is essential to producing the nutrients we need to produce synovial fluid. It is this fluid which lubricates our cartilage and maintains healthy joints.

When you have a Glucosamine deficiency, cartilage hardens and bone spurs develop which leads to deformities in the joints. Your mobility becomes limited and in short, this is how osteoarthritis develops.

Chondroitin Sulfate:- Chondroitin is a component of cartilage. It is a gigantic molecule, mainly composed of repeated chains of glucosamine sulfate. Because of this, it functions in a way that is similar to glucosamine. Many of the clinical studies with chondroitin utilised injected forms of chondroitin, something we imagine you would prefer to avoid on a daily basis. Fortunately, because our products are in liquid form, our chondroitin sulfate boasts a higher bioavailability than mere solid tablets or capsules. The chondroitin, just like the other specially formulated ingredients in every dose of our products helps the Glucosamine do its job better.

ACOG Issues Recommendations On Prevention Of Blood Clots In Gynecologic Surgery Patients

Blood clots are a leading cause of disability and death in patients following surgery, despite medical advances in their prevention, diagnosis, and treatment. The American College of Obstetricians and Gynecologists (ACOG) issued updated evidence-based treatment recommendations to help reduce the incidence of this frequent, but often preventable, cause of death in gynecologic surgery patients. The recommendations detail the risk factors for developing blood clots among surgery patients as well as the treatments to help prevent them.

According to ACOG, each year 2 million Americans are diagnosed with deep vein thrombosis (DVT) and nearly a third of them develop a pulmonary embolism (PE), resulting in 60,000 deaths a year. Blood clots that develop in the veins located deep in the muscles of legs, thighs, and pelvis are called DVT. When a piece of a DVT breaks free, travels to the heart, and is pumped into the arteries of the lung, this is called a PE. Pulmonary emboli can be fatal if they are large and block one or both of the major arteries that send blood to the lungs.

"Women should be aware of this rare, but serious, complication of surgery and should discuss preventative treatment options with their surgeon," says Daniel Clarke-Pearson, MD, who headed the work group that developed the revised treatment recommendations. "Physicians should evaluate every patient prior to surgery to determine her risk level of developing DVT or PE and prescribe the appropriate preventive measures."

Blood clots can also result in lifelong chronic problems, including postthrombotic syndrome, venous insufficiency, and pulmonary hypertension. DVTs can result in long-lasting swelling, pain, pigmentation, and scaling of the affected leg. Some patients who develop PE can suffer with heart function problems that may require ongoing medication and possibly surgery.

"Some of the many known risk factors for blood clots include surgery, confinement to bed, prolonged sitting, cancer, increasing age, pregnancy and the postpartum period, hormone therapy, oral contraception, obesity, smoking, varicose veins, inflammatory bowel disease, and certain acquired or inherited blood disorders (such as Factor V Leiden)," said Dr. Clarke-Pearson. Risk categories have recently been refined, and surgery patients are now classified as low-, moderate-, high-, or highest-risk according to their age, surgery type (minor or major), and personal risk factors.

Compression devices and medication are the two types of treatments to prevent blood clots in patients undergoing surgery. There are two types of compression devices: graduated compression stockings (GCS) and intermittent pneumatic compression devices (IPC). Both fit over the legs and help prevent pooling of blood in the calves. Anticoagulant medication that thins the blood includes two forms of the drug heparin. For patients at highest risk of developing clots, a combined approach of medication and a compression method may be appropriate. Getting patients out of bed and walking as soon as possible after surgery also helps prevent blood clots.

"A significant number of lives can be saved by providing relatively simple and safe preventive treatments," according to Dr. Clarke-Pearson. "Methods to prevent DVT and PE are well established after years of clinical trials." More >>

Setback for Cargill's glucosamine novel food bid

A decision on whether to allow Cargill's Regenasure vegetarian glucosamine hydrochloride (HCl) as a novel food ingredient has been delayed because of a lack of information on whether it would affect people with diabetes.

Cargill applied to the UK's Food Standards Agency (FSA) last August for permission to market Regenasure as an ingredient for beverage products aimed at the joint health market.

The FSA had previously ruled in 2004 that Cargill's glucosamine HCl, derived from A. niger, was substantially equivalent to the shellfish derived glucosamine, but now the firm is seeking novel food permission to use the ingredient in a range of products, mainly beverages and fermented milk-based products, at levels that would provide 750mg per daily serving.

In the firm's application, Cargill said that A. niger has a history of safe use generally in food production since the 1920s. The strain used to produce the Novel Ingredient (NI) has been used in the US and other countries for citric acid production since 1993. The company also said no glucosamine of any source is presently used in beverages marketed in Europe.

In the FSA's draft opinion, which is now up for consultation, experts from the Advisory Committee on Novel Foods and Processes (ACNFP) looked at the various strict requirements to grant Novel Ingredient (NI) permission.

The committee report took into account a series of human studies, including the effect of glucosamine on glucose metabolism and studies on high intake levels.

However, the committee found there have not been enough data to date to determine whether long-term glucosamine intake has a detrimental effect in people with severe diabetes.

The report also raised concern that the target population for products containing glucosamine would include middle-aged or elderly people, including a significant proportion of diabetics, or those whose condition has not been diagnosed.

Glucosamine Spoof

Glucosamine Trials Show Little Benefit Against Arthritis

Although millions of arthritis sufferers buy glucosamine supplements to ease their joint pain, there's still no convincing proof the product works, according to a major new analysis.
In fact, the results of 15 trials of over-the-counter glucosamine vary so widely that industry bias may be a factor influencing the more positive outcomes, concludes a team writing in the July issue of Arthritis & Rheumatism.

"There's a big difference between trials, much more than you would expect by chance," explained lead investigator Dr. Steven Vlad, a fellow in rheumatology at Boston University Medical Center.

But an editorialist in the journal refutes those claims.Dr. Jean-Yves Reginster, of the World Health Organization's Collaborating Center for Public Health Aspects of Rheumatic Disease, in Liege, Belgium, counters that industry trials are typically more stringent than independent academic research. He also believes that Vlad's group included trials in their analysis that were very unalike in terms of timeframes and methodology, confusing the results.

Glucosamine may slow arthritis patients' bone turnover

Supplementing their diet with glucosamine, people with arthritis may slow their bone turnover and help build cartilage, according to a new animal study published in Arthritis and Rheumatism.

The study by Suanne Wane and colleagues from the University of Toronto in Ontario, Canada examined a building block of proteins known as glycosaminoglycans, which the body uses to build cartilage, in rabbits with arthritis.

In the study, rabbits were given 100 mg of glucosamine a day for eight weeks and the researchers compared two groups of rabbits with arthritis, one given glucosamine and the other given a placebo for the bone turnover rates.

Wang and team found rabbits supplemented with glucosamine had a bone turnover rate around the knee joint similar to that of normal animals while untreated rabbits had a higher rate.

Andrew Lessman Glucosamine plus Chondroitin Cartilage

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Sugar supplement hope for diabetes

Scientists discovered that a compound called N-acetyl glucosamine (GlcNAc) prevented the development of diseases equivalent to MS and type 1 diabetes in tests on mice.

A team from the University of California, Irvine found GlcNAc molecules suppressed damaging autoimmune responses, New Scientist reported.

