Natural Dietary Supplements
When a dietary supplement is available in the store, it is naturally assumed that it is safe. Some government agency has checked to make certain it is not harmful, right Not anymore. In 1994, the Dietary Supplement Health and Education Act removed dietary supplements from premarket safety evaluations required of food ingredients and drugs. Drugs and food ingredients still undergo a lengthy Food and Drug Administration (FDA) safety review before they can be marketed, but the 1994 legislation eliminated the FDA's authority to regulate the safety of nutritional supplements before they go on the market. Now, the FDA can intervene only after an illness or injury occurs. Claims may not be made about the use of dietary supplements to diagnose, prevent, treat, or cure a specific disease. For example, a product may not carry the claim cures cancer or treats arthritis. The FDA can still restrict the sale of an unsafe dietary supplement when there is evidence that the product presents a...
The major mode of treatment for food allergies and intolerances is for the person to avoid consuming the food or foods that seem to cause health problems. This involves a high degree of dietary awareness and careful food selection. When foods are eliminated from the diet, it is important to ensure the nutritional adequacy of the diet, and some individuals may need to take dietary supplements. There are some food intolerances, such as lactose intolerance, where individuals may be able to reduce the amount of the food consumed and not totally eliminate it from the diet. People with lactose intolerance do not have to completely eliminate milk products, though they must reduce their intake of lactose (milk sugar) to a manageable level. see also Additives and Preservatives.
Survey data and intervention study findings. The last chapter in this section reviews the use of dietary supplements and their association with reduction in certain cancer risks as well as the increased risk seen with beta-carotene supplementation in cigarette smokers. Supplements reviewed include beta-carotene, vitamins C and E, selenium, calcium and folic acid, as well as multivitamins. The chapter provides the reader with critical information about the difficulties in collecting information about use of dietary supplements, the timing of their use, and the motivation for use before or after diagnosis of cancer.
Methylsulfonylmethane (MSM) is another dietary supplement that is taken for the treatment of joint pain from arthritis. Its benefits for patients with osteoarthritis were investigated in a randomized, double-blind, placebo-controlled trial with 50 men and women (40-76 years old) with pain from osteoarthritis of the knee who were enrolled in an outpatient medical center 75 . The patients received MSM 3 g or placebo twice each day (6 g d) for 12 weeks. The outcomes included the Western Ontario and McMaster University Osteoarthritis Index visual analog scale (WOMAC), patient and physician global assessments, and SF-36 (an overall health-related quality-of-life measurement).
In case of poisoning, do not try to use only pranic healing. Get proper medical treatment and apply pranic healing to strengthen and facilitate the healing process. As stated earlier, a disease or illness could be caused by internal and or external factors. If the cause is malnutrition, obviously enough nourishing food or nutritional supplements should be taken by the patient. Since chemical poison is a physical or external factor, then one should definitely use a physical or chemical form of treatment. Pranic healing should also be used to minimize the damage done to the body and to greatly facilitate the healing process.
N-3 fatty acids should be added to foods rather than be used solely as dietary supplements, which is a quasi-pharmaceutical approach. Furthermore, the development of a variety of n-3-rich foodstuffs would allow increased n-3 dietary intakes with little change of dietary habits. n-3 fatty acids maintain their preventative and therapeutic properties when packaged in foods other than fish. Efficient use of dietary n-3 fatty acids will require the simultaneous reduction in the food content of n-6 fatty acids and their substitution with monounsaturated oils. Dietary n-3 fats give rise to higher tissue levels of EPA when the 'background' diet is low in n-6 fats. Compared to n-6 fatty acids, olive oil increases the incorporation of n-3 fatty acids into tissues.
Pantothenate is widely distributed in food rich sources include animal tissues, especially liver, and yeast, with moderate amounts occurring in whole grain cereals and legumes (see Table 1). It is fairly stable during cooking and storage, although some destruction occurs at high temperatures and at pH values below 5 or above 7. Highly processed foods have lower contents than fresh foods. Commercial vitamin supplements containing pantothenate usually contain the calcium salt, which is crystalline and more stable than the acid.
There is a dearth of placebo controlled studies on the plethora of over-the-counter medications, nutritional supplements, and new treatments Many turn out to be no different from powerful placebos. The mutual expectations and faith in the treatment's efficacy provide the therapeutic ingredient. Theories about the mechanisms underlying placebo effects include discussions of the role of anxiety, conditioning, endorphins, experimenter bias, and suggestion. The role of belief and expectation in mediating the placebo response seems to have the most empirical support.
