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VISTA^® Advanced Carotenoid Formula

Formulated to optimize antioxidant levels in the macula, providing protection from oxidative stress and optimizing visual performance*

Carotenoids: Lutein, Meso-zeaxanthin and Zeaxanthin are known as macular pigments. These pigments are uniquely located in the center area of the retina called the macula.^5,6 The macula is responsible for processing our crisp, clear high-definition vision used for reading, driving and to see colors. It requires more oxygen to function than any other tissue in the body¹, therefore extremely susceptible to oxidative stress and damage.

Carotenoids are potent antioxidants to help protect our vision throughout life. In addition to their antioxidation capability, carotenoids are dichroic filters that selectively allow green, yellow and red wavelengths to pass through them while reflecting blue light. This function not only reduces photooxidative stress but also plays an important role in optimizing our vision.⁷ For example enriching macular pigment results in a reduction in glare disability, improved contrast sensitivity, faster critical flicker fusion and a reduction in photostress recovery times.^{7, 8}

Algae Oil: Rich in high quality omega-3 fatty acid called Docosahexaenoic Acid (DHA). The retina has a high concentration of omega-3’s, particularly DHA, which optimizes fluidity of photoreceptor membranes, retinal integrity, and visual function. Furthermore, many studies demonstrated that DHA has a protective, for example antiapoptotic, role in the retina.²

Bilberry: Contains anthocyanins which are plant-based polyphenols that have shown potent antioxidant and anti-inflammatory activities. Antioxidants play an important role in the prevention and treatment of age-related ophthalmic diseases; whose pathogeneses involve oxidative stress and inflammation.³

Astaxanthin: A powerful antioxidant, astaxanthin has been found to increase blood flow around the eye.⁹

Vitamin E: Mixed blend of delta and gamma isomers. Vitamin E is a strong antioxidant that provides protection and support to many of our organs. In the eye, Vitamin E helps protect it from UV light.⁴

References:

1. Mahabadi, N., Khalili, Y. A., Neuroanatomy, Retina; NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.
2. Querques, G., et. al., Retina and Omega-3, Journal of Nutrition and Metabolism Volume 2011, Article ID 748361, 12 pages doi:10.1155/2011/748361
3. Bungau S., et. al., Health Benefits of Polyphenols and Carotenoids in Age-Related Eye Diseases; Oxidative Medicine and Cellular Longevity Volume 2019, Article ID 9783429, 22 pages https://doi.org/10.1155/2019/9783429
4. Schilling R., Health Benefits of Vitamin E Tocotrienols; Review of Dr Barrie Tan’s presentation at the 26^th Anti-Aging Conference of the American Academy of Anti-Aging Medicine in Las Vegas (Dec 13-15, 2018)
5. Snodderly et. al., The Macular Pigment II Spatial Distribution in Primate Retina’s; Investigative Ophthalmology and Vision Science, 1984 Vol 25
6. Landrum, J., Bone, R., Mini Review: Lutein, Zeaxanthin and the Macular Pigment; Archives of Biochemistry and Biophysics, 385, No. 1, January 1, pp. 28–40, 2001
7. Stringham, J., et. al., Macular Carotenoid Supplementation Improves Visual Performance, Sleep Quality, and Adverse Physical Symptoms in Those with High Screen Time Exposure; Foods 2017. 6, 47; doc10.3390/foods6070047
8. Stringham, J., Garcia, P., et. al., Macular Pigment and Visual Performance in Glare: Benefits for Photostress Recovery, Disability Glare, and Visual Discomfort; IOVS September 2011, Vol. 52, No. 10
9. Nagaki Y., et. al., The Effect of Astaxanthin on Retinal Capillary, Blood Flow in Normal Volunteers; Journal of Clinical Therapeutics and Medicines Vol. 21, No. 5 (May) 2005

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VISTA^® Advanced AREDS2 Formula

Formulated to promote age-related eye health*

This formulation is designed to reduce risk of progression from intermediate stage dry age-related macular degeneration to the advanced wet stage of the disease as shown in the results of the NIH funded AREDS studies. ¹

Zinc: Known as the “Essential Toxin”,² Zinc plays a critical role in our health including supporting our immune system and promoting wound healing among other benefits.² The NIH recommends a daily intake of 11mg for adult men and 8mg per day for adult women. The AREDS & AREDS2 studies both used 80mg of zinc per day to see if it had any impact on reducing the progression to advanced age-related macular degeneration.  In the AREDS2 study, two cohorts, one receiving 80mg of zinc and the other receiving 25mg of zinc showed no clinically significant difference in disease progression.³

VISTA^® Advanced AREDS2 is formulated with a safer level, 25mg of zinc which is lower than the 40mg per day maximum allowance as defined by the NIH. The AREDS2 study showed patients receiving 80mg per day doses of zinc for an average of 6.3 years had significant increases in hospitalizations for genitourinary causes, raising the possibility that chronically high intakes of zinc adversely affect some aspects of urinary physiology.³

Selenium: An essential trace mineral selenium is necessary for proper thyroid and immune system functioning. In the eye, Selenium promotes Vitamin E absorption and has been shown to slow the progression of eye symptoms related to Graves’ Disease⁴, an autoimmune condition affecting the thyroid. In diabetics, selenium may play a vital role in the prevention of diabetic retinopathy.⁵

L-Glutathione: An enzyme that helps protect the eye against chemical and oxidative stress. In the lens and cornea, Glutathione contributes to the transparent and refractive properties which are essential for image formation on the retina.⁶ In the cornea glutathione plays a role in maintaining normal hydration levels, and, in protecting corneal integrity.⁶

References:

1. Chew E.Y, et.al. Secondary Analyses of the Effects of Lutein/Zeaxanthin on Age-Related Macular Degeneration Progression AREDS2 Report No. 3; JAMA Ophthalmology Published online December 5, 2013
2. Plum et.al., The Essential Toxin: The Impact of Zinc on Human Health; Int. J. Environ. Res. Public Health 2010, 7, 1342-1365; doi:10.3390/ijerph7041342
3. National Institute of Health (NIH) Zinc Health Professionals Fact Sheet; Updated July 15, 2020 https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/
4. Zheng et.al., Effects of Selenium Supplementation on Graves’ Disease: A Systematic Review and Meta-Analysis, Evidence-Based Complementary and Alternative Medicine Volume 2018, Article ID 3763565
5. Gonzalez de Vega et.al. Protective effect of selenium supplementation following oxidative stress mediated by glucose on the retinal pigment epithelium, https://pubmed.ncbi.nlm.nih.gov/29119175/
6. Ganea, E., Harding, J., Glutathione – related enzymes and the eye, Current Eye research 2006 Jan;31(1): 1-11

AREDS and AREDS2 are registered trademarks of The U.S. Department of Health and Human Services (HHS). Jun 16, 2016

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VISTA^® Advanced Dry Eye Formula

Formulated to promote moist, healthy tears*

GLA & Omega-3: Omega-3 and 6 fatty acids play an integral role in the body’s ability to regulate and balance inflammation.

Supplementation with gamma-linolenic acid (GLA) and omega-3 (n-3) polyunsaturated fatty acids (PUFAs) has been found to decrease the production of disease-relevant inflammatory mediators that are implicated in the pathogenesis of chronic dry eye.¹

Hyaluronic Acid: Found naturally in our cells, Hyaluronic Acid plays a key role in the repair and healing of the corneal epithelium.²

Lactoferrin: Found naturally in our tears, it has anti-inflammatory effects and promotes cell growth. Patients with chronic dry eyes have low levels of lactoferrin in their tear film which accounts for the typical redness and soreness experienced by those with dry eye syndrome.³

Astaxanthin: A powerful antioxidant, astaxanthin has been found to increase blood flow around the eye.⁴

Eyebright: An Herb used in traditional herbal medicine for centuries, particularly for minor eye ailments like redness and irritation.⁵

References:

1. Sheppard JD Jr, Singh R, McClellan AJ, et al. Long-term Supplementation With n-6 and n-3 PUFAs Improves Moderate-to-Severe Keratoconjunctivitis Sicca: A Randomized Double-Blind Clinical Trial. Cornea. 2013;32(10):1297-1304. doi:10.1097/ICO.0b013e318299549c
2. Carlson E., et. al., Impact of Hyaluronic Acid-Containing Artificial Tear Products on Reepithelialization in an In Vivo Corneal Wound Model; JOURNAL OF OCULAR PHARMACOLOGY AND THERAPEUTICS Volume 34, Number 4, 2018, DOI: 10.1089/jop.2017.0080
3. Devendra J., Singh S. Effect of Oral Lactoferrin on Cataract Surgery Induced Dry Eye: A Randomized Controlled Trial, Journal of Clinical and Diagnostic Research, October, 2015.
4. Nagaki Y., et. al., The Effect of Astaxanthin on Retinal Capillary, Blood Flow in Normal Volunteers; Journal of Clinical Therapeutics and Medicines Vol. 21, No. 5 (May) 2005
5. https://www.healthline.com/nutrition/eyebright

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VISTA^® Advanced Active Osteo Formula

For bone growth and strengthening*

VISTA^® Advanced Active Osteo Formula promotes strong, flexible bones with a powerful blend of nutrients designed to help maintain an active lifestyle. The unique formula is comprised of six vital nutrients for bone health:

Microcrystalline Hydroxyapatite (MCHA): Microcrystalline hydroxyapatite concentrate (MCHC) is derived from whole bone. It provides much greater nourishment than calcium alone. MCHA contains calcium, magnesium and phosphorus in the form of hydroxyapatite, as well as collagenous and non-collagenous bone proteins.

Calcium: 500 mg of elemental calcium from 2,000 mg of microcrystalline hydroxyapatite (MCHC), a bioavailable source of calcium derived from whole bone. Calcium is necessary for building strong bones and helping muscles contract.* The body cannot produce its own calcium. That’s why it’s important to get enough calcium through the food we eat or through supplementation. When the body doesn’t get the amount of calcium it needs, it’s taken from the bones. This is fine occasionally, but if it happens too often, bones get weak and easier to break. Low calcium levels can lead to various bone conditions.^D* The U.S. National Library of Medicine recognizes calcium as effective for supporting bone loss. The MCHA Thickness Study showed that women who received 1,000 mg of calcium from MCHA along with Vitamin D had a significant increase in bone thickness.^E*

Vitamin D3: a vitamin that the body needs in order to absorb calcium and protect strong bones.* Bioactive calcium hydroxyapatite works synergistically to enhance bone mineralization.^F*

Strontium: Studies indicate that supplementing with strontium may help reduce bone pain, increase bone mineral density, and reduce the risk of some fractures.^A*

Silica: Silicon improves bone matrix quality and facilitates bone mineralization. Increased intake of bioavailable silicon has been associated with increased bone mineral density.^B*

Magnesium: a mineral your body uses to make protein and build strong bones.* The National Institutes of Health recognizes that people with a higher intake of magnesium have stronger bone mineral density—important for reducing risk of fractures.

Vitamin K1: Vitamin K is critical for bone formation. It helps maintain bone mass.^C*

References:

