Chronic Joint Pain & Inflammation, Anti-Aging Program | Barron Report

A Five-Pronged Approach to Chronic Joint Pain and Inflammation

avocado soybean unsaponifiables side effects

This report is for anyone who has joint pain… and anyone looking to avoid it down the road.

Joint pain is an interesting animal. Everyone has it at some point. For many people, it’s only an occasional problem — easily taken care of by a single aspirin or some Ben Gay (or herbal deep tissue oil for that matter). For others, though, it’s a chronic problem, reducing them to a lifetime of dependency on high doses of NSAIDS or prescription drugs.

Over the years, I’ve formulated and recommended a number of products for pain. Years ago, before they were all the rage, I recommended Glucosamine and Chondroitin sulfate. Also, over the years, I’ve recommended CMO (cetyl myristoleate), MSM, fish oil, boswellia, and proteolytic enzymes, among others.

Why so many things?

Because no one solution works for everyone! That’s so important, I’m going to repeat it one more time. No one solution works for everyone!

Glucosamine and Chondroitin

I don’t care what advertising statements you’ve read or how hard someone has tried to sell you a magic bullet, no one formula works for everyone. Each person is unique. Their bodies are different. And the causes of joint pain and cartilage destruction are varied.

If Glucosamine and Chondroitin already work for you, then this report is not for you (necessarily). If CMO does the trick, same thing. If you’re happy with proteolytic enzymes or herbal deep tissue oil, this probably is not for you (most likely). But if they haven’t worked, or if you still suffer from chronic pain, and the only help you’ve been able to find is from daily doses of aspirin or prescription drugs, or if you’re concerned about more than just the pain issue and are looking to prevent further degradation of your joints, then read on.

The Five Part Joint Rebuilding Formula

With that in mind, let’s look at the formula in question from top to bottom.

  • Avocado Soybean Unsaponifiables (ASU)
  • UC-II ® Undenatured Chicken Collagen
  • Ginger
  • CMO (cetyl myristoleate)
  • Boswellin® PS

1. Avocado Soybean Unsaponifiables (ASU)

avocado soybean unsaponifiables side effectsIn order to understand what ASUs are (apologies to Arizona State University) and how they work, we need to make a minor detour and talk about aggrecan. In fact, this discussion should help tie together some of the supplements that you may already be familiar with. Aggrecan is the acronym for a small bio-chemical molecule called, oxymoronically, the large aggregating chondroitin sulfate proteoglycan. Specifically, an aggrecan molecule consists of a protein backbone which is attached to up to 150 chondroitin sulfate chains and 60 keratan sulfate chains. Aggrecan is abundant in the human body and represents up to 10% of the dry weight of cartilage. As many as 100 of these aggrecan monomers will then interact with hyaluronic acid molecules to form a single massive chain called an aggregate, which is a key component of joint cartilage.

Aggrecan plays a crucial role in the functioning of articular cartilage (the cartilage found in joints), primarily working to maintain high levels of hydration in the cartilage–thereby keeping the cartilage healthy and functional. As a side note, it is the presence in aggrecan of large numbers of chondroitin sulfate chains that is primarily responsible for the osmotic pressure that results in articular cartilage being 75% water.

When at rest, such as sitting down and watching TV, the osmotic swelling in the articular cartilage is at a maximum. However, when walking or standing, the weight of the body is transferred to the articular cartilage found at the ends of the long bones. At this point, your weight compresses the cartilage, literally squeezing water out of it. This continues until the osmotic swelling generates a force equal to the compressive force on the cartilage generated by your weight. When you sit down again (reducing the load), the compressive force is removed, and the cartilage once again swells to its full extent. The more aggrecan present, the better able your body is to perform this function. Note: the reason people supplement with chondroitin sulfate and glucosamine sulfate is actually to increase aggrecan levels. They are components of aggrecan, and it is aggrecan that lies at the core of cartilage health. But as it turns out, there may be a more efficient way to increase aggrecan levels.

Bottom line: maintaining high levels of aggrecan is essential for optimizing joint health. (As a side note, aggrecan plays a major role in brain and spinal cord development and function too.)

A French Discovery on Osteoarthritis

A little over a decade ago, researchers from the University Hospital in Liege, Belgium reported in the August 2003 issue of The Journal of Rheumatology that a phytosterol/sterolin extract concentrated from the oils found tightly bound to avocado and soybean fibers could significantly boost production of aggrecan, thereby helping slow down and even repair some of the damage caused by osteoarthritis–in as little as nine days.1 Christelle Sanchez, Michelle A Deberg, Nathalie Piccardi, et al. “Avocado/soybean unsaponifiables increase aggrecan synthesis and reduce catabolic and proinflammatory mediator production by human osteoarthritic chondrocytes.” J Rheumatol August 2003 30(8):1825-1834. http://www.jrheum.org/content/30/8/1825.abstract

It should be noted that although eating avocado and soybean oil separately does indeed enhance aggrecan production (somewhat); it is only these special compounds found in ASU extract (made up of one-third avocado and two-thirds soybean unsaponifiables) that restore aggrecan synthesis blocked by the inflammation-causing compound interleukin-1-beta. In addition, ASUs also reduce levels of several other inflammatory factors such as MMP-3 production. In other words, ASU is not the same as avocado and soy oil. It is specially extracted from the fiber of avocados and soy. The problem is that before extraction, the ASUs are so tightly bound to the fiber, that they are mostly unusable by the human body.

