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https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements

Printed version of www.consumerlab.com/review/Review_Glucosamine_Chondroitin_MSM_Supplements/jointsupplements/

Product Review: Glucosamine, Chondroitin, and MSM Supplements for Joint Health
Initial Posting: 5/5/12 Updated 5/8/12

What It Is What It Does Quality Concerns and What CL Tested For What CL Found Test Results by Product What to Consider When Buying and Using Concerns and Cautions Full list of Ingredients by Product How Products Were Evaluated

Update: Joint Juice Glucosamine-Chondroitin Blueberry Acai: (5/8/12) Upon original publication of this Review, this product was incorrectly classified by ConsumerLab.com as Not Approved for not including a warning for people with phenylketonuria. While such a warning is required for the artificial sweetener aspartame, it is not required for acesulfame K, the artificial sweetener in this product. ConsumerLab.com appreciates this error being brought to its attention on 5/8/12 by the distributor of the product, Joint Juice, Inc. The product has been reclassified as Approved, having met all quality criteria of this Review.

What It Is:
Glucosamine, chondroitin sulfate, and MSM (methylsulfonylmethane) occur naturally in the body. The glucosamine used in supplements is typically derived from the shells of shrimp or crabs although a corn source is also available. Glucosamine is available in a variety of chemical forms, such as glucosamine hydrochloride and glucosamine sulfate. These vary in terms of the amount of actual glucosamine available for use in the body from an equal weight of each form (See ConsumerTips for Glucosamine for more information). Chondroitin sulfate is generally derived from pig or cow cartilage, but even shark and chicken cartilage has been used. Chondroitin-like mucopolysaccharides from algae are also available. MSM is synthetically produced.

What It Does:
Glucosamine and Chondroitin: Glucosamine and chondroitin sulfate supplements are used to slow the progression of osteoarthritis the deterioration of cartilage between joint bones and to reduce the associated pain. A study sponsored by the National Institutes of Health (NIH) called the Glucosamine/Chondroitin Arthritis Intervention Trial (or GAIT study), showed that the combination of glucosamine and chondroitin sulfate seems to be effective in osteoarthritis patients with moderate to severe knee pain, although not those with mild pain. A well-controlled study of glucosamine sulfate (1,500 mg per day) versus placebo for lower back pain caused by osteoarthritis showed that both glucosamine and placebo improved symptoms reported by patients. However, there was no significant difference in the level of improvement between the groups, suggesting that glucosamine is not truly effective for lower back pain (Wilkens, JAMA 2010). A 2007 review of several past, large-scale studies of chondroitin alone concluded that it did not provide a benefit. However, a six-month study of chondroitin sulfate (800 mg once daily) versus placebo in patients with hand osteoarthritis showed a significantly greater decrease in hand pain and improvement in hand function among those taking chondroitin sulfate (Gabay, Arth & Rheum 2011). The duration of morning stiffness was also slightly reduced. These benefits were not noticeable until after 3 months of treatment. There was no significant difference in grip strength or the amount of analgesic used by patients. The chondroitin tested in the study was a tablet containing highly purified (95% pure) chondroitin of fish origin and is marketed as Chondrosulf (IBSA, Switzerland) in Europe where it is approved as a Symptomatic Slow Acting Drug for Osteoarthritis (IBSA website accessed 9/21/2011). Glucosamine is thought to promote the formation and repair of cartilage. Chondroitin is believed to promote water retention and elasticity in cartilage and inhibit enzymes that break down cartilage. In veterinary medicine, glucosamine and chondroitin, often in combination, are commonly used in the treatment of degenerative joint disease typically in older dogs and cats as well as in horses. (See separate review of Joint Health Supplements for Dogs, Cats, and Horses. MSM: MSM is used primarily for treating pain associated with osteoarthritis and has been proposed for treating other conditions including rheumatoid arthritis, inflammation of the bladder wall (interstitial cystitis), snoring, muscle spasm, and cancer. All of these uses for MSM, including those for arthritis, are based on limited research, so its effectiveness hasn't been well established. Many additional claims are found on MSM products, including skin-softening and https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements 1/11

13/05/13 https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements on limited research, so its effectiveness hasn't been well established. Many additional claims are found on MSM products, including skin-softening and nail-strengthening effects, but none of these are well supported by research. The mechanism by which MSM may work isn't well understood, although it is known to contribute sulfur to the body, which can then be used to synthesize certain amino acids (building blocks for proteins), and it can act as an antioxidant. As a veterinary medicine, MSM is used to treat muscle and tendon soreness and inflammation in horses -- see separate review of Joint Health Supplements for Dogs, Cats and Horses.
See the ConsumerTips later in this report for insightful information on buying and using these supplements. For more information about the clinical evidence for these and other supplement ingredients, see the article on Osteoarthritis on this website. Also see ConsumerLab.coms Product Review of SAMe Supplements, as SAMe can help treat osteoarthritis pain.