1.  
   1. El-Hajj Fuleihan G. Strontium ranelate—a novel therapy for osteoporosis or a permutation of the same? N Engl J Med 2004;350:504-6 [Editorial].
   2. Ferrari S, Zolezzi C, Savarino L, et al. The oral strontium load test in the assessment of intestinal calcium absorption. Minerva Med 1993;84:527-31.
   3. McCaslin FE, Janes JM. The effect of strontium lactate in the treatment of osteoporosis. Proc Staff Meetings Mayo Clinic 1959;34(13):329-34.
   4. Meunier PJ, Roux C, Seeman E, et al. The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 2004;350:459- 68.
   5. Gaby AR. Preventing and Reversing Osteoporosis. Rocklin, CA: Prima Publishing, 1994, 88-9 [review].
   6. Skoryna SC. Effects of oral supplementation with stable strontium. Can Med Assoc J 1981;125:703-12.
   7. Reginster JY, Deroisy R, Dougados M, et al. Prevention of early postmenopausal bone loss by strontium ranelate: the randomized, two-year, double- masked, dose-ranging, placebo-controlled PREVOS trial. Osteoporos Int 2002;13:925-31.
2.  
   1. Silicon: A Review of Its Potential Role in the Prevention and Treatment of Postmenopausal Osteoporosis, Charles T. Price,* Kenneth J. Koval, and Joshua R. Langford. Int J Endocrinol. 2013; 2013: 316783
3.  
   1. Hart JP. Circulating vitamin K1 levels in fractured neck of femur. Lancet 1984;2:283 [letter].
   2. 2. Ttani M, Morimoto S, Nakajima M, et al. Decreased circulating levels of vitamin K and 25-hydroxyvitamin D in osteopenic elderly men. Metabolism 1998;47:195-9.
   3. Feskanich D, Weber P, Willett WC, et al. Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr 1999;69:74-9.
   4. Booth SL, Tucker KL, Chen H, et al. Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women. Am J Clin Nutr 2000;71:1201-8.
   5. Knapen MHJ, Hamulyak K, Vermeer C. The effect of vitamin K supplementation on circulating osteocalcin (Bone Gla protein) and urinary calcium excretion. Ann Intern Med 1989;111:1001-5.
   6. Orimo H, Shiraki M, Fujita T, et al. Clinical evaluation of Menatetrenone in the treatment of involutional osteoporosis—a double-blind multicenter comparative study with 1-alpha- hydroxyvitamin D3. J Bone Mineral Res 1992;7(Suppl 1):S122.
   7. Iwamoto I, Kosha S, Noguchi S, et al. A longitudinal study of the effect of vitamin K2 on bone mineral density in postmenopausal women a comparative study with vitamin D3 and estrogen-progestin therapy. Maturitas 1999;31:161-4.
   8. Shiraki M, Shiraki Y, Aoki C, Miura M. Vitamin K2 (menatetrenone) effectively prevents fractures and sustains lumbar bone mineral density in osteoporosis. J Bone Miner Res 2000;15:515-21.
   9. Ronn SH, Harslof T, Pedersen SB, Langdahl BL. Vitamin K2 (menaquinone-7) prevents age-related deterioration of trabecular bone microarchitecture at the tibia in postmenopausal women. Eur J Endocrinol 2016;175:541–9.
   10. Knapen MHJ, Drummen NE, Smit E, et al. Three-year low-dose menaquinone-7 supplementation helps decrease bone loss in healthy postmenopausal women. Osteoporos Int 2013;24:2499–507.
4.  
   1. Reid IR, Ames RW, Evans MC, et al. Long-term effects of calcium supplementation on bone loss and fractures in postmenopausal women: a randomized controlled trial. Am J Med 1995;98:331-5.
   2. Hosking DJ, Ross PD, Thompson DE, et al. Evidence that increased calcium intake does not prevent early postmenopausal bone loss. Clin Ther 1998;20:933- 44.
   3. Owusu W, Willett WC, Feskanich D, et al. Calcium intake and the incidence of forearm and hip fractures among men. J Nutr 1997;127:1782-7.
   4. Rulm LA, Sakhaee K, Peterson R, et al. The effect of calcium citrate on bone density in the early and mid-postmenopausal period: a randomized, placebo- controlled study. Am J Ther 1999;6:303-11.
   5. Nieves JW, Komar L, Cosman F, Lindsay R. Calcium potentiates the effect of estrogen and calcitonin on bone mass: review and analysis. Am J Clin Nutr 1998;67:18-24.
   6. Bonjour JP, Carrie AL, Ferrari S, et al. Calcium-enriched foods and bone mass growth in prepubertal girls: a randomized, double-blind, placebo-controlled trial. J Clin Invest 1997;99:1287-94.
   7. Welten DC, Kemper HCG, Post GB, van Stavberen WA. A meta-analysis of the effect of calcium intake on bone mass in young and middle aged females and males. J Nutr 1995;125:2802-13 [review].
   8. Heaney RP, Nordin BEC. Calcium effects on phosphorus absorption: implications for the prevention and co-therapy of osteoporosis.J Am Coll Nutr 2002;21:239-44. 9. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.
5.  
   1. Microcrystalline hydroxyapatite compound in prevention of bone loss in corticosteroid-treated patients with chronic active hepatitis. A. Stellon, A. Davies, A. Webb, and R. Williams Postgrad Med J. 1985 Sep; 61(719): 791–796
   2. Briancon D, Meunier PJ. Treatment of osteoporosis with fluoride, calcium, and vitamin D. Orthop Clin North Am. 1981 Jul;12(3):629–648. [PubMed] [Google Scholar]
   3. Dent CE, Davies IJ. Calcium metabolism in bone disease: effects of treatment with microcrystalline calcium hydroxyapatite compound and dihydrotachysterol. J R Soc Med. 1980 Nov;73(11):780–785. [PMC free article] [PubMed] [Google Scholar]
   4. Epstein O, Kato Y, Dick R, Sherlock S. Vitamin D, hydroxyapatite, and calcium gluconate in treatment of cortical bone thinning in postmenopausal women with primary biliary cirrhosis. Am J Clin Nutr. 1982 Sep;36(3):426–430. [PubMed] [Google Scholar]
   5. Kato Y, Epstein O, Dick R, Sherlock S. Radiological patterns of cortical bone modelling in women with chronic liver disease. Clin Radiol. 1982 May 3;33(3):313–317. [PubMed] [Google Scholar]
   6. Nillson BE, Westlin NE. The bone mineral content in the forearm of women with colles’ fracture. Acta Orthop Scand. 1974;45(6):836–844. [PubMed] [Google Scholar]
   7. Pines A, Raafat H, Lynn AH, Whittington J. Clinical trial of microcrystalline hydroxyapatite compound (‘Ossopan’) in the prevention of osteoporosis due to corticosteroid therapy. Curr Med Res Opin. 1984;8(10):734–742. [PubMed] [Google Scholar]
   8. Vedi S, Compston JE, Webb A, Tighe JR. Histomorphometric analysis of bone biopsies from the iliac crest of normal British subjects. Metab Bone Dis Relat Res. 1982;4(4):231–236. [PubMed] [Google Scholar]
   9. Wootton R, Reeve J. The relative merits of various techniques for measuring radiocalcium absorption. Clin Sci (Lond) 1980 Apr;58(4):287–293. [PubMed] [Google Scholar]
6.  
   • Supplementing with vitamin D3 daily or weekly can help reduce symptoms of diabetic neuropathy.
     1. Senyigit A. The association between 25-hydroxy vitamin D deficiency and diabetic complications in patients with type 2 diabetes mellitus. Diabetes Metab Syndr 2019;13:1381–6.
     2. Zhang B, Zhao W, Tu J, et al. The relationship between serum 25-hydroxyvitamin D concentration and type 2 diabetic peripheral neuropathy: A systematic review and a meta- analysis. Medicine (Baltimore) 2019;98:e18118.
     3. Yammine K, Hayek F, Assi C. Is there an association between vitamin D and diabetic foot disease? A meta-analysis. Wound Repair Regen 2020;28:90–6.
     4. Shehab D, Al-Jarallah K, Abdella N, et al. Prospective evaluation of the effect of short-term oral vitamin d supplementation on peripheral neuropathy in type 2 diabetes mellitus. Med Princ Pract 2015;24:250–6.
     5. Alam U, Fawwad A, Shaheen F, et al. Improvement in Neuropathy Specific Quality of Life in Patients with Diabetes after Vitamin D Supplementation. J Diabetes Res 2017;2017:7928083.
     6. Yammine K, Wehbe R, Assi C. A systematic review on the efficacy of vitamin D supplementation on diabetic peripheral neuropathy. Clin Nutr 2020.
     7. Grim J, Ticha A, Hyspler R, et al. Selected Risk Nutritional Factors for Chemotherapy-Induced Polyneuropathy. Nutrients 2017;9.
     8. Wang J, Udd K, Vidisheva A, et al. Low serum vitamin D occurs commonly among multiple myeloma patients treated with bortezomib and/or thalidomide and is associated with severe neuropathy. Support Care Cancer 2016;24:3105–10.
   • Vitamin D increases calcium absorption and helps make bones stronger. Vitamin D supplementation has reduced bone loss in women who don’t get enough of the vitamin from food and slowed bone loss in people with osteoporosis and in postmenopausal women. It also works with calcium to prevent some musculoskeletal causes of falls and subsequent fractures.
     1. Brot C, Jorgensen N, Madsen OR, et al. Relationships between bone mineral density, serum vitamin D metabolites and calcium: phosphorus intake in healthy perimenopausal women. J Intern Med 1999;245:509-16.
     2. Sahota O. Osteoporosis and the role of vitamin D and calcium-vitamin D deficiency, vitamin D insufficiency and vitamin D sufficiency. Age Ageing 2000;29:301-4.
     3. Dawson-Hughes B, Dallal GE, Krall EA, et al. Effect of vitamin D supplementation on wintertime and overall bone loss in healthy postmenopausal women. Ann Intern Med 1991;115:505-12.
     4. Adams JS, Kantorovich V, Wu C, et al. Resolution of vitamin D insufficiency in osteopenic patients results in rapid recovery of bone mineral density. J Clin Endocrinol Metab 1999;84:2729-30.
     5. Macdonald HM, Wood AD, Aucott LS, et al. Hip bone loss is attenuated with 1000 IU but not 400 IU daily vitamin D3: a 1-year double-blind RCT in postmenopausal women. J Bone Miner Res 2013;28:2202–13.
     6. Nordin BE, Baker MR, Horsman A, Peacock M. A prospective trial of the effect of vitamin D supplementation on metacarpal bone loss in elderly women. Am J Clin Nutr 1985;42(3):470-4.
     7. Lips P, Graafmans WC, Ooms ME, et al. Vitamin D supplementation and fracture incidence in elderly persons. Ann Intern Med 1996;124:400-6.
     8. Komulainen M, Tuppurainen MT, Kroger H, et al. Vitamin D and HRT: no benefit additional to that of HRT alone in prevention of bone loss in early postmenopausal women. A 2.5- year randomized placebo-controlled study. Osteoporosis Int 1997;7:126-32.
     9. Droisy R, Collette J, Chevallier T, et al. Effects of two 1-year calcium and vitamin D3 treatments on bone remodeling markers and femoral bone density in elderly women. Curr Ther Res 1998;59:850-62.
     10. Chapuy MC, Arlot ME, Duboeuf F, et al. Vitamin D3 and calcium to prevent hip fractures in the elderly women. N Engl J Med 1992;327:1637-42.
     11. Maki BE, Holliday PJ, Topper AK. A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population. J Gerontol 1994;49:M72-84.
     12. Leboff MS, Hawkes WG, Glowacki J, et al. Vitamin D-deficiency and post-fracture changes in lower extremity function and falls in women with hip fractures. Osteoporos Int 2008;19:1283-90.
     13. Pfeifer M, Begerow B, Minne HW, et al. Effects of a short-term vitamin D and calcium supplementation on body sway and secondary hyperparathyroidism in elderly women. J Bone Miner Res 2000;15:1113-8.
     14. Broe KE, Chen TC, Weinberg J, et al. A higher dose of vitamin D reduces the risk of falls in nursing home residents: a randomized, multiple-dose study. J Am Geriatr Soc 2007;55:234-9.
     15. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.

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VISTA^® Advanced Joint Collagen Formula

For cartilage regrowth and joint mobility*

VISTA^® Advanced Joint Collagen Formula is a potent blend of scientifically researched ingredients in one daily capsule. Each capsule packs a powerful punch, including the following:

UC-II® Type II Collagen 40 mg: Clinically tested UC-II® contains undenatured type II collagen that is proven to be more than twice as effective as glucosamine + chondroitin.¹ UC-II® contains undenatured type II collagen that helps the body rebuild joint cartilage and improve joint comfort*.^G*

CherryPURE™ Tart Cherry Concentrate 390 mg: CherryPURE™ is the first product of its kind to be standardized to such high levels of anthocyanins, polyphenols, flavonoids and natural melatonin. It helps reduce occasional pain and inflammation.^H*

Boswellia: Boswellia, Biblical frankincense, is an ancient botanical herb that’s long been used in Ayurvedic medicine. It promotes a healthy inflammation response.^I*

Quercetin: Quercetin is a flavonoid naturally occurring in fruits and vegetables. It provides natural support of healthy histamine and inflammation.^J*

Optim-C® Buffered Vitamin C: Optim-C® is buffered, long-lasting Vitamin C with Alpha Lipoic Acid.^K*

References:

1. Collagen
   • Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial
     1. Crowley DC, Lau FC, Sharma P, et al. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int J Med Sci. 2009;6(6):312- 321. Published 2009 Oct 9. doi:10.7150/ijms.6.312
     2. Crowley, David C et al. “Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial.” International journal of medical sciences vol. 6,6 312-21. 9 Oct. 2009, doi:10.7150/ijms.6.312
     3. Crowley, D. C., Lau, F. C., Sharma, P., Evans, M., Guthrie, N., Bagchi, M., Bagchi, D., Dey, D. K., & Raychaudhuri, S. P. (2009). Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. International journal of medical sciences, 6(6), 312–321. https://doi.org/10.7150/ijms.6.312
     4. Crowley DC, Lau FC, Sharma P, Evans M, Guthrie N, Bagchi M, Bagchi D, Dey DK, Raychaudhuri SP. Safety and efficacy of undenatured type II collagen in the treatment of osteoarthritis of the knee: a clinical trial. Int J Med Sci. 2009 Oct 9;6(6):312-21. doi: 10.7150/ijms.6.312. PMID: 19847319; PMCID: PMC2764342.
   • Role of Collagen Derivatives in Osteoarthritis and Cartilage Repair: A Systematic Scoping Review With Evidence Mapping
     1. Honvo G, Lengelé L, Charles A, Reginster JY, Bruyère O. Role of Collagen Derivatives in Osteoarthritis and Cartilage Repair: A Systematic Scoping Review With Evidence Mapping. Rheumatol Ther. 2020;7(4):703-740. doi:10.1007/s40744-020-00240-5
     2. Honvo, Germain et al. “Role of Collagen Derivatives in Osteoarthritis and Cartilage Repair: A Systematic Scoping Review With Evidence Mapping.” Rheumatology and therapy vol. 7,4 (2020): 703-740. doi:10.1007/s40744-020-00240-5
     3. Honvo, G., Lengelé, L., Charles, A., Reginster, J. Y., & Bruyère, O. (2020). Role of Collagen Derivatives in Osteoarthritis and Cartilage Repair: A Systematic Scoping Review With Evidence Mapping. Rheumatology and therapy, 7(4), 703–740. https://doi.org/10.1007/s40744-020-00240-5
     4. Honvo G, Lengelé L, Charles A, Reginster JY, Bruyère O. Role of Collagen Derivatives in Osteoarthritis and Cartilage Repair: A Systematic Scoping Review With Evidence Mapping. Rheumatol Ther. 2020 Dec;7(4):703-740. doi: 10.1007/s40744-020-00240-5. Epub 2020 Oct 17. PMID: 33068290; PMCID: PMC7695755.
   • Alternative and complementary therapies in osteoarthritis and cartilage repair
     1. Fuggle NR, Cooper C, Oreffo ROC, et al. Alternative and complementary therapies in osteoarthritis and cartilage repair. Aging Clin Exp Res. 2020;32(4):547-560. doi:10.1007/s40520-020-01515-1
     2. Fuggle, N R et al. “Alternative and complementary therapies in osteoarthritis and cartilage repair.” Aging clinical and experimental research vol. 32,4 (2020): 547-560. doi:10.1007/s40520-020-01515-1
     3. Fuggle, N. R., Cooper, C., Oreffo, R., Price, A. J., Kaux, J. F., Maheu, E., Cutolo, M., Honvo, G., Conaghan, P. G., Berenbaum, F., Branco, J., Brandi, M. L., Cortet, B., Veronese, N., Kurth, A. A., Matijevic, R., Roth, R., Pelletier, J. P., Martel-Pelletier, J., Vlaskovska, M., ... Reginster, J. Y. (2020). Alternative and complementary therapies in osteoarthritis and cartilage repair. Aging clinical and experimental research, 32(4), 547–560. https://doi.org/10.1007/s40520-020-01515-1
     4. Fuggle NR, Cooper C, Oreffo ROC, Price AJ, Kaux JF, Maheu E, Cutolo M, Honvo G, Conaghan PG, Berenbaum F, Branco J, Brandi ML, Cortet B, Veronese N, Kurth AA, Matijevic R, Roth R, Pelletier JP, Martel-Pelletier J, Vlaskovska M, Thomas T, Lems WF, Al-Daghri N, Bruyère O, Rizzoli R, Kanis JA, Reginster JY. Alternative and complementary therapies in osteoarthritis and cartilage repair. Aging Clin Exp Res. 2020 Apr;32(4):547-560. doi: 10.1007/s40520-020-01515-1. Epub 2020 Mar 13. PMID: 32170710; PMCID: PMC7170824.
   • Effects of Native Type II Collagen Treatment on Knee Osteoarthritis: A Randomized Controlled Trial
     1. Bakilan F, Armagan O, Ozgen M, Tascioglu F, Bolluk O, Alatas O. Effects of Native Type II Collagen Treatment on Knee Osteoarthritis: A Randomized Controlled Trial. Eurasian J Med. 2016;48(2):95-101. doi:10.5152/eurasianjmed.2015.15030
     2. Bakilan, Fulya et al. “Effects of Native Type II Collagen Treatment on Knee Osteoarthritis: A Randomized Controlled Trial.” The Eurasian journal of medicine vol. 48,2 (2016): 95-101. doi:10.5152/eurasianjmed.2015.15030
     3. Bakilan, F., Armagan, O., Ozgen, M., Tascioglu, F., Bolluk, O., & Alatas, O. (2016). Effects of Native Type II Collagen Treatment on Knee Osteoarthritis: A Randomized Controlled Trial. The Eurasian journal of medicine, 48(2), 95–101. https://doi.org/10.5152/eurasianjmed.2015.15030
     4. Bakilan F, Armagan O, Ozgen M, Tascioglu F, Bolluk O, Alatas O. Effects of Native Type II Collagen Treatment on Knee Osteoarthritis: A Randomized Controlled Trial. Eurasian J Med. 2016 Jun;48(2):95-101. doi: 10.5152/eurasianjmed.2015.15030. PMID: 27551171; PMCID: PMC4970562.
2. Tart cherry
   • In a preliminary trial, people with osteoarthritis who took tart cherry extract for three months reported reduced joint tenderness and less joint pain and disability.
     1. Allen M, Silver B. Cherries. J Agricultural Food Information 2010;11:275-281.
     2. Vaughan JG, Geissler C. The new Oxford book of food plants. New York: Oxford University Press, 2009, p. 74.
     3. Allen M, Silver B. Cherries. J Agricultural Food Information 2010;11:275-81.
     4. Vaughan JG, Geissler C. The new Oxford book of food plants. New York: Oxford University Press, 2009, p. 74.
     5. Khoo GM, Clausen MR, Pedersen BH, Larsen E. Bioactivity and total phenolic content of 34 sour cherry cultivars. J Food Composition & Analysis 2011; 24: 772-6.
     6. Traustadóttir T, Davies SS, Stock AA, et al. Tart cherry juice decreases oxidative stress in healthy older men and women. J Nutr 2009;139:1896-900.
     7. Seymour EM, Lewis SK, Urcuyo-Llanes DE, et al. Regular tart cherry intake alters abdominal adiposity, adipose gene transcription, and inflammation in obesity-prone rats fed a high fat diet. J Med Food 2009;12:935-42.
     8. Sarić A, Sobocanec S, Balog T, et al. Improved antioxidant and anti-inflammatory potential in mice consuming sour cherry juice (Prunus Cerasus cv. Maraska). Plant Foods Hum Nutr 2009;64:231-7.
     9. Khoo GM, Clausen MR, Pedersen BH, Larsen E. Bioactivity and total phenolic content of 34 sour cherry cultivars. J Food Composition & Analysis 2011; 24: 772-776.
     10. Traustadóttir T, Davies SS, Stock AA, et al. Tart cherry juice decreases oxidative stress in healthy older men and women. J Nutr 2009;139:1896-900.
     11. Seymour EM, Lewis SK, Urcuyo-Llanes DE, et al. Regular tart cherry intake alters abdominal adiposity, adipose gene transcription, and inflammation in obesity-prone rats fed a high fat diet. J Med Food 2009;12:935-42.
     12. Sarić A, Sobocanec S, Balog T, et al. Improved antioxidant and anti-inflammatory potential in mice consuming sour cherry juice (Prunus Cerasus cv. Maraska). Plant Foods Hum Nutr 2009;64:231-7.
     13. Blando F, Gerardi C, Nicoletti I. Sour cherry (Prunus cerasus L) anthocyanins as ingredients for functional foods. J Biomed Biotechnol 2004;5:253-258.
     14. Ballmer-Weber BK, Scheurer S, Fritsche P, et al. Component-resolved diagnosis with recombinant allergens in patients with cherry allergy. J Allergy Clin Immunol 2002;110:167-73.
   • Anthocyanins in tart cherry may support faster muscle recovery in athletes.
     1. Ducharme NG, Fortier LA, Kraus MS, et al. Effect of a tart cherry juice blend on exercise-induced muscle damage in horses. Am J Vet Res 2009;70:758-63.
     2. Connolly DA, McHugh MP, Padilla-Zakour OI, et al. Efficacy of a tart cherry juice blend in preventing the symptoms of muscle damage. Br J Sports Med 2006;40:679-83.
     3. Bowtell JL, Sumners DP, Dyer A, et al. Montmorency cherry juice reduces muscle damage caused by intensive strength exercise. Med Sci Sports Exerc 2011;43:1544-51.
     4. Howatson G, McHugh MP, Hill JA, et al. Influence of tart cherry juice on indices of recovery following marathon running. Scand J Med Sci Sports 2010;20:843-52.
     5. Bowtell JL, Sumners DP, Dyer A, et al. Montmorency cherry juice reduces muscle damage caused by intensive strength exercise. Med Sci Sports Exerc 2011;43:1544-51.
   • Some studies indicate that supplementing with tart cherry may support muscle strength recovery and reduce pain, especially after exercise.
     1. Ducharme NG, Fortier LA, Kraus MS, et al. Effect of a tart cherry juice blend on exercise-induced muscle damage in horses. Am J Vet Res 2009;70:758-63.
     2. Connolly DA, McHugh MP, Padilla-Zakour OI, et al. Efficacy of a tart cherry juice blend in preventing the symptoms of muscle damage. Br J Sports Med 2006;40:679-83.
     3. Bowtell JL, Sumners DP, Dyer A, et al. Montmorency cherry juice reduces muscle damage caused by intensive strength exercise. Med Sci Sports Exerc 2011;43:1544-51.
     4. Howatson G, McHugh MP, Hill JA, et al. Influence of tart cherry juice on indices of recovery following marathon running. Scand J Med Sci Sports 2010;20:843-52.
     5. Bowtell JL, Sumners DP, Dyer A, et al. Montmorency cherry juice reduces muscle damage caused by intensive strength exercise. Med Sci Sports Exerc 2011;43:1544-51.
3. Boswellia
   • Boswellia, an herb used in Ayurvedic medicine to treat arthritis, has reduced rheumatoid arthritis symptoms in most reports.
     1. Etzel R. Special extract of Boswellia serrata (H15) in the treatment of rheumatoid arthritis. Phytomed 1996;3:91-4.
     2. Singh GB, Singh S, Bani S. New phytotherapeutic agent for the treatment of arthritis and allied disorders with novel mode of action. 4th International Congress on Phytotherapy, Munich, Germany, Sep 10-3, 1992.
     3. Chopra A, Lavin P, Patwardhan B, Chitre D. Randomized double blind trial of an Ayurvedic plant derived formulation for treatment of rheumatoid arthritis. J Rheumatol 2000;27:1365-72.
     4. Sander O, Herborn G, Rau R. Is H15 (resin extract of Boswellia serrata, “incense”) a useful supplement to established drug therapy of chronic polyarthritis? Results of a double-blind pilot study. Z Rheumatol 1998;57:11-6 [in German].
     5. Srivastava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypoth 1992;39:342-8.
     6. Chopra A, Lavin P, Patwardhan B, Chitre D. Randomized double blind trial of an Ayurvedic plant derived formulation for treatment of rheumatoid arthritis. J Rheumatol 2000;27:1365-72.
4. Quercetin
   • In one study, quercetin lowered the incidence of upper respiratory tract infections in athletes following intensive exercise.
     1. Nieman DC, Henson DA, Gross SJ, et al. Quercetin reduces illness but not immune perturbations after intensive exercise. Med Sci Sports Exerc 2007;39:1561-9.
     2. Therapeutic Potential of Quercetin: New Insights and Perspectives for Human Health. Bahare Salehi, Laura Machin, Lianet Monzote, Javad Sharifi-Rad, Shahira M. Ezzat, Mohamed A. Salem, Rana M. Merghany, Nihal M. El Mahdy, Ceyda Sibel Kılıç, Oksana Sytar, Mehdi Sharifi-Rad, Farukh Sharopov, Natália Martins, Miquel Martorell, and William C. Cho. ACS Omega 2020 5 (20), 11849-11872. DOI: 10.1021/acsomega.0c01818K.
5. Vitamin C and Alpha Lipoic Acid
   • Antioxidants, including vitamin C, neutralize exercise-related free radicals before they can damage the body, so antioxidants may aid in exercise recovery. Especially in cases of vitamin C deficiency, supplementing with the vitamin may improve exercise performance.
     1. Kanter M. Free radicals, exercise and antioxidant supplementation. Proc Nutr Soc 1998;57:9-13 [review].
     2. Dekkers JC, Van Doornen LJ, Kemper HC. The role of antioxidant vitamins and enzymes in the prevention of exercise-induced muscle damage. Sports Med 1996;21(3):213-38 [review].
     3. Jakeman P, Maxwell S. Effect of antioxidant vitamin supplementation on muscle function after eccentric exercise. Eur J Appl Physiol 1993;67:426-30.
     4. Kaminski M, Boal R. An effect of ascorbic acid on delayed-onset muscle soreness. Pain 1992;50:317-21.
     5. Thompson D, Williams C, McGregor SJ, et al. Prolonged vitamin C supplementation and recovery from demanding exercise. Int J Sport Nutr Exerc Metab 2001;11:466-81.
     6. Thompson D, Williams C, Garcia-Roves P, et al. Post-exercise vitamin C supplementation and recovery from demanding exercise. Eur J Appl Physiol 2003;89:393-400.
     7. Itoh H, Ohkuwa T, Yamazaki Y, et al. Vitamin E supplementation attenuates leakage of enzymes following 6 successive days of running training. Int J Sports Med 2000;21:369-74.
     8. McBride JM, Kraemer WJ, Triplett-McBride T, Sebastianelli W. Effect of resistance exercise on free radical production. Med Sci Sports Exerc 1998;30:67-72.
     9. Evans WJ. Vitamin E, vitamin C, and exercise. Am J Clin Nutr 2000;72:647S-52S [review].
     10. Dawson B, Henry GJ, Goodman C, et al. Effect of Vitamin C and E supplementation on biochemical and ultrastructural indices of muscle damage after a 21 km run. Int J Sports Med 2002;23:10-5.
     11. Beaton LJ, Allan DA, Tarnopolsky MA, et al. Contraction-induced muscle damage is unaffected by vitamin E supplementation. Med Sci Sports Exerc 2002;34:798-805.
     12. Petersen EW, Ostrowski K, Ibfelt T, et al. Effect of vitamin supplementation on cytokine response and on muscle damage after strenuous exercise. Am J Physiol Cell Physiol 2001;280:C1570-5.
     13. Kanter MM, Nolte LA, Holloszy JO. Effects of an antioxidant vitamin mixture on lipid peroxidation at rest and postexercise. J Appl Physiol 1993;74:965-9.
     14. Kaikkonen J, Kosonen L, Nyyssonen K, et al. Effect of combined coenzyme Q10 and d-alpha-tocopheryl acetate supplementation on exercise-induced lipid peroxidation and muscular damage: a placebo-controlled double-blind study in marathon runners. Free Radic Res 1998;29:85-92.
     15. Singh A, Failla ML, Deuster PA. Exercise-induced changes in immune function: effects of zinc supplementation. J Appl Physiol 1994;76:2298-303.
     16. Johnston CS, Swan PD, Corte C. Substrate utilization and work efficiency during submaximal exercise in vitamin C depleted-repleted adults. Int J Vitam Nutr Res 1999;69:41-4.
     17. Gerster H. The role of vitamin C in athletic performance. J Am Coll Nutr 1989;8:636-43 [review].
     18. Paschalis V, Theodorou AA, Kyparos A, et al. Low vitamin C values are linked with decreased physical performance and increased oxidative stress: reversal by vitamin C supplementation. Eur J Nutr 2016;55:45–53.
     19. Tiidus PM, Houston ME. Vitamin E status and response to exercise training. Sports Med 1995;20:12-23 [review].
     20. Akova B, Surmen-Gur E, Gur H, et al. Exercise-induced oxidative stress and muscle performance in healthy women: role of vitamin E supplementation and endogenous oestradiol. Eur J Appl Physiol 2001;84:141-7.
     21. Simon-Schnass I, Pabst H. Influence of vitamin E on physical performance. Int J Vitam Nutr Res 1988;58:49-54.
     22. Shepard RJ. Vitamin E and athletic performance. J Sports Med 1983;23:461-70 [review].
   • Vitamin C supports immune function and is a critical nutrient for wound healing. Supplementing with it may decrease the risk of excessive bleeding in the surgical setting.
     1. Dowd PS, Kelleher J, Walker BE, Guillou PJ. Nutrition and cellular immunity in hospital patients. Br J Nutr 1986;55:515-27.
     2. Stotts NA, Whitney JD. Nutritional intake and status of clients in the home with open surgical wounds. J Community Health Nurs 1990;7:77-86.
     3. Thomas DR. Specific nutritional factors in wound healing. Adv Wound Care 1997;10:40-3 [review].
     4. Wendt MD, Soparkar CN, Louie K, et al. Ascorbate stimulates type I and type III collagen in human Tenon’s fibroblasts. J Glaucoma 1997;6:402-7.
     5. Vaxman F, Olender S, Lambert A, et al. Effect of pantothenic acid and ascorbic acid supplementation on human skin wound healing process. A double-blind, prospective and randomized trial. Eur Surg Res 1995;27:158-66.
     6. Vaxman F, Olender S, Lambert A, et al. Can the wound healing process be improved by vitamin supplementation? Experimental study on humans. Eur Surg Res 1996;28:306-14.
     7. Blee TH, Cogbill TH, Lambert PJ. Hemorrhage associated with vitamin C deficiency in surgical patients. Surgery 2002;131:408-12.
   • Vitamin C is needed to make collagen, the “glue” that strengthens connective tissue. Vitamin C supplementation can speed healing of various types of trauma.
     1. Kanter M. Free radicals, exercise and antioxidant supplementation. Proc Nutr Soc 1998;57:9-13 [review].
     2. Jakeman P, Maxwell S. Effect of antioxidant vitamin supplementation on muscle function after eccentric exercise. Eur J Appl Physiol 1993;67:426-30.
     3. Kaminski M, Boal R. An effect of ascorbic acid on delayed-onset muscle soreness. Pain 1992;50:317-21.
     4. McBride JM, Kraemer WJ, Triplett-McBride T, Sebastianelli W. Effect of resistance exercise on free radical production. Med Sci Sports Exerc 1998;30:67-72.
     5. Rokitzki L, Logemann E, Huber G, et al. alpha-Tocopherol supplementation in racing cyclists during extreme endurance training. Int J Sport Nutr 1994;4:253-64.
     6. Meydani M, Evans WJ, Handelman, et al. Protective effect of vitamin E on exercise-induced oxidative damage in young and older adults. Am J Physiol 1993;264(5 pt 2):R992-8.
     7. Tiidus PM, Houston ME. Vitamin E status and response to exercise training. Sports Med 1995;20:12-23 [review].
     8. Kaikkonen J, Kosonen L, Nyyssonen K, et al. Effect of combined coenzyme Q10 and d-alpha-tocopheryl acetate supplementation on exercise-induced lipid peroxidation and muscular damage: a placebo-controlled double-blind study in marathon runners. Free Radic Res 1998;29:85-92.
     9. Levine M. New concepts in the biology and biochemistry of ascorbic acid. N Engl J Med 1986;314:892-902 [review].
     10. Mazzotta MY. Nutrition and wound healing. J Am Podiatr Med Assoc 1994;84:456-62 [review].
     11. Mazzotta MY. Nutrition and wound healing. J Am Podiatr Med Assoc 1994;84:456-62 [review].
     12. Ringsdorf WM Jr, Cheraskin E. Vitamin C and human wound healing. Oral Surg Oral Med Oral Pathol 1982;53:231-6 [review].
     13. Gey GO, Cooper KH, Bottenberg RA. Effect of ascorbic acid on endurance performance and athletic injury. JAMA 1970;211:105.
   • A preliminary report suggested that vitamin C helped many people avoid surgery for their disc-related low back pain.
     1. Greenwood J. Optimum vitamin C intake as a factor in the preservation of disc integrity. Med Ann District of Columbia 1964;33:274-6.
   • Alpha-lipoic acid may reduce symptoms of diabetic peripheral neuropathy and may work best in combination with medical treatment for neuropathy. Its possible benefit in chemotherapy-induced neuropathy needs further investigation.
     1. Papazafeiropoulou A, Xourgia E, Papantoniou S, et al. Effect of 3-month alpha-lipoic acid treatment on sural nerve conduction velocity and amplitude in patients with diabetic neuropathy: a pilot study. Arch Med Sci Atheroscler Dis 2019;4:e141–3.
     2. Agathos E, Tentolouris A, Eleftheriadou I, et al. Effect of alpha-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy. J Int Med Res 2018;46:1779-90.
     3. Zhao M, Chen J, Chu Y, et al. Efficacy of epalrestat plus alpha-lipoic acid combination therapy versus monotherapy in patients with diabetic peripheral neuropathy: a meta-analysis of 20 randomized controlled trials. Neural Regen Res 2018;13:1087–95.
     4. Wang X, Lin H, Xu S, et al. Alpha lipoic acid combined with epalrestat: a therapeutic option for patients with diabetic peripheral neuropathy. Drug Des Devel Ther 2018;12:2827– 40.
     5. Wang X, Lin H, Xu S, Lu Y. Lipoic Acid Combined with Epalrestat versus Lipoic Acid in Treating Diabetic Peripheral Neuropathy:A Meta-analysis. Zhongguo Yi Xue Ke Xue Yuan Xue Bao 2017;39:656–64.
     6. Guo Y, Jones D, Palmer J, et al. Oral alpha-lipoic acid to prevent chemotherapy-induced peripheral neuropathy: a randomized, double-blind, placebo-controlled trial. Support Care Cancer 2014;22:1223–31.
     7. Maschio M, Zarabla A, Maialetti A, et al. The Effect of Docosahexaenoic Acid and alpha-Lipoic Acid as Prevention of Bortezomib-Related Neurotoxicity in Patients with Multiple Myeloma. Integr Cancer Ther 2019:1534735419888584.