ASU has been sold in Europe in a purified form for a number of years now as a prescription drug. As such, it has a number of studies supporting its effectiveness. For example, in a double-blind trial, 260 individuals with arthritis of the knee were given either a placebo or purified ASU at 300 or 600 mg daily. The results over 3 months showed that use of ASU significantly improved arthritis symptoms when compared to a placebo.2 Appelboom T, Schuermans J, et al. “Symptoms modifying effect of avocado/soybean unsaponifiables (ASU) in knee osteoarthritis. A double blind, prospective, placebo-controlled study.” Scand J Rheumatol. 2001;30(4):242-7. http://www.ncbi.nlm.nih.gov/pubmed/11578021 Now, to be fair, several subsequent studies questioned whether or not those benefits held up long-term, but in 2013, the results of a 399 patient, 3-year, randomized controlled trial of ASU was published in Annals of the Rheumatic Diseases. To date, it is the definitive long-term study on ASU. It concluded that 3-year treatment with ASU definitely reduced the number of patients who experienced narrowing of their joint space width, thus confirming a potential structure modifying effect for ASU in hip osteoarthritis.3 Maheu E, Cadet C, Marty M, Moyse D, et al. “Randomised, controlled trial of avocado-soybean unsaponifiable (Piascledine) effect on structure modification in hip osteoarthritis: the ERADIAS study.” Ann Rheum Dis. 2014 Feb;73(2):376-84. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3913295/

What It Means for Arthritis

If you’ve tried Chondroitin sulfate, Glucosamine sulfate, MSM, CMO, whatever, and none of them have worked for you, then ASUs offer an exciting alternative.

ASU Periodontal

asu periodontal supplementationIt turns out, there may be another benefit to ASU supplementation. It is now understood that one biochemical in particular is responsible for the erosion of oral structures–literally eating away at your jawbone and the ligaments that hold your teeth to your jaw. This oral toxin is called Interleukin-1beta (IL-1beta), and it has been referred to as the “common mediator of the inflammation process.” Your body’s countermeasure to IL-1beta is a family of biochemicals called “Transforming growth factor-beta.” TGF-beta has been identified as one of the factors capable of counteracting IL-1beta’s destructive effects and plays a key role in tissue regeneration. Unfortunately, one of the effects of IL-1beta is that it inhibits the production of TGF-beta, the very substance that can counteract it and repair the damage. Luckily we have ASU.

A French study found that ASU can exert a preventive action on the erosive effects exerted by IL-1beta in periodontal diseases.4 Andriamanalijaona R, Benateau H, et al. “Effect of interleukin-1beta on transforming growth factor-beta and bone morphogenetic protein-2 expression in human periodontal ligament and alveolar bone cells in culture: modulation by avocado and soybean unsaponifiables.” J Periodontol. 2006 Jul;77(7):1156-66. http://www.ncbi.nlm.nih.gov/pubmed/16805677 Specifically, researchers found that ASU stimulated the production of the protective TGF-beta family of growth factors. In other words, ASU helped the periodontal ligament and oral bone cells protect themselves by inhibiting the erosive effect of IL-1beta. According to the researchers, these “findings support the hypothesis that ASU could exert a preventive action on the deleterious effects exerted by IL-1beta in periodontal diseases.”

A second French study found that ASU might be beneficial in patients with gingival inflammation and periodontitis by preventing the erosive effects of IL-1beta that occur in periodontal diseases.5 Kut-Lasserre C, Miller CC, Ejeil AL, et al. “Effect of avocado and soybean unsaponifiables on gelatinase A (MMP-2), stromelysin 1 (MMP-3), and tissue inhibitors of matrix metalloproteinase (TIMP- 1 and TIMP-2) secretion by human fibroblasts in culture.” J Periodontol. 2001 Dec;72(12):1685-94. http://www.ncbi.nlm.nih.gov/pubmed/11811504

And finally, a third French Study showed that avocado and soybean unsaponifiables protect all types of gingival elastic fibers from degradation by HLE.6 Kut C, Assoumou A, Dridi M, et al. “Morphometric analysis of human gingival elastic fibres degradation by human leukocyte elastase protective effect of avocado and soybean unsaponifiables (ASU).” Pathol Biol (Paris). 1998 Sep;46(7):571-6. http://www.ncbi.nlm.nih.gov/pubmed/9842576 HLE is one of several hydrolytic (water removing) enzymes contained in neutrophils. Physiologically, it digests foreign material ingested by immune cells. However, when triggered by the inflammation and infection associated with gingivitis, it attacks the elastic and preelastic fibers that help hold your teeth in place. This destruction is a hallmark of periodontal disease. Thus the study concluded that ASU may be beneficial in patients with gingival inflammation and periodontitis since HLE plays a major role in these disease states.

2. UC-II ® Undenatured Chicken Collagen

Although ASU works directly to build and repair joint cartilage, it doesn’t address a major aspect of the problem (in fact few things address this particular aspect). A key component of most joint destruction (sometimes an initial cause as in rheumatoid arthritis and sometimes a secondary factor triggered by an initial trauma to the tissue as in osteoarthritis) is when the immune system goes out of control and starts attacking the cartilage. In other words, once a person starts down the road of joint pain, either early on or later in the process, at some point the immune system usually “goes wrong” and becomes a factor in the gradual destruction of joint tissue. Literally, the immune system reprograms itself to treat joint tissue as a foreign invader and “eat it up.” Re-reprogramming the immune system through the use of immunomodulators is often an essential step in stopping and reversing this damage.