Weight loss Weight loss (as distinct from wasting syndrome) is common in people with HIV AIDS. Weight loss can be intentional or unintentional. People with HIV infection lose weight for different reasons difficulty eating (perhaps because an infection in the mouth, such as thrush, makes eating difficult), lack of appetite, apathy and depression, prolonged diarrhea, nausea and vomiting, HIV itself, opportunistic infections that affect various organs of the body, and fever. Treatments vary, depending on the cause, and include diet adjustments, appetite stimulants, small but frequent meals, high-calorie and protein foods, nutritional supplements, or intravenous feeding (a procedure called parenteral hyperalimentation or total parenteral nutrition). An adequate exercise program is also especially important for people with HIV infection and AIDS. Diarrhea, nausea, and vomiting, can be treated with drugs. If fever is a factor in weight loss, treatment will try to reduce fever with aspirin,...
Chondroitin is a glycosaminoglycan that is found in the proteoglycans of articular cartilage. It is an ingredient found commonly in dietary supplements used to treat osteo-arthritis. It is commonly combined with glucosamine. Most chondroitin is made from extracts of cartilaginous cow and pig tissues other sources such as shark cartilage are also used. Since chondroitin is not a uniform substance, and is naturally present in a wide variety of forms, the composition of each supplement varies. Only a minority of chondroitin taken by mouth is absorbed.
This dietary supplement can be remarkably effective in patients with osteoarthritis. While the bulk of the evidence that underpins its use refers to use in patients with osteoarthritis of the knee, from a clinical perspective those findings are replicated in other joints. Not only can pain be reduced, so too can joint stiffness. Time to effect may be measured in days to months. It is suggested in the literature that refers to knee osteoarthritis that the joint lining may increase in depth with sustained use and so it may be that glucosamine use can prevent osteoarthritis as well as actually treating it.
While many health care providers experience frustration in trying to motivate their patients to exercise, the problem is often amplified when such patients return with complaints of exercise-related aches and pains. Most exercise-related injuries occur from overuse stress on the muscles, tendons, bones, orjoints. Sporting activities with major risk for creating pain are, not surprisingly, those that include repetitive, high-intensity, high-impact forces going through the affected joints, especially when there is a high association of the activities with risks of injury. Various nutritional supplements can mitigate the effects of exercise-induced wear-and-tear on the body. (See Table 28-1 on page 319.) The mechanism of action for these supplements focuses on ligamentous and cartilaginous tissue repair and maintenance.
Bovine CuZn-SOD was marketed as an anti-inflammatory drug under the trade name Orgotein. However, due to adverse immunological side effects, it was withdrawn from the market, and its marketing license was suspended in 1994 124 . The product has been marketed in Spain by the company OXIS International, where it has been used in humans for the prevention and treatment of radiation-induced tissue inflammation and fibrosis 125,126 . The enzyme was marketed for use in animals in the United States as the active ingredient in Palosein, which is used for the alleviation of musculoskeletal inflammation in dogs and horses. The enzyme is also marketed as a dietary supplement 127 , however, there is little evidence to support its therapeutic efficacy in this context. A recombinant CuZn-SOD (Oxsodrol) was registered with the FDA in 1991 by Savient Pharmaceuticals as an orphan drug for the treatment of bronchopulmonary dysplasia in premature infants 128 . The enzyme has undergone phase-II clinical...
SAMe (S-adenosylmethionine also known as Sammy) is a supplement claimed to be an effective treatment for multiple medical conditions. SAMe is a naturally occurring compound involved in fundamental biochemical reactions called methylation reactions. These reactions also involve vitamin B12 and folic acid. SAMe has been commercially available for years in European countries, including Germany, Italy, and Spain. SAMe became available as a dietary supplement in the United States in the spring of 1999.
Homocysteine is toxic, producing cardiovascular disease and neural tube defects. Despite the high flux through the homocysteine pool, therefore, the pool size must be kept small (i.e. there must be rapid remethylation or rapid movement into transsulfuration). Serious toxicity has not been reported for S-adenosylmethionine1. However, the current interest in S-adenosylhomocysteine as a dietary supplement is disturbing18 in light of the toxicity of the closely related compounds methionine and homocysteine. S-adenosylhomocysteine is being widely used as an antidepressant and in treatment of arthritis and liver disease in recommended doses of up to 1.6 g day.