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VISTA^® Advanced Turmeric 46 Formula

A natural anti-inflammatory*

VISTA^® Advanced Turmeric 46 Formula contains Curcuwin®, a unique form of curcumin that uses a proprietary process clinically proven to absorb 46X more effectively than standard curcumin extract. This increased absorption makes the curcuminoids more bioavailable and longer lasting for enhanced health benefits.*

Health Benefits of Turmeric: Turmeric is a spice common in Indian cuisine and traditionally used in Ayurvedic medicine for its health benefits. It contains natural chemical compounds called curcuminoids, one of which is curcumin. This powerful antioxidant compound has been shown to support joint, heart, brain, and cellular wellness, by promoting a healthy inflammatory response.^L*

Superior Bioavailability: Many forms of turmeric are poorly absorbed in the body. For that reason, VISTA^® Advanced Turmeric 46 Formula contains CurcuWIN®, a water soluble curcumin extract. Curcuwin® uses a proprietary delivery system that has been clinically shown to increase the absorption and retention of curcuminoids in the body.^M*

References:

1. Turmeric
   • In a double-blind trial, supplementation with curcuminoids significantly improved pain and overall functioning in people with osteoarthritis of the knee.
     1. Panahi Y, Rahimnia AR, Sharafi M, et al. Curcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial. Phytother Res 2014;28:1625–31.
   • Turmeric’s active constituent, curcumin, is a potent anti-inflammatory compound that protects the body against free radical damage.
     1. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: A double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5.
     2. Deodhar SD, Sethi R, Srimal RC. Preliminary studies on antirheumatic activity of curcumin (diferuloyl methane). Ind J Med Res 1980;71:632-4.
     3. Srivastava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypoth 1992;39:342-8.
     4. Chopra A, Lavin P, Patwardhan B, Chitre D. Randomized double blind trial of an Ayurvedic plant derived formulation for treatment of rheumatoid arthritis. J Rheumatol 2000;27:1365-72.
   • Turmeric’s active compound curcumin has shown potent anti-platelet activity in preliminary studies.
     1. Srivastava R, Dikshit M, Srimal RC, Dhawan BN. Anti-thrombotic effect of curcumin. Thromb Res 1985;40:413-7.
     2. Srivastava KC, Bordia A, Verma SK. Curcumin, a major component of food spice turmeric (Curcuma longa) inhibits aggregation and alters eicosanoid metabolism in human blood platelets. Prost Leuk Essen Fat Acids. 1995;52:223-7.
     3. Pulliero G, Montin S, et al. Ex vivo study of the inhibitory effects of Vaccinium myrtillus (bilberry) anthocyanosides on human platelet aggregation. Fitoterapia 1989;60:69-75.
     4. Liu J. Effect of Paeonia obovata 801 on metabolism of thromboxane B2 and arachidonic acid and on platelet aggregation in patients with coronary heart disease and cerebral thrombosis. Chin Med J 1983;63:477-81 [in Chinese].
   • Turmeric is an herb known traditionally for its anti-inflammatory effects, a possible advantage for people suffering from low back pain.
     1. Satoskar RR, Shah SJ, Shenoy SG. Evaluation of antiinflammatory property of curcumin (diferuloyl methane) in patients with postoperative inflammation. Int J Clin Pharmacol Ther Toxicol 1986;24:651-4.
     2. Ghatak N, Basu N. Sodium curcuminate as an effective anti-inflammatory agent. Indian J Exp Biol 1972;10:235-6.
     3. Chandra D, Gupta SS. Anti-inflammatory and anti-arthritic activity of volatile oil of curcuma longa (Haldi). Indian J Med Res 1972;60:138-42.
     4. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: A double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5.
   • Turmeric has anti-inflammatory effects. One trial found curcumin (from turmeric) was more effective than anti-inflammatory medication for relieving postsurgical inflammation.
     1. Norred CL, Zamudio S, Palmer SK. Use of complementary and alternative medicines by surgical patients. AANA J 2000;68:13-8.
     2. Murphy JM. Preoperative considerations with herbal medicines. AORN J 1999;69:173-5, 177-8, 180-3.
     3. Robb-Nicholson C. By the way, doctor. My surgeon advised me to stop taking gingko biloba before my hip surgery. Can you explain why? Are there any other herbs I should avoid? Harv Womens Health Watch 2000;7:8.
     4. Arora RB, Basu N, Kapoor V, Jain AP. Anti-inflammatory studies on Curcuma longa (turmeric). Indian J Med Res 1971;59:1289-95.
     5. Satoskar RR, Shah SJ, Shenoy SG. Evaluation of antiinflammatory property of curcumin (diferuloyl methane) in patients with postoperative inflammation. Int J Clin Pharmacol Ther Toxicol 1986;24:651-4.
2. Curcuwin®
   • Curcuwin CLINICAL TRIALS https://info.davincilabs.com/curcuwin-ingredient-guide
     1. CurcuWIN® FloMeD Study on Endothelial Function, 2016:
        A randomized, double- blind,acebo-controlled investigation of endothelial function involving 59 healthy adults was performed over a period of 8 weeks. A significant increase in endothelial base-lines, measured by FMD (flow-mediated dilation) were seen over those on the placebo.* The higher curcuminoid supplementation produced a dose-mediated improvement in endothelial function – a 37-percent increase measured by FMD. Evidence from this study also points to a potential decreased risk of CVD in those who regularly consume curcuminoids.
     2. CurcuWIN® And the Attenuation of Performance Decrements:
        A randomized, double-blind, cebo-controlled investigation involving 64 healthy men and women aged 19-29 who were given either a placebo, 250 mg, or 1000 mg of CurcuWIN®and tested by the Exercise Physiology Laboratory within the Kinesiology Department at Texas Christain University over eight weeks. Results showed that eight weeks of high-dosage curcumin supplementation might attenuate performance decrements following intense anaerobic exercise.* Significant decreases in peak extension torque values within 24 hours after athletic activities were seen in those on 1000 mg doses.*
     3. CurcuWIN® and Comparative Absorption of Curcumin Formulas:
        A randomized, double-blind, crossover study with healthy human volunteers tested the relative absorption of standard curcumin and three microencapsulated branded formulas. The study concluded that CurcuWIN® increased relative absorption of total curcuminoids 46-times over standard, unformulated curcumin, and significantly higher than other top formulated versions. The appearance of curcuminoids in the blood was significantly higher than branded curcumin, whereas the other branded formula was only 1.3-fold higher than the unformulated curcumin. Human clinical trial showed CurcuWIN increased serum curcuminoid levels 46 times over standard curcumin. OmniActive Health Technologies | Jan 27, 2014. https://www.newhope.com/ingredients/study-shows-omniactives-curcuwin-more-bioavailable

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VISTA^® Advanced Max Relief AM Formula

For peripheral neuropathy*

VISTA^® Advanced Max Relief AM Formula is a cutting edge, non-prescription dietary supplement designed for nerve system support. The formula provides key nutrients to improve blood flow and aid in nerve repair. These essential nutrients help the body heal naturally instead of masking discomfort.

BioFolate® (L-Methylfolate calcium) is an active form of folate that allows the body to stimulate blood flow and help address the symptoms of nerve damage such as occasional pain, numbness, and uncomfortable tingling.^N*

Vitamin B-6 and Vitamin B-12 (methylcobalamin) are useful in treating neuropathy since they support healthy nervous system function.^O*

CurcuWIN® Turmeric is a unique form of curcumin that uses a proprietary process clinically proven to absorb 46X more effectively than standard curcumin extract. This powerful antioxidant compound has been shown to support joint, heart, brain, and cellular wellness, by promoting a healthy inflammatory response.^L,M*

DL-phenylalanine is an amino acid that may reduce occasional pain by decreasing the enzyme that breaks down endorphins.^P*

Alpha Lipoic Acid is an important nutrient for mitochondrial function with antioxidant properties. It helps improve numbness and occasional pain by supporting the nerve system. Alpha-lipoic acid is also an antioxidant that may help maintain blood sugar levels already in normal range, improve nerve function, and relieve uncomfortable symptoms in the legs and arms.^Q*

References:

