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Cosamin DS

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What is Cosamin DS?
Cosamin DS is a unique and patented nutritional supplement that contains high grade glucosamine HCI (500mg), chondroitin sulfate (400mg) and manganese ascorbate (5mg). When given together in correct proportions, these compounds work together to support the structure and function of articular cartilage.

What is articular cartilage and why is it important?
Articular cartilage is a firm, resilient, slippery tissue that covers the ends of bones in the joints. Cartilage is important because it lubricates the surface of joints and also acts as a "shock absorber". When the cartilage becomes abnormal, the joint does not function well. Understanding the structure and function of cartilage can help you understand how to optimize joint function.

How does the structure of joint cartilage contribute to joint function?
Cartilage is made up of 2 parts: cells, and material that surrounds the cells, called the matrix. Some tissues, like the liver, heart or kidney are mostly cells, but cartilage has relatively few cells and a very abundant matrix. In fact, the matrix makes up 95% of cartilage volume. The matrix can also be divided into 2 parts, both of which are made by the cartilage cells: a protein called collagen, and carbohydrate molecules called glycosaminoglycans or GAGs for short. Collagen is a rope-like protein that gives cartilage its tensile strength. The GAGs are responsible for the matrix being slippery and resilient. Normally, the cartilage cells make enough collagen and GAGs to keep up with the losses that occur during daily wear and tear.

What happens when the cartilage matrix breaks down?
If the amounts and quality of collagen and GAGs in the matrix change, the strength, slipperiness and resiliency of cartilage are affected. Changes in the matrix may be due to a decrease in matrix production or an increase in destruction, but the net result is that the cartilage can no longer act to lubricate the joint or absorb shock as well as it did before. Because the matrix is not working as well, cells in the cartilage and in other joint tissues may be damaged by the forces that result from using the joint. Scientists are still not sure exactly what starts matrix breakdown, but several factors can contribute, including overuse of the joint, poor diet, genetics and the aging process.

What can be done to support matrix structure and function?
Scientists have studied compounds that may be able to re-establish the balance between matrix production and matrix destruction. These compounds have been termed "structure modifying agents". Their purpose is to normalize the matrix by increasing the production of GAGs and/or slowing the rate of matrix destruction. Some structure modifying agents are given by injection, and others are available in oral form. A recent study using Cosamin has shown a structure modifying effect.'

What is glucosamine?
Glucosamine is a small molecule that is normally made in the body by cartilage cells. In the cartilage, glucosamine acts as a building block for GAGs*. Supplementing the diet with glucosamine is beneficial because it also stimulates cartilage cells and production of GAGs in articular cartilage*.

Is there a preferred form of glucosamine?
In order for the body to optimally absorb glucosamine, the compound must be in the form of a salt, that is, it must be bound to another molecule. Forms of glucosamine that have been studied include glucosamine hydrochloride (GluHCI) and glucosamine sulfate (GluSO4). Studies have confirmed that both forms of glu-cosamine are absorbable, but these two forms are not the same. In fact, you get more glucosamine from GluHCI than you would from the same milligram amount of GluSO4, because HCI is a smaller molecule than SO4. GluSO4 products available on the US market might contain sodium chloride or potassium chloride, which further dilutes the glucosamine on a weight basis. GluSO4 and GluHCl are not interchangeable. You would need to take more GluSO4 than GluHCI to get the same amount of pure glucosamine, and this may increase the risk of annoying side effects such as intestinal gas.

What is chondroitin sulfate?
Like glucosamine, chondroitin sulfate (CS) also occurs naturally in the body. It is a large molecule that is made in a series of reactions by the cartilage cells. Chondroitin sulfate is normally the most abundant GAG in the cartilage matrix, and it is responsible for binding with collagen so that cartilage can be strong, slippery and flexible. Supplementing the diet with chondroitin sulfate is beneficial because it helps to block the action of destructive enzymes in the joint*.

Are all chondroitin sulfates and glucosamines the same?
No. The purity and grade of these compounds can vary widely, depending on how they are manufactured.


Why is it important to use glucosamine and CS together?
The GluHCI and CS in Cosamin work together in a synergistic way to support joint cartilage*. Taking the two compounds together is better than taking either alone, because they have different but complementary mechanisms of action. Glucosamine helps the body stimulate cartilage, while chondroitin sulfate decreases cartilage breakdown*.

