Joint Products: Some Pricey Ingredients Are Worth Your Money

MSM and HA remain the big-gun superstars in joint products.
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MSM and HA remain the big-gun superstars in joint products.

We’ve discussed basic oral joint supplements, those with glucosamine and/or chondroitin in them, which are your “starter” level products. We discussed specific minimal levels of ingredients needed to reach an effective dose, and we consider this so important that we’re repeating it here (Minimum Dosages). Download a PDF of this entire article here.

Your older horse may appreciate the relief from arthritic joint pain that nutraceuticals can provide.

Your older horse may appreciate the relief from arthritic joint pain that nutraceuticals can provide.

minimum-dosages

Download the Minimum Dosages PDF here.

Glucosamine and chondroitin are excellent first-level joint nutraceuticals, and they’re where everyone should start their horses, whether for therapeutic or preventative reasons (yes, you should begin using them before your horse actually shows signs of arthritis). However, we frequently hear complaints from horse owners who claim these products “don’t work.”

They do work, but there are valid reasons why they might not be working for your individual horse:

1. The horse’s problem isn’t just arthritis, meaning you need to get a real veterinary diagnosis;

2. The levels of ingredients in the product you purchased aren’t up to therapeutic levels, meaning there’s not enough of the ingredients in them to work (a waste of money);

3. The horse needs more “powerful” (and yes, pricier) ingredients.

And it’s those that we’re going to take on in this article.

MORE BANG FOR MORE BUCKS. Sometimes horses with advanced joint issues or high athletic demands need more help than glucosamine and/or chondroitin can give. That’s when you need the “double-barrel shotguns” of the supplement world: hyaluronic acid (HA) and MSM (methysufonylmethane). Of course, there are a host of other ingredients out there. Some are worth your money, but many aren’t.

The veterinarian-injected products—Adequan and Legend—work reliably well. However, there’s a big difference between injecting a supplement and feeding it, and it’s not just the shot.

When you inject a supplement, it gets directly into the bloodstream and body and bypasses the digestive tract. As a result, injectables have high availability and potency because 100% of the supplement gets into the central compartment of the body.

When a horse eats a supplement, the ingredient travels to the stomach where it’s partially digested. Stomach acid is strong enough to burn through wood, so you can imagine what it may do to degrade a joint supplement floating around in it. Consequently, right off the bat, whatever joint supplement you feed may be greatly diminished in concentration when passing through the stomach. Fortunately, some supplement does survive the stomach acid.

That remaining supplement then enters the small intestine, where it may be absorbed into the bloodstream through the intestinal wall. In order for a molecule to be absorbed through the intestine wall in its whole intact state, it must be quite small. This helps to explain why glucosamine works so well in horses, because it is a very small molecule.

For larger molecules, the body usually breaks them down into smaller components before they’re absorbed. In some cases, they’re not absorbed at all, passing on through to the manure pile. For those that are broken down and absorbed, there’s little research to prove that the pieces (or substrates) have the same anti-inflammatory effect in the joints that the parent compound does.

Such is the case with oral hyaluronic acid, a large molecule that can’t be absorbed into the bloodstream whole. It’s also quite expensive. Is it worth feeding hyaluronic acid to horses? Yes.

RESEARCH OR REALITY? There’s research that supports the use of joint supplements and research that disputes it. What matters to us are the results that we see when we use them. Anecdotal evidence can have a strong impact on choosing to use a product that isn’t “proven” to work. Such is the case with oral hyaluronic acid.

Since, in most cases, HA is given in conjunction with glucosamine, chondroitin, MSM, or other products, one might wonder how much it’s contributing to the anti-inflammatory effect. By-and-large, owners report improvements in their horses when HA is included, so many choose to not split hairs.

Our advice is: If you can afford it, and it works, use it—because it seems that some products work in certain horses better than in others.

ha_sources

Download a PDF of HA sources here.

MSM.  Another strong addition to basic glucosamine and chondroitin is methylsufonylmethane, aka MSM. This sulfur-based molecule is in the same family as DMSO and garlic, although it doesn’t bear the harsh smell. It’s known for binding free-radicals (harmful chemicals released from inflamed tissue) and having an anti-inflammatory effect in the body.

At high concentrations, MSM has even been shown to be a pain-killer because it can numb nerve endings to lessen the body’s sensation of pain. MSM is absorbed quite well, but it needs to be fed to horses in high concentrations in order to achieve the effects noted.

Some companies have caught on to the research regarding MSM and are marketing it in effective higher concentrations. But many still don’t. These manufacturers sell their products at a cheaper price, but their relatively low levels of MSM are likely why many horse owners report that they don’t see an improvement in their horses when they use them.

Frankly, we find the results we see in field trials and clinical settings with MSM are far more powerful than any research regarding its poor efficacy. The fact is, many research projects show promising clinical results, but they’re discredited because reviewers don’t like the project design, the number of test subjects, or the outcome of statistical analysis.