The human gastrointestinal (GI) tract is supposed to contain 85 percent good bacteria and 15 percent bad bacteria. Unfortunateiy, many Westerners today have the opposite ratio. When our ancestors consumed fresh plant life hundreds and thousands of years ago they unknowingly ingested large amounts of these beneficial microorganisms. However, with the advent of modern farming techniques, which use chemicals such as pesticides, herbicides, and fungicides, these essential microorganisms have been greatly depleted from our food supply. Therefore, supplementation is often needed. For more information about probiotics, go to Warrior Probiotics in the Warrior Nutritional Supplements chapter. Note Minerals should not make you nauseated if you use ones that are naturally derived from a live plant source. One of the best sources of minerals is coral-derived highly ionized minerals. Ionized minerals are biologically more active and better assimilated. For more on this, go to the Warrior...
Diet Many people believe that diet affects their arthritis or that dietary supplements or vitamins improve their symptoms. A lot has been published about the effects of diet on arthritis. Other than the fact that uric acid levels are elevated in people who drink large amounts of alcohol or eat a lot of red meat or organ meats (see gout), the results have not been consistent. Many of the studies have been uncontrolled and open label (see clinical trial), and their results may therefore be biased toward showing a positive effect. Several studies have found that a vegan or vegetarian diet resulted in a modest improvement in RA, but the scientific evidence is not strong enough to recommend this as a useful component of routine treatment. Many dietary supplements such as yeast, cider vinegar, honey, copper, zinc, magnesium, garlic, ginger, alfalfa, and shark cartilage have been used to treat arthritis without adequate evidence available to support or refute claims for their efficacy....
Steroids such as prednisone are powerful medications that can be lifesaving but have a definite metabolic downside, especially if used for long periods of time. They are often prescribed for arthritis as well as for autoimmune disorders, inflammation of the bowel and any other inflammatory condition. These drugs actually cause water retention and weight gain. They can also damage the kidneys and pancreas and cause diabetes. The same nutritional supplements that can relieve arthritis are safer alternatives that will not hinder weight loss.
Both glucosamine and chondroitin sulphate are very popular nutritional supplements in the treatment of osteoarthritis. Glucosamine is a precursor to glycosaminoglycan, which is used in cartilage formation and repair. Chondroitin sulphate is the most abundant glycosaminoglycan in cartilage, providing it with resiliency.
Glucosamine sulfate and chondroitin sulfate supplements are the most widely used dietary supplements for the treatment of osteoarthritis, with an annual sales of nearly 730 million in 2004 66 . Glucosamine is an amino monosac-charide that is the most fundamental building block required for the biosynthesis of several classes of compounds that require amino sugars, such as glycosaminoglycans and proteoglycans 67 . The raw material for glucosamine is derived from chitin, a biopolymer present in the exoskeleton of marine invertebrate animals 68 . Chondroitin sulfates are a class of glycosaminoglycans required for the formation of proteoglycans found in joint cartilage 67 . Many of the design flaws of glucosamine sulfate and chondroitin sulfate studies, including the failure to adhere to the intention-to-treat principle, the enrollment of small numbers of patients, potential bias because of sponsorship by a manufacturer of dietary supplements, and inadequate masking of the study agent,...
Hermansen, K. et al., Beneficial effects of a soy-based dietary supplement on lipid levels and cardiovascular risk markers in type 2 diabetic subjects, Diabetes Care, 24, 228, 2001. 42. Dayong, Wu. et al., Effect of dietary supplementation with black currant seed oil on the immune response of healthy elderly subjects, Am. J. Clin. Nutr., 70, 536, 1999.
While this program provides a useful precedent for policing claims, neither the FDA nor the FTC has focused enforcement resources on DTC genetic tests (American Society of Human Genetics, 2007). This is due, in part, to fragmented regulatory jurisdiction between the FDA and FTC (Ries, 2008). The FDA has warned some dietary supplement manufacturers about making impermissible claims that their products can treat, cure or prevent disease. Companies that engage in tied selling of nutri-genetic tests and dietary supplements may face penalties in relation to product claims. For example, a US government report on nutrigenetic testing described a DTC testing company that marketed Cat's Claw as a 'DNA repair' supplement, despite the lack of peer-reviewed evidence substantiating the plant's pharmacological effects. The report notes that ' t he FDA has already sent Warning Letters to several dietary supplement manufacturers who explicitly claimed that Cat's Claw could help treat cancer and...
