4th place: Revive Active Premium Joint Complex

With 70 points, Revive Active Premium Joint Complex costs £34.84 per month + £1.90 shipping. It comes in daily powder sachets, which can be mixed with water, juice or smoothies. Produced in the USA and due to its powder format, it scored well due with its unusually high MSM and Kolllagen amounts amongst the standard Glucosamine and Chondroitin dosages.

It does not include omega-3 fatty acids, strong antioxidants, amino acids, vitamin D, vitamin E, zinc or selenium and therefore misses many key ingredients. The sachet format, however, represents a convenient alternative for those willing to spend more and miss out on a few nutrients.

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5th place: Met-Rx Super Joint Guard

Met-Rx Super Joint Guard has 63 points, because of its good array of vitamins and essential fats. Unfortunately, they are “bundled” into an untransparent proprietary mix so individual dosages are unavailable and the points were lost as a result. They are also mostly dosed far too low compared to dosages used in clinical studies to make any sort of impact.

It does include a good quantity of Glucosamine sulfate and Chondroiton sulfate and even Hyaluronic acid, but it is lacking in trace minerals lacking zinc and selenium altogether.

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6th place: Arthri-flex Advantage

Arthri-Flex Advantage scored 60 points, because it combines Glucosamine Sulfate, naturally occurring Chondroitin Sulfate and MSM. Significantly, the Chondroitin comes from “Premium Chicken Sternum Type II Kollagen” and is not quantified on the packaging. The chondroitin could therefore not be quantified for this evaluation and the points were lost as a result. It also is not It does not contain Selenium, Vitamin D and vitamin E or omega-3 acids.

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7th place: Labrada Elasti Joint Grape Powder

This drink powder from the USA scored 60 points with its extremely high dosages of Kollagen and MSM. The standard dosages of Glucosamine and Chondroitin due to an approximate amount of 10g drinking powder per day. It has, however, a very limited nutrient profile, because omega 3 acids, antioxidants, vitamins and trace minerals are missing altogether. It was therefore ranked 7th although it has the same number of points as 6th ranked Arthri-Flex Advantage.

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8th place: Nature’s Plus, Advanced Therapeutics, Ultra RX Joint Complete System, 2 Piece Kit

This product scored 55 points with its good mix of the basic nutrients Glucosamine, Chondroitin and MSM, but it is missing omega-3s, amino acids and most clinically proven vitamins and trace elements.

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9th place: Trec Nutrition – Joint Therapy Plus

50 points. Each bottle contains 90 capsules formulated from glucosamine, chondroitin, collagen, vitamin C and manganese. This supplement costs around £27.99 and the recommended dose is three capsule daily. It is also missing a large number of joint and cartilage micronutrients.

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10th place: Wellesse Premium Liquid Supplements, Joint Movement Glucosamine

45 points. Wellesse Premium Liquid is the only drinkable joint food on the market. Imported from the US it is a great alternative for all those, who do not like to swallow capsules.

However, this luxury comes at a price. The measurements are in US fluid ounces, the bottle includes 16 fl oz and the recommendation is 1 fl oz per day. The bottle will therefore last just over two weeks. From a nutritional perspective, the formula is also very incomplete and it has a high prive point. It is missing all trace elements, vitamins E and D, omega-3s, amino acids and antioxidants.

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Side-by-side evaluations

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In this comparison we only considered food supplements with clinically-proven effective micronutrients, which are available over-the-counter either on the high street or online for delivery in the UK & Ireland.

We used a standard scoring system for the various ingredients and concentrations to allow for a transparent side-by-side comparison:

• We awarded up to 20 points per active ingredient for the most thoroughly researched, clinically proven beneficial joint nutrients glucosamine, chondroitin and MSM.
• We awarded up to 10 points for well-researched nutrients and natural remedies Omega-3, Hyaluronic acid and pine bark extract. These micronutrients are thought to be slightly less effective than glucosamine and chondroitin. They also cannot be sold as medicines according to our research. There is good evidence of their beneficial effects and there are no significant side effects.
• We awarded up to five points for all other positively-researched micronutrients that are important for the musculoskeletal system, cell protection and the immune system. In our calculations, these include Collagen, vitamin A, vitamin E, vitamin C, vitamin D, amino acids, selenium, manganese and zinc. When deficient in the body, these micronutrients can lead to joint problems and are therefore important for general health. Even without a known deficiency, increasing the intake of these nutrients can have important health benefits (although not necessarily always clinically proven). This applies in particular as the body ages and demand for nutrients increases as a result of illness or medication. There are no known adverse side effects even in larger dosages.

Dosages: A micronutrient only becomes effective when sufficiently dosed. We have allocated reduced scores accordingly, where a nutrient is present in the product, but the dosage is lower than generally recommended.

Under these criteria a perfect score of 135 points could have been scored by any supplement according to our system. However, no supplement was able to achieve this.  

Firstly, this particular “perfect” nutrient mix does not yet exist. Secondly, it would take a large amount capsules of (approx. six to eight) to provide the appropriate nutrient dosages on a daily basis.

Other potential criteria such as packaging, dosage form (tablets, capsules or powder) as well as price have not been included in point allocation, because of a natural variation in personal preferences.

