Joint Medication: Part 5 - Joint Supplements
On a weekly basis, I am asked which joint supplement I recommend. I have found this extremely difficult - throughout my university and postgraduate studies, there has been minimal focus on supplementation. When I decided that I wanted to write a blog about joint supplements, I wanted to address the following questions:
The science behind the ingredients.
What constitutes a good supplement?
Which red flags to look out for.
This blog is not meant to be an advertisement for one supplement company over another - rather, a tool to help you decide which supplement is suitable for your horse and why. This should be based on the concentration of the ingredients, how they work and the daily maintenance cost.
One of the major difficulties associated with writing this blog has been the lack of equine specific studies. Past literature reviews have considered studies into equine supplements to be of ‘low quality’ (1). Most of the studies about supplements are based on how the ingredients work in people, and there can, of course, be a placebo effect. This means that if you put someone on a specific ingredient, they could say that they are feeling better because they think that they are feeling better, or because of a change in their normal routine. This can subsequently improve discomfort in their joints during the study period, but it could be wrongly attributed to the supplement.
I would be extremely happy to receive any scientific, published studies about specific ingredients found in joint supplements showing improvement in lameness scores. I will update the blog accordingly. My e-mail address is accessible through my website.
A supplement is a feed additive aimed at counteracting environmental stress. The most common components in joint supplements are:
Hyaluronic Acid (HA).
Green Lipped Mussel.
MSM is available naturally though fruit, vegetables and grains and functions as an anti-inflammatory, anti-oxidant and supporting the immune system (2). Supplementation can therefore help with arthritis, cartilage preservation, improving range of motion, decreasing pain (3) and reducing muscle soreness after exercise (2). Interestingly, it may also have some efficacy in improving seasonal allergies within 3 weeks (4).
None of the MSM studies presented were based on how the equine body uses MSM.
This ingredient is generally obtained from crustacean shells. It is critical in formation of glycosaminoglycans like HA. Although the exact way in which it works is unknown, it is thought to protect the cartilage, and stimulate cartilage cells (5). Inconsistent improvements are present in humans receiving glucosamine, and this may be due to the fact that the rate of absorption is different in different people (6).
In an equine study (7), horses that got 30 mg/kg glucosamine twice a day (15,000 mg for a 500 kg horse twice daily [therefore 30 g a day in total]) showed an improved response to joint inflammation compared to horses that did not receive supplementation - keep an eye out for the normal maintenance dose of glucosamine in supplements below.
Chondroitin sulfate is generally obtained from bovine trachea and nasal septum. It is thought to counteract the cartilage inflammatory response (8). Frustratingly, there is a lack of scientific research in actual outcomes of horses supplemented with chondroitin.
In combination, evidence suggests that glucosamine and chondroitin work better together at preventing cartilage breakdown in horses (9). However, this study was performed on pieces of equine cartilage in a lab, and not on a live horse, undergoing the normal stressors of ridden work.
For the third consecutive blog in this series, another route of administration of HA is through supplementation. An average 70 kg human has about 15 g of HA, and 5 g of this is naturally replaced by the body every day (10).
Studies show that daily dosing with 100 mg (11) and 250 mg (12) decreased joint swelling.