They do this by attaching to receptors on the outside of immune cells, preventing them from attacking the body's own cells and tissue, the researchers discovered.

Experiments in 2002 showed that glucosamine - which is similar to GlcNAc but less potent - worked as well as regular immunosuppressants in increasing the amount of time transplanted hearts lasted in mice.

Nick Giannoukakis, a pathologist at the University of Pittsburgh School of Medicine in Pennsylvania, who carried out the earlier study, said he was "astounded" by the latest results.

But he warned that further work was needed to show that glucosamine or GlcNAc could reverse symptoms in animals with autoimmune diseases as well as prevent them.

There is already some evidence to support this - in 2005 researchers revealed that glucosamine could suppress MS symptoms in mice that had recently developed the disease.

Glucosamine-like supplement inhibits multiple sclerosis, type 1 diabetes

(NewsTarget) A glucosamine-like dietary supplement has been found to suppress the damaging autoimmune response seen in multiple sclerosis and type 1 diabetes mellitus, according to University of California, Irvine health sciences researchers.

In studies on mice, Dr. Michael Demetriou and colleagues with the UC Irvine Center for Immunology found that N-acetylglucosamine (GlcNAc), which is similar but more effective than the widely available glucosamine, inhibited the growth and function of abnormal T-cells that incorrectly direct the immune system to attack specific tissues in the body, such as brain myelin in MS and insulin-producing cells of the pancreas in diabetes. Study results appear on the online version of the Journal of Biological Chemistry.

"This finding shows the potential of using a dietary supplement to help treat autoimmune diseases," said Demetriou, an assistant professor of neurology, and microbiology and molecular genetics. "Most importantly, we understand how this sugar-based supplement inhibits the cells that attack the body, making metabolic therapy a rational approach to prevent or treat these debilitating diseases."

'Functional' beverages loaded with nutrients

When you reach for something to drink, do you just want something to quench your thirst or do you think about the nutritional benefits of that beverage?

The Beverage Marketing Corp. reports one of the fastest growing markets for the beverage industry is functional beverages. The interest in health and wellness has created a demand for drinks that are refreshing, convenient, good tasting and offer some health benefits. There are numerous categories of functional beverages including sports drinks, flavored waters, vitamin-enhanced waters, ready-to-drink teas, soy-based drinks and enhanced fruit juices.

The enhanced sports drinks, waters and fruit juices have vitamins, minerals and perhaps selected herbs added to their formulations. This trend may have begun when orange juice companies successfully added calcium to their products and consumers readily purchased them. Minute Maid has launched a line of premium enhanced juices designed to meet consumers' health needs. Minute Maid Heart Wise was first introduced in 2003. This juice contains natural plant extracts called plant sterols that have been clinically proven to help reduce blood cholesterol levels. Plant sterols bind with cholesterol in the intestine to block as much as 50 percent of the cholesterol from being absorbed into the bloodstream. In the scientific study, participants drank two 8-ounce servings a day with meals for eight weeks and their LDL cholesterol (the "bad" cholesterol) level dropped 14 percent.

Minute Maid Active is one of the new enhanced juices that contains 750 milligrams of glucosamine HCl in every 8 ounces to promote healthy joints. Glucosamine use has been studied in the treatment of arthritis and has shown some benefit as an anti-inflammatory agent and seems to improve joint function. This enhanced juice especially has been popular with baby boomers who tend to be more active and interested in health and well-being.

The third new option is called Minute Maid Multi-Vitamin. It contains 16 essential vitamins and minerals. The most recent USDA surveys of the average American diet reveal a deficiency of several of these vitamins and minerals. This juice contains vitamins C, A and E along with zinc and selenium for support of a healthy immune system. Calcium, vitamin D, phosphorus, magnesium and manganese have been added to help maintain healthy bones. Vitamin B is important for energy metabolism, and chromium has been added to help maintain normal blood sugar levels.

Of course orange juice is also a good source of folic acid which reduces birth defects of the spine and brain. Folic acid also is important for the normal production of red blood cells and prevention of anemia.

As you can see, these beverages can be included as part of a healthy eating plan and they contribute important nutrients that may be missing in the diet. They taste great, too.

As this science evolves, expect to see more nutritionally enhanced beverages on grocery store shelves.

Canine hip dysplasia a challenge for dogs, owners, veterinarians

As a small-animal veterinarian, I would have to say I spend more time discussing canine hip dysplasia than any other condition.
Veterinarians, drug companies, and now even pet-food manufacturers have made the pet-owning public more aware of CHD. I, for one, am pleased to see pet owners more concerned with this, because increased knowledge of the condition should lead to more dogs with CHD being treated appropriately and fewer high-risk dogs being bred.
Hip dysplasia is a developmental condition that is the result of a combination of many interrelated factors. Looseness of the hip joint is the primary factor. Looseness of the hip allows the head of the femur (the "ball" of the ball-and-socket) to slip partially out of the socket.
As the ball and socket interact in this abnormal way, the bones are placed under tremendous stress. The body responds by remodeling the affected bones; the physical structure of the joint literally changes. The remodeled joint is abnormal and further stress is placed on the joint surfaces. As this cycle continues, the cartilage on the joint surfaces erodes, leading to arthritis. Arthritis pain may be characterized by difficulty rising, limping, reluctance to play and vocalizing.
Diagnosing hip dysplasia is relatively simple. A thorough patient history, physical exam findings (such as pain upon hip manipulation) and X-rays are used to confirm CHD.
Treating CHD can be a challenge because different dogs have different pain thresholds and treatments vary in scope and cost. Most commonly, CHD is treated medically with NSAIDs and other pain-relieving drugs. Nutritional supplements thought to help protect the joint cartilage (such as glucosamine and chondroitin) are often used alongside pain relievers. Many pet-food manufacturers have developed new diets to aid dogs with CHD.

There are now "large breed" puppy foods aimed at "leveling" the growth curve of large breeds in an effort to decrease the incidence of CHD. Some dog foods even contain large doses of glucosamine and chondroitin; these diets hope to protect the joints and help control the pain of arthritis.

Several surgical options exist for treating dogs with CHD. These include procedures aimed at realigning the joint to prevent damage, total hip replacement to build an entirely new joint, and salvage procedures that simply try to alleviate pain.

I prefer to prevent hip dysplasia whenever possible. This is best accomplished by breeding only dogs that have had their hips evaluated and certified. There are two primary certifying methods — OFA (Orthopedic Foundation for Animals) and Penn-HIP (University of Pennsylvania Hip Improvement Program).

Glucosamine Eliminates Multiple Sclerosis and Type 1 Diabetes Mellitus

29/05/07 A glucosamine-like dietary supplement has been found to suppress the damaging autoimmune response seen in multiple sclerosis and type-1 diabetes mellitus, according to University of California, Irvine health sciences researchers.

In studies on mice, Dr. Michael Demetriou and colleagues with the UC Irvine Center for Immunology found that N-acetylglucosamine (GlcNAc), which is similar but more effective than the widely available glucosamine, inhibited the growth and function of abnormal T-cells that incorrectly direct the immune system to attack specific tissues in the body, such as brain myelin in MS and insulin-producing cells of the pancreas in diabetes. Study results appear on the online version of the Journal of Biological Chemistry.