Have there been any clinical trials using CosaminDS in the US?
CosaminDS is the only patented glucosamine/chondroitin product supported by controlled U.S. clinical studies. Since there is no generic equivalent to CosaminDS these studies may not be applied to other products. Two clinical studies have recently been completed. The first is a controlled human clinical, trial which showed improvement in patients and was presented at the 1999 American Academy of Orthopedic Surgeons Conference in Anaheim/The second human clinical trial was performed by the Department of Defense and was published in Military Medicine.s There is currently a 350 patient controlled study underway by David Hungerford, MD at Johns Hopkins School of Medicine. In addition to these clinical trials, there are many published animal studies documenting functional effects as well as structural effects on cartilage.

Why, are "similar" products sometimes available at less cost?
Other products may try to mimic CosaminDS but do not measure up. Since the high-grade raw material used in CosaminDS is available exclusively to Nutramax Laboratories, CosaminDS has unique quality, and there is no generic equivalent. Because it is manufactured in a state of the art facility, CosaminDS has high purity and uniformity. Additionally, CosaminDS is the only patented glu-cosamine/chondroitin sulfate product that has been used in US human and animal trials. In fact, a recent continuing education course for physicians recommends that they use the "brand name used in clinical trials.

Is CosaminDS safe?
Yes. CosaminDS has an excellent safety record, with no demonstrable toxicity and minimal incidence of mild, dose-dependent, reversible side effects such as intestinal gas. There are no known interactions with any drug or nutritional supplement, and no known contraindications.

Does CosaminDS interact with coumadin?
Carefully designed animal studies have determined that CosaminDS has no clinical effect on blood clotting. There is no indication that CosaminDS has any interaction with coumadin or any other drug. However, many factors can influence blood clotting. We recommend that all individuals taking coumadin have their clotting times evaluated frequently when starting to use a nutritional supplement or a drug.

I am on a Iow salt diet. Can I take CosaminDS?
Yes. Physicians often recommend a sodium-restricted diet to people with high blood pressure or heart disease. For example, each capsule of CosaminDS contains 27 mg of sodium. At three capsules per day, this is a total of 81 mg of sodium, which represents only a small percentage of the total daily-accepted amount of sodium in a sodium-restricted diet (2000 mg per day).

I am a diabetic. Can I take CosaminDS?
Yes. Although glucosamine and chondroitin sulfate are biochemi-cally 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. However, many factors can affect insulin secretion and blood glucose levels in diabetic patients, and we recommend that these individuals check their blood glucose levels frequently when initiating CosaminDS or any other new element into their regimen.

Can CosaminDS be taken during pregnancy?
No studies have been done in humans that specifically address this question, so the use of CosaminDS during pregnancy should be an individual decision made by the patient after consultation with a physician.

I am allergic to sulfa drugs. Can I take CosaminDS?
There is no cross-reactivity between sulfa drugs and CosaminDS. Sulfa drugs are characterized by having a particular molecular structure and people who are allergic to sulfa drugs are probably reacting to this characteristic molecular structure. The compounds in CosaminDS do not have similar molecular structures. 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.

I am allergic to shellfish, such as crab and shrimp. Can I still take CosaminDS?
Yes. People who are allergic to shellfish are actually reacting to proteins that are present in the shellfish, but not in other foods. Glucosamine is extracted from chitin that makes up the shells of crabs and similar shellfish. Some glucosamine products may also contain impurities, like proteins, which could cause allergic reactions. However, the glucosamine in CosaminDS is 99% pure. Because it contains no iodine, no shellfish protein, and no heavy metals, CosaminDS is extremely unlikely to cause an allergic reaction

During the initial 60 day period: Adults weighing under 200 lbs. should take three (3) capsules daily (2 in the AM. 1 in the PM). Individuals weighing over 200 lbs. should take two (2) capsules twice a day. For children, consult your licensed health care professional. After 60 days, the number of capsules taken can be gradually decreased to a level that maintains the individual. The number of capsules may be increased at any time.

WARNING:This information is provided for health care professionals only.
This publication and the product contained herein have not been approved or evaluated by the Food and Drug Administration.
This publication, and the product contained herein are not intended to diagnose, treat, cure or prevent any disease.
The product relates to nutritional support only.The product relates to nutritional support only.