Quality Concerns and What CL Tested for:


Glucosamine and Chondroitin: Although prior testing has shown the vast majority of glucosamine products to meet label claims, glucosamine from shellfish such as shrimp and crabs may potentially be contaminated with lead. Chondroitin, on the other hand, is an ingredient with which ConsumerLab.com has found problems in the past with products not always providing the amount claimed of this expensive ingredient. There had been concern with bovine (cow) sources of chondroitin several years ago on account of Mad Cow disease (known scientifically as bovine spongiform encephalitis or BSE). There have not been any reported cases of the disease from chondroitin and the risk seems to be miniscule because the prion thought to be the causative agent of the disease exists only in very low levels in cartilage; it's most abundant in nervous and glandular tissues. The issue of BSE, however, may be avoided by choosing a product made from the cartilage of other animals, such as pigs (now a common source), chickens, or sharks. MSM: MSM is chemically related to DMSO (dimethyl sulfoxide), which has been used in ways similar to MSM. Unlike MSM, however, DMSO is a chemical solvent. DMSO was found to cause a range of adverse reactions and is no longer approved as a supplement. It still has limited use, however, for those under medical supervision. Because no government agency is responsible for routinely testing glucosamine, chondroitin, and MSM supplements for their contents or quality, ConsumerLab.com independently evaluated several human and veterinary products to determine whether they contained the amounts of these ingredients stated on their labels. All products were also tested for lead contamination. MSM products were additionally tested for DMSO contamination. Although not thought to be a health risk in small amounts, DMSO in products indicates poor-quality manufacturing. In addition, all tablets and caplets (excluding chewable or time-release) were tested for their ability to properly disintegrate ("break-apart").

What CL Found:
Among the 22 supplements ConsumerLab.com selected and tested, only 18 met quality standards and FDA labeling requirements. Through ConsumerLab.coms Voluntary Certification Program, in which products undergo the same testing, an additional 20 products were found to meet quality standards. No problems were found with the MSM content of the selected products (and none contained an unacceptable level of DMSO), but among the 21 products claiming to contain glucosamine and/or chondroitin, four products (19%) failed to pass ConsumerLab.coms review due to lead contamination, less ingredient than labeled, or failure to meet other FDA labeling requirements. All tablet and caplet products were found to properly break apart in solution (disintegrate). The reasons why products failed are described below and in the results table: Whole Foods Glucosamine and Chondroitin Complex was contaminated with 13.2 micrograms of lead per daily serving. This far exceeds the 0.5 mcg limit set by the State of California (the only state to set a limit) which nearly all other products did not exceed. Products sold in California that exceed this limit are required to carry a warning label regarding lead. While toxicity is not likely in adults from using from this product, lead accumulates in the body (in bones) and, at high levels, can adversely affect the nervous system and increase blood pressure. Children are particularly sensitive to lead and should not be exposed to more than 6 mcg in total per day. KAL Glucosamine Chondroitin MSM was also contaminated with lead, although at a lower level than the Whole Foods product. It was found to contain 1.7 micrograms of lead per daily serving. TR CAPS TR Joint Plus Caps was found to contain only 71.5% of its claimed chondroitin. Maximum Strength DONA Crystalline Glucosamine Sulfate contained its claimed amount of glucosamine but its label lacked a required shellfish allergen warning statement (as glucosamine is made from crab shell and some people may be allergic) and the product included an ingredient (Eudragit RL) which has not been approved for use in supplements in the U.S. -- although it is approved for use in drugs. The Supplement Facts panel was also not properly written: listing a daily serving of two caplets but showing the amount of glucosamine in only one caplet. This product is apparently sold in Europe as well as the U.S. Why are some of these supplements contaminated with lead? It is hard to know for sure, but a likely source is the crab shells from which glucosamine is made, which can be contaminated. Minerals and botanical ingredients also have the potential for lead contamination. The Whole Foods products contained glucosamine, as well as calcium (330 mg/day) and an unlisted amount of peppermint leaf. Every supplement manufacturer is required to test their ingredients or finished product for lead contamination. However, under current law, the manufacturer sets its own limit based on what is considers acceptable. Some manufacturers have advocated a limit of 10 mcg per daily serving, much higher than the State of California permits without a warning label. ConsumerLab.com has protested against such a high level. Why do some chondroitin products contain less chondroitin than claimed? Some manufacturers may rely on non-specific tests, such as the "CPC (cetyl pyridinium chloride) titration method" or size-exclusion chromatography method when evaluating chondroitin. These tests can easily be tricked by other compounds that are not chondroitin. Real chondroitin is relatively expensive. An ingredient supplier might sell lower priced "chondroitin" to which compounds have been added to fool these tests. A manufacturer looking to cut corners might buy lower cost material "certified" with a non-specific test and, as a result, end up making products with no or little real chondroitin. ConsumerLab.com evaluated chondroitin products using a more specific, validated method known as the "enzymatic HPLC method." For each product that failed to contain its listed chondroitin, re-testing was performed in a second independent laboratory for confirmation (see How Products Were Evaluated). Cost comparisons The cost of supplements for joint health vary considerably and paying more doesnt necessarily mean you are getting a better product. If you just want glucosamine , Puritan's Pride Premium Glucosamine HCL at 12 cents per day, was, by far, the least expensive supplement. Other products with glucosamine (without chondroitin or MSM) were much more expensive (over $1 per day), although many of them include additional ingredients of some potential benefit, such as turmeric (or curcumin) and boswellia. A potential downside to the Puritans Pride product, however, is that it is a single daily pill while most clinical trials have divided the dose into more than one pill per day. https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements 2/11

