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Vital Nutrients Guide

The following information outlines evidence from scientific research on all the nutrients used as ingredients in our products and, as such, is intended only for use by qualified healthcare professionals.

All our ingredients have been linked to specific health benefits in widely recognised, peer-received medical and research studies, details of which are provided. In many cases, our ingredients are authorised by the European Union in their register of food health and nutrition claims.

Our guide below provides the health properties of all the ingredients used in our products, with links to further evidence and studies.  

ActiFlex Joint Care

Alpha Lipoic Acid (ALA)

Alpha Lipoic Acid is naturally present in the human body, as an essential co-factor for energy production, and is also recognised as a potent anti-oxidant and free radical scavenger.

A recent review of Alpha Lipoic Acid’s multiple functions and potential benefits concluded that it is a “potentially highly effective therapeutic agent for many conditions related with oxidative damage”.

Indeed, supplementation with Alpha-Lipoic Acid has demonstrated significant improvements in blood glucose control, lipid profile, and weight loss, according to two recent systematic reviews.

Bioperine (Black Pepper Extract)

Piperine, the active ingredient in Bioperine is commonly used to increase absorption of various nutrients, including Curcumin, as evidenced in extensive clinical studies.

Several additional health benefits are also linked with Piperine, such as insulin resistance and anti-inflammatory benefits, especially in chronic diseases.

Boron

Boron has been proven, as outlined by Integrative Medicine journal, to be an important trace mineral because it is essential for the growth and maintenance of bones, beneficially impacts the body’s use of vitamin D, boosts magnesium absorption, reduces levels of inflammatory biomarkers and raises levels of antioxidant enzymes.

In a 2017 pilot study of 80 patients with Rheumatoid Arthritis (RA), Boron was found to be a useful adjuvant therapy, demonstrating significantly improved clinical scores and reduced anti-inflammatory markers, compared to a placebo.

Boswellia Serrata

According to an article by Versus Arthritis, Boswellia Serrata can prevent the production of inflammatory substances in the joints, with four randomised controlled trials suggesting it might have some beneficial effects in treating patients with osteoarthritis of the knee.

In 2018, a meta-analysis of studies assessing the efficacy of dietary supplements in Osteoarthritis highlighted Boswellia Serrata, as well as Curcumin, as offering large and clinically important benefits, particularly in the short term.

Calcium

Calcium contributes to the maintenance of normal bones, normal muscle function and normal energy-yielding metabolism as recognised by the European Commission.

Osteoporosis is a common complication of Rheumatoid Arthritis (RA), highlighted in a 2016 study, where the prevalence of osteoporosis was significantly higher in patients with RA than healthy controls. The study also found that routine supplementation of calcium and vitamin D decreased the risk of bone mineral density (BMD) loss, and concluded that it should be recommended for all patients with Rheumatoid Arthritis.

Coenzyme Q10

Coenzyme Q10 is a potent anti-oxidant compound naturally present in the body, that can be depleted in certain conditions.

In a 2020 systematic review of CoQ10 supplementation on oxidative stress, CoQ10 was shown to significantly increase key antioxidant enzymes and total anti-oxidant capacity (TAC), as well as reduce MDA, a key marker of oxidative stress.

In Rheumatoid Arthritis (RA) specifically, a randomized controlled trial found that CoQ10 supplementation resulted in significant reductions in pro-inflammatory mediators and markers of oxidative stress.

Copper

Copper is an essential trace element and a transition metal needed as a co-factor for many anti-oxidant enzymes, but also plays a significant role in iron metabolism, anti-oxidant defense, and immunity, to name a few.

According to the European Commission’s authorised claims, Copper supports maintenance of normal connective tissues, contributes to normal energy-yielding metabolism and to normal iron transport in the body.

Curcumin / Turmeric

Curcumin, a naturally occurring polyphenol and active component of the turmeric plant, has been extensively researched and is of particular interest for its anti-oxidant and anti-inflammatory properties. According to a 2017 review of its effects on human health, Curcumin has been found to increase anti-oxidant enzymes and reduce markers of inflammation and oxidative stress, both of which are enhanced in many chronic diseases, including rheumatoid and osteoarthritis.

