Cartonica High Strength Joint Supplement

Size: 500ml (33 day supply)

Directions: Shake well before use. Take one 15ml serving per day. May be consumed undiluted or diluted with water to taste. Do not exceed stated dose.

Storage: Store in a cool, dry place. Once opened keep refrigerated and consume within two months. Keep out of reach of children.

Allergens: Contains shellfish (glucosamine) and fish (chondroitin). Collagen from beef. Not suitable for vegetarians. No porcine. No yeast. No gluten. No lactose.

Below is a description of each ingredient in the Cartonica blend, their purpose in joint health along with references to published studies.

Vitamin B12

Vitamin B12 or cobalamin is a water-soluble vitamin that plays a key role in various physiological functions. For example, healthy production of red blood cells, maintenance of nerve function and proper regulation of mood.

In addition, it also supports joint health in two ways; first, lowers the risk of bone fracture, second, it helps normalise homocysteine levels, which may be increased in patients with joint disease. (1,2)

Vitamin C

Vitamin C or ascorbic acid is a water-soluble vitamin with powerful antioxidant properties. It binds to the harmful chemical species called free radicals and counteracts their negative effects.

Human studies have shown that vitamin C helps prevent cartilage loss and slows down the progression of joint diseases. (3,4)

Vitamin D3

Vitamin D3 or cholecalciferol is a fat-soluble vitamin. It is key to maintaining optimal bone health as it helps your body absorb calcium and phosphorus from your diet.

It helps prevent bone loss by preventing the breakdown of bone tissues and subsequent release of calcium into the bloodstream. In addition, vitamin D supplementation (either oral or using an injection) increases bone mass and reduces the risk of falls. (5,6)

Turmeric

Turmeric is a spice of the ginger family. It contains a powerful anti-inflammatory and antioxidant known as curcumin.

Turmeric is a safe and highly effective natural treatment for several joint diseases. Curcumin improves joint tenderness and swelling. It reduces inflammation by blocking the activity of pro-inflammatory substances, prevents cartilage degradation, and counteracts cellular damages. (7,8)

Green Tea Extract

Green tea extract is a rich source of potent antioxidants, polyphenols. While green tea extract is sometimes used in weight loss programmes, one of the polyphenols, epigallocatechin-3 gallate (EGCG), has been shown to be beneficial for joint health.

EGCG helps prevent and alleviate the symptoms of joint disease through its anti-inflammatory activity. It works by blocking the activity of inflammatory substances in the cells of cartilage. (9)

Hydrolysed Collagen Type II

Hydrolysed collagen type II has been widely studied as a potential treatment for various joint health conditions.

Naturally-occurring type II collagen is a major component of joint cartilage. Joint diseases such as autoimmune arthritis cause a gradual loss of collagen type II and proteoglycans. This results in pain, tenderness, stiffness, and limited mobility. (10)

Laboratory study shows that administration of hydrolysed collagen type II to the culture medium stimulates the production as well as secretion of type II collagen in cartilage tissues. Moreover, ingested hydrolysed collagen type II accumulates in cartilage where it stimulates the synthesis of macromolecules that are necessary for maintaining proper functioning of the joints. (11,12)

Glucosamine Sulphate

Glucosamine is a naturally-occurring amino acid that plays a key role in the growth and repair of joint cartilage.

Oral glucosamine sulphate once daily for three years is found to be effective in improving the symptoms of osteoarthritis (OA). (13)

While the exact mechanism behind the benefits of glucosamine is yet to be discovered, scientists believe that it might help maintain joint health by stimulating the production of macromolecules in cartilage and blocking the effects of inflammatory substances. (14)

Chondroitin Sulphate

Chondroitin sulphate or Chondroitin Polysulphate is a naturally-occurring substance in joint cartilage. It is necessary for maintaining the resistance and elasticity of cartilage. It is usually given in combination with glucosamine sulphate.

Chondroitin supplementation has been studied and is believed to help joints by one or more of the (15,16,17,18)

• Stabilises the joint space and modifies bone metabolism in the joints.
• Inhibits the destruction of cartilage tissues in the joints.
• Regulates the synthesis of hyaluronan, a substance that lubricates and cushions the joints.
• Reduces the production of pro-inflammatory substances in the joints.

L-Carnitine

L-carnitine is an amino acid that is naturally found in the body. The body converts ingested L-carnitine into acetyl-L-carnitine, which prevents cartilage degradation and helps reduce pain associated with degenerative joint diseases such as osteoarthritis. (19)

It appears to work primarily by reducing the serum levels of pro-inflammatory substances. (20)

Methylsulfonylmethane (MSM)

Methylsulfonylmethane or dimethyl sulfone is an organosulphur compound naturally found in the body. It has antioxidant and anti-inflammatory properties.