Delivery, customer service: All test orders were received within 3 – 5 business days and all returns were processed to a satisfactory degree. We have therefore not included this factor as a separate score either.

These natural remedies were not included in the evaluation

Pain relievers, medicines and homeopathic remedies were excluded. We also attempted to focus on products, which had their ingredients and dosages clearly labelled. Products with “proprietary mixes” which did not break down the exact nutrient composition lost points on poor transparency.

In addition, there are many more natural remedies, vitamins and trace elements which are regularly recommended by orthopaedic specialists and scientists. We did not include the following ingredients in the analysis, because we could not find insufficiently conclusive information. Conversely, this does not mean, that these substances aren’t beneficial for joints or the immune system:

• Incense: inconclusive study results.
• Green-lipped mussel: may help, but product quality varies significantly. It includes large amounts of glucosamine and selenium, which is why it is better to take outright glucosamine + selenium supplements.
• Boron: initial research suggests that a boron deficiency can cause joint problems. This micronutrient has not yet been sufficiently researched.
• Willow Bark: In the single study testing it against a non-steroidal anti-inflammatory drug (NSAID) for osteoarthritis, it wasn’t as effective for pain relief.

The differences between the individual products can be significant. In general you should keep in mind:

• Supplements must include a combination of clinically proven micronutrients and offer these at a dosage similar to the one used in the clinical study.
• Products with a daily recommended consumption of only one or two capsules are not sufficiently dosed to effectively assist joint health. Generally speaking, 3 to 6 capsules are physically required on a daily basis to provide enough amounts of effective nutrients to have a beneficial effect on joint and cartilage.
• For this reason, the more expensive supplements tend to be of higher quality, although this isn’t always the case.
• Good products can be bought online as well as on the high street pharmacy or drug store. You should buy only when ingredients and quantities are clearly stated. This can sometimes be difficult to determine. Products, which did not clearly list all nutrients lost points as a result.

The following clinically-proven micronutrients should be included in a quality joint and cartilage food supplement:

• Glucosamine and Chondroitin: These two substances are considered the “joint supplement classics”. Glucosamine sulphate and chondroitin sulphate are the most effective form of these compounds. Unfortunately, some manufacturers don’t offer adequate dosages in their products. At least 1,200 mg of glucosamine and 400 mg of chondroitin sulphate should be consumed per day. The benefits of these compounds can be complemented and boosted by the following ingredients:
• Omega-3 fatty acids (DHA and EPA) from fish oil. They have an anti-inflammatory effect, promote good cardiovascular health and help reduce bad (LDL) cholesterol levels.
• Pine bark extract has been researched extensively since the mid-1990s and proven effective for its anti-inflammatory and analgesic effects on osteoarthritis and arthritis.
• MSM (methylsulfonylmethane) is an organic sulphur compound. MSM has anti-inflammatory effects and helps to protect against cartilage degradation.
• Amino acids such as methionine and cysteine are good sources of sulfur as well as MSM. Joint experts recommend a diet rich in these amino acids.
• Hyaluronic acid is usually injected directly into the joint, but also recommended by many experts for use as a dietary supplement. Further research studies are desirable to show effective dosage and treatment duration.
• Collagen hydrolysate: Taken as a separate powder and normally dosed at 10 grams per day. Not as well researched as glucosamine and chondroitin, but still recommended.
• Vitamin C is important for immune system. It also helps to protect against cell-damaging free radicals and is involved in the formation of collagen fibres. In the Stone Age humans consumed approximately 4,000 mg vitamin C daily via their diet at the time. Today most adults in the Western world struggle to consume the minimum daily recommended dose of 80 mg per day.
• Vitamin E is a fat soluble antioxidant. Highly-dosed vitamin E is also an anti-inflammatory analgesic. About half of all people in Central Europe are deficient in vitamin E.
• Vitamin D is important for the immune system, calcium metabolism and therefore bone health. A lack of vitamin D is one of the main causes of osteoporosis according to nutritionists. Approximately 90% of people are deficient in this vitamin and supplementation is therefore highly recommended, not just for for arthritis patients.
• Selenium, manganese, copper and zinc are trace elements with an inhibitory effect on inflammation. They protect the cartilage from breakdown and promote beneficial metabolism of connective tissue⁷.

Pain Killers versus Food Supplements?

Should you rather use conventional pain relief or nutritional supplements and natural remedies? It is very important to have a full medical examination and professional diagnosis before determining the correct course of action for any joint problem. Only a fully qualified medical professional will be able to provide a correct diagnosis and determine the most likely causes of pain and joint degradation.

Pain killers can help quickly, cheaply and are almost universally available. However, they do not promote the generation and repair of cartilage, can have detrimental long-term health effects (can lead heart and liver problems) are therefore not appropriate for long-term use. It is thus important to discuss your health with a doctor or pharmacist in order to chose the most appropriate painkiller and dosage.

Dietary supplements and other natural remedies for joints do not have immediate effects. They may need to be taken for weeks, and in some cases months, before the nutritional benefits initially become obvious. Crucially, however, they tend not to have known side effects and for the most part have been proven effective in peer-reviewed, clinical studies in supporting better long-term cartilage health and sometimes even re-generation.

It’s important that if you have a shellfish allergy you do not take glucosamine. Allergies to other substances such as chondroitin and MSM are rare, but should be checked against in individual cases.