In the past, I have recommended several immunomodulators including CMO (cetyl myristoleate) and L-Carnosine, but UC-II seems to represent a choice uniquely suited to dealing with joint and cartilage problems. Although this discussion ultimately applies to all forms of joint damage, for the moment, let’s focus our attention specifically on rheumatoid arthritis.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a common autoimmune disease in which killer T-cells of the body’s own immune system (most likely triggered by invading bacteria) reprogram themselves to attack joint cartilage, resulting in inflammation and joint destruction. The current treatment strategies of suppressing immunity and inflammation offer only limited success. “Oral tolerance,” on the other hand, is a long-recognized mechanism for inducing immune tolerance–that is, suppressing a misdirected immune response. But rather than suppressing the entire immune system, oral tolerance targets specific immune cells responsible for tissue damage. Inducing the immune system to tolerate joint cartilage, rather than identifying it as a “foreign” substance, requires a specific sequence of events to take place within that part of the immune system found in the gastrointestinal tract lining. Studies have shown that small doses of undenatured type II collagen can indeed trigger this particular sequence of events, thereby deactivating killer T-cell attacks of joint cartilage in humans.7 Bagchi D, Misner B, Bagchi M, et al. “Effects of orally administered undenatured type II collagen against arthritic inflammatory diseases: a mechanistic exploration.” Int J Clin Pharmacol Res. 2002;22(3-4):101-10. http://www.ncbi.nlm.nih.gov/pubmed/12837047 Other studies have demonstrated that the undenatured type II chicken collagen found in UC-II retains its activity when exposed to human digestive fluids, which is not necessarily true of other sources. Time-dose measurements by ELISA immuno-assay of UC-II activity have shown that it retains approximately 50% activity even after as long as 90 minutes after exposure to digestive juices.

What is UC-II?

chicken collagenMost type II chicken collagen sold in dietary supplements is denatured, or hydrolyzed, which is another way of saying that the chemicals and high-heat used to process and refine it have changed its molecular configuration. An undenatured extract is made using little or no heat and limited processing. It is usually extracted using pepsin with just enough processing to concentrate the collagen and make it soluble. Denatured or hydrolyzed extracts, on the other hand, typically use high heat, acids, and enzymes to make the protein molecules more soluble; but these methods fundamentally alter the structure of the protein. Denatured proteins are often called hydrolyzed proteins–thus denatured collagen is often called hydrolyzed collagen. This does not make it useless. Hydrolyzed type II chicken collagen still has value as a source of some of the components of aggrecan, including collagen itself, hyaluronic acid, chondroitin sulfate, and glucosamine. But to receive this benefit you need to consume it in large amounts, as much as 3-10 grams a day. But more importantly, one significant thing does change in the process of denaturing. When denatured, type II chicken collagen loses its immunomodulating ability. Type II collagen must be in its native (undenatured) form to be effective in this capacity.

UC-II is extracted from chicken sternum cartilage using a patented, low-temperature process that ensures the undenatured biological activity of the type II collagen even when exposed to digestive juices for 90 minutes or more. As mentioned earlier, undenatured collagen administered orally works with the immune system to promote healthy joints by a process called oral tolerization. This process helps the body to differentiate between foreign invaders, such as bacteria, and elements that are good for the body, such as nutrients. The process of oral tolerization takes place in the small intestine where food is absorbed. Through a complex process, lymphoid tissue in the mucosal lining of the small intestine screens incoming compounds and serves as a “switch,” turning the body’s immune response on or off to foreign substances, depending upon what that substance is. In the case of undenatured type II chicken collagen, small amounts (typically around 10 milligrams) taken orally have been shown to correct a faulty immune response specifically targeted at the type II collagen present in bone joint cartilage — in effect, modulating the body’s immune response so it works correctly once again. At a cost of over $17,000 per kilogram of active ingredient, UC-II is undoubtedly the single most expensive ingredient I have ever used in a formula. Fortunately, it only takes 10 mg a day of its active ingredient for maximum effect. (In fact, it loses effectiveness if too much is used, losing all effectiveness at levels over 20 mg a day). But cost aside, the fact that it specifically addresses the problem of the immune system destroying the body’s own cartilage mandates its inclusion in the formula.