Although fish oil supplements contain omega-3 fatty acids, they're not advised as a substitute for fish-or as a dietary supplement for most people. Popping a fish oil capsule won't undo the effects of an otherwise unhealthful diet. Instead, enjoy fish for its nutritional benefits, flavor-and variety in your eating style. The American Heart Association advises a fish oil capsule for some people with elevated triglycerides-and under a physician's care.
Fact Everyone does not need a vitamin supplement Most healthy people can get enough nutrients with a varied, balanced eating plan from MyPyramid. Quacks rarely say who does not need a supplement. See MyPyramid Your Healthful Eating Guide in chapter 10. 8. Fact There's nothing magical about supplements promoted as natural. From the standpoint of science, the chemical structure of natural and synthetic dietary supplements is essentially the same. And the body uses them in the same manner. (There's one exception natural vitamin E is more potent than its synthetic form.) Herbal products aren't necessarily safe just because they're natural. Even substances found in nature can have natural toxins, with potent, druglike effects. 10. Fact Quacks are typically salespeople. Rather than offering accurate advice, their bottom line is to sell you something. Be wary when someone tries to diagnose your health status, then offers to sell you a remedy, such as a routine dietary supplement.
Chondroitin sulphates Major components of the extracellular matrix and connective tissue of animals. They are repeating polymers of glucuronic acid and sulphated N-acetyl glucosamine residues that are highly hydrophilic and anionic. Found in association with proteins. 'Chondroitin' is sold as a dietary supplement in the hope that it will relieve osteoarthritis, but the evidence for efficacy is minimal.
As scientists attempted to determine the antiscorbutic value of various foods, they found that animal experiments often added to the confusion, because different animal species vary in their vitamin requirements. In 1907, Axel Holst (1860-1931) and Theodor Frolich (1870-1947) discovered an appropriate animal model for the systematic evaluation of antiscorbutics. Holst, Professor of Hygiene and Bacteriology at the University of Christiana, Oslo, had studied bacteriology in France and Germany. He had also visited the laboratory of the Dutch physician and bacteriologist Christiaan Eijkman (1858-1930) in Indonesia to learn about a disease known as beriberi. Searching for a mammalian model for beriberi, Holst tested the guinea pig. When he noted signs of scurvy, he enlisted the assistance of Frolich, a pediatrician concerned with infantile scurvy. Holst and Frolich demonstrated that scurvy in the guinea pig was induced by diet and cured by diet. If Holst had used the rat as his...
Pharmaceutical potential A number of plants classified within the genera Fushia and Clarkia are cultivated for ornamental purposes. The fixed oil obtained from the seeds of Oenothera biennis or evening primrose oil is widely marketed as a dietary supplement for cosmetic purposes, and more specifically for the treatment of atopic eczema and premenstrual syndrome. Evening primrose has attracted a great deal of interest on account of its effects on diabetic neuropathy and rheumatoid arthritis. The pharmacological properties of evening primrose oil could be on account of y-linolenic acid which is metabolized in arachi-donic acid, an immediate precursor of some prostaglandins (Fig. 168). Gallic acid and ellagic acid released from hydrolysable tannins are cyto- Fig. 168. Pharmacological basis of evening toxic and are often responsible for the primrose oil y-linolenic acid is metabolized in antitumoral property of medicinal Ona- arachidonic acid, an immediate precursor of
Glucosamine and chondroitin sulfate (Available as many dietary supplement preparations in health food stores) Glucosamine and chondroitin sulfate are substances found in the joints that, with other raw materials, form the constituents of cartilage. Clinical trials, not always of rigorous design, suggest that glucosamine is approximately as effective as an NSAID in the treatment of osteoarthritis. The mechanism of action is unclear, and it may not be a simple case of replacing the raw materials that make up cartilage but rather an anti-inflammatory mechanism. Large controlled clinical trials are underway.
Among patients with peripheral neuropathy, CAM users report using magnets and acupuncture (30 each), herbal remedies (22 ) and chiropractic (22 ) 14 . In this study, CAM use was associated with the presence of diabetic neuropathy and burning pain. Chiropractic and massage are frequently used by patients with chronic low back pain 15 . In a questionnaire study of 170 chronic pain patients attending a pain clinic in Montreal, 96 (56 ) had used a CAM modality in the past month, of which the most common were nutritional supplements (34 ), massage (11 ) and meditation (7 ) (Figure 13.1) 16 .