A 2016 meta-analysis of randomised controlled trials (RCTs) assessing Curcumin efficacy in patients with arthritis, found that curcumin supplementation significantly reduced arthritis-related symptoms, and concluded that the evidence supports the efficacy of Curcumin in the treatment of arthritis. Further, more recentRCTs have since supported these findings.

Read more about Curcumin and Turmeric here

Magnesium

Magnesium contributes to normal muscle function, maintenance of normal bones, a normal energy yielding metabolism and a reduction in tiredness and fatigue, according to the European Commission.

Known to mediate inflammation and pain signalling, magnesium is also involved in Vitamin D metabolism. Without adequate Magnesium, Vitamin D metabolism could be compromised. 

Yet, a recent study found that 68% of men and 44% women with Osteoarthritis of the knee were consuming below the daily estimated average requirements for Magnesium. Researchers found that low magnesium intakes were strongly associated with increased knee pain and function, a correlation which remained significant after adjusting for age, gender, ethnicity, BMI, lifestyle factors and medication.

Read more about Magnesium here

Manganese

Manganese is an essential mineral that functions as a co-factor for several enzymes, including anti-oxidant enzymes. It contributes to a normal energy-yielding metabolism, the maintenance of normal bones, the normal formation of connective tissue and the protection of cells from oxidative stress, as recognised by the European Commission.

Selenium

Selenium is an important mineral and co-factor for essential anti-oxidant enzymes. As such, the European Commission recognises selenium's contribution to the protection of cells from oxidative stress and to the normal functioning of the immune system.

Indeed, a recent systematic review of 13 randomised controlled trials demonstrated that selenium supplementation significantly increased anti-oxidant enzymes and total antioxidant capacity, while reducing markers of oxidative stress.

Read more about Selenium here

Vitamin C

Vitamin C is another critical anti-oxidant with anti-inflammatory and immune supporting functions. It is recognised by the European Commission as supporting normal collagen formation for healthy cartilage function and bones (both vital for health joints).

It also contributes to the reduction of tiredness and fatigue, a normal energy-yielding metabolism and the normal function of the immune system, as per the EU authorised claims register.

Patients with Rheumatoid Arthritis have been found to have reduced blood concentration of Vitamin C and other anti-oxidants, alongside increased markers of oxidative stress, when compared to healthy controls. However, after 12 weeks’supplementation of Vitamin C and other antioxidants, blood concentrations improved significantly with an associated reduction in markers of oxidative stress.

Vitamin D

Vitamin D contributes to normal muscle function, the maintenance of normal bones and the normal function of the immune system, according to the European Commission. 

In fact, Vitamin D has been found to regulate the physiological behaviour of over 36 different cell types in the body. It has been shown to down regulate pro-inflammatory compounds responsible for inflammation, and in Rheumatoid Arthritis in particular, serum Vitamin D is inversely associated with disease activity, according to a recent review article.

Read more about Vitamin D here

Vitamin K2

Vitamin K2 contributes to the maintenance of normal bones, as recognised by the European Commission. 

As reported in Arthritis Digest UK, Vitamin K2 specifically shows promise in the treatment of osteoarthritis. Evidence shows it may be a useful adjunct for the treatment of osteoporosis, along with vitamin D and calcium, rivaling bisphosphonate therapy without toxicity. It may also significantly reduce morbidity and mortality in cardiovascular health. Vitamin K2 appears promising in the areas of diabetes, cancer and osteoarthritis.

Studies suggest, as covered in an Arthritis Foundation article, vitamin K destroys inflammatory cells that contribute to rheumatoid arthritis.

A 2020 meta-analysis of randomised controlled trials looking at the combination of Vitamin K and Vitamin D supplementation on human bone quality, concluded that this combination leads to significantly increased total Bone Mineral Density (BMD) and reduced Osteocalcin levels (which are responsible for the breakdown of bones).

Read more about Vitamin K2 here

Zinc

As an antioxidant, Zinc contributes to the protection of cells from oxidative stress and to the normal functioning of the immune system, according to the European Commission. They also recognise its contributions in the maintenance of normal bones.

In fact, Zinc plays a key role in over 300 enzymes, and as highlighted above, a critical role in regulating the immune system. Yet, a recent systematic review of 62 studies identified a consistent pattern of zinc deficiency in patients with autoimmune conditions, including Rheumatoid Arthritis, when compared to healthy controls.