13/05/13 https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements while most clinical trials have divided the dose into more than one pill per day.
Among MSM products, Doctors Best Best MSM 1500 was the least expensive, at just 6 cents per 1,500 mg. If you are looking for both glucosamine and chondroitin, the least expensive supplement providing 1,500 mg of glucosamine and 1,200 mg of chondroitin (the combination most commonly recommended) was Simply Right Triple Strength Glucosamine and Chondroitin (sold at Sams Club) at a daily cost of 17 cents. 21st Century Glucosamine 750 Chondroitin 500 Triple Strength was the next least expensive (22 cents per day). To get glucosamine and MSM, the least expensive product was, by far, NOW Vegetarian Glucosamine & MSM. The suggested 2 capsule serving costs 20 cents. This serving provides 1,000 mg each of glucosamine and MSM. (Increasing the dose to 3 capsules per will provide the generally recommended dose of 1,500 mg of glucosamine.) The other two products in this category cost $1.30 or more per daily serving. If you want all three of the reviewed ingredients glucosamine, chondroitin, and MSM the lowest cost for a serving providing at least 1,500 mg of glucosamine and 1,200 mg of chondroitin is about 40 to 60 cents, available from products such as GNC Triflex, GNC Triflex Fast-Acting, Jarrow Formulas Glucosamine + Chondroitin + MSM, or Vitamin Shoppe Joint Solutions Triple Strength Glucosamine & Chondroitin with MSM. The amounts of MSM in these products ranges, but the highest amount (900 mg) is in GNC Triflex. Interestingly, the most expensive product didnt even contain its listed amount of chondroitin: TR CAPS TR Joint Plus Caps 8 Hour Time-Release cost $2.50 for the full 3 tablet daily serving but, as noted earlier, contained only 71.5% of its listed chondroitin. Some triple-combination products do not specify the amounts of chondroitin and MSM they contain; instead, they include within proprietary blends, formulas, or complexes. While there may be value to some of these blends, you wont really know what you are getting. For example, we checked Nutrilite Glucosamine-7s blend, which turned out to provide a substantial amount of MSM (1,636 mg per daily serving) but not a lot of chondroitin (79.6 mg). Conversely, a daily serving of Natures Bounty Flexamins blend contained a little more chondroitin (234 mg per daily serving) but less MSM (132.2 mg). Whenever possible, ConsumerLab.com suggests purchasing products that specify how much they contain of each ingredient.

Test Results by Product:


Listed alphabetically within each product group below are test results for forty-two supplements of which ConsumerLab.com selected twenty-two. Twenty were tested at the request of their manufacturers/distributors through CL's Voluntary Certification Program and are included for having passed testing. Also listed is one product similar to another that passed but is sold under a different brand name. Shown for each product are the claimed amounts of glucosamine, chondroitin, and MSM and the suggested daily serving on its label. Additional notable ingredients are found in the last column, along with cost comparisons. Products that passed all tests are indicated as Approved in the third column; if a product failed testing, the reason is explained in red text. A separate review of Joint Health Supplements for Dogs, Cats, and Horses is available, as is a review of SAMe supplements, which are also used for treating osteoarthritis. ##TABLE_REVIEWS_LINK_ROWS_7## CONSUMERLAB.COM RESULTS FOR JOINT HEALTH SUPPLEMENTS (GLUCOSAMINE, CHONDROITIN, AND MSM) Click on beneath a product name to find a vendor that sells it. To find retailers that sell some of the listed products click here. Product Name and Suggested Daily Use Manufacturer or Distributor Click on "Ingredients" for Full Listing Claimed Amount and Form of Joint Health Ingredient Per Suggested Daily Serving on Label -- TEST RESULTS -OVERALL RESULTS: APPROVED (Passed) or NOT APPROVED (Failed) Met Claim Broke Apart Properly Free of Unacceptable Levels of Lead Cost Per Suggested Daily Serving (Unless Otherwise Noted)1 Additional Key Ingredients, Product Notes, and/or Special Designations2 Price Paid Cost Per 1,500 mg Glucosamine 1,500 mg Glucosamine Sulfate 2KCl APPROVED $1.08 Meriva (Turmeric, Phosphatidylcholine, extract, eggshell membrane)
$26.99/150 tablets

Glucosamine Only Products: Dr. David Williams Joint Advantage Gold Advanced Relief (3 tablets twice daily)* Dist. by Healthy Directions Ingredients Maximum Strength DONA Crystalline Glucosamine Sulfate (2 caplets daily) 1,500 mg Glucosamine Sulfate 2KCl NOT APPROVED

$1.16
$34.79/60 caplets

Product missing Mfd. by Rottapharm Ltd., Ireland. Note: Supplement required shellfish Dist. in USA by WynnPharm Inc. Facts box shows allergen amount per caplet (750 statement. Also Ingredients mg), but should show contains an amount per daily ingredient serving. (Eudragit RL) not unapproved for use in supplements, (although approved in https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements

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https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements approved in drugs).