Studies on Joint Mobility and Flexibility

There have been a number of studies conducted with UC-II on both animals and humans, including research at the Harvard University Medical School — all of which have shown that the undenatured type II chicken collagen found in UC-II effectively reprograms the immune system to promote healthy joints and increase joint mobility and flexibility.8 David C. Crowley, Francis C. Lau, et al. “Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial.” Int J Med Sci. 2009; 6(6): 312–321. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2764342/

In a pilot clinical study, for example, five older women (58-78 years old) suffering from significant joint pain were given undenatured type II chicken collagen (10 mg/day) for 42 days.9 Bagchi Improvements in pain reduction and joint flexibility were reported, along with reduced morning stiffness. In another study, researchers at Harvard Medical School found that six of 10 rheumatoid arthritis patients taking undenatured type II collagen for three months showed substantial improvement, while one patient recovered completely. In addition, there were no side effects. And finally, as Phase II of that Harvard trial, the researchers conducted a 90-day, double-blind, placebo-controlled, follow-up study on patients with severe rheumatoid arthritis. They found that 28 patients taking undenatured type II collagen showed significant improvement compared to the placebo group, while four patients recovered completely.10 Trentham, RA Dynesius-Trentham, et al., “Effects of Oral Administration of Type II collagen on Rheumatoid Arthritis.” Science, 261:1727-1730, 1993. http://www.sciencemag.org/content/261/5129/1727.abstract

An Important Note on Supplement Amounts

When we talk about a 10 mg dose, we’re talking about 10 mg of active glycosylated undenatured type II chicken collagen. But there are no readily available pure sources of this component. Standard hydrolyzed chicken collagen, as explained earlier, has virtually none. And most sources of undenatured collagen offer it in the range of 10-25% concentrations. In UC-II, for example, active glycosylated undenatured type II chicken collagen comprises 25% of the whole. That means it takes 40 mg a day of UC-II to get 10 mg of active undenatured collagen. I have noticed that several of the supplement providers who are using UC-II in their formulas have mistakenly used 10 mg of UC-II itself. That means they are only providing 2.5 mg of active undenatured collagen. Given the cost, I can see why, but from your perspective, you want a full 10 mg, which requires 40 mg a day of UC-II– or more from other sources.

What It Means

For anyone suffering from progressive cartilage damage (which ultimately means anyone suffering from rheumatoid arthritis or long term osteoarthritis), reprogramming the immune system with undenatured type II chicken collagen as found in UC-II is an essential component of his or her joint repair regimen.

3. Ginger

Ginger is a COX-2 (Cyclo-Oxygenase-2) inhibitor. The COX-2 enzyme plays a key role in the inflammation process, which is a normal, healthy attempt by the body to heal itself. However, when inflammation gets out of control (such as in the case of arthritis or other chronic inflammatory disorders), ongoing pain and discomfort is the result–not to mention that systemic inflammation is considered to be a contributing factor to catastrophic illnesses such as heart disease and cancer. A botanical COX-2 inhibitor such as found in ginger can block the action of the COX-2 enzyme in much the same way as prescription drugs do, but without the side effects.

There are two COX enzymes present in the human body, COX-1 and COX-2. The COX-1 enzyme is found in most tissues and is necessary for a variety of important internal functions, such as protecting the stomach lining, maintaining renovascular function, and platelet aggregation. The COX-2 enzyme, though, has an entirely different function. It is a necessary component of the inflammation process, which is a normal, healthy attempt by the body to heal itself. However, when inflammation gets out of control (such as in the case of arthritis or other chronic inflammatory disorders), ongoing pain and discomfort is the result. Prescription COX-2 inhibitors such as Vioxx and Celebrex have proven helpful in relieving out of control inflammation and its accompanying pain — but with notable side effects such as an increased risk of heart attacks and strokes.11 “Celebrex, Vioxx and Bextra News.” Consumer Affairs. (Accessed 11 May 2015.) http://www.consumeraffairs.com/celebrex-vioxx-and-bextra-news That’s where botanical COX-2 inhibitors such as ginger can help. Botanical COX-2 inhibitors block the action of the COX-2 enzyme in much the same way as prescription drugs do, but without the side effects.

Although it’s probably better known for its anti-nausea properties, ginger is also an effective COX-2 inhibiting, anti-inflammatory herb that has historically been used for arthritis and rheumatism. In a study of patients with rheumatoid arthritis, osteoarthritis, and muscular discomfort, the majority of those who received ginger experienced, to varying degrees, relief of pain and swelling. None of the patients reported adverse effects during the period of ginger consumption, which ranged from three months to 2.5 years.12 Srivastava KC, Mustafa T. “Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders.” Med Hypotheses. 1992 Dec;39(4):342-8. http://www.ncbi.nlm.nih.gov/pubmed/1494322 Another double blind trial found ginger extract to be effective at relieving pain in people with osteoarthritis of the hip or knee. Likewise, in another double blind study, ginger was significantly more effective than a placebo in pain relief and overall improvement.13 Altman RD, Marcussen KC. “Effects of a ginger extract on knee pain in patients with osteoarthritis.” Arthritis Rheum. 2001 Nov;44(11):2531-8. http://www.ncbi.nlm.nih.gov/pubmed/11710709

Ginger contains very potent anti-inflammatory compounds called gingerols. These substances explain why so many people with osteoarthritis or rheumatoid arthritis experience reductions in their pain levels and improvements in their mobility when they consume ginger regularly. In two clinical studies involving patients who responded to conventional drugs and those who didn’t, physicians found that 75% of arthritis patients and 100% of patients with muscular discomfort experienced relief of pain and/or swelling.14 Srivastava

A twelve month placebo-controlled, double-blind, crossover study published in Osteoarthritis Cartilage magazine (no really, that’s its name) tracked 29 patients with painful arthritis in the knee (6 men and 23 women ranging in age from 42-85 years).15 Wigler I, Grotto I, Caspi D, Yaron M. “The effects of Zintona EC (a ginger extract) on symptomatic gonarthritis.” Osteoarthritis and Cartilage November 2003 Volume 11, Issue 11, Pages 783–789. http://www.oarsijournal.com/article/S1063-4584(03)00169-9/abstract By the end of the first six months, those given ginger were experiencing significantly less pain on movement and handicap than those given placebo. Pain on movement decreased from a score of 76.14 at baseline to 41.00, while handicap decreased from 73.47 to 46.08. In contrast, those who were switched from ginger to placebo experienced an increase in pain of movement (up to 82.10) and handicap (up to 80.80) from baseline. In the final phase of the study when all patients were getting ginger, pain remained low in those already taking ginger in phase 2, and decreased again in the group that had been on placebo.

