What is articular cartilage and why it is important?

Articular cartilage is a firm, resilient, slippery tissue that covers the ends of bones in movable joints. Cartilage is important because its physical characteristics are responsible for much of the shock absorption and lubrication that facilitates normal joint function. Like all tissues, cartilage is made and maintained by specialized cells. The cells that produce and maintain cartilage are called chondrocytes and they make up only 5% of the total volume of cartilage tissue. The remaining 95% of the volume is made up of an intercellular gel-like matrix composed of protein, water and collagen, and chains of sugar-based molecules called glycosaminoglycans (GAGs). The chondrocytes produce the matrix, and the matrix, in turn, surrounds and supports the chondrocytes. Because such a large percentage of cartilage is composed of the matrix, normal cartilage structure and function depend to a large extent on matrix integrity.

How does the structure of the cartilage matrix contribute to joint function?

Normal cartilage is resilient, firm, and slippery because of the arrangement of collagen fibres and GAGs in the matrix. These two components bind together, forming a spongy network that combines the water-holding characteristics of the GAGs with the high tensile strength of collagen. When weight is applied to the joint, water is squeezed out of the matrix sponge and into the joint space. When the pressure is released, the GAGs pull water back into the matrix, absorbing as much as their binding with collagen will allow. This sponge-like action of the matrix has several effects: firstly, it is what gives cartilage its resiliency. Secondly, the water extruded from the matrix reduces friction and contributes to joint lubrication. Thirdly, and most importantly, the cycling of water from the matrix again carries nutrients to the chondrocytes and removes waste products from them. This is crucial to cartilage function, because unlike most tissues, cartilage has no internal blood vessels.

What happens when the cartilage matrix breaks down?

A decrease in the number or length of GAG chains has serious effects on the cartilage tissue.

One effect is that the reduced chain length leads to reduced binding with collagen. This allows the remaining GAGs to separate more widely and absorb more water. A second and related effect is that when GAG molecules occupy less of the matrix volume there is more space for water. These two changes result in a softer, more watery matrix, which has less resiliencies and less tensile strength. This soft matrix is more easily damaged by normal wear and tear, which leads in turn to a degraded environment for the cartilage cells. The damaged chondrocytes are more likely to produce abnormal GAGs, and so a vicious cycle is established, leading eventually to joint breakdown.

Although science does not know exactly what starts matrix breakdown, we do know several factors that can predispose to it, including wear and tear to cartilage, chronic joint overuse, abnormal loading of joint surfaces, use of steroids and certain non-steroidal anti-inflammatory drugs, joint immobilization and the aging process.

What are symptomatic slow-acting drugs for osteoarthritis (SYSADOA)?

This group of compounds is defined by several characteristics:

1. These compounds either occur naturally in joint tissues, or are structurally similar to compounds occurring naturally in joint tissues;

2. These compounds are not only structural building blocks of joint tissue, but also have a recognisable, reproducible effect on the metabolism of joint tissues.

 

They do not mask joint problems, but instead have overall beneficial effects on cartilage, helping to slow the progression of joint cartilage breakdown and are available in both injectable and oral forms. This has caused them to be referred to as structure-modifying, as well as slow-acting symptomatic drugs for the treatment of osteoarthritis. Examples of oral forms include Glucosamine and Chondroitin Sulfate. Both these compounds are reported to improve cartilage metabolism and to have anti-inflammatory effects and thus may slow the degenerative process of
osteoarthritis.

An example of an injectable chondroprotective agent is Hyaluronic Acid administered directly into the joint by specialist.

Is Chondroitin Sulfate absorbed from the digestive tract?

Although Chondroitin Sulfate is a larger molecule than Glucosamine, radio-labelled studies have shown, like Glucosamine, that it is absorbed from the intestinal tract. Once Chondroitin Sulfate enters the blood stream it has been traced to the joint tissues, where it acts to slow cartilage breakdown.

Why sulfate is important for joint heath?

Cartilage proteoglycans are highly sulfated. The amount of sulfate made available to cells is an important factor in the degree of proteoglycan sulfation. In vitro experiments on cultured cells suggest that increases in serum sulfur concentration enhance GAG synthesis. It has also been found that the rate of sulfated GAG synthesis in human articular cartilage is sensitive to small deviations from physiologic sulfate concentrations. Additionally, sulfate pools in humans are among the smallest of all species, making them especially susceptible to physiologically relevant small changes. In humans, sulfate balance is poorly understood and may vary on dietary factors or on dietary supplements.

One study measured human urinary sulfate excretion after ingestion of methionine or Chondroitin Sulfate supplements in the setting of high- or low-protein diets. The authors observed that more sulfate was excreted in the urine in those with a background of high-protein diets compared with those on low-protein diets. This suggests that in the low-protein state, the body increased sulfate retention from supplements. These observations raise the possibility that sulfate supplementation may have a beneficial role in cartilage health.

Are all Glucosamine, MSM and Chondroitin Sulfate are the same?

