Osteo Bi-Flex Edge Joint & Muscle is one of the most recent additions to the Osteo Bi-Flex line. As the name implies, it is intended for athletes, although it does not contain anything which would be particularly beneficial to athletes as opposed to the average person…[Skip to the Bottom Line]
While originally thought to directly induce collagen synthesis, more recent research indicates that Glucosamine may actually work by inhibiting Interleukin-1, a protein which regulates inflammatory response and ultimately breaks down collagen. By inhibiting IL-1, glucosamine may reduce inflammation and slow down the degradation of collagen, thereby preserving the joint and possibly reducing joint pain. This was evidenced in a recent 2013 study, as well as a 2009 study which noted lower levels of CX-II (a bio-marker of collagen breakdown) in athletes (bicyclists and soccer players) following Glucosamine supplementation (most effective at 3 grams daily).
Unfortunately, while Glucosamine Sulfate can actually be quite effective for certain joint conditions and promoting overall joint health, Glucosamine HCL has performed significantly worse in multiple studies. Both the Osteoarthritis Research Society International and the European League Against Rheumatism recommend Glucosamine Sulfate over Glucosamine HCL.
Skeptics of Glucosamine often point to a particularly notable 2006 study, published in the “New England Journal of Medicine”, involving over 1500 subjects, in which Glucosamine (as HCL) failed to outperform the placebo group. However, given that Glucosamine Sulfate has demonstrated pretty reliable efficacy throughout many trials, the reason for this failure can likely be attributed to the form being Glucosamine HCL, as opposed to Glucosamine Sulfate.
Glucosamine Sulfate has outperformed Glucosamine HCL throughout multiple meta-analyses (collections of studies). Furthermore, when Glucosamine HCL is grouped in with Glucosamine Sulfate trials, the overall efficacy tends to be reduced. Unfortunately, Osteo Bi Flex Edge Joint & Muscle contains the substandard HCL form of Glucosamine which likely means it is ineffective.
5-LOXIN (BOSWELLIA SERRATA):
5-Loxin is a patented standardized form of Boswellia Serrata extract that is marketed on its own for joint health as well as in combination with such compounds as glucosamine and hyaluronic acid. Boswellia has been the subject of several human studies, and has shown promise as a treatment for osteoarthritis in all.
A 2008 study published in “Arthritis Research and Therapy”, as well as two (2010 and 2011) studies published in the “International Journal of Medical Sciences” noted significant improvement in measures of mobility and pain in subjects given two different patented forms of Boswellia extract (Aflapin and 5-Loxin) in doses ranging from 100mg to 250mg.
A 2011 study involving 56 patients, each showing ‘signs and symptoms’ of osteoarthritis, found that supplementation with 6 grams Boswellia extract daily effectively relieved many of the symptoms the subjects had previously reported, and increased mobility. However, it’s worth mentioning that this study was un-blinded and therefore more susceptible to bias.
Even if we disregard the unblinded study, we’re left with some pretty clear evidence for the efficacy of Boswelia (specifically 5-Loxin) for treating joint pain and discomfort. Osteo Bi Flex Joint & Muscle contains 100mg of 5-Loxin which is in-line with the above-mentioned studies.
Coenzyme Q10 is an antioxidant compound that has been under investigation for several potential benefits, though not so much joint health. CoQ10 possesses general antioxidant properties which may decrease overall oxidative stress and reduce muscle damage resulting from exercise. There is preliminary evidence to suggest that Coenzyme Q10 may increase time to fatigue (resulting from oxidation), but these effects would most likely be negligible in the average athlete. Ultimately, Coenzyme Q10 is not a bad addition to the Osteo Bi Flex Joint & Muscle blend, but doesn’t really “make” the formula.
Chondroitin, a major component of cartilage, is generally seen along-side glucosamine in joint supplements based on the belief that the two work synergistically together to reduce inflammation and repair joints. In vitro, chondroitin and glucosamine have been demonstrated to synergistically induce collagen synthesis. However, in vivo studies comparing and contrasting the effects of chondroitin relative to glucosamine fail to find such synergy between the two. In fact, most of the benefit obtained from supplementation with glucosamine and chondroitin is thought to be from glucosamine alone, as chondroitin has shown little promise when studied in isolation. However, in the context of Osteo Bi Flex Joint & Muscle, Chondroitin might actually help the overall efficacy because the form of Glucosamine (HCL) is subpar to begin with.
Methylsulfonylmethane (MSM) is similar in efficacy to glucosamine, but a significant synergistic effect has never been recorded. It is hypothesized that the real benefit of MSM lies in the fact that it contains sulfur, which is a component of collagen, and thus necessary for functional, healthy joints. According to this hypothesis, only people with sulfur deficiencies would derive benefit, and would be able to derive the same benefit from other sulfur containing compounds such as the amino acid Cysteine. However, this is just a hypothesis and an exact mechanism of action is not currently known. Overall, it appears MSM offers the same benefits as Glucosamine Sulfate, so (same deal as Chondroitin) it may actually improve the efficacy of Osteo Bi-Flex Joint & Muscle.