Not only did participants’ subjective experiences of pain lessen, but swelling in their knees, an objective measurement of lessened inflammation, dropped significantly in those treated with ginger. The mean target knee circumference in those taking ginger dropped from 43.25cm when the study began to 39.36cm by the 12th week. When this group was switched to placebo in the second phase of the study, their knee circumferences increased, while those who had been on placebo but were now switched to ginger experienced a decrease in knee circumference. In the final phase, when both groups were given ginger, mean knee circumference continued to drop, reaching lows of 38.78 and 36.38 in the two groups.

adding ginger to diet

As it turns out, ginger’s abilities to reduce oxidative stress, apoptosis, and inflammation have a protective effect on the diabetic brain,16 El-Akabawy G, El-Kholy W. “Neuroprotective effect of ginger in the brain of streptozotocin-induced diabetic rats.” Ann Anat. 2014 May;196(2-3):119-28. http://www.ncbi.nlm.nih.gov/pubmed/24680376 as well as sugar induced inflammatory damage to the kidneys.17 Yang M, Liu C, Jiang J, Zuo G, Lin X, et al. “Ginger extract diminishes chronic fructose consumption-induced kidney injury through suppression of renal overexpression of proinflammatory cytokines in rats.” BMC Complement Altern Med. 2014 May 27;14(1):174. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047007/  In addition, a growing number of experimental studies suggest that 6-shogaol, a key bioactive component found in ginger, may play an important role as a memory-enhancing and anti-oxidant agent against neurological diseases. 6-Shogaol has also recently been shown to have anti-neuroinflammatory effects, which is important when it comes to protecting against the loss of brain function and neurological disorders such as Parkinson’s disease.18 Moon M, Kim HG, Choi JG, Oh H, et al. “6-Shogaol, an active constituent of ginger, attenuates neuroinflammation and cognitive deficits in animal models of dementia.” Biochem Biophys Res Commun. 2014 Jun 20;449(1):8-13. http://www.ncbi.nlm.nih.gov/pubmed/24796668 And it may account for ginger’s purported benefits when it comes to Alzheimer’s.19 Zeng GF1, Zhang ZY, Lu L, Xiao DQ, Zong SH, He JM. “Protective effects of ginger root extract on Alzheimer disease-induced behavioral dysfunction in rats.” Rejuvenation Res. 2013 Apr;16(2):124-33. http://www.ncbi.nlm.nih.gov/pubmed/23374025

What It Means

The bottom line is that ginger’s anti-inflammatory benefits, which include reducing pain and inflammation, help minimize any further degradation to joint cartilage–thus allowing ASU an opportunity to repair existing damage without having to fight through new damage.

 4. CMO (cetyl myristoleate)

cetyl myristoleate cmoCetyl myristoleate (CMO) is the common name for cis-9-cetyl myristoleate. (You can think of it as a relative of the Omega-9 fatty acid found in olive oil.) It is a completely natural medium chain fatty acid found in certain animals, including cows, whales, beavers, and mice–but not in people. CMO was discovered in 1972 by Harry W. Diehl, Ph.D., a researcher at the National Institutes of Health. At the time, Dr. Diehl was responsible for testing anti-inflammatory drugs on lab animals. In order for him to test the drugs, he first had to artificially induce arthritis in the animals by injecting a heat-killed bacterium called Freund’s adjuvant. Dr. Diehl discovered that Swiss albino mice did not get arthritis after injection of Freund’s adjuvant. Eventually, he was able to determine that cetyl myristoleate was the factor present naturally in mice that was responsible for this protection. When CMO was injected into various strains of rats, it offered the same protection against arthritis.20 Diehl HW, May EL. “Cetyl myristoleate isolated from Swiss albino mice: an apparent protective agent against adjuvant arthritis in rats.” J Pharm Sci. 1994 Mar;83(3):296-9. http://www.ncbi.nlm.nih.gov/pubmed/8207671 There have been three notable studies on humans.

Studies

The first double blind study was conducted in 1997 under the auspices of the Joint European Hospital Studies Program and published in the Townsend letter. Of the 106 people who received cetyl myristoleate, 63% showed improvement vs just 15% for the 226 people in the placebo group.21 H. Siemandi, et al. “The Effect of cis-9-Cetyl Myristoleate (CMO) and Adjunctive Therapy on Arthritis and Auto-Immune Disease: A Randomized Trial. The Townsend Letter for Doctors and Patients. Aug 1997;169/170: 58-63

In 2001, a study of 1814 arthritis patients found that over 87% of the subjects in the study had greater than 50% recovery and over 65% of those showed from 75% – 100% recovery following a sixteen day regimen. All types of arthritis were positively affected by CMO. Only those subjects with liver damage or digestive problems or those taking immune suppressing medications were not helped.