No. The purity and grade of these compounds vary widely, depending on how they are produced. In the numerous studies that document the usefulness of Glucosamine, MSM and Chondroitin as well, only the purest grades of these compounds were used. When compounds of lesser purity and quality are used, it would be expected that efficacy decreases proportionally. Another important point to remember is that dietary supplements are not subject to the strict regulation that required for pharmaceuticals. Therefore, these compounds may be inaccurate or misleading. Osteoactiv products contain only pharmaceutical grade active ingredients to ensure consistent quality and purity. It should be careful to buy only from a reputable manufacturer, where strict quality control programs are used to validate product purity and consistency from start to finish.

Why is it important to use Glucosamine, MSM and Chondroitin together?

The Glucosamine, MSM and Chondroitin work together in a synergistic manner to help the body rebuild joint cartilage.

 

Taking the 3 ingredients together is more effective than taking either alone based on their different mechanism of actions. Glucosamine helps the body to rebuild cartilage. Chondroitin helps to decrease cartilage breakdown. MSM helps to nourishes joints and maintain healthy connective tissue.

What can be expected after taking Flexijoint 3-in-1 Joint Care Powder?

 

For severe osteoarthritis symptoms, it is recommended to take one sachet for a period of at least 8 to 12 weeks before observing significant improvement. For light to moderate osteoarthritis symptoms, it is recommended to take for a period of at least 6 weeks. If used appropriately, Flexijoint 3-in-1 Joint Care Powder provides excellent results. For optimum results, two factors should be considered.

Firstly, since Flexijoint 3-in-1 Joint Care Powder depends in part on living cartilage cells for its effect, best results will be seen in those joints that have not yet been denuded of cartilage. Joints that have degenerated to the stage of bone on bone will not be able to respond maximally to Flexijoint 3-in-1 Joint Care Powder.

 

Secondly, it is important to remember that Flexijoint 3-in-1 Joint Care Powder is designed to help the body rebuild joint cartilage. This improvement in joint structure translates to an improvement in joint functional ability. Unlike non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, Flexijoint 3-in-1 Joint Care Powder does not work by masking the symptoms of joint problems.

 

Rebuilding articular cartilage takes time. Most individuals will see and feel an improvement in 8 weeks or less. Continued use of Flexijoint 3-in-1 Joint Care Powder will help to maximize cartilage production and improve synovial fluid quality in the majority of users.

 

Once improvement has been observed, the maintenance dose is one sachet daily and continue for another 3 to 4 months (or as directed by healthcare professional).

Is Flexijoint product safe?

In all the studies reviewed, adverse effects of Glucosamine, Chondroitin and MSM were mild, infrequently reported, and usually consisted of transient effects on the gastrointestinal system. This obviously gives them a huge advantage over the NSAIDs with their frequent and potentially serious side effects.

It seems, therefore, that these three widely used ingredients are safe and may indeed provide benefit to some patients with osteoarthritis, particularly in the relief of symptoms and possibly over longer periods slowing down the structural progression of the disease.

 

Can Flexijoint product be taken by diabetics?

Yes. Although Glucosamine and Chondroitin Sulfate are biochemically classed as carbohydrates (sugars), the body is not able to break them down into glucose, so these compounds do not raise blood sugar by providing an additional source of glucose. There has been some concern among researchers about reports that large concentrations of Glucosamine can affect insulin secretion and action in animal and in vitro models. However, there is no evidence from clinical trials that Glucosamine in usual doses affects insulin sensitivity or plasma glucose concentrations, even when taken by diabetics.

However, since many factors can affect insulin secretion and blood glucose levels in diabetic patients, we recommend that these individuals check their blood glucose levels frequently when initiating Osteoactiv product or any other new element into their regimen.

Can Flexijoint 3-in-1 Joint Care Powder be taken by individuals on a low salt diet?

​

Yes. Flexijoint 3-in-1 Joint Care Powder contains 120mg of sodium per sachet, which represents only a small percentage of the total daily intake of sodium allowed for individuals with hypertension in a sodium-restricted diet. The salt intake recommended by the Heart Foundation is less than 4g of salt per day (approximately 1550mg of sodium per day). Therefore, the daily intake of sodium from the supplement of Flexijoint 3-in-1 Joint Care Powder is not significantly enough to affect the control of hypertension and is very much less than the recommended daily intake of sodium.

 

The Heart Foundation advises individuals with hypertension to adopt a healthy lifestyle by reducing excess body weight, increasing physical activity, lowering alcohol intake and adopting an increased potassium salt and reduced salt eating pattern. However, potassium chloride salt substitutes can be potentially dangerous in patients with renal dysfunction or those taking potassium-sparing diuretics.

Can Flexijoint 3-in-1 Joint Care Powder be taken by individuals allergic to sulfa drugs?

There is no cross-reactivity between sulfa drugs and MSM content in Flexijoint 3-in-1 Joint Care Powder. Do not get confused between the two. MSM provides organic sulfur and is a nutrient. Sulfa-based drugs, also known as sulfonamides, do not occur naturally and are used as antibiotics. The sulfa molecule is much larger and can cause severe reactions in some individuals. While many people are allergic to sulfa drugs, no similar reactions have ever been reported with MSM. A third sulfur-containing compound, known as sulfites, is a form of preservative that can cause allergic reactions in some individuals. MSM does not contain sulfites, and should not cause a reaction in sulfite-sensitive individuals. An allergy to sulfa drugs should not be interpreted as an allergy to sulfur. Sulfur is an essential element that is present in many foods and occurs in every cell in the body.