ActiFlex Gut Health

Aloe Vera

Aloe Vera has been used for over 5000 years by Egyptian, Indian, Chinese and European cultures for a range of ailments. It contains over 70 biologically active components, known for their antioxidant, anti-inflammatory and immune-enhancing properties.

In a randomised, double blind, placebo-controlled trial involving patients with Ulcerative Colitis (an inflammatory bowel condition), Aloe Vera supplementation led to a reduction in disease activity, and clinical improvement (including remission), in significantly more patients compared to a placebo.

Apple Pectin

Apple pectin is a prebiotic fibre that has been shown to selectively stimulate the growth of beneficial bacteria in the gut. In fact, a recent study found that, when compared to Inulin - one of the most widely recognized and researched prebiotic fibres - Apple pectin stimulated a significantly greater diversity of gut bacteria.

Prebiotics are type of fibres that remain intact through the digestive tract and are selectively fermented by gut bacteria, to confer health benefits to the host. Prebiotics have demonstrated wide ranging benefits in gastrointestinal disorders, obesity, cardiovascular disorders, immunity, and the enhanced GI absorption of certain minerals.

Bromelain

Bromelain is a group of enzymes found in the fruit and stem of the pineapple plant. It has attracted growing interest for its well-recognized anti-inflammatory, anti-microbial, analgesic (pain-relieving) and wound healing properties.

A 2020 pilot study investigating Bromelain in combination with Boswellia Serrata, supplemented for 1-6 months, demonstrated significant improvements in quality of life (QoL) in patients with Osteoarthritis. This supports a previous study demonstrating significant improvements in pain, stiffness and physical function after 16-weeks’ Bromelain supplementation, in patients with knee Osteoarthritis.

Chamomile

Chamomile is one of the most ancient medicinal herbs, and contains 120 bioactive compounds, of which 36 flavonoids. It is known for its anti-inflammatory, antispasmodic, and anti-cancer properties, among others.

A recent systematic review of randomized controlled trials also found significant improvements in Generalised Anxiety Disorder and sleep quality during Chamomile supplementation vs. placebo.

Fenugreek

Fenugreek, a well-known plant, commonly used as a condiment or spice, is also known for its diverse range of phytochemicals, including saponins, polyphenols, flavonoids and more. It has been shown to confer anti-inflammatory, anti-oxidant, anti-diabetic, anti-cancer and anti-hyperlipidaemic benefits, according to a recent review.

It also contains galactomannan, a prebiotic fibre shown to enhance the growth of good bacteria, according to a recent study.

Ginger

Ginger has been used for thousands of years for its anti-inflammatory, antioxidant, anti-tumour and anti-ulcer properties. According to a recent systematic review, it has demonstrated significant improvements in pregnancy-related nausea, functional dyspepsia, gastrointestinal motility and gastric emptying, as well as chemotherapy-induced nausea and vomiting.

Ginger also exerts prebiotic potential to increase beneficial bacteria in the gastrointestinal tract (including Bifidobacterium spp and Lactobacillus spp), as demonstrated in a recent study. This makes for a perfect pairing with the Bifidobacteria and Lactobacillus probiotics found in this gut health formulation.

L-Glutamine

Glutamine is the most abundant amino acid in the human body, however, during catabolic conditions, such as sepsis, injury, surgery or intense physical activity, it can become conditionally essential, as its availability is compromised. It plays numerous important roles, including in energy metabolism, immunity, intestinal integrity, and the production of important proteins, antioxidants and neurotransmitters.

In the gastrointestinal tract specifically, glutamine is involved in the maintenance of normal intestinal tissue integrity, normal functioning of tight junctions (which create a protective barrier), down-regulation of inflammatory markers, and modulation of gut bacteria.

Liquorice Root

Liquorice root contains a number of bioactive constituents, including flavonoids, isoflavones and chalones, known for their anti-inflammatory, anti-microbial, anti-tumour and antioxidant capacities.

Liquorice has also been shown to reduce H.Pylori, gastric load and dyspepsia, according to a review of clinical studies using liquorice.