"This finding shows the potential of using a dietary supplement to help treat autoimmune diseases," said Demetriou, an assistant professor of neurology, and microbiology and molecular genetics. "Most importantly, we understand how this sugar-based supplement inhibits the cells that attack the body, making metabolic therapy a rational approach to prevent or treat these debilitating diseases."

The UC Irvine study defines how metabolic therapy with the sugar GlcNAc and other related nutrients modifies the growth and autoimmune activitiy of T-cells. Virtually all proteins on the surface of cells, including T-cells, are modified with complex sugars of variable lengths and composition. Recent studies have shown that changes in these sugars are often associated with T-cell hyperactivity and autoimmune disease.

In mouse models of both MS and type 1 diabetes, Demetriou and colleages found that GlcNAc prevented this hyperactivity and autoimmune response by increasing sugar modifications to the T-cell proteins. This therapy normalized T-cell function and prevented development of paralysis in MS and high blood glucose levels in type 1 diabetes.

This study comes on the heels of others showing the potential of GlcNAc in humans. One previous clinical study reported that 8 of 12 children with treatment-resistant autoimmune inflammatory bowel disease improved significantly following two years of treatment with GlcNAc. No significant adverse side effects were noted.

"Together, these findings identify metabolic therapy using dietary supplements such as GlcNAc as potential treatments for autoimmune diseases." Demetriou said. "Excitement for this treatment strategy stems from the novel mechanism for affecting T-cell function and autoimmunity and the availability and simplicity of its use. However, additional studies in humans will be required to assess the full potential of this therapeutic approach."

Autoimmune diseases such as MS and type 1 diabetes mellitus result from poorly understood interactions between inherited genetic risk and environmental exposure. MS results in neurological dysfunction, while uncontrolled blood glucose in type 1 diabetes can lead to damage of multiple organs.

Glucosamine-Like Supplement Inhibits Multiple Sclerosis, Type 1 Diabetes

A glucosamine-like dietary supplement has been found to suppress the damaging autoimmune response seen in multiple sclerosis and type-1 diabetes mellitus, according to University of California, Irvine health sciences researchers.

In studies on mice, Dr. Michael Demetriou and colleagues with the UC Irvine Center for Immunology found that N-acetylglucosamine (GlcNAc), which is similar but more effective than the widely available glucosamine, inhibited the growth and function of abnormal T-cells that incorrectly direct the immune system to attack specific tissues in the body, such as brain myelin in MS and insulin-producing cells of the pancreas in diabetes. Study results appear on the online version of the Journal of Biological Chemistry.

"This finding shows the potential of using a dietary supplement to help treat autoimmune diseases," said Demetriou, an assistant professor of neurology, and microbiology and molecular genetics. "Most importantly, we understand how this sugar-based supplement inhibits the cells that attack the body, making metabolic therapy a rational approach to prevent or treat these debilitating diseases."

The UC Irvine study defines how metabolic therapy with the sugar GlcNAc and other related nutrients modifies the growth and autoimmune activitiy of T-cells. Virtually all proteins on the surface of cells, including T-cells, are modified with complex sugars of variable lengths and composition. Recent studies have shown that changes in these sugars are often associated with T-cell hyperactivity and autoimmune disease.

In mouse models of both MS and type 1 diabetes, Demetriou and colleages found that GlcNAc prevented this hyperactivity and autoimmune response by increasing sugar modifications to the T-cell proteins. This therapy normalized T-cell function and prevented development of paralysis in MS and high blood glucose levels in type 1 diabetes.

This study comes on the heels of others showing the potential of GlcNAc in humans. One previous clinical study reported that 8 of 12 children with treatment-resistant autoimmune inflammatory bowel disease improved significantly following two years of treatment with GlcNAc. No significant adverse side effects were noted.

"Together, these findings identify metabolic therapy using dietary supplements such as GlcNAc as potential treatments for autoimmune diseases." Demetriou said. "Excitement for this treatment strategy stems from the novel mechanism for affecting T-cell function and autoimmunity and the availability and simplicity of its use. However, additional studies in humans will be required to assess the full potential of this therapeutic approach."

Autoimmune diseases such as MS and type 1 diabetes mellitus result from poorly understood interactions between inherited genetic risk and environmental exposure. MS results in neurological dysfunction, while uncontrolled blood glucose in type 1 diabetes can lead to damage of multiple organs.

###

Ani Grigorian, Sung-Uk Lee, Wenqiang Tian, I-Ju Chen and Guoyan Gao of UC Irvine and Richard Mendelsohn and James W. Dennis of the Samuel Lunenfeld Research Institute in Toronto participated in the study, which was funded by the National Institutes of Health, the National Multiple Sclerosis Society, the Juvenile Diabetes Research Foundation, the Wadsworth Foundation and the Canadian Institutes for Health Research.

About the University of California, Irvine: The University of California, Irvine is a top-ranked university dedicated to research, scholarship and community service. Founded in 1965, UCI is among the fastest-growing University of California campuses, with more than 25,000 undergraduate and graduate students and about 1,800 faculty members. The second-largest employer in dynamic Orange County, UCI contributes an annual economic impact of $3.7 billion. For more UCI news, visit http://www.today.uci.edu/.

Arthritis Drugs - Is the Cure Worse Than the Disease?

Research is always ongoing into new and better medications for arthritis which is a very good thing. But where is all this leading us?

Of course we need effective pain medication for arthritis to enable sufferers to live normal lives. But are all these expensive medications controlling the disease or simply masking the symptoms?

Here’s a “quick and dirty” lowdown on what’s currently available both “over the counter” (OTC) and on prescription only.

For mild cases of arthritis -

Some milder cases of arthritis never make it into the doctor’s surgery. Indeed the sufferer might not even be aware that they are suffering from arthritis at all. They may be feeling a few “aches and pains” which they put down to old age or even the cold damp weather.

That may be all well and good, but even OTC medications can be dangerous if taken over a long period of time. The concept of “more is better” can also happen if the pain gradually becomes worse. This can lead to serious side effects.

OTC medications include aspirin and ibuprofen. These medications can cause intestinal bleeding and kidney damage in large doses. Aspirin also destroys vitamin C in the body leading to lower immunity.

For More Advanced Arthritis-

By this stage most people have consulted their doctor. Prescription medication at this stage normally consists of the Nonsteroidal anti-inflammatory drugs or NSAIDS. These do target the pain and inflammation of arthritis symptoms but have a range of side effects including stomach upset, abdominal pain, and ulcers.

People with high blood pressure, those with kidney problems and especially people who have heart problems are especially at risk with NSAIDS.

Enter the COX-2 inhibitors. These have been designed for people whose stomach problems cannot tolerate the above. Unfortunately the risks remain for chest pain, heart attack and stroke victims.

For Advanced Arthritis-

For those suffering extreme pain and swelling the medical profession brings out the heavy artillery - Corticosteroids. These drugs contain man made cortisone and can be injected directly into the affected joints or taken orally.

Long term use of these can produce sleep problems, weight gain, osteoporosis and loss of immunity. Also available to those for whom nothing else seems to work are Biologic Response Modifiers (Biologics). Biologics are derived from live sources, plants and animals and are not manufactured chemically. They are mainly used for sufferers of Rheumatoid Arthritis and are given intravenously or by injection. They can’t be taken in tablet form.