1,500 mg Glucosamine HCl APPROVED $0.12 Lowest cost glucosamine Gluten free

Puritan's Pride Premium Glucosamine HCL 1500 mg (1 coated caplet daily)* Mfd. by Puritan's Pride, Inc.

$14.00/120 coated caplets

Ingredients Shaklee Joint Health Complex (2 coated caplets daily) Dist. by the Shaklee Corporation Ingredients Vitamin C, Boswellia serrata extract, and assorted minerals
$44.65/60 coated caplets

1,500 mg Glucosamine HCl

APPROVED

$1.49 Gluten free and vegetarian

USANA Optimizers Procosa (3 tablets daily)* Dist. by USANA Health Sciences, Inc. Ingredients Similar to Approved Product:**

1,500 mg Glucosamine HCl

APPROVED

$1.09 Vitamin C, curcumin complex, and assorted minerals


$30.56/84 tablets

Vitamin World Triple Strength Glucosamine HCL 1500 mg Similar to: Puritan's Pride Premium Glucosamine HCL 1500 mg (1 coated caplet daily) Mfd. by Vitamin World, Inc. Ingredients Chondroitin Only Products: Source Naturals Chondroitin Sulfate (1 tablet one to three times daily) Dist. by Source Naturals, Inc. Ingredients 600 to 1,800 mg Chondroitin Sulfate APPROVED Cost Per 1,200 mg Chondroitin $0.421 Gluten free
$12.80/60 tablets

MSM Only Products: CVS pharmacy MSM 1000 mg (1 capsule two to three times daily)* Dist. by CVS Pharmacy, Inc. Ingredients Doctor's BEST Best MSM 1500 (1 tablet one or two times daily) Dist. by Doctor's Best, Inc. Ingredients 1,500 to 3,000 mg APPROVED 2,000 to 3,000 mg APPROVED N/A

Cost per 1,500 mg MSM $0.171


$6.79/60 capsules

$0.061 Lowest cost MSM Vegetarian


$6.62/120 tablets

GNC TriFlex Complete Vitapak MSM (1 caplet daily)* Dist. by General Nutrition Corporation Ingredients

1,500 mg

APPROVED

$1.67 (Pack includes vitamin and mineral pills) Gluten free


$49.99/30 packets

Spring Valley MSM 1000 mg (1 capsule two to three times daily)* Mfd. by US Nutrition, Inc. Ingredients

2,000 to 3,000 mg

APPROVED

N/A

$0.151 Gluten free


$9.00/90 capsules

COMBINATION PRODUCTS https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements

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13/05/13 COMBINATION PRODUCTS

https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements

Glucosamine and Chondroitin Combination Products: 21st Century Glucosamine 750 Chondroitin 600 Triple Strength (1 to 2 tablets daily)* Dist. by 21st Century HealthCare, Inc. Ingredients 750 to 1,500 mg Glucosamine Sulfate 2 KCl 600 to 1,200 mg Chondroitin Sulfate APPROVED $0.11 to $0.22
$33.74/300 tablets

Cosamin DS (1 to 3 tablets daily)* Dist. by Nutramax Laboratories, Inc. Ingredients

500 to 1,500 mg Glucosamine HCl 400 to 1,200 mg Chondroitin Sulfate

APPROVED

$0.39 to $1.20
$59.99/150 tablets

Elations Healthier Joints Cranberry Apple (powder, 1 packet [7 grams] daily) Dist. by The Elations Company Ingredients

1,500 mg Glucosamine HCl 1,200 mg Chondroitin Sulfate

APPROVED

N/A

$0.86 Calcium and boron


$5.99/box of 7 (7 gram) packets

FeelAnew Glucosamine and Chondroitin with Nexrutine (2 tablets twice daily) Mfd. by Natrol, Inc. Ingredients

2,222 mg Glucosamine Sulfate 2KCl 668 mg Chondroitin Sulfate

APPROVED

$0.61 Gluten free Nexrutine phellodendron extract


$18.36/120 tablets

GNC Glucosamine 750 Chondroitin 600 (1 caplet one to two times daily)* Dist. by General Nutrition Corporation Ingredients

750 to 1,500 mg Glucosamine HCl 600 to 1,200 mg Chondroitin Sulfate

APPROVED

$0.25 to $0.50 Gluten free


$29.99/120 caplets

Joint Juice GlucosamineChondroitin Blueberry Acai (liquid, 1 bottle, 8 fl oz [237 mL], once daily) Dist. by Joint Juice, Inc. Ingredients Simply Right Triple Strength Glucosamine and Chondroitin (1 coated tablet twice daily) Dist. by Sam's West, Inc. Ingredients Thorne Research Glucosamine and Chondroitin (1 vegetarian capsule three times daily) Mfd. by Thorne Research, Inc. Ingredients

1,500 mg Glucosamine HCl 200 mg Chondroitin Sulfate

APPROVED

N/A

$0.74 per 8 oz. bottle Vitamins C and D, potassium and sodium


$4.42 per package of 6 bottles

1,500 mg Glucosamine HCl 1,200 mg Chondroitin Sulfate

APPROVED

$0.17 Lowest cost glucosamine/ chondroitin combination Gluten free


$17.44/200 coated tablets

1,500 mg Glucosamine Sulfate 2KCl 750 mg Chondroitin Sulfate

APPROVED

N/A

$0.96
$28.65/90 vegetarian capsules

Trader Joe's Glucosamine 1,500 mg APPROVED Chondroitin Glucosamine HCl https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements

N/A

$0.43

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13/05/13 Chondroitin (3 controlled release tablets daily)


Dist. by Trader Joe's Ingredients Twinlab Joint Fuel (3 capsules twice daily)* Mfd. by ISI Brands, Inc. Ingredients

https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements Glucosamine HCl


Gluten free 1,200 mg Chondroitin Sulfate
$12.99/90 controlled release tablets

1,500 mg Glucosamine Sulfate 2KCl 100 mg Chondroitin Sulfate

APPROVED

N/A

$1.38 Vitamins C and E, zinc, selenium, turmeric root extract, and quercetin
$27.57/120 capsules

Whole Foods Glucosamine and Chondroitin Complex (1 tablet three times daily) Dist. by Whole Foods Market Ingredients

1,500 mg Glucosamine Sulfate 2KCl 1,200 mg Chondroitin Sulfate

NOT APPROVED

Found 13.2 micrograms of lead per daily serving

$0.75 Calcium
$24.99/100 tablets

Glucosamine and MSM Combination Products: Maxi-Health Super Glucosamine Complex (3 capsules once daily) Dist. by Maxi-Health Research, Inc. Ingredients NOW Vegetarian Glucosamine & MSM (2 vegetarian capsules once daily) Mfd. by NOW FOODS Ingredients 1,000 mg Glucosamine HCl 1,000 mg MSM
$12.14/120 vegetarian capsules

1,500 mg Glucosamine Sulfate 2KCl 750 mg MSM

APPROVED

N/A

$1.30 Gluten free and k osher


$77.90/180 capsules

APPROVED

N/A

$0.20 Gluten free and vegetarian/vegan

Nutri-Supreme Research Ultra Joint Support with Glucosamine and OptiMSM (4 tablets once daily) Dist. by Nutri-Supreme Research Ingredients

1,500 mg Glucosamine HCl 3,000 mg MSM

APPROVED

$1.33 Kosher and vegetarian


$39.90/120 tablets

Glucosamine, Chondroitin, and MSM Combination Products: BioGenesis Nutraceuticals ArthroGenx (2 vegetable capsules twice daily) Mfd. by BioGenesis Nutraceuticals, Inc. Ingredients 1,500 mg Glucosamine Sulfate 2 KCl 250 mg Chondroitin Sulfate 500 mg MSM APPROVED N/A $1.37 Niacin, Boswellia serrata extract, ginger, rosemary, and turmeric extract
$41.00/120 vegetable capsules

Drinkables Liquid Supplements Liquid Joint Care Natural Citrus Flavor (liquid, 2 tablespoons [1 fl oz; 30 mL] once daily)* Dist. by Remington Health Products, LLC Ingredients

2,000 mg Glucosamine HCl 1,200 mg Chondroitin Sulfate 500 mg MSM

APPROVED

N/A

$0.91 Gluten free Vitamin D, proprietary blend of collagen and hyaluronic acid
$29.99/33 oz bottle

Finest Natural Glucosamine Chondroitin Double Strength (3 tablets daily)*

1,500 mg Glucosamine HCl

APPROVED Glucosamine Chondroitin sulfate and

$0.62 Proprietary blend of collagen, Boswellia serrata extract, vitamin C, hyaluronic acid, and assorted minerals 6/11

1,350 mg Proprietary Dist. by Walgreens Co. blend of Chondroitin Sulfate and MSM https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements

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Ingredients

https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements Sulfate and MSM sulfate and complex MSM not


tested3

minerals
$49.99/240 tablets

GNC Triflex (3 caplets once daily)* Dist. by General Nutrition Corporation Ingredients

1,500 mg Glucosamine HCl 1,200 mg Chondroitin Sulfate 900 mg MSM

APPROVED

$0.41 Gluten free Vitamin C and hyaluronic acid


$32.49/240 caplets

GNC TriFlex Complete Vitapak TriFlex Fast Acting (4 caplets once daily)* Dist. by General Nutrition Corporation Ingredients

1,500 mg Glucosamine HCl 1,200 mg Chondroitin Sulfate 250 mg MSM

APPROVED

$1.67 (Pack includes vitamin and mineral pills) Gluten free Vitamin C, proprietary blend of Cutch tree wood and bark extract, Chinese skullcap root extract, and hyaluronic acid
$49.99/30 packets

GNC Triflex Fast-Acting (4 caplets once daily)* Dist. by General Nutrition Corporation Ingredients

1,500 mg Glucosamine HCl 1,200 mg Chondroitin Sulfate 250 mg MSM

APPROVED

$0.56 Gluten free Vitamin C, proprietary blend of Cutch tree wood and bark extract, Chinese skullcap root extract, and hyaluronic acid
$33.49/240 caplets

Jarrow Formulas Glucosamine + Chondroitin + MSM (4 capsules once daily) Dist. by Jarrow Formulas Ingredients