1. Turmeric
   • Curcumin Could Prevent the Development of Chronic Neuropathic Pain in Rats with Peripheral Nerve Injury. https://www.sciencedirect.com/science/article/pii/S0011393X12000999?via%3Dihub
   • In a double-blind trial, supplementation with curcuminoids significantly improved pain and overall functioning in people with osteoarthritis of the knee.
     1. Panahi Y, Rahimnia AR, Sharafi M, et al. Curcuminoid treatment for knee osteoarthritis: a randomized double-blind placebo-controlled trial. Phytother Res 2014;28:1625–31.
   • Turmeric’s active constituent, curcumin, is a potent anti-inflammatory compound that protects the body against free radical damage.
     1. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: A double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5.
     2. Deodhar SD, Sethi R, Srimal RC. Preliminary studies on antirheumatic activity of curcumin (diferuloyl methane). Ind J Med Res 1980;71:632-4.
     3. Srivastava KC, Mustafa T. Ginger (Zingiber officinale) in rheumatism and musculoskeletal disorders. Med Hypoth 1992;39:342-8.
     4. Chopra A, Lavin P, Patwardhan B, Chitre D. Randomized double blind trial of an Ayurvedic plant derived formulation for treatment of rheumatoid arthritis. J Rheumatol 2000;27:1365-72.
   • Turmeric’s active compound curcumin has shown potent anti-platelet activity in preliminary studies.
     1. Srivastava R, Dikshit M, Srimal RC, Dhawan BN. Anti-thrombotic effect of curcumin. Thromb Res 1985;40:413-7.
     2. Srivastava KC, Bordia A, Verma SK. Curcumin, a major component of food spice turmeric (Curcuma longa) inhibits aggregation and alters eicosanoid metabolism in human blood platelets. Prost Leuk Essen Fat Acids. 1995;52:223-7.
     3. Pulliero G, Montin S, et al. Ex vivo study of the inhibitory effects of Vaccinium myrtillus (bilberry) anthocyanosides on human platelet aggregation. Fitoterapia 1989;60:69-75.
     4. Liu J. Effect of Paeonia obovata 801 on metabolism of thromboxane B2 and arachidonic acid and on platelet aggregation in patients with coronary heart disease and cerebral thrombosis. Chin Med J 1983;63:477-81 [in Chinese].
   • Turmeric is an herb known traditionally for its anti-inflammatory effects, a possible advantage for people suffering from low back pain.
     1. Satoskar RR, Shah SJ, Shenoy SG. Evaluation of antiinflammatory property of curcumin (diferuloyl methane) in patients with postoperative inflammation. Int J Clin Pharmacol Ther Toxicol 1986;24:651-4.
     2. Ghatak N, Basu N. Sodium curcuminate as an effective anti-inflammatory agent. Indian J Exp Biol 1972;10:235-6.
     3. Chandra D, Gupta SS. Anti-inflammatory and anti-arthritic activity of volatile oil of curcuma longa (Haldi). Indian J Med Res 1972;60:138-42.
     4. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: A double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5.
   • Turmeric has anti-inflammatory effects. One trial found curcumin (from turmeric) was more effective than anti-inflammatory medication for relieving postsurgical inflammation.
     1. Norred CL, Zamudio S, Palmer SK. Use of complementary and alternative medicines by surgical patients. AANA J 2000;68:13-8.
     2. Murphy JM. Preoperative considerations with herbal medicines. AORN J 1999;69:173-5, 177-8, 180-3.
     3. Robb-Nicholson C. By the way, doctor. My surgeon advised me to stop taking gingko biloba before my hip surgery. Can you explain why? Are there any other herbs I should avoid? Harv Womens Health Watch 2000;7:8.
     4. Arora RB, Basu N, Kapoor V, Jain AP. Anti-inflammatory studies on Curcuma longa (turmeric). Indian J Med Res 1971;59:1289-95.
     5. Satoskar RR, Shah SJ, Shenoy SG. Evaluation of antiinflammatory property of curcumin (diferuloyl methane) in patients with postoperative inflammation. Int J Clin Pharmacol Ther Toxicol 1986;24:651-4.
2. Curcuwin CLINICAL TRIALS https://info.davincilabs.com/curcuwin-ingredient-guide
   1. CurcuWIN® FloMeD Study on Endothelial Function, 2016:
      A randomized, double- blind, placebo-controlled investigation of endothelial function involving 59 healthy adults was performed over a period of 8 weeks. A significant increase in endothelial base-lines, measured by FMD (flow-mediated dilation) were seen over those on the placebo.* The higher curcuminoid supplementation produced a dose-mediated improvement in endothelial function – a 37-percent increase measured by FMD. Evidence from this study also points to a potential decreased risk of CVD in those who regularly consume curcuminoids.
   2. CurcuWIN® And the Attenuation of Performance Decrements
      A randomized, double-blind, placebo-controlled investigation involving 64 healthy men and women aged 19-29 who were given either a placebo, 250 mg, or 1000 mg of urcuWIN®and tested by the Exercise Physiology Laboratory within the Kinesiology Department at Texas Christain University over eight weeks. Results showed that eight weeks of high-dosage curcumin supplementation might attenuate performance decrements following intense anaerobic exercise.* Significant decreases in peak extension torque values within 24 hours after athletic activities were seen in those on 1000 mg doses.*
   3. CurcuWIN® and Comparative Absorption of Curcumin Formulas:
      A randomized, double-blind, crossover study with healthy human volunteers tested the relative absorption of standard curcumin and three microencapsulated branded formulas. The study concluded that CurcuWIN® increased relative absorption of total curcuminoids 46-times over standard, unformulated curcumin, and significantly higher than other top formulated versions. The appearance of curcuminoids in the blood was significantly higher than branded curcumin, whereas the other branded formula was only 1.3-fold higher than the unformulated curcumin.
   4. Human clinical trial showed CurcuWIN increased serum curcuminoid levels 46 times over standard curcumin. OmniActive Health Technologies | Jan 27, 2014. https://www.newhope. com/ingredients/study-shows-omniactives-curcuwin-more-bioavailable
3. Folic acid
   1. Rima Obeid 1 2, Susanne H Kirsch 3, Sarah Dilmann 3, Cosima Klein 3, Rudolf Eckert 4, Jürgen Geisel 3, Wolfgang Herrmann 3. Folic acid causes higher prevalence of detectable unmetabolized folic acid in serum than B-complex: a randomized trial. https://pubmed.ncbi.nlm.nih.gov/25943647/
   2. N & O. Mauro Geller1, Lisa Oliveira1, Rafael Nigri1, Spyros GE Mezitis2, Marcia Gonçalves Ribeiro3, Adenilson de Souza da Fonseca4, Oscar Roberto Guimarães5, Renato Kaufman6 and Fernanda Wajnsztajn6. B Vitamins for Neuropathy and Neuropathic Pain. https://www.hilarispublisher.com/open-access/b-vitamins-for-neuropathy-and-neuropathic-pain-2376-1318-1000161.pdf
   3. B Akoglu, et al. European Journal of Clinical Nutrition (2007), 1-6.
   4. Scott JM, et al.Lancet. 1981 2:337-340.
   5. Natural Standard Research Collaboration (NIH). Folate (folic acid) Monograph 2009.
   6. Alternative Medicine Review Vitamin B6 Monograph Volume 6, Number 1, 2001.
   7. Natural Standard Research Collaboration (NIH). Vitamin B12 Monograph 2009.
4. B vitamins
   • B vitamins, and vitamin B12 in particular, may be helpful in treating various types of neuropathies. People with type 2 diabetes taking metformin should be monitored for B12 deficiency.
     1. Zhang M, Han W, Hu S, Xu H. Methylcobalamin: a potential vitamin of pain killer. Neural Plast 2013;2013:424651.
     2. Solomon L. Vitamin B12-responsive neuropathies: A case series. Nutr Neurosci 2016;19:162–8.
     3. Shibuya K, Misawa S, Nasu S, et al. Safety and efficacy of intravenous ultra-high dose methylcobalamin treatment for peripheral neuropathy: a phase I/II open label clinical trial. Intern Med 2014;53:1927–31.
     4. Franques J, Chiche L, De Paula A, et al. Characteristics of patients with vitamin B12-responsive neuropathy: a case series with systematic repeated electrophysiological assessment. Neurol Res 2019;41:569–76.
     5. Tavares Bello C, Capitao R, Sequeira Duarte J, et al. Vitamin B12 Deficiency in Type 2 Diabetes Mellitus. Acta Med Port 2017;30:719–26.
     6. Gupta K, Jain A, Rohatgi A. An observational study of vitamin b12 levels and peripheral neuropathy profile in patients of diabetes mellitus on metformin therapy. Diabetes Metab Syndr 2018;12:51–8.
     7. Roy R, Ghosh K, Ghosh M, et al. Study of Vitamin B12 deficiency and peripheral neuropathy in metformin-treated early Type 2 diabetes mellitus. Indian J Endocrinol Metab 2016;20:631–7.
     8. Biemans E, Hart H, Rutten G, et al. Cobalamin status and its relationship with depression, cognition and neuropathy in patients with type 2 diabetes mellitus using metformin. Acta Diabetol 2015;52:383–93.
     9. Wang D, Zhai J, Liu D. Serum folate, vitamin B12 levels and diabetic peripheral neuropathy in type 2 diabetes: A meta-analysis. Mol Cell Endocrinol 2017;443:72–9.
     10. Russo G, Giandalia A, Romeo E, et al. Diabetic neuropathy is not associated with homocysteine, folate, vitamin B12 levels, and MTHFR C677T mutation in type 2 diabetic outpatients taking metformin. J Endocrinol Invest 2016;39:305–14.
     11. Wang D, Zhai J, Liu D. Serum folate, vitamin B12 levels and diabetic peripheral neuropathy in type 2 diabetes: A meta-analysis. Mol Cell Endocrinol 2017;443:72–9.
     12. Trippe B, Barrentine L, Curole M, Tipa E. Nutritional management of patients with diabetic peripheral neuropathy with L-methylfolate-methylcobalamin- pyridoxal-5-phosphate: results of a real-world patient experience trial. Curr Med Res Opin 2016;32:219–27.
     13. Jacobs A, Cheng D. Management of diabetic small-fiber neuropathy with combination L-methylfolate, methylcobalamin, and pyridoxal 5’-phosphate. Rev Neurol Dis 2011;8:39–47.
     14. Walker M, Morris L, Cheng D. Improvement of cutaneous sensitivity in diabetic peripheral neuropathy with combination L-methylfolate, methylcobalamin, and pyridoxal 5’-phosphate. Rev Neurol Dis 2010;7:132–9.
     15. Talaei A, Siavash M, Majidi H, Chehrei A. Vitamin B12 may be more effective than nortriptyline in improving painful diabetic neuropathy. Int J Food Sci Nutr 2009;60:71–6.
     16. Xu Q, Pan J, Yu J, et al. Meta-analysis of methylcobalamin alone and in combination with lipoic acid in patients with diabetic peripheral neuropathy. Diabetes Res Clin Pract 2013;101:99–105.
     17. Schloss J, Colosimo M. B Vitamin Complex and Chemotherapy-Induced Peripheral Neuropathy. Curr Oncol Rep 2017;19:76.
     18. Schloss J, Colosimo M, Airey C, et al. A randomised, placebo-controlled trial assessing the efficacy of an oral B group vitamin in preventing the development of chemotherapy- induced peripheral neuropathy (CIPN). Support Care Cancer 2017;25:195–204.
   • In one trial, a combination of vitamins B1, B6, and B12 before and after surgery prevented post-surgical reductions in immune activity.
     1. Vinogradov VV, Tarasov IuA, Tishin VS, et al. Thiamin prevention of the corticosteroid reaction after surgery. Probl Endokrinol (Mosk) 1981;27:11-6 [in Russian].
     2. Lettko M, Meuer S. Vitamin B-induced prevention of stress-related immunosuppression. Ann NY Acad Sci 1990;585:513-5. https://pubmed.ncbi.nlm.nih.gov/16008162/
     3. Yu Sun 1, Mei-Shu Lai, Chien-Jung Lu . Effectiveness of vitamin B12 on diabetic neuropathy: systematic review of clinical controlled trials. https://pubmed.ncbi.nlm.nih.gov/16008162/
     4. Ken Ikeda 1, Yasuo Iwasaki 1, Ryuji Kaji 2. Neuroprotective effect of ultra-high dose methylcobalamin in wobbler mouse model of amyotrophic lateral sclerosis. https://pubmed. ncbi.nlm.nih.gov/25982504/
5. DL-phenylalanine
   • Several studies suggest that a synthetic version of phenylalanine called D-phenylalanine, may reduce pain by decreasing the enzyme that breaks down endorphins.
     1. Ehrenpreis S. Analgesic properties of enkephalinase inhibitors: animal and human studies. Prog Clin Biol Res 1985;192:363-70.
     2. Balagot RC, Ehrenpreis S, Kubota K, Greenberg J. Analgesia in mice and humans by D-phenylalanine: Relation to inhibition of enkephalin degradation and enkephalin levels. In: Bonica JJ, Liebeskind JC, Albe-Fessard DG, eds., Advances in Pain Research and Therapy, Vol 5. New York: Raven Press, 1983, 289-93.
     3. Gaby AR. Editor’s Corner. Northwest Acad Prev Med 1983;July:3, 5, 8.
     4. Walsh NE, Ramamurthy S, Schoenfeld LS, Hoffman J. Analgesic effectiveness of D-phenylalanine in chronic pain patients. Arch Phys Med Rehabil 1986;67:436-9.
     5. Kitade T, Odahara Y, Shinohara S, et al. Studies on the enhanced effect of acupuncture analgesia and acupuncture anesthesia bu D-phenylalanine (2nd report)—schedule of administration and clinical effects in low back pain and tooth extraction. Acupunct Electrother Res 1990;15:121-35.
   • D-phenylalanine (DPA) decreases pain by blocking the enzymes that break down the body’s natural painkillers. Clinical studies suggest DPA may inhibit some types of chronic pain.
     1. Ehrenpreis S. Analgesic properties of enkephalinase inhibitors: animal and human studies. Prog Clin Biol Res 1985;192:363-70.
     2. Guisti P, Carrara M, Cima L, Borin G. Antinociceptive effect of some carboxypeptidase A inhibitors in comparison with D-phenylalanine. Eur J Pharmacol 1985;116:287-92.
     3. Walsh NE, Ramamurthy S, Schoenfeld LS, Hoffman J. D-phenylalanine was not found to exhibit opiod receptor mediated analgesia in monkeys. Pain 1986;26:409-10.
     4. Ehrenpreis S, Balagot R, Comaty JE, Myles SB. Naloxonr reversible analgesia in mice produced by D-phenylalanine and hydrocinnamic acid, inhibitors of carboxypeptidase A. In Bonica JJ, et al., eds. Advances in Pain Research and Therapy, Vol. 3. New York: Raven Press, 1979.
     5. Ehrenpreis S. Pharmacology of enkephalinase inhibitors: animal and human studies. Acupunct Electrother Res. 1985;10:203-8.
     6. Balagot RC, Ehrenpreis S, Kubota K, Greenberg J. Analgesia in mice and humans by D-phenylalanine: Relation to inhibition of enkephalin degradation and enkephalin levels. In: Bonica JJ, Liebeskind JC, Albe-Fessard DG, eds., Advances in Pain Research and Therapy, Vol 5. New York: Raven Press, 1983, 289-93.
     7. Mitchell MJ, Daines GE, Thomas BL. Effect of L-tryptophan and phenylalanine on burning pain threshold. Phys Ther 1987;67:203-5.
     8. D’Alessandro R. D-Phenylalanine does not affect nociceptive, flexion reflex thresholds in normal humans. Anesth Analg 1983;62:857-8.
     9. Budd K. Use of D-phenylalanine, an enkephalinase inhibitor, in the treatment of intractable pain. In: Bonica JJ, Liebeskind JC, Albe-Fessard DG, eds., Advances in Pain Research and Therapy, Vol 5. New York: Raven Press, 1983, 305-8.
     10. Donzelle G, Bernard L, Deumier R, et al. Curing trial of complicated oncologic pain by D-phenylalanine. Anesthesie, Analgesie, Reanimation 1981;38:655-8 [in French].
     11. Balagot RC, Ehrenpreis S, Kubota K, Greenberg J. Analgesia in mice and humans by D-phenylalanine: Relation to inhibition of enkephalin degradation and enkephalin levels. In: Bonica JJ, Liebeskind JC, Albe-Fessard DG, eds., Advances in Pain Research and Therapy, Vol 5. New York: Raven Press, 1983, 289- 93.
     12. Walsh NE, Ramamurthy S, Schoenfeld LS, Hoffman J. Analgesic effectiveness of D-phenylalanine in chronic pain patients. Arch Phys Med Rehabil 1986;67:436-9.
     13. Sicuteri F. Enkephalinase inhibition relieves pain syndromes of central dysnociception (migraine and related headache). Cephalalgia 1981;1:229-32.
     14. Kitade T, Minamikawa M, Nawata T, et al. An experimantal study on the enhancing effects of phenylalanine on acupuncture analgesia. Am J Chin Med 1981;9:243-8.
     15. Takeshige C, Mera H, Hisamitsu T, et al. Inhibition of the analgesia inhibitory system by D-phenylalanine and proglumide. Brain Res Bull 1991;26:385-91.
     16. Kitade T, Odahara Y, Shinohara S, et al. Studies on the enhanced effect of acupuncture analgesia and acupuncture anesthesia by D-phenylalanine (first report)—effect on pain threshold and inhibition by naloxone. Acupunct Electrother Res 1988;13:87-97.
     17. Kitade T, Odahara Y, Shinohara S, et al. Studies on the enhanced effect of acupuncture analgesia and acupuncture anesthesia bu D-phenylalanine (2nd report)—schedule of administration and clinical effects in low back pain and tooth extraction. Acupunct Electrother Res 1990;15:121-35.
6. Alpha lipoic acid
   • Alpha Lipoic Acid 300 mg dosage
     • A systematic review and meta-analysis of α-lipoic acid in the treatment of diabetic peripheral neuropathy
       The results of this meta-analysis provide evidence that treatment with ALA (300-600 mg/day i.v. for 2-4 weeks) is safe and that the treatment can significantly improve both nerve conduction velocity and positive neuropathic symptoms. https://pubmed.ncbi.nlm.nih.gov/22837391/
     • MAINTAIN study shows that the addition of methylcobalamin (750 mcg) and ALA (100 mg) to pregabalin improves the efficacy of pregabalin in improving the symptoms of neuropathy and also improve the nerve function as observed by the increase in the nerve conduction velocity. MAINTAIN study might be one of the few or the only study to show that the methylcobalamin (750 mcg) and ALA (100 mg) improve diabetic peripheral neuropathic conditions as assessed by improvement in NCV and pain scores. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992764/
     • Effect of alpha-lipoic acid on blood glucose, insulin resistance and glutathione peroxidase of type 2 diabetic patients
       This study supports the use of ALA (300 mg daily) as an antioxidant in the care of diabetic patients. https://pubmed.ncbi.nlm.nih.gov/21666939/
     • Effect of oral administration of alpha-lipoic acid, vitamin B1, vitamin B2 and rutoside on contrast sensitivity in patients with type 1 and 2 diabetes. Alpha-lipoic acid (300 mg), vitamins B1 and B2, and rutoside sustain or improve CS in patients with DM1 and DM2, and can be considered as an early prophylaxis and treatment of DR. https://iovs.arvojournals.org/article.aspx?articleid=2266281
     • The typical dosage of oral lipoic acid for treating complications of diabetes is 100 to 200 mg 3 times daily. In studies that found benefits, several weeks of treatment were often necessary for full effects to develop. https://www.wnyurology.com/content.aspx?chunkiid=21480
     • Alpha-lipoic acid supplements are generally considered safe when taken as recommended. However, if you take this supplement when you have a significant thiamin (vitamin B-1) deficiency, alpha-lipoic toxicity might occur. Don’t use alpha-lipoic acid if you’re a heavy alcohol user. https://www.mayoclinic.org/diseases-conditions/diabetic-neuropathy/in-depth/ diabetic-neuropathy-and-dietary-supplements/art-20095406
     • Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: a meta-analysis. https://pubmed.ncbi.nlm.nih.gov/14984445/
   • Alpha-lipoic acid may reduce symptoms of diabetic peripheral neuropathy and may work best in combination with medical treatment for neuropathy. Its possible benefit in chemotherapy-induced neuropathy needs further investigation.
     1. Papazafeiropoulou A, Xourgia E, Papantoniou S, et al. Effect of 3-month alpha-lipoic acid treatment on sural nerve conduction velocity and amplitude in patients with diabetic neuropathy: a pilot study. Arch Med Sci Atheroscler Dis 2019;4:e141–3.
     2. Agathos E, Tentolouris A, Eleftheriadou I, et al. Effect of alpha-lipoic acid on symptoms and quality of life in patients with painful diabetic neuropathy. J Int Med Res 2018;46:1779–90.
     3. Zhao M, Chen J, Chu Y, et al. Efficacy of epalrestat plus alpha-lipoic acid combination therapy versus monotherapy in patients with diabetic peripheral neuropathy: a meta-analysis of 20 randomized controlled trials. Neural Regen Res 2018;13:1087–95.
     4. Wang X, Lin H, Xu S, et al. Alpha lipoic acid combined with epalrestat: a therapeutic option for patients with diabetic peripheral neuropathy. Drug Des Devel Ther 2018;12:2827–40.
     5. Guo Y, Jones D, Palmer J, et al. Oral alpha-lipoic acid to prevent chemotherapy-induced peripheral neuropathy: a randomized, double-blind, placebo-controlled trial. Support Care Cancer 2014;22:1223–31.
     6. Maschio M, Zarabla A, Maialetti A, et al. The Effect of Docosahexaenoic Acid and alpha-Lipoic Acid as Prevention of Bortezomib-Related Neurotoxicity in Patients with Multiple Myeloma. Integr Cancer Ther 2019:1534735419888584.
     7. Effect of alpha-lipoic acid supplementation on oxidative stress markers and antioxidative defense in patients with diabetic neuropathy https://www.atherosclerosis-journal.com/article/S0021-9150(17)31101-2/fulltext

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VISTA^® Advanced Max Relief PM Formula

For nighttime pain relief and restful sleep*

VISTA^® Advanced Max Relief PM Formula helps your muscles and body relax while calming your nerves. The powerful 1-2 combination calms nerves to support deep rest and recovery so that you wake up feeling energized.* It features:

Full spectrum CBD 20 mg: Provides endocannabinoid system support. Made from alcohol-extracted Hemp flowers from trusted US farm partners. Lab-tested for purity with full traceability.^R*

Ashwagandha: Clinically proven adaptogen that has been shown to increase the body’s ability to recover from stress while stimulating an overall feeling of balance.^S*

Turmeric: A powerful antioxidant compound that has been shown to support joint, heart, brain, and cellular wellness, by promoting a healthy inflammatory response.^L,M*

5-HTP: Used by the human body to make serotonin, an important substance for normal nerve and brain function.^T*

Additional sleep-promoting and stress-easing nutrients in this formula include: Melatonin, L-Theanine,^U* Valerian, Lemon balm and Chamomile.*

References:

1. CBD
   1. Using CBD Oil for Pain Management. https://www.healthline.com/health/cbd-oil-for-pain
   2. Baron EP. (2018). Medicinal properties of cannabinoids, terpenes, and flavonoids in cannabis, and benefits in migraine, headache, and pain: An update on current evidence and cannabis science. DOI: 10.1111/head.13345
   3. Cannabinoids suitable for migraine prevention. (2017). ean.org/amsterdam2017/fileadmin/user_upload/E-EAN_2017_-_Cannabinoids_in_migraine_-_FINAL.pdf
   4. Cannabis and cannabinoids (PDQ®) — health professional version. (2019). cancer.gov/about-cancer/treatment/cam/hp/cannabis-pdq
   5. Ewing LE, et al. (2019). Hepatotoxicity of a cannabidiol-rich cannabis extract in the mouse model. DOI:10.3390/molecules24091694
   6. Hammell, DC, et al. (2016). Transdermal cannabidiol reduces inflammation and pain-related behaviours in a rat model of arthritis. DOI: 10.1002/ejp.818
   7. Iffland K, et al. (2017). An update on safety and side effects of cannabidiol: A review of clinical data anxd relevant animal studies. DOI: 10.1089/can.2016.0034
   8. Johnson JR, et al. (2013). An open-label extension study to investigate the long-term safety and tolerability of THC/CBD Oromucosal spray and oromucosal THC spray in patients with terminal cancer-related pain refractory to strong opioid analgesics. DOI: 10.1016/j.jpainsymman.2012.07.014
   9. Johnson JR, et al. (2010). Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC: CBD extract and THC extract in patients with intractable cancer-related pain. DOI: 10.1016/j.jpainsymman.2009.06.008
   10. Simmerman E, et al. (2019). Cannabinoids as a potential new and novel treatment for melanoma: A pilot study in a murine model. DOI: 10.1016/j.jss.2018.08.055
   11. Volkow ND. (2015). The biology and potential therapeutic effects of cannabidiol. drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2015/biology-potential-therapeutic-effects-cannabidiol
   12. Vučković S, et al. (2018). Cannabinoids and pain: New insights from old molecules. DOI: 10.3389/fphar.2018.01259
   13. https://pubmed.ncbi.nlm.nih.gov/19675519/
   14. Endocannabinoid system: An overview of its potential in current medical practice
   15. Zadalla Mouslech 1, Vasiliki Valla
   16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5922297/
   17. Pharmacotherapeutic considerations for use of cannabinoids to relieve pain in patients with malignant diseases
   18. Marija Darkovska-Serafimovska,1Tijana Serafimovska,2 Zorica Arsova-Sarafinovska,1 Sasho Stefanoski,3 Zlatko Keskovski,3 and Trajan Balkanov4
2. Ashwagandha
   • A combination of boswellia, ashwagandha, turmeric, and zinc effectively treated pain and stiffness in one study, without the stomach irritation that is a common side effect of NSAIDs.
     1. Safayhi H, Mack T, Saieraj J, et al. Boswellic acids: Novel, specific, nonredox inhibitors of 5-lipoxygenase. J Pharmacol Exp Ther 1992;261:1143-6.
     2. Kimmatkar N, Thawani V, Hingorani L, Khiyani R. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee - a randomized double blind placebo controlled trial. Phytomedicine 2003;10:3-7.
     3. Sontakke S, Thawani V, Pimpalkhute S, et al. Open, randomized, controlled clinical trial of Boswellia serrata extract as compared to valdecoxib in osteoarthritis of knee. Indian J Pharmacol 2007;39:27-9.
     4. Kulkarni RR, Patki PS, Jog VP, et al. Treatment of osteoarthritis with a herbomineral formulation: A double-blind, placebo-controlled, cross-over study. J Ethnopharmacol 1991;33:91-5.
   • Ashwagandha stimulates the immune system and is considered a tonic or adaptogen—an herb with multiple actions that counteract the effects of stress and generally promote wellness.
     1. 1. Wagner H, Nörr H, Winterhoff H. Plant adaptogens. Phytomedicine 1994;1:63-76.
     2. 2. Bone K. Clinical Applications of Ayurvedic and Chinese Herbs. Queensland, Australia: Phytotherapy Press, 1996, 137-41.
   • Ashwagandha may be helpful for reducing the effects of stress, including chronic psychological stress.
     1. Brekhman II, Dardymov IV. New substances of plant origin which increase nonspecific resistance. Annu Rev Pharmacol 1969;9:419-30 [review].
     2. Panossian A, Wikman G, Wagner H. Plant adaptogens. III. Earlier and more recent aspects and concepts on their mode of action. Phytomedicine 1999;6:287-300 [review].
     3. Rege NN, Thatte UM, Dahanukar SA. Adaptogenic properties of six rasayana herbs used in Ayurvedic medicine. Phytother Res 1999;13:275-91 [review].
     4. Wagner H, Nörr H, Winterhoff H. Plant adaptogens. Phytomedicine 1994;1:63-76.
     5. Bhattacharya S, Goel R, Kaur R, Ghosal S. Anti-stress activity of sitoindosides VII and VIII, new acylsterylglucosides from Withania somnifera. Phytother Res 1987;1:32-39.
     6. Grandhi A, Mujumdar AM, Patwardhan B. A comparative pharmacological investigation of Ashwagandha and Ginseng. J Ethnopharmacol 1994;44:131-5.
     7. Dhuley JN. Effect of ashwagandha on lipid peroxidation in stress-induced animals. J Ethnopharmacol 1998;60:173-8.
     8. Bhattacharya SK, Muruganandam AV. Adaptogenic activity of Withania somnifera: an experimental study using a rat model of chronic stress. Pharmacol Biochem Behav 2003;75:547-55.
     9. Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of safety and efficacy of a high-concentration full-spectrum extract of ashwagandha root in reducing stress and anxiety in adults. Indian J Psychol Med 2012;34:255-62.
     10. Gopinathan PM, Grover SK, Gupta AK, Srivastava KK. Effects of a composite Indian herbal preparation on combat effectiveness in low-intensity-conflict operations. Mil Med 1999;164:814-9.
3. 5-HTP
   • Depression has been linked to serotonin imbalances in the brain. Supplementing with 5-HTP may increase serotonin synthesis and reduce symptoms.
     1. Van Praag HM, Lemus C. Monoamine precursors in the treatment of psychiatric disorders. Nutrition and the Brain, vol. 7, RJ Wurtman, JJ Wurtman, eds. New York: Raven Press, 1986 [review].
     2. Van Praag H, de Hann S. Depression vulnerability and 5-hydroxytryptophan prophylaxis. Psychiatry Res 1980;3:75-83.
     3. Angst J, Woggon B, Schoepf J. The treatment of depression with L-5-hydroxytryptophan versus imipramine. Results of two open and one double-blind study. Arch Psychiatr Nervenkr 1977;224:175-86.
     4. Nolen WA, van de Putte JJ, Dijken WA, et al. Treatment strategy in depression. II. MAO inhibitors in depression resistant to cyclic antidepressants: two controlled crossover studies with tranylcypromine versus L-5-hydroxytryptophan and nimifensine. Acta Psychiatr Scand 1988;78:676-83.
     5. Nolen WA, van de Putte JJ, Dijken WA, Kamp JS. L-5-HTP in depression resistant to re-uptake inhibitors. An open comparative study with tranylcypromine. Br J Psychiatry 1985;147:16-22.
     6. D’Elia G, Hanson L, Raotma H. L-tryptophan and 5-hydroxytryptophan in the treatment of depression. A review. Acta Psychiatr Scand 1978;57:239-52 [review].
     7. Jangid P, Malik P, Singh P, et al. Comparative study of efficacy of L-5-hydroxytryptophan and fluoxetine in patients presenting with first depressive episode. Asian J Psychiatr 2013;6:29–34.
   • 5-HTP is converted into serotonin and might, therefore, be helpful for insomnia. In one study, supplementing with 5-HTP appeared to improve sleep quality.
     1. Schneider-Helmert D, Spinweber CL. Evaluation of L-tryptophan for treatment of insomnia: A review. Psychopharmacology (Berlin) 1986;89(1):1-7.
     2. Lindsley JG, Hartmann EL, Mitchell W. Selectivity in response to L-tryptophan among insomniac subjects: a preliminary report. Sleep 1983;6:247-56.
     3. Wyatt RJ, Zarcone V, Engelman K, et al. Effects of 5-hydroxytryptophan on the sleep of normal human subjects. Electroencephalogr Clin Neurophysiol 1971;30:505-9.
     4. Puttini PS, Caruso I. Primary fibromyalgia syndrome and 5-hydroxy-L-tryptophan: a 90-day open study. J Int Med Res 1992;20:182-9.
     5. Bruni O, Ferri R, Miano S, Verrillo E. L-5-Hydroxytryptophan treatment of sleep terrors in children. Eur J Pediatr 2004;163:402-7.
   • 5-HTP is used by the human body to make serotonin, an important substance for normal nerve and brain function. Serotonin appears to play significant roles in sleep.
     1. Guyton AC, Hall JE. Textbook of Medical Physiology, 9th ed. Philadelphia: W. B. Saunders, 1996.
     2. Schneider-Helmert D, Spinweber CL. Evaluation of L-tryptophan for treatment of insomnia: A review. Psychopharmacology (Berlin) 1986;89(1):1-7.
     3. Caruso I, Sarzi Puttini P, Cazzola M, Azzolini V. Double-blind study of 5-hydroxytryptophan versus placebo in the treatment of primary fibromyalgia syndrome. J Int Med Res 1990;18:201-9.
     4. Soulairac A, Lambinet H. Etudes cliniques de líaction du precurseur de la serotonine le L-5-hydroxy-tryptophane, sur les troubles du sommeil. Schweiz Bundschau Med (PRAXIS) 1998;77(34a):19-23 [in French].
     5. The supplement 5-Hydroxytryptophan increases serotonin production and has shown antidepressant activity. It may be useful in the treatment of SAD. 1. Birdsall TC. 5-Hydroxytryptophan: a clinically-effective serotonin precursor. Alternative Med Rev 1998;3:271-80.

L-Theanine

1. L-Theanine Relieves Positive, Activation, and Anxiety Symptoms in Patients With Schizophrenia and Schizoaffective Disorder: An 8-Week, Randomized, Double-Blind, Placebo- Controlled, 2-Center Study https://www.psychiatrist.com/jcp/schizophrenia/l-theanine-relieves-positive-activation-anxiety-symptoms/
2. L-Theanine as a Functional Food Additive: Its Role in Disease Prevention and Health Promotion. https://www.mdpi.com/2306-5710/2/2/13/htm
3. The effects of L-theanine (Suntheanine®) on objective sleep quality in boys with attention deficit hyperactivity disorder (ADHD): a randomized, double-blind, placebo-controlled clinical trial. https://pubmed.ncbi.nlm.nih.gov/22214254.

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VISTA^® Advanced Elite Recovery Formula

For nighttime pain relief and restful sleep*

VISTA^® Advanced Elite Recovery Formula is a post-operative formula with the optimal level of supplements to support the body’s natural healing processes and aid recovery. This comprehensive all-in-one formula consists of healthy inflammatory response nutrients, powerful antioxidants, immune support boosters, cellular rejuvenation and healing vitamins and minerals.

Healthy Inflammatory Response Nutrients: Omega-3 fatty acids, found in fish oil, support a healthy inflammatory response and may improve recovery after surgery.* The triglyceride form of fish oil absorbs better in your body thereby not requiring higher dosages.^U* Turmeric is a powerful antioxidant compound has been shown to support joint, heart, brain, and cellular wellness, by promoting a healthy inflammatory response.^M* Pancreatin, Papain and Bromelain are enzymes commonly used for their digestive and healing properties.^V*

Antioxidants: CoQ10 is stored in the mitochondria of cells and helps generate energy within cells. The mitochondria are in charge of producing energy and protect cells from oxidative damage.^W* Resveratrol is a naturally occurring antioxidant found primarily in red wine.^X* Quercetin is one of the most abundant antioxidants in the diet and plays an important role in helping your body combat free radical damage.^Y*

Immune Support Boosters: One of the most critical paths to recovery is by boosting the immune system. Glutamine is one of the most abundant amino acids in the body and supports the health of the cells lining the gastrointestinal tract.¹ Studies have shown that using glutamine-enriched formulas after surgery increased immune cell activity, shortened hospital stays and improved nutritional status. Zinc is considered an essential nutrient required for numerous processes in your body, including immune health, growth and development.

Cellular Rejuvenation & Healing Matrix: Studies have shown that B vitamins after surgery prevent a reduction in immune activity. Vitamin B complex helps support cell health, growth of red blood cells and energy levels. Magnesium is needed for bone, protein, and fatty acid formation. Magnesium also aids in making new cells, activating B Vitamins, relaxing muscles, clotting blood, and forming adenosine triphosphate (ATP), which is energy the body runs on. One of magnesium’s other roles to help the biochemical reactions performed by enzymes. Vitamin K plays an important role in coagulation. Clotting is a process that helps prevent excessive bleeding both inside and outside the body. Your body needs vitamin K in order to produce the proteins that go to work during the clotting process.

References:

1. Omega-3 Fish Oil
   • Fish oil has anti-inflammatory effect and may help reduce pain. Many trials have proven that omega-3 fatty acids in fish oil partially relieve symptoms of rheumatoid arthritis.
     1. Kremer JM, Jubiz W, Michalek A, et al. Fishoil fatty acid supplementation in active rheumatoid arthritis. Ann Int Med 1987;106(4):497-503.
     2. Kremer JM, Lawrence DA, Jubiz W, et al. Dietary fish oil and olive oil supplementation in patients with rheumatoid arthritis. Clinical and immunologic effects. Arthritis Rheum 1990;33:810-20.
     3. Geusens P, Wouters C, Nijs J, et al. Longterm effect of omega3 fatty acid supplementation in active rheumatoid arthritis. Arthrit Rheum 1994;37:824-9.
     4. Van der Tempel H, Tulleken JE, Limburg PC, et al. Effects of fish oil supplementation in rheumatoid arthritis. Ann Rheum Dis 1990;49:76-80.
     5. Cleland LG, French JK, Betts WH, et al. Clinical and biochemical effects of dietary fish oil supplements in rheumatoid arthritis. J Rheumatol 1988;15(10):1471-5.
     6. Kremer JM, Lawrence DA, Petrillow GF, et al. Effects of highdose fish oil on rheumatoid arthritis after stopping nonsteroidal antiinflammatory drugs. Arthritis Rheum 1995;38:1107-14.
     7. Galarraga B, Ho M, Youssef HM, Hill A, McMahon H, Hall C, et al. Cod liver oil (n-3 fatty acids) as an non-steroidal anti-inflammatory drug sparing agent in rheumatoid arthritis. Rheumatology 2008;47:665-9.
     8. Proudman SM, James MJ, Spargo LD, et al. Fish oil in recent onset rheumatoid arthritis: a randomised, double-blind controlled trial within algorithm- based drug use. Ann Rheum Dis 2015;74:89–95.
     9. Rajaei E, Mowla K, Ghorbani A, et al. The effect of omega-3 fatty acids in patients with active rheumatoid arthritis receiving DMARDs therapy: double- blind randomized controlled trial. Glob J Health Sci 2015;8:18–25.
     10. Lee TH, Hoover RL, Williams JD, et al. Effect of dietary enrichment with eicosapentaenoic and docosahexaenoic acids on in vitro neutrophil and monocyte leukotriene generation and neutrophil function. N Engl J Med 1985;312(19):1217-24.
     11. Nordstrom DC, Honkanen VE, Nasu Y, et al. Alpha-linolenic acid in the treatment of rheumatoid arthritis. A double-blind, placebo-controlled and randomized study: flaxseed vs. safflower seed. Rheumatol Int 1995;14:231-4.
   • Omega-3 fatty acids, found in fish oil, have anti-inflammatory properties and may improve recovery and prevent infection after surgery.
     1. Gerster H. The use of n-3 PUFAs (fish oil) in enteral nutrition. Int J Vitam Nutr Res 1995;65:3-20 [review].
     2. Kollman KA, Lien EL, Vanderhoof JA. Dietary lipids influence intestinal adaptation after massive bowel resection. J Pediatr Gastroenterol Nutr 1999;28:41-5.
     3. Johnson JA 3d, Griswold JA, Muakkassa FF. Essential fatty acids influence survival in sepsis. J Trauma 1993;35:128-31.
     4. Wachtler P, Konig W, Senkal M, et al. Influence of a total parenteral nutrition enriched with omega-3 fatty acids on leukotriene synthesis of peripheral leukocytes and systemic cytokine levels in patients with major surgery. J Trauma 1997;42:191-8.
     5. Gianotti L, Braga M, Fortis C, et al. A prospective, randomized clinical trial on perioperative feeding with an arginine-, omega-3 fatty acid-, and RNA- enriched enteral diet: effect on host response and nutritional status. JPEN J Parenter Enteral Nutr 1999;23:314-20.
   • The omega-3 fatty acids present in fish oil, EPA and DHA, have anti-inflammatory effects and may relieve pain.
     1. Altman R, Gray R. Inflammation in osteoarthritis. Clin Rheum Dis 1985;11:353.
     2. Stammers T, Sibbald B, Freeling P. Fish oil in osteoarthritis. Lancet 1989;ii:503 [letter].
     3. Stammers T, Sibbald B, Freeling P. Efficacy of cod liver oil as an adjunct to non-steroidal anti-inflammatory drug treatment in the management of osteoarthritis in general practice. Ann Rheum Dis 1992;51:128-9.
2. Enzymes
   • Supplementing with a combination of the enzymes trypsin and chymotrypsin may improve low back pain.
     1. Hingorani K. Oral enzyme therapy in severe back pain. Br J Clin Pract 1968;22:209-10.
     2. Gaspardy G, Balint G, Mitsuova M, et al. Treatment of sciatica due to intervertebral disc herniation with Chymoral tablets. Rheum Phys Med 1971;11:14-9. 3. Gibson T, Dilke TFW, Grahame R. Chymoral in the treatment of lumbar disc prolapse. Rheumatol Rehabil 1975;14:186-90.
   • Proteolytic enzymes, including bromelain, may be helpful in healing sprains and strains because they are anti-inflammatory and appear to promote tissue healing.
     1. Cirelli MG. Five years experience with bromelains in therapy of edema and inflammation in postoperative tissue reaction, skin infections and trauma. Clin Med 1967;74(6):55-9.
     2. Trickett P. Proteolytic enzymes in treatment of athletic injuries. Appl Ther 1964;6:647-52.
     3. Sweeny FJ. Treatment of athletic injuries with an oral proteolytic enzyme. Med Times 1963:91:765.
     4. Boyne PS, Medhurst H. Oral anti-inflammatory enzyme therapy in injuries in professional footballers. Practitioner 1967;198:543-6.
     5. Deitrick RE. Oral proteolytic enzymes in the treatment of athletic injuries: A double-blind study. Pennsylvania Med J 1965;Oct:35-7.
     6. Rathgeber WF. The use of proteolytic enzymes (Chymoral) in sporting injuries. S Afr Med J 1971;45:181-3.
     7. Buck JE, Phillips N. Trial of Chymoral in professional footballers. Br J Clin Pract 1970;24:375-7.
     8. Tsomides J, Goldberg RI. Controlled evaluation of oral chymotrypsin-trypsin treatment of injuries to the head and face. Clin Med 1969;76(11):40.
     9. Holt HT. Carica papaya as ancillary therapy for athletic injuries. Curr Ther Res 1969;11:621-4.
     10. Blonstein JL. Oral enzyme tablets in the treatment of boxing injuries. Practitioner 1967;198:547.
     11. Baumüller M. Therapy of ankle joint distortions with hydrolytic enzymes—results from a double blind clinical trial. In Hermans GPH, Mosterd WL, eds. Sports, Medicine and Health. Amsterdam: Excerpta Medica, 1990, 1137.
     12. Craig RP. The quantitative evaluation of the use of oral proteolytic enzymes in the treatment of sprained ankles. Injury 1975;6:313-6.
   • Several trials have reported reduced pain and swelling, and/or faster healing in people with a variety of conditions who use papain.
     1. Cirelli MG. Five years experience with bromelains in therapy of edema and inflammation in postoperative tissue reaction, skin infections and trauma. Clin Med 1967;74(6):55-9.
     2. Trickett P. Proteolytic enzymes in treatment of athletic injuries. Appl Ther 1964;6:647-52.
     3. Sweeny FJ. Treatment of athletic injuries with an oral proteolytic enzyme. Med Times 1963:91:765.
     4. Boyne PS, Medhurst H. Oral anti-inflammatory enzyme therapy in injuries in professional footballers. Practitioner 1967;198:543-6.
     5. Deitrick RE. Oral proteolytic enzymes in the treatment of athletic injuries: A double-blind study. Pennsylvania Med J 1965;Oct:35-7.
     6. Rathgeber WF. The use of proteolytic enzymes (Chymoral) in sporting injuries. S Afr Med J 1971;45:181-3.
     7. Buck JE, Phillips N. Trial of Chymoral in professional footballers. Br J Clin Pract 1970;24:375-7.
     8. Tsomides J, Goldberg RI. Controlled evaluation of oral chymotrypsin-trypsin treatment of injuries to the head and face. Clin Med 1969;76(11):40.
     9. Holt HT. Carica papaya as ancillary therapy for athletic injuries. Curr Ther Res 1969;11:621-4.
     10. Blonstein JL. Oral enzyme tablets in the treatment of boxing injuries. Practitioner 1967;198:547.
     11. Baumüller M. Therapy of ankle joint distortions with hydrolytic enzymes—results from a double blind clinical trial. In Hermans GPH, Mosterd WL, eds. Sports, Medicine and Health. Amsterdam: Excerpta Medica, 1990, 1137.
     12. Craig RP. The quantitative evaluation of the use of oral proteolytic enzymes in the treatment of sprained ankles. Injury 1975;6:313-6.
   • Taking bromelain may help reduce swelling and speed the healing time for surgical wounds and soft tissue injuries.
     1. Tassman G, Zafran J, Zayon G. A double-blind crossover study of a plant proteolytic enzyme in oral surgery. J Dent Med 1965;20:51-4.
     2. Blonstein J. Control of swelling in boxing injuries. Practitioner 1960;203:206.
   • Several trials have reported reduced pain and swelling, and/or faster healing in people with a variety of conditions who use bromelain.
     1. Seligman B. Bromelain: an anti-inflammatory agent. Angiology 1962;13:508-10.
     2. Castell JV, Friedrich G, Kuhn CS, et al. Intestinal absorption of undegraded proteins in men: presence of bromelain in plasma after oral intake. Am J Physiol 1997;273:G139-46.
     3. Miller JM. Absorption of orally introduced proteolytic enzymes. Clin Med 1968;75:35-42 [review].
     4. Masson M. Bromelain in the treatment of blunt injuries to the musculoskeletal system. A case observation study by an orthopedic surgeon in private practice. Fortschr Med 1995;113:303-6.
     5. Miller JN, Ginsberg M, McElfatrick GC, et al. The administration of bromelain orally in the treatment of inflammation and edema. Exp Med Surg 1964;22:293-9.
     6. Cirelli MG. Five years experience with bromelains in therapy of edema and inflammation in postoperative tissue reaction, skin infections and trauma. Clin Med 1967;74(6):55-9.
     7. Vallis C, Lund M. Effect of treatment with Carica papaya on resolution of edema and ecchymosis following rhinoplasty. Curr Ther Res 1969;11:356-9.
     8. Trickett P. Proteolytic enzymes in treatment of athletic injuries. Appl Ther 1964;6:647-52.
     9. Sweeny FJ. Treatment of athletic injuries with an oral proteolytic enzyme. Med Times 1963:91:765.
   • Over-the-Counter Enzyme Supplements: What a Clinician Needs to Know
     Jithinraj Edakkanambeth Varayil, MD, Brent A. Bauer, MD, Ryan T. Hurt, MD, PhD. Over-the-Counter Enzyme Supplements: What a Clinician Needs to Know. August 04, 2014. DOI: https://doi.org/10.1016/j.mayocp.2014.05.015. https://www.mayoclinicproceedings.org/article/S0025-6196(14)00520-5/fulltext
     1. National Institutes of Health Office of Dietary Supplements. Dietary Supplement Health Education Act of 1994: Public Law 103-417:103rd Congress. http://www.ods.od.nih.gov/About/DSHEA_Wording.aspx. Accessed January 22, 2014.
     2. SPINSscan Natural, SPINSscan Specialty Gourmet, SPINSscan Conventional 52 Weeks Ending 12/25/2012. Vol 2013. http://www.spins.com. Accessed February 12, 2014.
     3. Therapeutic Research Faculty. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Updated January 22, 2014. Accessed January 22, 2014. Miller P.C. Bailey S.P. Barnes M.E. Derr S.J. Hall E.E.
     4. The effects of protease supplementation on skeletal muscle function and DOMS following downhill running.
     5. J Sports Sci. 2004;22:365-372 Hale L.P. Greer P.K. Sempowski G.D.
     6. Bromelain treatment alters leukocyte expression of cell surface molecules involved in cellular adhesion and activation. Clin Immunol. 2002;104:183-190 Desser L. Rehberger A. Paukovits W.
     7. Proteolytic enzymes and amylase induce cytokine production in human peripheral blood mononuclear cells in vitro. Cancer Biother. 1994;9:253-263 Edwards B.J. Perry H.M. Kaiser F.E. et al.
     8. Age-related changes in amylin secretion. Mech Ageing Dev. 1996;86:39-51 DiMagno E.P.
     9. Medical treatment of pancreatic insufficiency. Mayo Clin Proc. 1979;54:435-442 Suarez F. Levitt M.D. Adshead J. Barkin J.S.
     10. Pancreatic supplements reduce symptomatic response of healthy subjects to a high fat meal. Dig Dis Sci. 1999;44:1317-1321 Maurer H.R.
     11. Bromelain: biochemistry, pharmacology and medical use. Cell Mol Life Sci. 2001;58:1234-1245 Kleine M.W. Stauder G.M. Beese E.W.
     12. The intestinal absorption of orally administered hydrolytic enzymes and their effects in the treatment of acute herpes zoster as compared with those of oral acyclovir therapy.
     13. Phytomedicine. 1995;2:7-15 Taussig S.J. Batkin S.
     14. Bromelain, the enzyme complex of pineapple (Ananas comosus) and its clinical application: an update. J Ethnopharmacol. 1988;22:191-203 -Winter H.
     15. On the pharmacology of bromelain: an update with special regard to animal studies on dose-dependent effects. Planta Med. 1990;56:249-253 Ito C. Yamaguchi K. Shibutani Y. et al.
     16. Anti-inflammatory actions of proteases, bromelain, trypsin and their mixed preparation (author’s transl).
     17. Nihon Yakurigaku Zasshi. 1979;75 ([in Japanese]):227-237 Klein G. Kullich W. Schnitker J. Schwann H.
     18. Efficacy and tolerance of an oral enzyme combination in painful osteoarthritis of the hip: a double-blind, randomised study comparing oral enzymes with non-steroidal anti- inflammatory drugs.
     19. Clin Exp Rheumatol. 2006;24:25-30 Akhtar N.M.Naseer R. Farooqi A.Z. Aziz W. Nazir M.
     20. Oral enzyme combination versus diclofenac in the treatment of osteoarthritis of the knee: a double-blind prospective randomized study. Clin Rheumatol. 2004;23:410-415 Deitrick R.E.
     21. Oral proteolytic enzymes in the treatment of athletic injuries: a double-blind study. Pa Med. 1965;68:35-37 Stone M.B. Merrick M.A. Ingersoll C.D. Edwards J.E.
     22. Preliminary comparison of bromelain and ibuprofen for delayed onset muscle soreness management. Clin J Sport Med. 2002;12:373-378 Craig R.P.
     23. The quantitative evaluation of the use of oral proteolytic enzymes in the treatment of sprained ankles.
     24. Injury. 1975;6:313-316 Sakalova A. Bock P.R. Dedik L. et al.
     25. Retrolective cohort study of an additive therapy with an oral enzyme preparation in patients with multiple myeloma. Cancer Chemother Pharmacol. 2001;47:S38-S44 Popiela T. Kulig J. Hanisch J. Bock P.R.
     26. Influence of a complementary treatment with oral enzymes on patients with colorectal cancers: an epidemiological retrolective cohort study. Cancer Chemother Pharmacol. 2001;47:S55-S63 Martin T. Uhder K. Kurek R. et al.
     27. Does prophylactic treatment with proteolytic enzymes reduce acute toxicity of adjuvant pelvic irradiation? results of a double-blind randomized trial. Radiother Oncol. 2002;65:17-22 Zavadova E. Desser L. Mohr T.
     28. Stimulation of reactive oxygen species production and cytotoxicity in human neutrophils in vitro and after oral administration of a polyenzyme preparation. Cancer Biother. 1995;10:147-152 Wald M. Zavadova E. Pouckova P. Zadinova M. Boubelik M.
     29. Polyenzyme preparation Wobe-Mugos inhibits growth of solid tumors and development of experimental metastases in mice. Life Sci. 1998;62:PL43-PL48 FitzSimmons S.C. Burkhart G.A. Borowitz D. et al.
     30. High-dose pancreatic-enzyme supplements and fibrosing colonopathy in children with cystic fibrosis. N Engl J Med. 1997;336:1283-1289
3. Coenzyme Q10
   • Strenuous physical activity lowers blood levels of coenzyme Q10 (CoQ10). A few studies have reported that CoQ10 supplementation benefitted some trained athletes.
     1. Kaikkonen J, Nyyssonen K, Tuomainen TP, et al. Determinants of plasma coenzyme Q10 in humans. FEBS Lett 1999;443:163-6 [review].
     2. Mizuno K, Tanaka M, Nozaki S, et al. Antifatigue effects of coenzyme Q10 during physical fatigue. Nutrition 2008;24:293-9.
     3. Overvad OK, Diamant B, Holm L, et al. Efficacy and safety of dietary supplementation containing Q10. Ugeskr Laeger 1997;159:7309-15 [review] [in Danish].
     4. Zuliani U, Bonetti A, Campana M, et al. The influence of ubiquinone (Co Q10) on the metabolic response to work. J Sports Med Phys Fitness 1989;29:57-62 [review].
     5. Bonetti A, Solito F, Carmosino G, et al. Effect of ubidecarenone oral treatment on aerobic power in middle-aged trained subjects. J Sports Med Phys Fitness 2000;40:51-7.
     6. Weston SB, Zhou S, Weatherby RP, Robson SJ. Does exogenous coenzyme Q10 affect aerobic capacity in endurance athletes? Int J Sport Nutr 1997;7:197-206.
     7. Bucci L. Nutrients as ergogenic aids for sports and exercise. Boca Raton, FL: CRC Press, 1993, 54-7 [review].
     8. Snider IP, Bazzarre TL, Murdoch SD, et al. Effects of coenzyme athletic performance system as an ergogenic aid on endurance performance to exhaustion. Int J Sport Nutr 1992;2:272-86.
     9. Malm C, Svensson M, Ekblom B, et al. Effects of ubiquinone-10 supplementation and high intensity training on physical performance in humans. Acta Physiol Scand 1997;161:379-84.
     10. Laaksonen R, Fogelholm M, Himberg JJ, et al. Ubiquinone supplementation and exercise capacity in trained young and older men. Eur J Appl Physiol 1995;72:95-100.