Biologics suppress the immune system which leaves people prone to infections. They are also very expensive and can’t be stored without freezing.

Also available mainly to Rheumatoid Arthritis sufferers are Disease-modifying anti-rheumatic drugs (DMARDS) These work by stopping the immune system from attacking the joints. DMARDS may take up to three months to reduce symptoms but they do help to stop joint damage even though they can’t repair any previous damage.

Although these drugs are a boon to many, they work mainly at masking the symptoms of arthritis and can’t reverse the damage already caused. Most people thinks this is impossible, it isn‘t!

Natural treatments for arthritis do exist and can significantly stop some cases of arthritis, relieve pain and inflammation and in some cases, reverse joint damage.

Definitely worth a try!

Assessing Arthritis

A faster, more precise way to measure joint problems may lead to improvements in arthritis treatment. Right now, most doctors rely on the way arthritis patients' joints look and feel during an exam to assess how effective their treatment is. But a new high-tech device gives them a better idea of what's going on under the surface.

Rheumatoid arthritis patients can have swollen, warm, or red joints and a very limited range of motion. Doctors say there aren't many ways to measure the inflammation.

But now researchers are testing a high-tech way to assess patients. A thermal camera measures the pattern of the skin's temperature. Patients with arthritis have higher temperatures or "more red" around the joints. A second camera takes a 3d snapshot of to get a better look at the joint. Even the smallest changes are easily noted.

Thanks to physical therapy and medication, doctors can offer a more precise way to measure joint problems that may lead to improvements in arthritis treatment.

Doctors say the cameras are also effective for assessing adult rheumatoid arthritis patients and may be useful for tracking other diseases like skin cancer and diabetes. Researchers say eventually, both cameras will be combined within one device, making it more convenient for regular use in a doctor's office.

Rheumatoid arthritis drug link to atherosclerosis

A leading rheumatoid arthritis (RA) drug could promote atherosclerosis in patients, suggests research from the Netherlands.

The study showed RA patients taking the tumour necrosis factor (TNF)-alpha blocker infliximab had an increased atherogenic index and higher level of total cholesterol a year after treatment was initiated.

TNF-alpha blockers may add to the increased cardiovascular risk RA patients are known to have. Cardiovascular disease is more common in RA patients than the general population.

Under NICE guidance, RA patients are offered infliximab or the TNF-alpha blocker etanercept in combination with methotrexate if they have failed to respond to two other disease modifying anti-rheumatic drugs including methotrexate.

For the study, plasma lipoprotein concentrations were assessed in 55 RA patients and 55 controls, showing no differences between the groups' lipid profiles.

RA patients had a disease activity score above 3.2 and were starting therapy with infliximab.

At one year, 31 RA patients were reassessed for lipid profile. HDL cholesterol levels were similar to those at baseline and the atherogenic index was 4 per cent higher than baseline. Total cholesterol had increased from 5.55 mmol/l to 6.01 mmol/l.

Studies show chondroitin does nothing for arthritis pain

In another blow to those who swear by chondroitin for arthritis pain, an analysis of 20 studies found no evidence that the popular supplement prevents or reduces joint pain.

"We do not have evidence to suggest that chondroitin has a clinically relevant effect on patients' pain," says author Peter Juni, head of clinical epidemiology and biostatistics at the University of Bern in Switzerland.

Chondroitin is believed to help draw fluid into the cartilage, making it more flexible.

The paper comes a little more than a year after a major 16-site, $14 million National Institutes of Health study found no clear proof that the popular supplement combo glucosamine and chondroitin reduces joint pain.

The U.S. consumer market for glucosamine and chondroitin pills, almost always sold in combination, was $810 million in 2005, says Katja Rauhala, research manager with the Nutrition Business Journal.

The study was published in the Annals of Internal Medicine. The researchers analyzed chondroitin studies dating to 1970. The 20 clinical trials they studied included 3,846 patients. But early studies tended to involve small numbers of patients and were poorly designed, without proper documentation and analysis, Juni says.

For that reason, the researchers excluded all but three studies from their analysis. Those three were large, recent and well designed and together cover 40 percent of all the patients in the 20 trials.

After examining those studies, the Swiss researchers concluded that there is no evidence that chondroitin is unsafe, but also none to suggest that it helps diminish joint pain.

As to why so many patients swear by chondroitin as a treatment, Juni suggests that osteoarthritis — the degenerative joint disease seen especially in older people — is a condition that does not progress invariably toward more severe symptoms.

"You tend to have severe symptoms, and then you get better again," he says. "And if you happen to start chondroitin at the moment of severe disease and then it gets better, you might be convinced that it's the drug, but it's actually the body (healing)."

In an accompanying editorial in the journal, David Felson, an osteoarthritis expert at Boston University, says that despite the findings, some patients are convinced that chondroitin helps, and he believes there's no "harm in encouraging them to continue taking it as long as they perceive a benefit."

Frequent knee pain affects about 25 percent of adults, half of whom are estimated to have arthritis, Felson says.

One thing the study did not rule out is the possibility that chondroitin may lessen pain in patients with less severe arthritis. The most credible studies tended to include patients with more severe arthritis, Juni says.

Andrew Shao, vice president of scientific and regulatory affairs with the Council for Responsible Nutrition, a supplement industry group, says he doesn't think the analysis was fair in the criteria it used to exclude numerous studies that found chondroitin beneficial.

"Consumers speak with their wallets," Shao says. "This is not some kind of fad. Consumers are finding benefit from the drug."

Arthritis sufferer in jobs campaign

A WELSH woman with rheumatoid arthritis is backing a campaign to help fellow sufferers get back to work after a survey found that a third of them lose their jobs because of the disease.

Figures from the National Rheumatoid Arthritis Society NRAS show that 29% of sufferers were forced to give up work early.

And 86% of them had experienced or expected barriers to prevent them from staying in work from their employers.

Claire Tattersall, from Pembroke, first developed rheumatoid arthritis at the age of 14. Her symptoms were not recognised by her GP until she was in her mid-20s and she eventually had to give up work.

She feels the delay in diagnosis and consequently in treatment affected her ability to work and led to her losing her home. She said, “Getting drugs earlier would have helped keep my home, which was repossessed, as I would have been able to work and pay my mortgage.”


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The Working With Rheumatoid Arthritis Taskforce today launches its manifesto containing five recommendations to government to help many of the 600,000 people who suffer from this disease to stay in work.

Paul Emery, taskforce chairman and Professor of Rheumatology at the University of Leeds, said, “We are calling today on the Government to ensure that funding, access and support is made available for the newer treatments, in line with NICE guidance.”

Navamedic ASA (NO): Started Commercial Chitin Production

LYSAKER, Norway, 26 April 2007--Today, Navamedic ASA's subsidiary ChitiNor AS has started the commercial production of chitin at the chitin factory at Senjahopen.

Navamedic's 100%-owned subsidiary ChitiNor AS has constructed a chitin factory adjacent to Nergård Reker AS at Senjahopen. The construction process has been finalized within budget, and total investments are less than NOK 10 million. ChitiNor AS will receive grants of NOK 2 million and an additional loan of NOK 2 million from Innovation Norway.