The dietary supplement S-adenosyl-L-methionine (SAMe) has been reported to be effective for the management of a variety of problems, including depression, liver disease, and arthritis 76 . It has been suggested that SAMe can reduce pain in osteoarthritis because it reduces inflammation, increases proteoglycan synthesis, or has an analgesic effect 76 . It is unknown whether SAMe is an inhibitor of COX-2. Studies using human articular chondrocytes have shown SAMe-induced increases in proteoglycan synthesis 77 . A double-blind crossover study compared SAMe (1200 mg) with celecoxib (Celebrex 200 mg) for 16 weeks to reduce pain associated with osteoarthritis of the knee. Sixty-one adults diagnosed with osteoarthritis of the knee were enrolled, and 56 completed the study. The investigators reported that SAMe had a slower onset of action, but was as effective as celecoxib in the management of symptoms of knee osteoarthritis 76 . They concluded that longer studies are needed to determine the...
Since Congress passed the Dietary Supplement Health Education Act (DSHEA) in 1994, most herbal supplements have not been regulated by the FDA. Products labeled dietary supplement are exempt from FDA control, as long as they do not claim to cure any disease. Therefore, herbal products are not subjected to the same rigorous testing and standards as over-the-counter and prescription drugs. Because most
Glucosamine is a dietary supplement that appears to be effective for treating arthritis. Glucosamine mildly suppresses the immune system it appears to decrease the activity of the inflammatory component of the immune system (Th1 response) and increase the activity of the anti-inflammatory component (Th2 response). In EAE, the animal model of MS, glucosamine decreases disease severity (12). These findings are encouraging. Further animal studies and, if indicated, human studies are needed to understand the possible effects of glucosamine on MS. Glucosamine generally is well tolerated. It may cause mild side effects, such as gastrointestinal complaints, headache, and drowsiness.
In 1989, some 5,000 people suffered debilitating health problems from impurities in a batch of L-tryptophan distributed by Showa Denko, a Japanese firm that did not specialize in drugs or nutritional supplements 36 of them died and many more were left permanently crippled. As a result, the sale of L-tryptophan supplements was banned in 1990. The FDA contends that the illness suffered by these victims, a blood disease called eosinophilia-myalgia syndrome (EMS), and related illnesses are attributable to L-tryptophan itself. Cases have also been reported for uncontaminated batches and for the similar compound L-5-hydroxytryptophan, but many experts dispute the validity of these reports.
Evidence from epidemiologic studies suggests that vitamin E supplementation is beneficial for reducing CVD risk. Nevertheless, data from randomized clinical trials, in populations both with and without a history of CVD, generally do not support the epide-miologic findings. The review of evidence by the US Preventive Services Task Force included five well-designed, large cohort studies that investigated the association between vitamin supplementation and CVD mortality, three clinical trials of primary prevention of CVD, and seven clinical trials of secondary prevention of cardiac events. As stated earlier, the Task Force concluded that findings did not demonstrate a consistent or significant effect of vitamin E on either incidence of CVD or death from this disease. Four large clinical trials are currently in progress in the United States to study the effect on CVD of vitamin E supplements alone or combined with other antioxidants the Women's Health Study, the Women's Antioxidant and...
Peet M, Laugharne J D, Mellor J, Ramchand C N. Essential fatty acid deficiency in erythrocyte membranes from chronic schizophrenic patients, and the clinical effects of dietary supplementation. Prostaglandins Leukot Essent Fatty Acids 1996 55 71-75. 45. Fetrow C W, Avila J R. Efficacy of the dietary supplement S-adenosyl-L-methionine. Ann Pharmacother 2001 35 1414-1425.
Evening primrose oil (OEP) is a dietary supplement that contains essential fatty acids (omega-3 and omega-6) and has been investigated in-depth for its effectiveness for conditions that are associated with a deficiency in essential fatty acids. OEP has a good safety profile with mild side effects and rare serious adverse events. OEP should not be taken during pregnancy, prior to surgery, in patients at risk for seizures or taking phenothiazine-related medications, antiplatelets, thrombolytics, low-molecular-weight heparins, or anticoagulants. There have been no reports of toxic ingestion, mortality, or teratogenicity with OEP supplementation, and usage during lactation is presumed to be safe. The German Commission E has not approved the use of OEP for any condition at this time. OEP is possibly effective for essential fatty acid deficiency and breast pain, and for rheumatoid arthritis after 6 months of treatment. Efficacy of OEP has not been clearly established for the following...