2,000 mg Glucosamine Sulfate 2 KCl 1,500 mg Chondroitin Sulfate 300 mg MSM

APPROVED

N/A

$0.43 Gluten free Vitamin C and manganese


$12.75/120 capsules

KAL Glucosamine Chondroitin MSM (3 tablets once daily) Mfd. by Nutraceutical Corp. Ingredients

1,500 mg Glucosamine Sulfate 2KCl 1,200 mg Chondroitin Sulfate 1,500 mg MSM

NOT APPROVED

Found 1.7 micrograms of lead per daily serving

$0.59 Vitamin C
$17.84/90 tablets

Nature Made Triple Flex (2 caplets once daily)* Dist. by Nature Made Nutritional Products Ingredients

1,500 mg Glucosamine HCl 800 mg Chondroitin Sulfate 750 mg MSM

APPROVED

$0.83 Gluten free


$24.99/60 caplets

Nature's Bounty Flex-a-min Triple Strength with Joint Flex (2 coated tablets once daily) Mfd. by Arthritis Research Corp. Ingredients

1,500 mg Glucosamine HCl 1,210 mg Proprietary blend of Chondroitin Sulfate and MSM

APPROVED Glucosamine Found 132.0 mg chondroitin sulfate per tablet Found 66.1 mg MSM per tablet

$0.62 Gluten free Vitamin D, proprietary blend of collagen, silica, citrus bioflavonoids, Boswellia serrata extract, and hyaluronic acid
$18.49/60 coated tablets

Nutrilite glucosamine-7 1,500 mg APPROVED https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements

$1.05

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13/05/13 Nutrilite glucosamine-7 (2 tablets twice daily)


Dist. by Access Business Group International LLC Ingredients

https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements 1,500 mg APPROVED Glucosamine Sulfate Glucosamine


1,780 mg Proprietary blend of MSM and Chondroitin Sulfate Found 19.9 mg chondroitin sulfate per tablet Found 409 mg MSM per tablet

$1.05 Vitamin C, proprietary blend of boron, manganese amino acid chelate, and hyaluronic acid, Boswellia serrata extract, acerola concentrate, and citrus bioflavonoids
$13.60/120 tablets

Osteo Bi-Flex Advanced (2 coated caplets daily)* Mfd. by Rexall Sundown, Inc. Ingredients

1,500 mg Glucosamine HCl 1,250 mg Proprietary blend of Chondroitin Sulfate and MSM

APPROVED Glucosamine Chondroitin sulfate and MSM not tested3

$0.69 Proprietary blend of collagen, Boswellia serrata extract, vitamin C, and assorted minerals
$25.92/75 coated caplets

Schiff Move Free Advanced -Triple Strength, Plus MSM & Vitamin D3 (2 coated tablets once or twice daily) Mfd. by Schiff Nutrition Group, Inc. Ingredients

1,500 to 3,000 mg Glucosamine HCl 200 to 400 mg Chondroitin Sulfate 750 to 1,500 mg MSM

APPROVED

$0.67 to $1.35 Vitamin D, proprietary blend of Chinese Skullcap and Black Catechu, and hyaluronic acid
$26.99/80 coated tablets

TR CAPS TR Joint Plus Caps 8 Hour Time-Release (1 time release capsule, one to three times daily) Dist. by TR Caps Ingredients

500 to 1,500 mg Glucosamine Sulfate 2 KCl 400 to 1,200 mg Chondroitin Sulfate 100 to 300 mg MSM

NOT APPROVED Glucosamine and MSM Found only 71.5% of claimed chondroitin sulfate APPROVED

N/A

$0.83 to $2.50
$49.99/60 capsules

Trace Minerals Research ActivJoint Platinum (2 to 6 tablets, once daily)* Dist. by Trace Minerals Research Ingredients

400 to 1,200 mg Glucosamine Sulfate 2KCl and HCl 200 to 600 mg Chondroitin Sulfate 266.67 to 800 mg MSM

$0.36 to $1.09 Gluten free B vitamins, assorted minerals, and an herbal blend (alfalfa leaf, burdock root, capsicum fruit, horsetail herb, devil's claw tuber, sarsaparilla root, hydrangea root, red clover herb, yucca root, celery seed)
$16.34/90 tablets

Vitamin Shoppe Joint Solutions Triple Strength Glucosamine & Chondroitin with MSM (1 tablet twice daily)* Dist. by The Vitamin Shoppe Ingredients

1,500 mg Glucosamine Sulfate 2 KCl 1,200 mg Chondroitin Sulfate 500 mg MSM

APPROVED

$0.58
$34.99/120 tablets

webber naturals Glucosamine Chondroitin MSM (5 capsule, once daily) Dist. by WN Pharmaceuticals Ltd. Ingredients

1,500 mg Glucosamine Sulfate 2KCl 1,200 mg Chondroitin Sulfate 1,500 mg MSM

APPROVED

N/A

$1.24
$29.74/120 capsules

Wellesse Joint Movement 2,000 mg APPROVED Glucosamine Natural Berry Glucosamine HCl Flavor (liquid, 2 tablespoons [1 oz; 30 1,200 mg Chondroitin https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements

N/A

$1.12 Vitamin D

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13/05/13 (liquid, 2 tablespoons [1 oz; 30 mL], once daily)*


Mfd. by Botanical Laboratories, Inc. Ingredients

https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements 1,200 mg Chondroitin Sulfate


500 mg MSM

$17.99/16 oz bottle

N/A Not applicable: Only non-chewable, non-capsule, non-enteric coated, and non-time release formulations are tested for disintegration. * Tested through CL's Voluntary Certification Program prior to, at time of, or after initial posting of this Product Review. ** Product identical in formulation and manufacture to a product that has passed testing but sold under a different brand. For more information see CL's Multi-Label Testing Program.