Navamedic will not make internal use of its chitin production from the start. In March 2006 a letter of intent (LOI) was signed with Lytone Enterprise Inc. in Taiwan, for the sale of the first full year' chitin production. The LOI has a value of approximately NOK 7 million based on the USD/NOK rate at the time of signature.

For further information, please contact:

Cartilage repairs not seen in studies

Question: I recently read online that the supplement I take for my knee pain probably doesn't work. I use a chondroitin sulfate glucosamine mixture from my local health-food store. I thought it helped but now I wonder if I should keep taking the supplement.

Answer: The original idea was deceptively simple and had a certain elegant logic: Our joints are cushioned and protected by cartilage, which can get worn down over time, so eating powdered cartilage should help replenish our natural cartilage. Furthermore, cartilage is pretty much the same from one source to another. It can be obtained from the most abundant, cheapest source -- usually shark cartilage.

The concept's flaw is that it does not take into account cartilage metabolism. Cartilage contains chondroitin sulfate, a large protein that gives cartilage its elasticity. It also contains glucosamine, a complex sugar known as a mucopolysaccharide. Glucosamine causes cartilage to retain water, a good thing. It simulates production of a joint lubricant, has an anti-inflammatory property and can speed healing of damaged cartilage. Complex metabolic pathways produce both, however. The fallacy comes in thinking that all we have to do is eat cartilage and somehow it will reach our damaged joints and repair them.

While chondroitin and glucosamine supplements may be sold separately, most joint supplements include both. Consumers spend more than $800 million a year on these supplements alone to treat arthritis. Dietary supplements are regulated as foods, not drugs, and do not have to meet strict requirements for safety and effectiveness demanded by the Food and Drug Administration.

A recent article in The Annals of Internal Medicine reported on an evaluation of 20 studies focusing on the effectiveness of chondroitin in treating arthritis. Of these, only three were considered sufficiently well-designed to yield valid conclusions. These did not support the use of chondroitin for relieving the pain of osteoarthritis, the most common form of arthritis older adults experience. One reason may be that chondroitin is poorly absorbed through the gastrointestinal tract when taken by mouth. Studies show that only about 5 percent of the chondroitin you take by mouth is absorbed and available to have any effect.

In contrast, when glucosamine is taken in by mouth, 89 percent is absorbed in the GI tract and more than 25 percent is available in the first pass as it circulates through the body. Studies in which researchers label glucosamine with a radioactive isotope -- and administer it orally -- show a significant amount of the labeled material turns up in joint cartilage and in surrounding ligaments and tendons, making it at least available to have some beneficial effect.

Because pain relief is difficult to measure, some patients undoubtedly benefit from the placebo effect. It would be better if measurable regeneration of damaged or worn cartilage could be demonstrated in conjunction with pain relief, but so far such studies are lacking.

Until more is known, there is probably no harm, and some possible good, derived from taking a joint supplement. However, it appears the real active ingredient is the glucosamine, not the chondroitin. The usual recommended dose of glucosamine is 1,500 milligrams per day.

As with all supplements, try to find one that is stamped "USP." This means it meets standards for potency and availability by the United States Pharmacopoeia.

Gero Vita Expands Product Line with Focus on Quality, Convenience, and Value for the Health-Conscious Consumer

Los Angeles, CA, April 25, 2007 --(PR.com)-- Nutritional supplement users now have an easier way to get fundamental nutrients without paying high markups at retail stores, thanks to California-based nutraceutical company Gero Vita™. The company’s new Gero Vita™ Essentials product line features multifunctional nutrients that benefit the fundamental components of wellness—including heart, brain, bone, joint, and cellular health.

Developed to complement the company’s existing line of exclusive formulas, which are sold direct-to-consumer, the collection includes CoQ10, CoQ10-H2, Pycnogenol®*, Triple-Strength Glucosamine Chondroitin, and Triple Omega 3-6-9. Each nutrient has been chosen for its potential to promote real benefits for the structure and function of the body, as illustrated in accumulating research.

For example, the Essentials line features Triple-Strength Glucosamine Chondroitin, which contains 1500 mg of glucosamine and 1200 mg of chondroitin—dosages that have been clinically verified for joint mobility and comfort. The company will continue to expand the research-based collection during the coming months.

“Millions have relied on Gero Vita™’s exclusive nutritional formulas for almost two decades. With the new Essentials line, customers now have a complete solution for their natural health needs,” said Jim Chiang, the company’s Vice President of Operations.

To introduce its Essentials line to the health-focused public, Gero Vita™ is offering an unprecedented offer for a limited time: customers can try two Essentials free of charge with each regularly priced purchase. Visit www.gvi.com or call 1-800-678-7860 for details and restrictions.

“We want to reward our customers with an unprecedented offer to help them maximize each dollar they spend on nutraceuticals without ever sacrificing quality,” said Chiang.

Founded in 1989, Gero Vita™ is an innovative nutraceutical company that produces state-of-the-art nutritional supplements and vitality products. Gero Vita™ is also affiliated with the Journal of Longevity, a monthly magazine that explores scientific and alternative approaches to health and wellness.

*Pycnogenol® is a registered trademark of Horphag Research, Ltd.

GlucOsamine Gel - GlucOsamine Gel helps care for joint and muscles

Glucosamine is widely associated with joint health and it is now available as Glucosamine Gel, a clear dermatologically tested topical formulation.

In addition to the widely acknowledged benefits of Glucosamine, the gel also contains Horse Chestnut Extract and releases the gentle scent of cooling Menthol as it is applied.

Non-sticky and non-greasy, Glucosamine Gel is easy to apply, and massage may soothe aches and pains.

Directions

Apply a thin layer of gel where appropriate and gently rub in until absorbed. This can be repeated up to six times a day. For additional benefits keep the gel in the fridge and apply after a warm bath.

Precautions

Do not use on children under 12 years old - keep out of their reach.

Do not use near eyes or broken skin.

Not to be used during pregnancy.

Store at room temperature or in the fridge-do not freeze.

Do not use if sensitive to any of the ingredients.

If irritation develops, discontinue use.

For external use only.

Ingredients

Aqua (water), alcohol denat, n-acetyl glucosamine, propylene glycol, aesculus hippocastanum (horse chestnut extract), carbomer, phenoxyethanol, sodium hydroxide, menthol, methylparaben, butylparaben, ethylparaben, propylparaben.

Glucosamine Gel is a registered trade mark of Health Perception (UK) Ltd.

Developed with University of Brighton Department of Pharmacy

Health Perception (UK) Ltd., Sandhurst, Berks

For more information please contact Health Perception on 01252 861 454

Arthritis in children

From BBC

About one in 1,000 children has arthritis. Usually it's a form of inflammatory arthritis known as juvenile idiopathic arthritis (formerly known as juvenile chronic arthritis). This is a separate condition from rheumatoid arthritis. In many cases the inflammation stops in late childhood, but about a third of children affected have problems that last into their adult life.

There are three common types of juvenile idiopathic arthritis:

Pauciarticular arthritis

This often starts at the age of two or three. The problem is limited to four joints or fewer, which become swollen and painful. Sometimes the eyes are affected, too.

Polyarthritis

This affects five or more joints. It can start at any age, from a few months onwards, and usually spreads from one joint to another quite quickly. Children often feel generally unwell, sometimes with a fever.

