Does Supple help arthritis pain? Supple® is a dietary supplement marketed on TV in the infomercial called “Smart Medicine”. As an aside, the infomercial looks a lot like the Larry King Show. The host of the infomercial is Dr Monita Poudyal. The person she interviews is Peter Apatow, CEO of Supple Beverages. The Supple TV commercial looks impressive but does Supple work? Let’s now look at Supple, the claims made during the infomercial and see what can be determined.
Supple is a dietary supplement. Supple is not a prescription or over the counter drug. It’s said that the ingredients in Supple have been used alongside medications in other countries. There is a disclaimer spoken before the infomercial starts. The person speaking the disclaimer sounds very much like Dr Monita Poudyal, who is hosting the infomercial.
During the infomercial, It is stated that supple can help:
- Joint pain
- Back pain
- muscle pain
- weakness and fatigue
- Weight loss
- Carpel tunnel
The active ingredients in Supple are glucosamine HCL and chondroitin sulfate which are found in other supplements to help ease the pain of osteoarthritis (OA). I am not aware of any published peer reviewed studies showing that the active ingredients in Supple help any condition other than osteoarthritis. Also, not all studies show that these ingredients work.
The Supple Company
According to the Supple website, the company is located at 355 Byrd Ave Neenah Wisconsin. The link is a Google street view of the company location. As you can see, the picture appears to be of a parking lot attached to a building. I did not see any building that said “Supple.”
Supple customer service can be reached by calling 1-866-219-6371 from 7 AM — 11 PM CST, Monday — Friday, and from 7 AM — 5 PM on Saturday. According to the Better Business Bureau, Supple LLC is also called Supple Beverages LLC.
The BBB gives Supple Beverages a rating of “A-“ when this review was created. According to the Better Business Bureau, the company Supple LLC was formed in 2001 in Colorado. The BBB file on the company was opened in 2008. See the BBB file on Supple LLC for updates and more information.
According to the Supple website (supplebodies.com) 1 bottle of (300 ml or about 10 oz) has 30 calories. Supple contains the following active ingredients
- Glucosamine HCL 1500 mg
- Chondroitin Sulfate 1200 mg
Supple also contains several vitamins such as vitamin C, D and E as well as niacin, calcium and others. Some of these nutrients may play a role in bone health (mostly vitamin C, D and calcium) but, with the exception of maybe vitamin D, most people in the industrialized world are not deficient in these vitamins or minerals. As such, I dont think they add anything to the effectiveness of Supple for arthritis.
Glucosamine HCL: The Evidence
Some research studies have noted that glucosamine HCL may help reduce the pain associated osteoarthritis (OA). But, when we look at the research we find that there are more studies in support of glucosamine sulfate than for glucosamine HCL.
When I looked at the research, I found over 10 studies noting that glucosamine sulfate appeared to help arthritis pain. The evidence for glucosamine HCL is less convincing with far fewer studies showing it works. Here is a study noting that glucosamine HCL doesn't work.
This does not mean that glucosamine HCL will not help some people. But, it may not be as effective as glucosamine sulfate. Some research even hits that the sulfate in glucosamine sulfate may be responsible for its pain modifying effects.
Since glucosamine HCL does not have sulfate, it might be expected to be less effective.
Here is a study – using pig cells – noting that glucosamine sulfate was better than glucosamine HCL.
Given that most of the well-done peer reviewed research appears to favor glucosamine sulfate, I have often been perplexed that most glucosamine products sold in America contain glucosamine HCL. Just go to your local health food store or supermarket and look at the popular brands sold today and you can see this for yourself.
For those interested, here is glucosamine sulfate on Amazon.
Regardless of which type of glucosamine you use, one thing is clear; glucosamine does not re-grow cartilage. This is a myth.
Glucosamine HCL is also found in Joint Juice too. You've probably seen this product at your local supermarket. Click the link to see my review on that product.
Supple and RA
Does supple help rheumatoid arthritis? In 2007 there was a study published titled, Effects of glucosamine administration on patients with rheumatoid arthritis. In this study, which consisted of 51 people with RA, those who received 1500 mg of glucosamine HCL per day for 12 weeks – along with their arthritis medications – reported that their pain felt better than those who received a placebo.
The way people reported feeling better in this study consisted on rating their pain on a scale from 0-10 or from another test called the Face Scale, where people pointed to pictures of faces that represented different emotions.
Here's the thing. The blood test measurements in the study were confusing in that some inflammation markers such as CRP (C Reactive Protein) did not change in those who took glucosamine, while another marker (called MMP-3) was reduced.
While some might say that a study like this could lend some evidence that glucosamine HCL helps RA, this is just a single study – and more importantly – it doesn't seem to have been replicated. This study was conducted in 2007 so why no follow up studies?
Chondroitin Sulfate: The Evidence
Does chondroitin sulfate help osteoarthritis? The evidence appears to be less solid than for that of glucosamine sulfate. This is most likely due to the lack of well-controlled research. A few studies have noted that chondroitin sulfate may slow down the joint space degeneration that occurs with OA. That is interesting. The problem is that studies do not consistently show that chondroitin works.
There is no published peer reviewed proof that chondroitin sulfate helps gout, fibromyalgia, carple tunnel syndrome or weight loss as is intimated in the Supple infomercial.
It appears that chondroitin sulfate levels are increased in men who have prostate cancer. At this point, nobody is saying that chondroitin sulfate causes prostate cancer however, I feel it would be wise to avoid supplements that contain chondroitin sulfate until more is known. Do ask your doctor about this possible connection.