Amounts shown are for general comparison purposes and are calculated from the price paid by ConsumerLab.com (without tax or shipping). Prices may vary by retailer and number of pills

per package. Cost for Glucosamine-Only products based on 1,500 mg serving; cost for Chondroitin-Only based on 1,200 mg serving; and cost for MSM-Only based on 1,500 mg serving.
2 3

Not tested but claimed on label. CL did not test this product for chondroitin sulfate and MSM as the label did not list individual amounts of these ingredients, but as parts of a complex.

Unless otherwise noted, information about the products listed above is based on samples purchased by ConsumerLab.com (CL) for this Product Review. Manufacturers may change ingredients and label information at any time. So be sure to check labels carefully when evaluating the products you use or buy. If a product's ingredients differ from what is listed above, it may not be the same as what was tested. For each product, the sample was composed of one or more products from a lot having an expiration date (if labeled) later than the date of testing. Because ingredients and labeling may vary from lot to lot and there may be a lack of consistency within lots, CL cannot assure that results for other samples will be the same as those listed above. The information contained in this report is based on the compilation and review of information from product labeling and analytic testing. CL applies what it believes to be the most appropriate testing methods and standards. The information in this report does not reflect the opinion or recommendation of CL, its officers or employees. CL cannot assure the accuracy of information provided to it by third parties. Liability to any person for any loss or damage caused by errors, omissions, or inaccuracies in this report is hereby disclaimed.

Copyright ConsumerLab.com, LLC, 2012. All rights reserved. Not to be reproduced, excerpted, or cited in any fashion without the express written permission of ConsumerLab.com LLC.

ConsumerTips: What to Consider When Buying and Using:


Glucosamine & Chondroitin: Glucosamine in supplements can be purchased in different chemical forms. Glucosamine hydrochloride (HCl) is the form that has been used most often in studies where glucosamine is combined with chondroitin. Glucosamine sulfate (more correctly called glucosamine sulfate 2-KCl (the KCl stands for potassium chloride) or glucosamine sulfate 2-NaCl (the NaCl stands for sodium chloride)) are the forms that have been used most often when glucosamine alone has been studied. There appears to be no conclusive evidence that one form is better than another. However, the amount of true (or "free") glucosamine per gram of each compound varies greatly. In fact, 1,500 mg of glucosamine hydrochloride actually yields 1,246 mg of free glucosamine while 1,500 mg of glucosamine sulfate with 2 NaCl or 2 KCl yield, respectively, only 938 mg or 888 mg of free glucosamine. Although the hydrochloride form provides more free glucosamine than the sulfate forms, 1,500 mg per day of either form appears to be effective. People watching their salt intake may, however, want to avoid products made with the form that includes NaCl (sodium chloride). Chondroitin is typically sold as chondroitin sulfate, which is also the form that's been used in most studies. About 1,200 mg of chondroitin sulfate is recommended per day. Chondroitin sulfate is usually in a salt form to help stabilize it, so don't be concerned if you see "sodium chondroitin sulfate" on the label or "calcium chondroitin sulfate." These are the complete chemical names although not all manufacturers use them and the active ingredient, chondroitin sulfate, is the same. Supplement labels typically provide the amount of "free" chondroitin in the product, but some products do not make this adjustment. For example, a label indicating 1200 mg of chondroitin sulfate (90% by USP method) is really only providing 1,080 mg of actual chondroitin after adjusting for 90% purity. Be aware that 1,200 mg of chondroitin sulfate from the sodium salt form will contribute 105 mg per day of sodium. To reduce your sodium intake, consider products made with the calcium salt form. With that form you'll add about 191 mg of calcium per day to your diet instead of sodium. Chondroitin can vary in terms of its purity, which tends to range from about 80 to 90%. The GAIT study sponsored by the NIH used chondroitin sulfate made by Bioberica which is believed to be 95% pure. The manufacturer of CosaminDS (a glucosamine/chondroitin combination product which is Approved in this Review) claims to be the exclusive licensee for this form of chondroitin. Chondroitin can also vary in terms of the chain length (and molecular weight) of its components although the clinical significance of this is not well known. Results of laboratory studies with cell cultures indicate that shorter length molecules are better absorbed, but it is possible that longer length molecules are also digested to shorter length units. It is, therefore, difficult to say whether either form works better than the other. Some products mention in their labeling that they contain chondroitin A which is a subcomponent of the larger chondroitin polysaccharide. This is probably of little importance. All chondroitin from cow or pig sources contain combinations of chondroitin A (or chondroitin 4 sulfate), chondroitin C (or chondroitin 6 sulfate) and a non-sulfated component. Both glucosamine and chondroitin should be taken in divided doses throughout the day (that is, 500 mg of glucosamine HCl or sulfate and 400 mg of chondroitin sulfate three times per day or 750 mg glucosamine HCI or sulfate and 600 mg chondroitin sulfate two times per day). Because the amount of glucosamine or chondroitin per pill varies across products, the number of pills needed daily varies and this should be considered when comparing the costs https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements 9/11