Systemic disease

This affects the whole body and causes fever and rashes as well as inflamed and painful joints. It usually starts in children under five and used to be called Still's disease. mORE >>

Supplements and vitamins, what do women really need to take?

Glucosamine information. You can spend a lot of time and a whole lot of money trying to find the vitamins and supplements that are right for you. But if you¹re a woman of say, 45 or older, in generally good health, which of these pills and potions do you really need?

"The general rule of thumb, the only thing that is absolutely recommended for those women is a calcium D magnesium supplement and that's mainly because the evidence is good that it really helps prevent osteoporosis and bone loss," said Nurse Practitioner Karen Roberts.

Beyond that, Roberts says if a woman is eating in a health way --­ and that means plenty of fruits, vegetables and whole grains --­ all other vitamins, herbs and supplements are optional, including a multi-vitamin.

"I certainly think it's something that wouldn't hurt every woman, to take a multi, and most of us could do better with our diets, absolutely," Roberts said.

In addition, there are three supplements that are recommended to women over 40 that have proven effective with certain conditions. Research has shown fish oil with Omega 3 to reduce the incidence of cardiovascular disease. Another supplement shown to be good for the heart, is CoenzymeQ10, recommended by many area cardiologists.

"They feel that it has substantiated the claim that it improves circulation and reduces the oxidated damage of the tissues which is thought to be related to those free radicals," she said.

The third supplement, Glucosamine, can help with those middle-aged aches and pains.

"Glucosamine has had some pretty solid evidence in terms of assisting with joint issues," she said. "So for people who have osteoarthritis or any other kind of condition that would effect the joint, there¹s been some pretty good evidence that glucosamine does, in fact, seem to help with cartilage repair in the joint and ease some of those joint-related symptoms.

In the end, the best way to get your vitamins and minerals is from a healthy diet based on the new food pyramid, available at mypyramid.gov.

Karen Roberts writes a column on women's health issues called Dear Crabby at www.BoomerGirl.com.

Support Spring/Summer Shape-up with Joint Care Supplements and Topical Crème from Natrol

CHATSWORTH, Calif.--(BUSINESS WIRE)--With springtime comes warming weather when Americans tend to increase their fitness routines to be “swimsuit-ready” for summer. However, this increased exercise activity may take its toll on the body’s joints. Natrol, Inc. (Nasdaq: NTOL), a premier manufacturer and marketer of nationally branded nutritional products, offers a targeted supplement to support joint health--Natrol® Omega-3 Glucosamine, which also contains Chondroitin and glucosamine.*

According to Dr. Michael Yatcilla, Natrol’s Vice President of Research and Development, “Glucosamine is proven to rebuild joints by repairing the cartilage that forms them and, because this rebuilding takes time, best results are obtained with daily supplementation.” He added, “In addition, Omega-3 Essential Fatty Acids help soothe and comfort joints, and Chondroitin helps nourish cartilage for optimal joint health, so these combined nutrients from Natrol provide the next generation in natural joint care.”*

Glucosamine and Chondroitin have long been the regular staple for promoting comfort, mobility, strength and structure for joints, bones and ligaments. These ingredients work together to supply vital building blocks for cartilage to stay supple and healthy. Omega-3 Essential Fatty Acids (EFAs) may also promote joint comfort and optimal function.*

Following is more information these Natrol products:

* Natrol® Omega-3 Glucosamine† is a supplement with USP Verified MEG-3® Fish Oil (which is molecularly distilled for purity), and containing DHA and EPA fatty acids for natural joint comfort, cushion, lubrication and protection. This supplement also contains 1500 mg of Glucosamine per day to help rebuild joints by repairing and regenerating the cartilage that forms them, and 100 mg of Chondroitin Sulfate to help nourish cartilage for optimal joint health. Recommended dosage is three softgels daily with meals, and average U.S. SRP is $23.99 for 90 softgels.*

* Natrol® MSM with Glucosamine Crème, a topical crème with a natural eucalyptus fragrance, is an ideal complement to Omega-3 Glucosamine for topical use to massage into muscles, joints and other areas. This product sells for an average U.S. SRP of $9.99 for 4 ounces.*

Natrol MSM with Glucosamine Crème and Natrol Omega-3 Glucosamine supplements are available at health food, drug and grocery stores, mass market-retailers, Natrol.com and other online retailers. For more information, interested persons can go to www.Natrol.com or call 1-800-2-NATROL (1-800-262-8765).

About Natrol – Nourishing the Potential of Mind and Body SM

Natrol, Inc. (Nasdaq: NTOL), headquartered in Chatsworth, CA, has a portfolio of health and wellness brands representing quality nutritional supplements, functional herbal teas, and sports nutrition products. Established in 1980, Natrol’s portfolio of brands includes: Natrol®, Prolab®, Laci Le Beau®, Promensil®, Trinovin®, Nu Hair® and Shen Min®. The company also manufactures supplements for its own brands and on behalf of third parties.

Natrol distributes products nationally through more than 54,000 retailers, as well as internationally in over 40 other countries through distribution partners and a wholly owned subsidiary in the UK. Natrol’s dedication to quality is evidenced by its commitment to high manufacturing standards, earning the company an “A” rating from the Natural Products Association's Good Manufacturing Practices (“GMP”) Certification Program—a designation achieved by less than ten percent of U.S. nutrition companies. For more information, visit www.Natrol.com.

†Contains 100 mg DHA and 66.7 mg of EPA combined per serving, which is 104% of the 160 mg Daily Value for a combination of DHA and EPA. Each serving also has 10 IU of Vitamin E (from d-Alpha Tocopherol), which is 33% of the 100 IU Daily Value, and 166.7 mg of Borage Oil, including 31.7 mg of GLA.

MEG-3® is a trademark of Ocean Nutrition Canada, Ltd., and used under license.

Arthritis Supplements Often Come Up Short

f the bottle of supplements you bought to help ease arthritis pain hasn't helped, the reason might be that the pills don't contain the ingredients they're supposed to.

Of the 20 joint supplements marketed to people and their pets that were selected by ConsumerLab.com and tested by independent laboratories, 40 percent failed to contain what their labels promised.

All the problems popped up among products that claimed to contain chondroitin, a key - and pricey - ingredient. Of 11 such brands, eight came up short on the substance, which is purported to inhibit enzymes that break down the cartilage in joints.

For instance, Nature's Plus Ultra Maximum Strength Chondroitin 600, which touts "highest quality" chondroitin, turned out to have no chondroitin at all.

Even pets are getting shorted. Nutri-Vet Nutritionals Hip & Joint Soft Chews, which is marketed for dogs, contained less than 1 percent of its claimed chondroitin and less than half the promised glucosamine, a substance thought to stimulate cartilage production.

This means that people are spending a lot of money on a product that won't do anything, said Dr. Tod Cooperman, president of ConsumerLab.com, a Westchester, N.Y.-based company that independently evaluates health and nutrition products and periodically publishes reviews.

Cooperman says the findings are especially disturbing since there is some scientific evidence that the supplements containing chondroitin and glucosamine can indeed help arthritis sufferers.

When contacted by MSNBC.com, several of the manufacturers of these supplements questioned the validity of ConsumerLab.com's results.