In 2002, a double blind study of 64 people with chronic knee pain, published in the Journal of Rheumatology, concluded that CMO provided a significant functional improvement in range of motion vs placebo. In fact, the study concluded that CMO “may be an alternative to the use of nonsteroidal anti-inflammatory drugs for the treatment of osteoarthritis.”22 Hesslink R, Jr, Armstrong D, III, et al. “Cetylated fatty acids improve knee function in patients with osteoarthritis.” J Rheumatol. 2002;29:1708–1712. http://www.ncbi.nlm.nih.gov/pubmed/12180734

What It Means

The 500 mg of CMO I added to the formula provides four distinct benefits:

  • It serves as a lubricant for the joints and muscles, virtually equivalent to silicone in its effectiveness.
  • It facilitates the rebuilding of cartilage.
  • It functions as an immunomodulator — helping to stop an errant immune system from attacking joint cartilage.23 Hunter KW, Jr. Gault RA, Stehouwer JS, Tam-Chang SW. “Synthesis of cetyl myristoleate and evaluation of its therapeutic efficacy in a murine model of collagen-induced arthritis.” Pharmacol Res. 2003 Jan;47(1):43-7. http://www.ncbi.nlm.nih.gov/pubmed?term=12526860%20
  • It functions like a fatty acid in that it mediates inflammatory processes.

5. Boswellin® PS

boswellin from boswellia plantBoswellia serrata, the Indian version of frankincense, has been a staple of Ayurvedic medicine from time immemorial for its ability to manage inflammatory disorders. Positive effects of boswellia in some chronic inflammatory diseases including rheumatoid arthritis,24 Umar S, Umar K, Sarwar AH, et al. “Boswellia serrata extract attenuates inflammatory mediators and oxidative stress in collagen induced arthritis.” Phytomedicine. 2014 May 15;21(6):847-56. http://www.ncbi.nlm.nih.gov/pubmed/24667331 bronchial asthma,25 Hamidpour R, Hamidpour S, Hamidpour M, Shahlari M. “Frankincense ( ru xiang; boswellia species): from the selection of traditional applications to the novel phytotherapy for the prevention and treatment of serious diseases.” J Tradit Complement Med. 2013 Oct;3(4):221-6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3924999/ psoriasis,26 Togni S, Maramaldi G, et al. “A cosmeceutical formulation based on boswellic acids for the treatment of erythematous eczema and psoriasis.” Clin Cosmet Investig Dermatol. 2014 Nov 11;7:321-7. http://www.ncbi.nlm.nih.gov/pubmed/25419153 osteoarthritis,27 Gupta PK, Samarakoon SM, et al. “Clinical evaluation of Boswellia serrata (Shallaki) resin in the management of Sandhivata (osteoarthritis).” Ayu. 2011 Oct;32(4):478-82. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3361921/ ulcerative colitis and Crohn’s disease have been reported.28 Ammon HP. “Modulation of the immune system by boswellia serrata extracts and boswellic acids.” Phytomedicine. 2010 Sep;17(11):862-7. Epub 2010 Aug 8. http://www.ncbi.nlm.nih.gov/pubmed/20696559 Until recently, research on boswellia has focused almost exclusively on the boswellic acids, particularly AKBA (acetyl-11-keto-beta-boswellic acid) as the most active component in boswellia, and have looked to maximize that component. However, more current research has indicated that some of the water soluble polysaccharides in boswellia are also essential components in that they initiate and support the anti-inflammatory activity, whereas the lipid-soluble boswellic acids help to provide a sustained action. In fact, a particular boswellin polysaccharide extract known as Polysal has demonstrated a dose dependent anti-inflammatory potential, similar to the boswellic acids.

For the following reasons, Boswellin® PS now stands out as the boswellin ingredient of choice.

  • It’s 100% natural.
  • It has enhanced AKBA content VS regular boswellin extracts.
  • But in addition to the active boswellic acids, Boswellin® PS contains Polysal, the exclusive water soluble polysaccharide components which contribute to an immediate anti-inflammatory action – perfectly complementing the more sustained action of AKBA. Polysal primarily consists of galactose, arabinose, D-glucuronic acid, and 4-o-methyl-glucuronoarabino-galactan.

Other research

In animal studies, dogs suffering from osteoarthritis received boswellia extract once daily for six weeks. After just two weeks, 71% of the animals showed significant improvement in clinical symptoms of arthritis, including reduced pain, stiffness, and lameness.29 Reichling J, Schmökel H, Fitzi J, et al. “Dietary support with Boswellia resin in canine inflammatory joint and spinal disease.” Schweiz Arch Tierheilkd. 2004 Feb;146(2):71-9. http://www.ncbi.nlm.nih.gov/pubmed/14994484

In a human study, boswellia was similarly shown to be effective in adults with osteoarthritis.30 Kimmatkar N, Thawani V, Hingorani L, Khiyani R. “Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee–a randomized double blind placebo controlled trial.” Phytomedicine. 2003 Jan;10(1):3-7. http://www.ncbi.nlm.nih.gov/pubmed/12622457 Thirty subjects with osteoarthritis of the knee took part in a 16-week, randomized, double-blind, placebo-controlled trial. All of those who took a boswellia supplement reported less pain and swelling, increased knee flexion, and the ability to walk a greater distance.