As a supplement MSM has been shown to be effective in relieving joint pain and improving the functions of the joints. Interestingly, it is thought that the benefits are increased if using MSM with collagen type II. (21,22)

The beneficial effects of MSM on joint health are believed to be due to its powerful anti-inflammatory property. In addition, it might also decrease cartilage degeneration in the joints. (23,24)

References

1. Dhonukshe-rutten RA, Pluijm SM, De groot LC, Lips P, Smit JH, Van staveren WA. Homocysteine and vitamin B12 status relate to bone turnover markers, broadband ultrasound attenuation, and fractures in healthy elderly people. J Bone Miner Res. 2005;20(6):921-9.
2. Kuzminski AM, Del giacco EJ, Allen RH, Stabler SP, Lindenbaum J. Effective treatment of cobalamin deficiency with oral cobalamin. Blood. 1998;92(4):1191-8.
3. Chang Z, Huo L, Li P, Wu Y, Zhang P. Ascorbic acid provides protection for human chondrocytes against oxidative stress. Mol Med Rep. 2015;12(5):7086-92.
4. Mcalindon TE, Jacques P, Zhang Y, et al. Do antioxidant micronutrients protect against the development and progression of knee osteoarthritis?. Arthritis Rheum. 1996;39(4):648-56.
5. Sunyecz JA. The use of calcium and vitamin D in the management of osteoporosis. Ther Clin Risk Manag. 2008 Aug; 4(4): 827–836.
6. Harwood RH, Sahota O, Gaynor K, Masud T, Hosking DJ. A randomised, controlled comparison of different calcium and vitamin D supplementation regimens in elderly women after hip fracture: The Nottingham Neck of Femur (NONOF) Study. Age Ageing. 2004;33(1):45-51.
7. Chandran B, Goel A. A randomized, pilot study to assess the efficacy and safety of curcumin in patients with active rheumatoid arthritis. Phytother Res. 2012;26(11):1719-25.
8. Henrotin Y, Priem F, Mobasheri A. Curcumin: a new paradigm and therapeutic opportunity for the treatment of osteoarthritis: curcumin for osteoarthritis management. Springerplus. 2013; 2: 56.
9. Singh R, Ahmed S, Islam N, Goldberg VM, Haqqi TM. Epigallocatechin-3-gallate inhibits interleukin-1beta-induced expression of nitric oxide synthase and production of nitric oxide in human chondrocytes: suppression of nuclear factor kappaB activation by degradation of the inhibitor of nuclear factor kappaB. Arthritis Rheum. 2002;46(8):2079-86.
10. Eyre D. Collagen of articular cartilage. Arthritis Res. 2002;4(1):30-5.
11. Oesser S, Seifert J. Stimulation of type II collagen biosynthesis and secretion in bovine chondrocytes cultured with degraded collagen. Cell Tissue Res. 2003;311(3):393-9.
12. Bello AE, Oesser S. Collagen hydrolysate for the treatment of osteoarthritis and other joint disorders: a review of the literature. Curr Med Res Opin. 2006;22(11):2221-32.
13. Reginster JY, Deroisy R, Rovati LC, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet. 2001;357(9252):251-6.
14. Henrotin Y, et al. Physiological effects of oral glucosamine on joint health: current status and consensus on future research priorities. BMC Res Notes. 2013; 6: 115.
15. Uebelhart D, Thonar EJ, Delmas PD, Chantraine A, Vignon E. Effects of oral chondroitin sulfate on the progression of knee osteoarthritis: a pilot study. Osteoarthr Cartil. 1998;6 Suppl A:39-46.
16. Jomphe C, Gabriac M, Hale TM, et al. Chondroitin sulfate inhibits the nuclear translocation of nuclear factor-kappaB in interleukin-1beta-stimulated chondrocytes. Basic Clin Pharmacol Toxicol. 2008;102(1):59-65.
17. David-raoudi M, Deschrevel B, Leclercq S, Galéra P, Boumediene K, Pujol JP. Chondroitin sulfate increases hyaluronan production by human synoviocytes through differential regulation of hyaluronan synthases: Role of p38 and Akt. Arthritis Rheum. 2009;60(3):760-70.
18. Chou MM, Vergnolle N, Mcdougall JJ, et al. Effects of chondroitin and glucosamine sulfate in a dietary bar formulation on inflammation, interleukin-1beta, matrix metalloprotease-9, and cartilage damage in arthritis. Exp Biol Med (Maywood). 2005;230(4):255-62.
19. Bianchi E, Di cesare mannelli L, Menicacci C, Lorenzoni P, Aglianò M, Ghelardini C. Prophylactic role of acetyl-l-carnitine on knee lesions and associated pain in a rat model of osteoarthritis. Life Sci. 2014;106(1-2):32-9.
20. Malek mahdavi A, Mahdavi R, Kolahi S. Effects of l-Carnitine Supplementation on Serum Inflammatory Factors and Matrix Metalloproteinase Enzymes in Females with Knee Osteoarthritis: A Randomized, Double-Blind, Placebo-Controlled Pilot Study. J Am Coll Nutr. 2016;35(7):597-603.
21. Kim LS, Axelrod LJ, Howard P, Buratovich N, Waters RF. Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial. Osteoarthr Cartil. 2006;14(3):286-94
22. Xie Q, Shi R, Xu G, Cheng L, Shao L, Rao J. Effects of AR7 Joint Complex on arthralgia for patients with osteoarthritis: results of a three-month study in Shanghai, China. Nutr J. 2008;7:31.
23. Butawan M, Benjamin RL, Bloomer RJ. Methylsulfonylmethane: Applications and Safety of a Novel Dietary Supplement. Nutrients. 2017 Mar; 9(3): 290.
24. Ezaki J, Hashimoto M, Hosokawa Y, Ishimi Y. Assessment of safety and efficacy of methylsulfonylmethane on bone and knee joints in osteoarthritis animal model. J Bone Miner Metab. 2013;31(1):16-25.