Other experts said they weren't surprised to hear that a lab found discrepancies between what's advertised on the label and what's actually found in each pill.

"We've known about this problem for a long time," said Dr. Wallace Sampson, editor of The Scientific Review of Alternative Medicine and a clinical professor of medicine at the Stanford University School of Medicine. "Dosing in these products can vary from 0 percent to 300 percent."

No one's watching
Lack of monitoring is the big problem, said Dr. Joan Von Feldt, an associate professor of medicine at the University of Pennsylvania in Philadelphia.

"These nutraceuticals aren't monitored or regulated in the same way as prescription drugs are," said Von Feldt, an arthritis specialist. "And this issue has been identified with a lot of these products. And it's not just a problem with the dose of the therapeutic agent, but also with the possibility of contaminants."

The types of products reviewed by ConsumerLab.com were supposed to contain either chondroitin, glucosamine, MSM or a combination of these ingredients. No problems were found among the products that contained just glucosamine or MSM. more >>

NOW Foods' Senior Scientist Joseph Zhou Named Adjunct Professor of Pharmacognosy at UIC

BLOOMINGDALE, IL (March 19, 2007) -- Joseph Zhou, Ph.D., NOW Foods' Senior Scientist, has been named to the faculty of the University of Illinois at Chicago (UIC) as Adjunct Professor of Pharmacognosy in the Department of Medicinal Chemistry and Pharmacognosy. UIC is the top-ranked university in the U.S. for the study of medicines from botanical sources.

As UIC Adjunct Professor, Dr. Zhou will teach a graduate-level course on "Standardization of Herbal Remedies." He was recommended for this position by renowned UIC Research Professor of Pharmacognosy Dr. Norman R. Farnsworth.

Dr. Zhou's work in the area of dietary supplement testing methodologies has received recognition in the scientific community. His work on more accurately assaying glucosamine in raw materials and dietary supplements containing glucosamine sulfate and/or glucosamine hydrochloride was accepted and published as an Official Method(SM) in the Journal of AOAC International (88 (4), 2005, pp 1048-1058 and 87 (5), 2004, pp. 1083-1092). Joseph has also published a test method for SAMe, and his team's method for Chondroitin Sulfate was accepted for publication by AOAC for July 2007.

In recognition of his work in establishing the AOAC Official Method(SM) for testing glucosamine products, Dr. Zhou was named the "2005 AOAC Study Director of the Year". This work involved organizing twelve validation laboratories world-wide and performing a collaborative study for testing glucosamine sulfate and glucosamine hydrochloride in both raw materials and dietary supplement finished products.

Commenting on his new role, Dr. Zhou said, "This is not just an honor for me, it is a validation that the scientific standards we practice at NOW Foods are recognized by the academic community."

Naturally Rockford: Seven tips for managing osteoarthritis naturally

BLOOMINGTON, Minn.—From a diminished quality of life, lost work productivity, and huge medical expenses, osteoarthritis can be a life-altering disease. With recent news that the common anti-inflammatory arthritis drugs can cause heart attacks, strokes, or aggravate high blood pressure, many people are left wondering what safe options are available to improve their overall joint health and keep them moving.

“There are many safe, natural substances available that have been proven beneficial in alleviating the pain, stiffness, and other symptoms associated with the many forms of this arthritis,” says Joseph Sweere, DC, a professor at Northwestern Health Sciences University in Bloomington, Minn. “Because of the over 100 classifications of this disease, it’s important for people to have their arthritis diagnosed by a health professional to fully understand their specific condition and to receive the appropriate treatment.”

The most common form is osteoarthritis, a degenerative joint disease in the weight-bearing joints of the lower spine, hips, hands, knees, feet and ankles, affecting 46 million people in the United States, according to the Arthritis Foundation. Osteoarthritis is caused by the breakdown of cartilage and bones from previous injury and the wear and tear of life, resulting in pain, stiffness, inflammation and limited movement of joints.

Dr. Sweere suggests the following natural options to treat osteoarthritis effectively:

Proper nutrition. “Lost cartilage doesn’t self-recover, so having a diet high in calcium, vitamin C, vitamin D3 (cholecaciferol) and magnesium is important to increase the body’s overall functionality and range of motion. Antioxidants, including grapeseed, pomegranate and blueberry extracts also help. Fish oils, with omega-3 fatty acids are beneficial in easing the pain of arthritis. Fish oil from Carlson Labs (www.carlsonlabs.com) is best because it is one of the few labs that provides mercury-free products,” says Dr. Sweere.

Other natural products. “Many naturally occurring non-drug products have become readily available over the years, and have proved beneficial for some people to reduce arthritis inflammation,” says Dr. Sweere. These include chondroitin sulfate, glucosamine sulfate, MSM (methyl sulflmethane) and SAMe (S-adenosyl methionine). Others include devil’s claw root, evening primrose oil, feverfew, flax oil and quercetin. “All can be found at your local health food store and are considered safe when one follows the directions on the label. However, glucosamine and chondroitin are best when taken together,” adds Dr. Sweere.

Pain-management therapies. “Many successful, popular therapies, including myofascial release therapy and the Graston Technique are practiced by chiropractors, physical therapists and occupational therapists to relieve pain related to joint, muscle and nerve disorders,” says Dr. Sweere. “Therapeutic massage and acupuncture are also safe and effective approaches to joint pain management. Consult with your health care provider to find the one best for you,” adds Dr. Sweere. Myofascial release therapy is a gentle, hands-on technique designed to release adhesions in the fascial system, a web of connective tissue that surrounds all the muscles. The Graston Technique involves manually applying stainless steel instruments to myofascial areas to relieve pain and increase range of motion.

Maintain a healthy weight. “Maintaining a normal body weight is a very important component to managing arthritis,” says Dr. Sweere. “The prevalence of osteoarthritis increases with more weight, which can wear down on the joints, allowing them to deteriorate more easily.”

Exercise. “Exercise and stretching programs can be beneficial for controlling arthritis symptoms,” explains Dr. Sweere. “Swimming is particularly beneficial because it allows for full-body movement without the stress of weight-bearing exercises while also aiding in weight management. Aquatherapy and hydrotherapy exercises are also helpful while in a swimming pool.”

Reduce stress. “Another important consideration for those with arthritis or joint inflammation is to reduce the amount of mechanical, environmental or chemical, and psychological stress in their lives,” says Dr. Sweere. “Mechanical stress involves reducing strain on the joints, which might include avoiding activities like unnecessary squatting or kneeling and high-impact sports or recreational activities. An example of chemical stress is smoke and tobacco, which lead to further degeneration of cartilage in our discs and in the spine. Psychological stress involves reducing prolonged states of anger, anxiety and fear that, in turn, depletes the body’s natural supply of cortisone, a powerful anti-inflammatory hormone that enables the body to protect the cartilage and lubrication system.”

Apply heat. “Applying moist heat to stiff, achy muscles and joints can ease arthritis pain, along with taking hot showers or whirlpool baths,” says Dr. Sweere. “Use caution when using heating pads and/or lamps, and remain awake and alert to avoid accidental overuse. Topical heat-producing anti-inflammatory ointments, creams, sprays and lotions containing capsicum (made from chili peppers) are highly effective.”

