BENEFITS OF TAKING ELGENOFLEX FOR THE PREVENTION OF MUSCULOSKELETAL DISORDERS AND SUPPORT OF THE MUSCULOSKELETAL SYSTEM IN PEOPLE WITH HIGH LEVEL OF PHYSICAL EXERTION
Although musculoskeletal disorders are not life-threatening, they are the most common cause of morbidity and disability, and considerably affect the quality of life of affected patients [1,2]. The most common musculoskeletal disorders are osteoarthritis, rheumatoid arthritis, and fibromyalgia. Taking food supplements for musculoskeletal disorders has gained popularity in the last two decades. Collagen hydrolysates, hyaluronic acid, chondroitin sulfate, glucosamine, and methylsulfonylmethane, which are all components of Elgenoflex, are among the substances most widely used for this purpose. Most clinical trials that investigated the beneficial effects of these substances involved patients with osteoarthritis and rheumatoid arthritis covered in a separate article. This article considers the evidence for the positive effects of Elgenoflex components for the prevention of musculoskeletal pain and musculoskeletal conditions, especially in people who are at increased risk because of a high level of physical activity, which puts considerable strain on the musculoskeletal system.
A study conducted at Penn State University examined the effect of supplementation with a collagen type II hydrolysate on activity-related joint pain in 147 healthy athletes [3]. The participants were taking either collagen hydrolysate (10 g daily) or a placebo for 24 weeks; joint pain was assessed by the participants in five different situations (like walking or lifting weight) and also by a physician. The authors found a statistically significant reduction in all six pain parameters in the supplement group in comparison with the placebo group, with a reduction in knee joint pain being the most significant.
Another study that reported the ability of collagen hydrolysates to alleviate pain was conducted in Wisconsin (USA) and involved 20 patients with fibromyalgia; 12 of them also had pain in the temporomandibular joint [4]. The patients were taking a supplement that contained collagen type II hydrolysate (the dose was not specified) and an aloe extract for a total of 90 days. The authors reported a significant reduction in pain (by 25% on average) in comparison with the baseline, as well as improvement in other fibromyalgia symptoms, such as fatigue and chronic headache [4].
A more recent study used exactly the same chicken collagen type II hydrolysate as that included in Elgenoflex—BioCell Collagen, a patented preparation produced by BioCell Technology LLC (Newport Beach, CA, USA). This randomized, double-blind, placebo-controlled pilot study enrolled eight healthy, physically active volunteers who experienced muscle and connective tissue strain and damage because of intense exercise [5]. The participants received BioCell Collagen (3 g daily) or a placebo for six weeks and were subjected to muscle-damaging resistance exercise challenges twice during the week following the supplementation period. The authors found a lower increase in serum markers for muscle tissue damage and enhanced stress resilience (as indicated by better performance at the repeated challenge) in the BioCell Collagen group in comparison with the placebo group [5], although the small size of the groups did not allow evaluation of the statistical significance of the findings.
Whereas moderate physical activity confers extensively documented health benefits, vigorous physical activity may not only cause pain and damage muscle tissue, but also have negative consequences for joints. In addition to increasing the probability of direct joint injuries, these activities, especially some sports such as soccer, increase the risk of osteoarthritis [6,7]. Some professional activities, such as farming, are also known to increase the risk of osteoarthritis [8]. Several studies suggest that dietary supplements containing the same ingredients as Elgenoflex, either individually or in combination, are able not only to alleviate pain but also to reduce degradation of collagen type II, which is a major and indispensable component of articular cartilage [9], and thus prevent or delay the development of osteoarthritis.
Two studies conducted in Japan by the same group used an extract of chicken combs (a source of hyaluronic acid) in athletes. In one study, 46 members of a university soccer team received the extract or a placebo for 12 weeks [10]. Out of three kinds of pain (at rest, on pressing, and on moving) in four joints (ankle, knee, hip and shoulder), pain on moving in the ankle was found to be the strongest and was thus chosen as a benchmark for the effect of the extract. The authors found a significant reduction in the scores for pain in the ankle of the dominant foot, but not the other foot, at four and 12 weeks of supplementation in the extract group in comparison with the placebo group [10]. The same authors had previously found increased levels of the markers of collagen type II degradation and synthesis in athletes in comparison with non-athletes [11]; in a follow-up study, they examined the effect of the chicken comb extract on the turnover collagen type II in 29 soccer players [12]. The authors found a significant reduction in the levels of a collagen type II degradation marker (as well as a marker of bone degradation) after 12 weeks of supplementation [12]. These data confirmed the results of an earlier study, which enrolled 43 patients with knee osteoarthritis, who received a chicken comb extract (equivalent to 60 mg of hyaluronic acid daily) for 16 weeks [13]. In this study, the authors also examined the markers of collagen degradation and synthesis and found that the synthesis to degradation ratio was increased in the hyaluronic acid group in comparison with the placebo group [13]. Since playing soccer is known to increase the risk of knee osteoarthritis [7], these findings indicate that supplements containing hyaluronic acid (including Elgenoflex) may be useful for prevention of this disease.
Similarly, Yoshimura and colleagues found that administration of glucosamine (1.5 or 3 g daily) to soccer players for three months reduced the levels of the marker of collagen type II degradation without affecting the marker of collagen type II synthesis [11]. The effect of glucosamine was short-lived and disappeared soon after supplementation was stopped. Similar results were observed in a more recent study that enrolled bicycle riders: the same doses of glucosamine reduced collagen type II degradation in a dose-dependent manner but did not affect its synthesis [14]. Thus, glucosamine supplementation may have chondroprotective effects in athletes.
A recent systematic review of 13 randomized controlled trials that lasted for at least one year was aimed at identifying substances effective in preserving articular cartilage and delaying the development of knee osteoarthritis [15]. The authors examined available data for 12 treatments, which included glucosamine and chondroitin sulfate (other components of Elgenoflex, i.e. collagen type II hydrolysates, oral hyaluronic acid, and methylsulfonylmethane were not assessed). This study found that glucosamine and chondroitin sulfate were the only effective treatments to delay or prevent osteoarthritis progression.
It should be noted that in this case the effects of glucosamine and chondroitin sulfate were analyzed separately, whereas their effects are known to be synergistic when they are used as components of the same supplement [16,17]. Likewise, a combination of methylsulfonylmethane and glucosamine was reported to be more effective in alleviating pain in osteoarthritis patients than each supplement individually [18]. Thus, supplements that contain several active ingredients, such as Elgenoflex, can be expected to be most efficient in alleviating pain and delaying the development of musculoskeletal disorders than supplements that contain only one or fewer ingredients. Even though in some of the above studies the intake doses of active compounds were higher than the amounts included in Elgenoflex, the lower doses could be expected to be offset by the presence of as many as five active ingredients.
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