But it’s not just arthritis. Boswellia seems to have the ability to reduce all forms of inflammation. In studies, bronchial asthma was reduced in 70% of 40 patients treated with 300 mg three times daily for 6 weeks in a double-blind trial.31 Gupta I, Gupta V, Parihar A, et al. “Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study.” Eur J Med Res. 1998 Nov 17;3(11):511-4. http://www.ncbi.nlm.nih.gov/pubmed/9810030 It has also proven effective in helping control the inflammation associated with Crohn’s disease32 Gerhardt H, Seifert F, Buvari P, et al. “[Therapy of active Crohn disease with Boswellia serrata extract H 15].” Z Gastroenterol. 2001 Jan;39(1):11-7. http://www.ncbi.nlm.nih.gov/pubmed/11215357 and colitis, as was mentioned earlier.

How it works

Boswellia works through entirely different mechanisms than anti-inflammatory drugs. Whereas most drugs function as Cox enzyme inhibitors, boswellia works by inhibiting lipoxygenase enzymes (LOX), which are powerful contributors to inflammation and disease. By inhibiting LOX enzymes, boswellia effectively blocks leukotriene synthesis. Leukotrienes play a major role in promoting a whole host of age-associated, inflammation-related diseases including joint problems, intestinal disorders, cancer, and lung related disease.

In addition, it appears that boswellia can inhibit the breakdown of connective tissues caused by tumor necrosis factor-alpha, a potent inflammatory agent in the body.33 Roy S, Khanna S, Krishnaraju AV, et al. “Regulation of vascular responses to inflammation: inducible matrix metalloproteinase-3 expression in human microvascular endothelial cells is sensitive to antiinflammatory Boswellia.” Antioxid Redox Signal. 2006 Mar-Apr;8(3-4):653-60. http://www.ncbi.nlm.nih.gov/pubmed/16677108

And finally, it appears that boswellia has the ability to modulate the immune system and inhibit inflammatory activity, thereby helping with a number of autoimmune conditions, including rheumatoid arthritis.34 Ammon HP. “Boswellic acids in chronic inflammatory diseases.” Planta Med. 2006 Oct;72(12):1100-16. http://www.ncbi.nlm.nih.gov/pubmed/17024588

Or to put it in simpler terms, the boswellic acids in boswellia seem to have the ability to suppress the proliferating tissue found in inflamed areas of the body and prevent the concomitant breakdown of connective tissue. In addition, boswellia has been found to improve blood supply to the joints and restore the integrity of weakened blood vessels, again with no side effects as seen with the traditional drugs of choice.

Conclusion on Chronic Joint Pain

This formula offers a five pronged approach to systemically relieving chronic joint pain and inflammation.

  • It incorporates ASU to increase aggrecan levels, thereby helping to repair and rebuild damaged cartilage in the weight bearing joints.
  • It makes use of the unique ability of the undenatured type II chicken collagen found in UC-II™ to train the body’s immune system to stop attacking joint cartilage.
  • It makes use of ginger’s ability to directly reduce pain and inflammation.
  • It makes use of CMO’s ability to lubricate joints, to support the rebuilding of cartilage, and stop the immune system from attacking joint tissue.
  • And it makes use of the ability of boswellia to control inflammation.

Things to Take With this Formula

supplements and adjuvantsSystemic proteolytic enzymes can be remarkably effective in reducing inflammation throughout the body. Reducing the inflammation can go a long way in stopping the damage from progressing any further — in addition to reducing the pain.

Immune boosters and pathogen destroyers can actually assist in alleviating many types of joint pain. Once again, the “scientific community” is years late in acknowledging the commonly known fact that, in most cases, joint pain is related to a compromised immune system. Take rheumatoid arthritis, for example. The Journal of Clinical Pathology has finally endorsed what the Mayo Clinic demonstrated conclusively years ago: that bacteria are involved. And new research is indicating that mycoplasma infections may be responsible for as much as 50% of all chronic disease, including arthritis.

Glucosamine and chondroitin sulfate are not a cure, but for some people 1,000-2,000 mg a day may provide some relief. Studies are decidedly mixed, but if it works for you, that’s all that counts.

Omega-3 fatty acids as found in fish and krill oil are also helpful in reducing inflammation.

MSM is a naturally occurring sulfur compound found in our bodies and in many foods. When taken as a supplement, it can play a major role in reducing joint inflammation.

Testimonials

The following testimonials were received via email. They are individual experiences, reflecting the real life experiences of those who have used this formula. The testimonials are not necessarily representative of all of those who will use this formula, but they are consistent with the results of studies cited in this report.

Back Pain

“I have major back issues, and I’ve been putting off having disc replacements now for two years since I started taking this formula.  I’m an active person, and I know this product has sustained me, supported my joints and slowed any decline.”

S H., Bend, OR

Knee Pain

“I’ve had problems with my right knee and the pain just wouldn’t let up until I started taking this formula.  The intense pain is completely gone now, and has given me much needed relief.  It’s great stuff!”

J K. Shrewsbury, MA

Knee and Hip Pain

“I obtained this formula for my husband who is 86 years old.  He has had a lot of trouble with his left knee and hip, but after being on this formula for only 5 days, his pain and discomfort are easing.  Jon Barron has come up with a marvelous product.  Triple Jointed is producing wonderful results!”