THE BOTTOM LINE:
While Osteo Bi-Flex Joint & Muscle does contain some effective ingredients for joint pain and over-all joint health, we’re extremely disappointed with the use of Glucosamine HCL as opposed to Glucosamine Sulfate, which may seriously reduce the efficacy of the formula. Furthermore, there isn’t much in the way of “Muscle” ingredients and the formula is not much different than other joint support formulas we’ve reviewed. At about 50 cents a dose, there are certainly more economical options out there and ultimately we’d recommend passing on Osteo Bi-Flex Joint & Muscle and opting for a more complete formula such as Osteo Bi-Flex Triple Strength.
[expand title=”REFERENCES” tag=”h5″]
- Sawitzke, Allen D., et al. “The effect of glucosamine and/or chondroitin sulfate on the progression of knee osteoarthritis: a report from the glucosamine/chondroitin arthritis intervention trial.” Arthritis & Rheumatism58.10 (2008): 3183-3191.
- Reginster, Jean Yves, et al. “Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial.” The Lancet 357.9252 (2001): 251-256.
- Herrero‐Beaumont, Gabriel, et al. “Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: A randomized, double‐blind, placebo‐controlled study using acetaminophen as a side comparator.” Arthritis & rheumatism 56.2 (2007): 555-567.
- Zhang, W., et al. “OARSI recommendations for the management of hip and knee osteoarthritis, part I: critical appraisal of existing treatment guidelines and systematic review of current research evidence.” Osteoarthritis and Cartilage15.9 (2007): 981-1000.
- Zhang, WMRNGea, et al. “OARSI recommendations for the management of hip and knee osteoarthritis, Part II: OARSI evidence-based, expert consensus guidelines.” Osteoarthritis and cartilage 16.2 (2008): 137-162.
- Zhang, Weiya, et al. “EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT).”Annals of the rheumatic diseases 64.5 (2005): 669-681.
- Clegg, Daniel O., et al. “Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis.” New England Journal of Medicine354.8 (2006): 795-808.
- Sengupta, Krishanu, et al. “A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin (R) for treatment of osteoarthritis of the knee.” Arthritis Research and Therapy 10.4 (2008): R85.
- Vishal, Amar A., Artatrana Mishra, and Siba P. Raychaudhuri. “A Double Blind, Randomized, Placebo Controlled Clinical Study Evaluates the Early Efficacy of Aflapin® in Subjects with Osteoarthritis of Knee.” International journal of medical sciences 8.7 (2011): 615.
- Lalithakumari, K., et al. “Safety and toxicological evaluation of a novel, standardized 3-O-acetyl-11-keto-β-boswellic acid (AKBA)-enriched Boswellia serrata extract (5-Loxin®).” Toxicology mechanisms and methods 16.4 (2006): 199-226.
- Kon, Michihiro, et al. “Effect of Coenzyme Q10 supplementation on exercise-induced muscular injury of rats.” Exerc Immunol Rev 13 (2007): 76-88.
- Mizuno, Kei, et al. “Antifatigue effects of coenzyme Q10 during physical fatigue.” Nutrition 24.4 (2008): 293-299.
- Yang, L., NY Calingasan, EG Wille, K. Cormier, K. Smith, RJ Ferrante, and MF Beal. “Combination Therapy with Coenzyme Q10 and Creatine Produces Additive Neuroprotective Effects in Models of Parkinson’s and Huntington’s Diseases.” Journal of Neurochemistry (2009)
- Sarter, Barbara. “Coenzyme Q10 and Cardiovascular Disease: A Review.” Journal of Cardiovascular Nursing 16.4 (2002): 9-20.
- Sawitzke, Allen D., et al. “Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT.” Annals of the rheumatic diseases 69.8 (2010): 1459-1464.
- Deal, Chad L., and Roland W. Moskowitz. “Nutraceuticals as therapeutic agents in osteoarthritis: the role of glucosamine, chondroitin sulfate, and collagen hydrolysate.” Rheumatic Disease Clinics of North America 25.2 (1999): 379-395.
- Bruyere, Olivier, and Jean-Yves Reginster. “Glucosamine and chondroitin sulfate as therapeutic agents for knee and hip osteoarthritis.” Drugs & aging24.7 (2007): 573-5Black, Corrinda, et al. “The clinical effectiveness of glucosamine and chondroitin supplements in slowing or arresting progression of osteoarthritis of the knee: a systematic review and economic evaluation.” (2009).80.
- Noyszewski, Elizabeth A., et al. “Preferential incorporation of glucosamine into the galactosamine moieties of chondroitin sulfates in articular cartilage explants.” Arthritis & Rheumatism 44.5 (2001): 1089-1095.
- Kim, L. S., et al. “Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial.” Osteoarthritis and Cartilage 14.3 (2006): 286-294.Ezaki, Junko, et al. “Assessment of safety and efficacy of methylsulfonylmethane on bone and knee joints in osteoarthritis animal model.”Journal of bone and mineral metabolism 31.1 (2013): 16-25.