Yes, of course, there’s value in statistical analysis. But statistics can’t explain the undeniable positive results that owners who give MSM to their horses (at the optimum dose) report.

We’ve heard claims that the placebo effect is in play, but horses can’t experience a placebo effect since they don’t know what they’re being fed in the first place. 

msm_sources

Download a PDF of MSM products here.

HOLD THE KITCHEN SINK. If you’ve seen ads and read labels, you know that lesser-known ingredients like avocado, cetyl myristoleate, and branched-chain amino acids are on the market. Both scientific research and use among horse owners suggest that products like these can have a positive effect when combating inflammation in horses. Some companies market combination products that literally include dozens of real and alleged joint ingredients.

Although no one’s readily admitting it, we suspect some people use expensive multi-ingredient products only because they can’t figure out which supplement is the best. What the heck! I’ll feed them all.

If you can afford it, and your horse doesn’t have any health problems that can be associated with the ingredients, you’re not going to hurt anything except your wallet. However, we suggest that you ponder these points, as they might save you a few bucks:

Some joint supplements can have deleterious side effects in horses.

For instance, Boswellia, horse tail extract, cat’s claw, devil’s claw and willow bark can all potentiate or exacerbate gastric ulcers, especially when given in combination with traditional non-steroidal anti-inflammatory drugs (NSAIDS) such as phynelbutazone (bute), flunixin meglumine (Banamine) or firocoxib (Equioxx, Previcox).

Some of these joint supplements have also been experimentally linked to coagulopathies (inability for blood to clot) and therefore should be used with caution in certain horses.

When giving combination joint products, you must pay particular attention to the amount of each ingredient. 

Some products only contain “cameo” amounts of certain ingredients. It’s enough to jack up the price, but not enough to actually help your horse.

But there’s a bit of a monkey wrench in the formula: Some research and anecdotal/clinical data shows that you can feed less of a certain ingredient if it’s given in combination with another.

For instance, it’s recommended that horses receive 10,000 mg of glucosamine per day to achieve a useful anti-inflammatory effect. However, if fed in conjunction with chondroitin, some research shows that you can feed only ¼ of that (2,500 mg) to achieve an anti-inflammatory effect. True to form, horse owners report that feeding combination products with glucosamine and chondroitin in them do help their horses feel better.

The problem is that we don’t have research to show how each and every one of the ingredients found in joint supplements acts in conjunction with one another.

So, does coenzyme Q-10 work if given with grapeseed oil (Reservatrol)? We just don’t know. For that reason, the closer you can come to providing the recommended levels of products given individually, the better off your horse will be.

If you use a multi-ingredient product, take a moment to compare its label to our recommendations. If it contains at or near the amount of supplement ingredients that we recommend, then it’s probably a keeper. If the majority of the ingredients are falling short of recommendations, shop around.

Sometimes these combination products contain ingredients that have no documented therapeutic effect in joints.

For instance, milk thistle, slippery elm, and marshmallow have no documented anti-inflammatory effect in joints. Because the nutraceutical industry isn’t well regulated, some companies get away with putting “fillers” into products that aren’t actually doing anything to help your horse. For instance, dextrose is a filler. It’s also a sugar, so horses are more likely to eat a product that contains it, which may be the manufacturer’s logic here.

The point is, just because something’s on a label or in an ad doesn’t mean it actually does anything. Do your research before blindly purchasing a product with unfamiliar ingredients.

We focused on glucosamine, chondroitin sulfate, MSM and HA in our charts because we’re discussing joint-supporting ingredients. Some products contain other important ingredients, such as devil’s claw, a strong anti-inflammatory or biotin for hoof growth, which may benefit you.

Cosequin may appear out of place in the “double-barrel” chart, but it works. It’s there because we believe it’s arguably the longest-running, most highly respected product.

faqs

BOTTOM LINE. Here’s the formula: First, be sure it’s arthritis. If your horse is sore, you need to be certain why. Delaying proper care trying a joint nutraceutical is unfair to your horse and may make things worse and more difficult.

We think glucosamine is a must-have ingredient (we’ll discuss its effects on insulin-resistant horses in an upcoming issue). You can choose a glucosamine, then add MSM and/or HA by using the products on our charts. This may be a more economical route, but it’s not as easy as choosing a commercial product that includes all three.

As consumers, we believe the National Animal Supplement Council (NASC) product seal is a plus. We’ve included that seal in our charts.

If your horse hasn’t been on a joint product before, start with our entry-level choices. If they don’t work well, move to the mid-level choices—or find a product with similar ingredient levels. Save the double-barrel shotgun recommendations for horses with extreme demands.

Finding a joint supplement that suits your budget, that your horse will eat, and that has a noticeable effect can be hard to do. If you have a product that meets those criteria, and it works, keep using it.

Article by Grant Miller, DVM, Contributing Veterinary Editor