Marshmallow Root

Marshmallow root has been used for centuries to soothe upper-gastrointestinal complaints such as an irritated mouth or throat, dry cough, and mild stomach or gut discomfort. It has been shown to form a protective layer and exert anti-inflammatory and anti-oxidative effects on inflamed mucosa, according to a recent study.

Methylsulfonylmethane (MSM)

MSM is a naturally occurring compound found in a range of foods and drinks, including fruits, vegetables, grains, tea and coffee. It has been shown to modulate the immune response through its anti-inflammatory and antioxidant properties. These properties are also believed to have a protective effect on the gastrointestinal mucosa (lining).

In arthritis specifically, clinical trials have found MSM to be effective in reducing pain, stiffness and swelling. These findings were supported by a recent systematic review, confirming that MSM exerted large and clinically significant effects on the clinical function of arthritis patients, at least in the short term.

Milk Thistle

Milk Thistle has been used for centuries, traditionally for the treatment of liver and biliary tract disorders. More recently, Milk Thistle has also been investigated in several other therapeutic areas, showing significant improvements in blood lipid profile in dyslipideamia, and blood glucose control in diabetes, mediated through its antioxidant and anti-inflammatory properties, according to a recent review.

Silymarin, an active compound of milk thistle, rich in antioxidant flavonoids, has also shown anti-inflammatory activity in patients with knee osteoarthritis, when used alone, or in combination with NSAIDS.

Probiotics

Two recent systematic reviews and meta-analyses have evaluated the benefits of probiotic supplementation in patients with Rheumatoid arthritis, with very promising results: one showing significantly improved RA disease activity scores, the other demonstrating significant improvements in inflammatory markers.

Lactobacillus Acidophilus, Lactobacillus Casei, and Bifidobacteria are some of the most well-recognised and well researched probiotic species. In fact, a randomized placebo-controlled trial (RCT) of patients with Rheumatoid arthritis receiving L. Casei supplementation, showed significant improvements in inflammatory markers and RA symptoms scores after just 8 weeks.

Another two RCTs demonstrated significant improvements in patients with RA receiving a combination of 3 probiotics (Lactobacillus Casei, Bifidobacterium Bifidum, and Lactobacillus Acidophilus) for 8 weeks. The first showed significant improvements in disease activity scores of 28 joints (DAS-28), and CRP (a marker of inflammation), while the other found significant improvements in DAS-28, CRP, pain scores, insulin resistance, and antioxidant Glutathione.

Quercetin

Quercetin is a natural flavonoid, commonly found in fruits and vegetables, also known for its potent anti-inflammatory and antioxidant properties.

A review of its effects on gastrointestinal integrity demonstrated that Quercetin enhances gastrointestinal barrier function, by supporting the assembly and expression of tight junction proteins in the gut, leading to decreased intestinal permeability.

Slippery Elm

Slippery Elm, derived from the bark of the slippery elm tree (Ulmus rubra), has long been used by Native Americans to treat a range of ailments, including fevers, sore throats and wounds (even gunshot wounds). It contains mucilage, which when mixed with water, creates a gel-like substance, believed to be able to coat and protect the gastrointestinal lining.

It has also been found to exhibit prebiotic potential, by modulating the composition of the gut microbiome, and promoting the growth of bacterial strains known to benefit human health; including Bifidobacterium, and Lactobacillus species.

Stinging Nettle

Stinging Nettle extract has been widely used since ancient times to treat various ailments. In fact, Ancient Egyptians used it to treat arthritis and lower back pain. It contains a range of vitamins and phytochemicals known for their antioxidant properties.

A randomized, double blind, placebo controlled trial of a supplement including stinging nettle extract (plus Vitamin E and fish oils) in patients with Osteoarthritis, found a significant reduction in the need for analgesics (pain relief) and NSAIDs after 3 months of treatment. It also reported significant improvements in Osteoarthritis symptoms, including pain, stiffness and function.

Zinc L-Carnosine

Zinc-L-Carnosine is a potent antioxidant that has been shown to protect the gastrointestinal mucosa, restore gastric lining, and improve GI disorders, according to a 2020 review. Indeed, based on their analysis, the authors concluded that “evidence supports the safety and efficacy of ZnC for the maintenance, prevention, and treatment of the mucosal lining and other epithelial tissues.”

Photo by Nithya Ramanujam on Unsplash