J B., Butler, OK

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References

References
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2 Appelboom T, Schuermans J, et al. “Symptoms modifying effect of avocado/soybean unsaponifiables (ASU) in knee osteoarthritis. A double blind, prospective, placebo-controlled study.” Scand J Rheumatol. 2001;30(4):242-7. http://www.ncbi.nlm.nih.gov/pubmed/11578021
3 Maheu E, Cadet C, Marty M, Moyse D, et al. “Randomised, controlled trial of avocado-soybean unsaponifiable (Piascledine) effect on structure modification in hip osteoarthritis: the ERADIAS study.” Ann Rheum Dis. 2014 Feb;73(2):376-84. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3913295/
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16 El-Akabawy G, El-Kholy W. “Neuroprotective effect of ginger in the brain of streptozotocin-induced diabetic rats.” Ann Anat. 2014 May;196(2-3):119-28. http://www.ncbi.nlm.nih.gov/pubmed/24680376
17 Yang M, Liu C, Jiang J, Zuo G, Lin X, et al. “Ginger extract diminishes chronic fructose consumption-induced kidney injury through suppression of renal overexpression of proinflammatory cytokines in rats.” BMC Complement Altern Med. 2014 May 27;14(1):174. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047007/
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21 H. Siemandi, et al. “The Effect of cis-9-Cetyl Myristoleate (CMO) and Adjunctive Therapy on Arthritis and Auto-Immune Disease: A Randomized Trial. The Townsend Letter for Doctors and Patients. Aug 1997;169/170: 58-63
22 Hesslink R, Jr, Armstrong D, III, et al. “Cetylated fatty acids improve knee function in patients with osteoarthritis.” J Rheumatol. 2002;29:1708–1712. http://www.ncbi.nlm.nih.gov/pubmed/12180734
23 Hunter KW, Jr. Gault RA, Stehouwer JS, Tam-Chang SW. “Synthesis of cetyl myristoleate and evaluation of its therapeutic efficacy in a murine model of collagen-induced arthritis.” Pharmacol Res. 2003 Jan;47(1):43-7. http://www.ncbi.nlm.nih.gov/pubmed?term=12526860%20
24 Umar S, Umar K, Sarwar AH, et al. “Boswellia serrata extract attenuates inflammatory mediators and oxidative stress in collagen induced arthritis.” Phytomedicine. 2014 May 15;21(6):847-56. http://www.ncbi.nlm.nih.gov/pubmed/24667331
25 Hamidpour R, Hamidpour S, Hamidpour M, Shahlari M. “Frankincense ( ru xiang; boswellia species): from the selection of traditional applications to the novel phytotherapy for the prevention and treatment of serious diseases.” J Tradit Complement Med. 2013 Oct;3(4):221-6. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3924999/
26 Togni S, Maramaldi G, et al. “A cosmeceutical formulation based on boswellic acids for the treatment of erythematous eczema and psoriasis.” Clin Cosmet Investig Dermatol. 2014 Nov 11;7:321-7. http://www.ncbi.nlm.nih.gov/pubmed/25419153
27 Gupta PK, Samarakoon SM, et al. “Clinical evaluation of Boswellia serrata (Shallaki) resin in the management of Sandhivata (osteoarthritis).” Ayu. 2011 Oct;32(4):478-82. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3361921/
28 Ammon HP. “Modulation of the immune system by boswellia serrata extracts and boswellic acids.” Phytomedicine. 2010 Sep;17(11):862-7. Epub 2010 Aug 8. http://www.ncbi.nlm.nih.gov/pubmed/20696559
29 Reichling J, Schmökel H, Fitzi J, et al. “Dietary support with Boswellia resin in canine inflammatory joint and spinal disease.” Schweiz Arch Tierheilkd. 2004 Feb;146(2):71-9. http://www.ncbi.nlm.nih.gov/pubmed/14994484
30 Kimmatkar N, Thawani V, Hingorani L, Khiyani R. “Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee–a randomized double blind placebo controlled trial.” Phytomedicine. 2003 Jan;10(1):3-7. http://www.ncbi.nlm.nih.gov/pubmed/12622457
31 Gupta I, Gupta V, Parihar A, et al. “Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study.” Eur J Med Res. 1998 Nov 17;3(11):511-4. http://www.ncbi.nlm.nih.gov/pubmed/9810030
32 Gerhardt H, Seifert F, Buvari P, et al. “[Therapy of active Crohn disease with Boswellia serrata extract H 15].” Z Gastroenterol. 2001 Jan;39(1):11-7. http://www.ncbi.nlm.nih.gov/pubmed/11215357
33 Roy S, Khanna S, Krishnaraju AV, et al. “Regulation of vascular responses to inflammation: inducible matrix metalloproteinase-3 expression in human microvascular endothelial cells is sensitive to antiinflammatory Boswellia.” Antioxid Redox Signal. 2006 Mar-Apr;8(3-4):653-60. http://www.ncbi.nlm.nih.gov/pubmed/16677108
34 Ammon HP. “Boswellic acids in chronic inflammatory diseases.” Planta Med. 2006 Oct;72(12):1100-16. http://www.ncbi.nlm.nih.gov/pubmed/17024588