The amount of collagen in the diet can be increased by consuming specific foods, such as meats with gristle or connective tissue still intact. Collagen also can be found in foods containing gelatin. Dietary supplements also can be used to increase the amount of collagen contributed by the diet. An example of such a supplement is collagen hydrolysate, which is prepared by enzymatic hydrolysis of collagenous tissue, such as bone, hide, and hide split from pigs and cows. Collagen hydrolysate is soluble in cold water and is composed of proteins with a molecular weight of 3 to 6 kD. In addition to these open-label trials, collagen hydrolysate has been studied in a prospective, randomized, double-blind, placebo-controlled clinical trial conducted by Adam 85 . Researchers recruited 81 patients with osteoarthritis of the knee or hip and used a complex crossover design to compare four different nutritional supplements that included collagen hydrolysate (10 g in the form of 20 capsules, each...
Patients with rheumatoid arthritis they also seem to help restore more normal immune responses. In one investigation, Robert Zurier, M.D., of the University of Massachusetts at Worcester, treated thirty-seven patients with rheumatoid arthritis and inflamed joints. He gave them either 1.4 grams of GLA or placebos daily. After twenty-four weeks both physicians and patients noted significant reductions in symptoms. The number of tender joints among patients taking GLA was reduced by 36 percent, and the overall score on tests measuring tender joints declined by 45 percent. In addition, the number of swollen joints decreased by 28 percent, and the patients' overall score for swollen joints fell by 41 percent. Some people benefited far more than did others, but that is frequently the case with nutritional supplements. It is likely that better responses would have occurred with a broader supplement regimen, but the study was designed to test GLA only.
Pollen is consumed by humans primarily as a dietary supplement. Its protein, vitamin, mineral, and fat content is variable, depending on the season and plant source. In a survey of a mixed sample of bee-collected pollen from seven states, the average protein content of pollen on a dry weight basis was 24.1 . However, when individual plant sources were analyzed, the range was 7.02 to 29.87 protein.
Clinical trials are now in progress to provide conclusive evidence not only in these diseases but also in arthritis, gastric ulcer, cancer, AIDS and colitis. However, this is not easy to perform, because there is still confusion about aloe preparations. It is not enough to say that a preparation, if not specified as a latex or gel, is referred to as an extract. Aloe products are classified as drugs while others as dietary supplements. Aloe is also a common ingredient in numerous hand, body and sun lotions, shaving creams, shampoos and personal care-products. This is why people sometimes forget to consider aloe a medicinal drug (Eshinazi, 1999). Aloe is also processed into various flavoured and unflavoured alcoholic drinks (Fernet Branca, etc.) that are ingested with the belief that this bitter liquid (amarum) will stimulate the appetite and or the digestion. There is a general conviction that bitters also have a tonic effect on the body and the term
Digestive and Kidney Disorders http www.niddk.nih.gov health nutrition.htm Dietary supplements National Center for Complementary and Alternative Medicine 18 Pearce, K. A., Boosalis, M. G. andYeager, B. Update on vitamin supplements for the prevention of coronary disease and stroke. Am. Fam. Physician 2000 62 1359-66.
Treatments for patients with osteoarthritis range from lifestyle changes, such as exercise, stretching, aerobic activities, and weight management, to dietary and nutritional interventions, including increasing levels of such nutrients as omega-3 fatty acids, vitamin C, and vitamin E. In addition, pharmacologic treatments, herbs, and nutritional supplements have been investigated for patients with osteoarthritis. Drugs that have been used to manage symptoms of patients with osteoarthri-tis include NSAIDs, COX-2 inhibitors, and glucocorticoids. Herbal products include green tea extracts, SKI306X, and devil's claw. Nutritional supplements that have been studied in osteoarthritis patients include glucosamine and chon-droitin sulfate, MSM, SAMe, and collagen hydrolysate. Research with these drugs and supplements has provided varying results about their efficacy in patients with osteoarthritis additional research is needed to determine the optimal treatments for patients with this disorder.
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