For additional resources about managing arthritis naturally, visit http://www.nwhealth.edu/nns, a Web site focusing on natural approaches to health and wellness hosted by Northwestern Health Sciences University.

You mentioned side effects, are you aware of any long-term side effects of these two agents?

Glucosamine and chondroitin seem to be, in safety studies that have been done in the United States, basically as safe as taking placebo. Reported side effects include; stomach upset, gastrointestinal upset and skin rash, but these are infrequent and if they were to occur the supplement could be discontinued.

Glucosamine should not be taken by people with a history of allergy to shellfish. Levels of the blood-thinning medication, coumadin, may be affected by chondroitin sulfate. Recent reports have shown that glucosamine might elevate insulin levels in diabetics.

What is Osteoarthritis?

What is Osteoarthritis?
Osteoarthritis (AH-stee-oh-ar-THREYE-tis) is the most common form of arthritis, with rheumatoid arthritis in a distant second. Osteoarthritis is also known as degenerative joint disease, OA, or osteoarthrosis. It is what people generally think of when they think of arthritis, as it commonly affects middle aged to elderly individuals but it can strike almost any age or as a result of injury.

Is there a cure for arthritis?
At the current time, there is no cure for arthritis.

What causes the pain?
Joints consist of bones, with various types of sockets or connections that link one bone end to another. Some bones just slide across each other, while others like the hip joint use a ball and socket. Between the bone ends there is a protective, slippery layer known as cartilage (KAR-til-uj). Whenever you move a joint, bones rub together with the cartilage padding the between. For people without arthritis, the cartilage’s job is to protect the bones when they rub against each other by acting as a shock absorber or cushion. Think of it as a thick Teflon® (Teflon® is a registered trademark of DuPont) coating for the joints. In osteoarthritis, that coating breaks down over and wears away. When the cartilage is thin or gone, bones can rub directly together.

What are the results?
While bones can break, most of the time they are very strong and rigid. When they rub together directly on each other, the immediate result is pain, swelling, and a loss of mobility. If this continues, the ends of the bone may even lose their original shape, causing deformities. Bone spurs (osteophytes) – small growths on the bone that make the surface even less smooth – can grow. Small pieces of bone or cartilage can break off and float around inside the joint, further causing pain and inflammation. In severe cases of osteoarthritis, you can sometimes even hear the bones making a grinding noise as they rub together. As you can see, osteoarthritis is one of the worst forms of arthritis due to the continual effects it has on people’s joints.
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How can I tell if I have osteoarthritis?
Only your doctor can make an accurate diagnosis of osteoarthritis, but some warning signs may include pain in weight bearing joints such as the knee or hip, pain during joint movement, swelling of the joints or even pain in your joints during strenuous activities. An X-ray will generally confirm the presence of osteoarthritis. Most people over the age of 60 will have radiographic (x-ray) evidence of the disease. Roughly one third will have active symptoms.

Who is at risk?
Anybody over the age of 45 is in the greatest risk range for developing osteoarthritis. Women are slightly more at risk than men, for reasons that we do not fully understand yet.

How can I deal with it?
If you are experiencing decreased flexibility, you should strongly consider trying liquid glucosamine Flexicose. Glucosamine is not a treatment for arthritis, but it has been clinically shown to ease joint discomfort, increase flexibility, and promote healthy cartilage. Flexicose contains 1,500 mg of superior-quality liquid glucosamine per 1/4 oz serving. Unlike most other glucosamine products out there, Flexicose also contains 12 other joint discomfort easing ingredients such as Chondroitin, MSM, Omega 3, Manganese and Niacinamide. Flexicose is affordable and backed by a 90 day money back guarantee. Learn more about Flexicose now or simply order now and get free shipping to the United States, Canada and Australia.

Glucosamine Side Effects

Glucosamine is a substance that has received a lot of press recently, due to its amazing ability to ease arthritis pain and slow down the progression of the disease. Many scientific studies have shown that glucosamine is very effective, potentially more so than standard anti inflammatory such as ibuprofen or aspirin. It also lacks the damaging side effects and long term toxicity of COX-2 inhibitors or NSAIDS such as ibuprofen or aspirin.

So how safe is Glucosamine?

Glucosamine is overall a very safe substance. It has been studied clinically since the very early 1980’s – so people have been taking it safely for over 20 years. There are only a few things you need to watch out for when taking glucosamine.

Shellfish Allergies
Because most glucosamine is derived from shellfish (a few manufacturers offer it derived from corn), you should consult your doctor prior to starting glucosamine therapy if you have a known allergy to glucosamine. If the glucosamine is pure but derived from shellfish, it is still possible that people who are allergic to shellfish can take glucosamine. Because the allergic reaction is to proteins in shellfish and glucosamine is derived from Chitin, a carbohydrate, it is generally ok to try glucosamine under the guidance of a doctor because the processing that takes place to extract the glucosamine destroys the proteins and the antigens that the body would normally react to.

Diabetics
Insulin levels with Glucosamine (HCL or Sulfate) can be subject to fluctuations, particularly in diabetics. Glucosamine is technically a carbohydrate (a sugar), but the body is not able to convert Glucosamine into Glucose. Hence, Glucosamine does not directly provide additional sources of Glucose. In diabetic patients, many factors can lead to changing blood levels and as a result it is very important to check with your doctor prior to initiating Glucosamine therapy and to be sure to be very careful about monitoring your blood sugar levels while on Glucosamine. Read the latest update on Glucosamine for Diabetics.

Pregnant Women
Pregnant women should avoid Glucosamine. There have not been enough long term studies on the fetus to clearly say that Glucosamine is 100% safe for the developing fetus. There is no evidence that it would be harmful but it would be best to be safe in a situation such as this.

Overdose
Extremely high levels of Glucosamine (many times the daily dose) can cause gastric fluctuations such as soft stools, diarrhea or nausea. Glucosamine does not have to be taken with meals but it would be convenient to mix with a drink when you take it if you so desired.

Except for those above advisements, when taken according to the label, glucosamine has a long track record of being very safe, unlike the NSAIDS, who have a long and very well known (to scientists) history of being very bad for you long term. Not only are they foreign substances, (glucosamine is totally natural and in your joints right now) even COX-2 inhibitors such as Vioxx® or Celebrex® have some rather nasty potential side effects. Plus, NSAIDS and COX-2 inhibitors do nothing but cover up the pain. If you stop taking NSAIDS or COX-2 inhibitors, the pain quickly comes back. Its still there, but your brain is numb to the pain. With glucosamine, there is a residual effect. Even if you stop taking it, you will still be protected for a little while - but your pain will come back. Although maintaining a daily dose is the best way for maximum pain relief and joint protection, glucosamine will be decreasingly effective for a period of time after you stop its administration.

When it comes down to it, you are given a choice. Take foreign drugs with lots of side effects like NSAIDS or COX-2 inhibitors that do nothing for the disease and can possibly make arthritis worse – OR – take something natural with very little side effects like Flexicose.

Flexicose contains 14 synergistic ingredients designed for maximum relief. Each dose of Flexicose contains 1,500 mg of liquid glucosamine. Best of all, Flexicose does not come with the potentially deadly side effects of COX-2 and NSAID drugs. Order Flexicose now, and get FREE U.S., Canada, and Australia shipping.