13/05/13 https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements glucosamine or chondroitin per pill varies across products, the number of pills needed daily varies and this should be considered when comparing the costs of products.
For treating symptoms of osteoarthritis of the hand, 800 mg once daily of a highly purified (95% pure) chondroitin sulfate has been used (Gabay, Arth & Rheum 2011). Some glucosamine-chondroitin products may contain manganese (which may potentially aid bone formation). The manganese levels in such products typically exceed the recommended intake, which is 2.3 mg per day for men and 1.8 mg per day for women an amount similar to that consumed in the typical American diet. Too much manganese (over 11 mg per day) for an extended period of time carries a risk of neurological side effects. While this amount of manganese is not dangerous if taken just during a few weeks of initial therapy, it should not be exceeded for an extended period of time. Beneficial effects from these products may take anywhere from several weeks to 3 months, and the products aren't likely to help those with severe osteoarthritis where cartilage has worn down so much that bones rub against bones. Losing weight and switching from high-impact to low-impact sports are also advised for people with osteoarthritis. If a positive response is not experienced within 3 months, continuing with the supplement or increasing the dose is not indicated. If the supplements are having a beneficial effect, it may be possible to reduce the dose after the first few months. A person under 200 lbs with a positive response to the full dose (1500 mg glucosamine and 1,200 mg chondroitin per day) could try reducing the dose to 1,000 glucosamine and 800 of chondroitin. Those under 115 lbs could try going to 500 glucosamine and 400 chondroitin. If symptoms return, they should return to the full dosage. Those over 200 lbs should stay on the full dosage. MSM: There are few well-controlled published clinical studies for MSM, so it's difficult to determine the optimal dose. The most commonly suggested daily dose is 2 grams. However, recommendations can range from 500 mg to 3 grams (1,000 mg = 1 gram). Occasionally, recommendations go as high as 8 grams/day. High-quality MSM is an odorless white crystalline powder. When improperly manufactured, it can be contaminated with DMSO, which has a faint sulfur-like or garlic smell. Some products claim as little as 167 mg of MSM per pill; others, as much as 1,500 mg. When buying an MSM product, consider this variation.

Concerns and Cautions:


Glucosamine and Chondroitin: Glucosamine and chondroitin, taken in appropriate amounts, are generally considered safe for healthy people not taking other medications, but be aware that, in some individuals, glucosamine can cause gastrointestinal discomfort, drowsiness, skin reactions, and headache and chondroitin can occasionally cause stomach upset. Glucosamine is an amino sugar, so it may theoretically affect blood sugar levels. However, a recent clinical study did not find evidence of such an increase. Because the glucosamine in supplements is commonly derived from shrimp or crab shells, people allergic to shellfish may experience an allergic reaction to these products. A vegetable-based glucosamine is now available, sold under the trademarks Regenasure and GreenGrown. Chondroitin is similar in structure to the blood-thinning drug heparin, so use of chondroitin with blood-thinning drugs or daily aspirin therapy may cause bleeding in some people. There are also reports of glucosamine and glucosamine/chondroitin affecting coagulation, increasing the INR (international normalized ratio) and the risk of bruising or bleeding in people using warfarin (Coumadin). If you use blood-thinning drugs, be sure to let your healthcare provider know if you take glucosamine or chondroitin, the dosage, and if you change the dosage. Chondroitin sulfate is a component of a substance called versican that appears to support the spread of prostate cancer. While chondroitin sulfate itself has not been shown to have this effect, men with, or at risk for, prostate cancer may want to avoid chondroitin sulfate until more is known. If you need to watch your sodium intake, consider choosing a product that does not use the sodium forms of glucosamine and chondroitin, as discussed above. Before starting on any supplement for joint pain, consult a physician to be sure of your diagnosis. This is particularly important with hip pain, which may be caused by rheumatoid arthritis, infection, damaged blood supply, gout or other diseases for which treatment with glucosamine, chondroitin, or MSM would be inappropriate. MSM: MSM is generally safe when taken at recommended dosage levels, but be aware that MSM occasionally causes nausea, diarrhea, or headache. MSM may also have an aspirin-like effect and shouldn't be used by patients already taking blood-thinning drugs, unless medically supervised. The safety of MSM hasn't been evaluated for children or for women who are pregnant or breast-feeding, so individuals in these groups should avoid using MSM. To further assist consumers, ConsumerLab.com licenses its flask-shaped CL Seal of Approved Quality (see The CL Seal) to manufacturers for use on labels of products that have passed its testing. ConsumerLab.com will periodically re-evaluate these products to ensure their compliance with ConsumerLab.com's standards.

Information on this site is provided for informational purposes only. It is not an endorsement of any product nor it is it meant to substitute for the advice provided by physicians or other healthcare professionals. The information contained herein should not be used for diagnosing or treating a health problem or disease. https://www.consumerlab.com/results/print.asp?reviewid=jointsupplements

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treating a health problem or disease.

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