Chondroitin sulfate doe appear to have blood thinner properties. As such those who take blood thinner medications (Coumadin / warfarin) should use caution. Chondroitin sulfate may make asthma symptoms worse.
Peter Apatow, the CEO of the company that makes Supple states in the Supple infomercial he says that you have to take the combination of glucosamine HCL and chondroitin sulfate to get the maximum benefits. But this is not what the research shows. Studies have not consistently shown that the combination of glucosamine and chondroitin work better.
Supple: Other Ingredients
Supple contains several other ingredients like vitamin C, D and E as well as some B vitamins. None of these nutrients appear to have any significant peer reviewed published evidence to support their use in helping OA pain. Supple does contain a little calcium. Some research finds that calcium may help OA but Supple only contains 8% of the Daily Value for calcium. That’s not a lot. One cup of milk has 30% of the DV for calcium.
What is Rebaudioside A?
At the very bottom of the Supple label of ingredients is Rebaudioside A, This is another name for Stevia, a natural sweetener. Rebaudioside A is a component of stevia but these names are often used interchangeably in the US.
Does Supple Help Weight Loss?
There is no published peer reviewed proof that glucosamine HCL or chondroitin sulfate or their combination help weight loss. In the infomercial, Peter Apatow says he lost 30 pounds by using Supple AND exercising. To his credit, he does not say specifically that Supple will cause weight loss. Rather he states that supple might help by relieving joint pain and allowing people to move more. This does make sense. Supple alone however will not promote weight loss.
The infomercial does mention that supple can be used as a snack. Since a bottle of supple is only 30 calories I can understand how someone would lose weight if they used Supple as a low calorie snack in place of a meal and did not eat as many calories as they normally did. Supple, without changing eating patterns will not cause weight loss.
Who Is Dr Monita Poudyal?
Dr Monita Poudyal is the “host” of the Supple infomercial. She is indeed a physician, and from what I can tell, she specializes in internal medicine and nephrology (kidney disorders) in Colorado.
Dr Poudyl is highly educated and she is the reason why I investigated Supple. Since I know the research behind glucosamine and chondroitin sulfate I was surprised that she would not challenge the fantastic claims about how Supple is supposed to rebuild cartilage as well as help other conditions that research does not support.
At the time the Supple commercial was made Dr. Poudyal was married of Peter Apatow. That fact was not disclosed in the infomercial. According to this article from ConsumerAffairs, they are now divorded.
One meta analysis did find that long term use of glucosamine sulfate (but not glucosamine HCL) might slow down cartilage breakdown but no study has ever shown a reversal of osteoarthritis.
At the start of the infomercial, Dr Poudyal says :
“the standard of care for the treatment of joint pain includes the use of safe, disease-modifying drugs that can naturally reverse the cartilage breakdown that occurs in osteoarthritis.”
Dr Poudyal goes on to say “These agents are not widely available in the u.s.”.
These statements by Dr. Poudyal are not entirely correct. Here's why:
- Glucosamine and chondroitin are not drugs. They are over the counter dietary supplements.
- Neither glucosamine HCL or chondroitin sulfate has been shown to reverse cartilage breakdown. Some research has noted that glucosamine sulfate may slow the progression of osteoarthritis; other research hints that chondroitin sulfate may slow the narrowing of joint space in those with osteoarthritis; So in these respects, they may modify the disease” but they do not “reverse” cartilage breakdown.
- The ingredients in Supple ARE available in the US. Many products contain glucosamine HCL and chondroitin sulfate. Go to your local supermarket and check out the arthritis supplements. You'll see I am right. The majority of glucosamine products sold in supermarkets contain glucosamine HCL. One such is example is Joint Juice which I've reviewed previously.
Supple LLC and The FTC
In 2016 the Federal Trade Commission (FTC) fined the makers of supple $150 million dollars for making false claims about their product. According to Wisconsin Public Radio, the company might only have to pay $285,000 “because of the financial condition of Supple and Aptow.” Here is an FTC press release on Supple dated October 5 2016.
Supple Side Effects?
I'm not aware of any side effects from the Supple drink itself. I believe in generally healthy people, Supple is likely safe. That said, I wanted to mention a few potential side effects of some of the ingredients in Supple in the hopes that people will speak to their doctor for a more in depth discussion.
There is a little evidence that glucosamine might make asthma worse.
Because both glucosamine and chronidrotin appear to have a blood thinner effect, those who take blood thinner drugs should ask their doctor before using these supplements.
Since chondroitin sulfate is often derived from cows, some have wondered if chondroitin sulfate supplements might in theory transmit mad cow disease. This, is probably very unlikely. All well established supplement companies go to great strides to ensure the purity of their products. No supplement has ever been linked cause mad cow disease transmission in the US. To be safe, deal with companies you trust and ask them what countries they get their chondroitin sulfate from and compare that to countries with low levels of mad cow disease.
Because glucosamine contains the sugar glucose, this might be a problem for diabetics. Glucosamine might raise blood sugar levels.
The use of Chondroitin sulfate by men is controversial because of some evidence that it may be linked to prostate cancer. For more information on this see my review of chrondroitin sulfate and prostate cancer.
Does Supple Work?
It’s possible that Supple might in some people who have mild osteoarthritis. My question is will it work better than other, cheaper products? Supple is pretty expensive. On the product website a 24 day supply cost $47.95 Plus 14.95 shipping and handling (by the way, I think that's a LOT for shipping and handling).
There is also an autoship” program where they send it to you automatically every 30 days. I’m not sure if you can opt out of this or not. Double check to make sure if you decide to order Supple.
Here is Supple on Amazon for those who want to compare prices and avoid the autoship program.
What do you think?