     11. Alf D, Schmidt ME, Siebrecht SC. Ubiquinol supplementation enhances peak power production in trained athletes: a double-blind, placebo controlled study. J Int Soc Sports Nutr 2013;10:24.
     12. Juan D. Hernández-Camacho,1 Michel Bernier,2 Guillermo López-Lluch,1 and Plácido Navas1,* Coenzyme Q10 Supplementation in Aging and Disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5807419/
     13. P Johansson 1, Ö Dahlström, U Dahlström, U Alehagen. Improved Health-Related Quality of Life, and More Days out of Hospital with Supplementation with Selenium and Coenzyme Q10 Combined. Results from a Double Blind, Placebo-Controlled Prospective Study. https://pubmed.ncbi.nlm.nih.gov/26482687/
     14. Gabriele Pizzino, 1 , * Natasha Irrera, 1 Mariapaola Cucinotta, 2 Giovanni Pallio, 1 Federica Mannino, 1 Vincenzo Arcoraci, 1 Francesco Squadrito, 1 Domenica Altavilla, 2 and Alessandra Bitto 1. Oxidative Stress: Harms and Benefits for Human Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5551541/
4. Resveratrol
   • Studies have found that in moderation red wine, which contains resveratrol, lowers risk of death from heart disease. Its antioxidant activity and effect on platelets leads some researchers to believe that it is the protective agent in red wine.
     1. Bertelli AA, Giovanninni L, Bernini W, et al. Antiplatelet activity of cis-resveratrol. Drugs Exp Clin Res 1996;22(2):61-3.
     2. Chen CK, Pace-Asciak. CR. Vasorelaxing activity of resveratrol and quercetin in isolated rat aorta. Gen Pharm 1996;27(2):363-6.
     3. Pace-Asciak CR, Rounova O, Hahn SE, et al. Wines and grape juices as modulators of platelet aggregation in healthy human subjects. Clin Chim Acta 1996;246(1-2):163-82.
     4. J. Gambini, 1 , * M. Inglés, 2 G. Olaso, 1 R. Lopez-Grueso, 3 V. Bonet-Costa, 1 L. Gimeno-Mallench, 1 C. Mas-Bargues, 1 K. M. Abdelaziz, 1 M. C. Gomez-Cabrera, 1 J. Vina, 1 and C. Borras 1. Properties of Resveratrol: In Vitro and In Vivo Studies about Metabolism, Bioavailability, and Biological Effects in Animal Models and Humans. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4499410/
     5. Ali Mobasheri,1,* Yves Henrotin,2 Hans-Konrad Biesalski,3 and Mehdi Shakibaei4. Scientific Evidence and Rationale for the Development of Curcumin and Resveratrol as Nutraceutricals for Joint Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3344210/
     6. N Elmali 1, O Baysal, A Harma, I Esenkaya, B Mizrak. Effects of resveratrol in inflammatory arthritis. https://pubmed.ncbi.nlm.nih.gov/17115116/
     7. Constanze Csaki 1, Nerses Keshishzadeh, Karoline Fischer, Mehdi Shakibaei . Regulation of inflammation signalling by resveratrol in human chondrocytes in vitro. https://pubmed. ncbi.nlm.nih.gov/17959154/
     8. Constanze Csaki 1, Ali Mobasheri, Mehdi Shakibaei. Synergistic chondroprotective effects of curcumin and resveratrol in human articular chondrocytes: inhibition of IL-1beta-induced NF-kappaB-mediated inflammation and apoptosis. https://pubmed.ncbi.nlm.nih.gov/19889203/
5. Quercetin
   • In one study, quercetin lowered the incidence of upper respiratory tract infections in athletes following intensive exercise.
     1. Nieman DC, Henson DA, Gross SJ, et al. Quercetin reduces illness but not immune perturbations after intensive exercise. Med Sci Sports Exerc 2007;39:1561-9.
     2. Stephan C Bischoff 1. Quercetin: potentials in the prevention and therapy of disease. https://pubmed.ncbi.nlm.nih.gov/18827577/
     3. Agnes W Boots 1, Guido R M M Haenen, Aalt Bast . Health effects of quercetin: from antioxidant to nutraceutical. https://pubmed.ncbi.nlm.nih.gov/18417116/
     4. Fatemeh Javadi 1, Arman Ahmadzadeh 2, Shahryar Eghtesadi 3, Naheed Aryaeian 3, Mozhdeh Zabihiyeganeh 4, Abbas Rahimi Foroushani 5, Shima Jazayeri 3. The Effect of Quercetin on Inflammatory Factors and Clinical Symptoms in Women with Rheumatoid Arthritis: A Double-Blind, Randomized Controlled Trial. https://pubmed.ncbi.nlm.nih.gov/27710596/
     5. Fatemeh Abharzanjani 1, Mohammad Afshar 2, Mina Hemmati 3, Maryam Moossavi 1. Short-term High Dose of Quercetin and Resveratrol Alters Aging Markers in Human Kidney Cells. https://pubmed.ncbi.nlm.nih.gov/28966753/
     6. Eun-Ju Sohn 1 2, Jung Min Kim 3, Se-Hui Kang 2, Joseph Kwon 2, Hyun Joo An 1, Jung-Suk Sung 4, Kyung A Cho 5, Ik-Soon Jang 2, Jong-Soon Choi 1 2. Restoring Effects of Natural Anti-Oxidant Quercetin on Cellular Senescent Human Dermal Fibroblasts. https://pubmed.ncbi.nlm.nih.gov/29737207/
     7. Jochen Kressler 1, Melinda Millard-Stafford, Gordon L Warren. Quercetin and endurance exercise capacity: a systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/21606866/
6. Glutamine
   • Studies have shown that using glutamine-enriched formulas after surgery increased immune cell activity, shortened hospital stays, improved nutritional status, and reduced infections.
     1. Campos FG, Waitzberg DL, Logulo AF, et al. The role of glutamine in nutrition in clinical practice. Arq Gastroenterol 1996;33:86-92 [review, in Portugese].
     2. O’Flaherty L, Bouchier-Hayes DJ. Immunonutrition and surgical practice. Proc Nutr Soc 1999;58:831-7 [review].
     3. Greig JE, Keast D, Garcia-Webb P, Crawford P. Inter-relationships between glutamine and other biochemical and immunological changes after major vascular surgery. Br J Biomed Sci 1996;53:116-21.
     4. Morlion BJ, Stehle P, Wachtler P, et al. Total parenteral nutrition with glutamine dipeptide after major abdominal surgery: a randomized, double-blind, controlled study. Ann Surg 1998;227:302-8.
     5. O’Riordain MG, De Beaux A, Fearon KC. Effect of glutamine on immune function in the surgical patient. Nutrition 1996;12:S82-4.
     6. Jian ZM, Cao JD, Zhu XG, et al. The impact of alanyl-glutamine on clinical safety, nitrogen balance, intestinal permeability, and clinical outcome in postoperative patients: a randomized, double-blind, controlled study of 120 patients. JPEN J Parenter Enteral Nutr 1999;23:S62-6.
     7. Morais AA, Santos JE, Faintuch J. Comparative study of arginine and glutamine supplements in malnourished surgical patients. Rev Hosp Clin Fac Med Sao Paulo 1995;50:276-9 [in Portugese].
   • The amino acid glutamine may benefit athlete’s immune systems. Double-blind trials giving athletes glutamine reported 81% having no subsequent infection compared with 49% in the placebo group.
     1. Antonio J, Street C. Glutamine: a potentially useful supplement for athletes. Can J Appl Physiol 1999;24:1-14 [review].
     2. Rowbottom DG, Keast D, Morton AR. The emerging role of glutamine as an indicator of exercise stress and overtraining. Sports Med 1996;21:80-97 [review].
     3. Welbourne TC. Increased plasma bicarbonate and growth hormone after an oral glutamine load. Am J Clin Nutr 1995;61:1058-61.
     4. Macintyre JG. Growth hormone and athletes. Sports Med 1987;4:129-42 [review].
     5. Varnier M, Leese GP, Thompson J, et al. Stimulatory effect of glutamine on glycogen accumulation in human skeletal muscle. Am J Physiol 1995;269:E309-15.
     6. Antonio J, Sanders MS, Kalman D, et al. The effects of high-dose glutamine ingestion on weightlifting performance. J Strength Cond Res 2002;16:157-60.
     7. Haub MD, Potteiger JA, Nau KL, et al. Acute L-glutamine ingestion does not improve maximal effort exercise. J Sports Med Phys Fitness 1998;38:240-4.
     8. Rohde T, MacLean DA, Pedersen BK. Effect of glutamine supplementation on changes in the immune system induced by repeated exercise. Med Sci Sports Exerc 1998;30:856-62.
     9. Castell LM, Newsholme EA. Glutamine and the effects of exhaustive exercise upon the immune response. Can J Physiol Pharmacol 1998;76:524-32 [review].
     10. Castell LM, Poortmans JR, Newsholme EA. Does glutamine have a role in reducing infections in athletes? Eur J Appl Physiol 1996;73:488-90.
   • A study giving athletes glutamine, an amino acid important for immune system function, reported significantly fewer infections with glutamine.
     1. Jones C, Palmer TE, Griffiths RD. Randomized clinical outcome study of critically ill patients given glutamine-supplemented enteral nutrition. Nutrition 1999;15:108-15.
     2. Griffiths RD. Outcome of critically ill patients after supplementation with glutamine. Nutrition 1997;13:752-4 [review].
     3. Nieman DC. Exercise and resistance to infection. Can J Physiol Pharmacol 1998;76:573-80 [review].
     4. Rohde T, MacLean DA, Pedersen BK. Effect of glutamine supplementation on changes in the immune system induced by repeated exercise. Med Sci Sports Exerc 1998;30:856-62.
     5. Castell LM, Newsholme EA. Glutamine and the effects of exhaustive exercise upon the immune response. Can J Physiol Pharmacol 1998;76:524-32 [review]. 6. Castell LM, Poortmans JR, Newsholme EA. Does glutamine have a role in reducing infections in athletes? Eur J Appl Physiol 1996;73:488-90.
     6. Zachary Legault 1, Nicholas Bagnall, Derek S Kimmerly. The Influence of Oral L-Glutamine Supplementation on Muscle Strength Recovery and Soreness Following Unilateral Knee Extension Eccentric Exercise. https://pubmed.ncbi.nlm.nih.gov/25811544/
     7. T Rohde 1, D A MacLean, B K Pedersen. Effect of glutamine supplementation on changes in the immune system induced by repeated exercise. https://pubmed.ncbi.nlm.nih.gov/9624643/
7. Zinc & Magnesium
   • Zinc lozenges used at the first sign of a cold have been shown to help stop the virus and shorten the illness.
     1. Macknin ML. Zinc lozenges for the common cold. Cleve Clin J Med 1999;66:27-32 [review].
     2. Eby G, Davis DR, Halcomb WW. Reduction in duration of common colds by zinc gluconate lozenges in a double-blind study. Antimicrobial Agents Chemotherapy 1984;25:20-4.
     3. Al-Nakib W, Higgins PG, Barrow I, et al. Prophylaxis and treatment of rhinovirus colds with zinc gluconate lozenges. J Antimicrobial Chemotherapy 1987;20:893-901.
     4. Prasad AS, Beck FWJ, Bao B, Snell D, Fitzgerald JT. Duration and severity of symptoms and levels of plasma interleukin-1 receptor antagonist, soluble tumor necrosis factor receptor, and adhesion molecules in patients with common cold treated with zinc acetate. J Infect Dis 2008;197:795-802.
     5. Macknin ML, Piedmonte M, Calendine C, et al. Zinc gluconate lozenges for treating the common cold in children. A randomized controlled trial. JAMA 1998;279:1962-7.
     6. Petrus EJ, Lawson KA, Bucci LR, Blum K. Randomized, double-masked, placebo-controlled clinical study of the effectiveness of zinc acetate lozenges on common cold symptoms in allergy-tested subjects. Curr Ther Res 1998;59:595-607.
     7. Prasad AS, Fitzgerald JT, Bao B, et al. Duration of symptoms and plasma cytokine levels in patients with the common cold treated with zinc acetate. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 2000;133:245-52.
     8. Eby G. Where’s the bias? Ann Intern Med 1998;128:75 [letter].
     9. Garland ML, Hagmeyer KO. The role of zinc lozenges in treatment of the common cold. Ann Pharmacolther 1998;32:63-9 [review].
     10. Weismann K, Jakobsen JP, Weismann JE, et al. Zinc gluconate lozenges for common cold. A double-blind clinical trial. Dan Med Bull 1990;37:279-81.
     11. Jackson JL, Peterson C, Lesho E. A meta-analysis of zinc salts lozenges and the common cold. Arch Intern Med 1997;157:2373-6.
     12. Macknin ML. Zinc lozenges for the common cold. Cleve Clin J Med 1999;66:27-32 [review].
   • Zinc deficiencies can impair immune function. Supplementing with zinc has been shown to increase immune function in healthy people. Zinc lozenges have been found helpful in against the common cold.
     1. Fraker PJ, Gershwin ME, Good RA, Prasad A. Interrelationships between zinc and immune function. Fed Proc 1986;45:1474-9.
     2. Prasad AS, Beck FWJ, Bao B, et al. Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress. Am J Clin Nutr 2007;85:837-44.
   • Zinc helps with healing. Even a mild deficiency can interfere with optimal recovery from everyday tissue damage and more serious trauma.
     1. Sandstead HH. Understanding zinc: Recent observations and interpretations. J Lab Clin Med 1994;124:322-7.
     2. Tenaud I, Sainte-Marie I, Jumbou O, et al. In vitro modulation of keratinocyte wound healing integrins by zinc, copper and manganese. Br J Dermatol 1999;140:26-34.
     3. Pereira CE, Felcman J. Correlation between five minerals and the healing effect of Brazilian medicinal plants. Biol Trace Elem Res 1998;65:251-9.
     4. Carlisle EM. Silicon as an essential trace element in animal nutrition. Ciba Found Symp 1986;121:123-39.
     5. Leach RM. Role of manganese in mucopolysaccharide metabolism. Fed Proc 1971;30:991.
   • Exercise depletes zinc, and severe zinc deficiency can compromise muscle function. One trial found that zinc improved muscle strength, and another study of athletes with low zinc levels found that zinc improved red blood cell flexibility during exercise, which could benefit blood flow to the muscles.
     1. Lukaski HC. Magnesium, zinc, and chromium nutriture and physical activity. Am J Clin Nutr 2000;72:585S-93S [review].
     2. Van Loan MD, Sutherland B, Lowe NM, et al. The effects of zinc depletion on peak force and total work of knee and shoulder extensor and flexor muscles. Int J Sport Nutr 1999;9:125-35.
     3. Manore MM. Dietary recommendations and athletic menstrual dysfunction. Sports Med 2002;32:887-901 [review].
     4. Micheletti A, Rossi R, Rufini S. Zinc status in athletes: relation to diet and exercise. Sports Med 2001;31:577-82 [review].
     5. Krotkiewski M, Gudmundsson M, Backstrom P, Mandroukas K. Zinc and muscle strength and endurance. Acta Physiol Scand 1982;116:309-11.
     6. Khaled S, Brun JF, Cassanas G, et al. Effects of zinc supplementation on blood rheology during exercise. Clin Hemorheol Microcirc 1999;20:1-10.
   • Zinc supplements have been reported to increase immune function. Some doctors recommend zinc supplements for people with recurrent infections.
     1. Pike J, Chandra RK. Effect of vitamin and trace element supplementation on immune indices in healthy elderly. Int J Vitam Nutr Res 1995;65:117-21.
     2. Chandra RK. Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Lancet 1992;340:1124-7.
     3. Chavance M, Herbeth B, Lemoine A, et al. Does multivitamin supplementation prevent infections in healthy elderly subjects? A controlled trial.Int.J Vitam Nutr Res 1993;63:11-6.
     4. Girodon F, Lombard M, Galan P, et al. Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann Nutr Metab 1997;41:98-107.
     5. Berger MM, Spertini F, Shenkin A, et al. Trace element supplementation modulates pulmonary infection rates after major burns: a double-blind, placebo- controlled trial. Am J Clin Nutr 1998;68:365-71.
     6. Duchateau J, Delespesse G, Vereecke P. Influence of oral zinc supplementation on the lymphocyte response to mitogens of normal subjects. Am J Clin Nutr 1981;34:88-93.
     7. Fraker PJ, Gershwin ME, Good RA, Prasad A. Interrelationships between zinc and immune function. Fed Proc 1986;45:1474-9.
     8. Fortes C, Forastiere F, Agabiti N, et al. The effect of zinc and vitamin A supplementation on immune response in an older population. J Am Geriatr Soc 1998;46:19-26.
     9. Girodon F, Lombard M, Galan P, et al. Effect of micronutrient supplementation on infection in institutionalized elderly subjects: a controlled trial. Ann Nutr Metab 1997;41:98-107.
     10. Chandra RK. Excessive intake of zinc impairs immune responses. JAMA 1984;252:1443.
     11. Macknin ML. Zinc lozenges for the common cold. Cleve Clin J Med 1999;66:27-32 [review].
   • Zinc is important for proper immune system function and wound healing. Zinc supplements taken before surgery may prevent zinc deficiency and promote healing.
     1. Thomas DR. Specific nutritional factors in wound healing. Adv Wound Care 1997;10:40-3 [review].
     2. Stotts NA, Whitney JD. Nutritional intake and status of clients in the home with open surgical wounds. J Community Health Nurs 1990;7:77-86.
     3. Yamamoto R, Inoue K, Hori T, et al. Clinical evaluation of changes in serum zinc and copper concentrations around pulmonary operation. Nippon Kyobu Geka Gakkai Zasshi 1994;42:1178-83 [in Japanese].
   • Zinc nasal sprays appear to be effective at shortening the duration of cold symptoms, however, some people have experienced long-lasting or permanent loss of smell after using the spray.
     1. Jafek BW, Linschoten MR, Murrow BW. Anosmia after intranasal zinc gluconate use. Am J Rhinol 2004;18:137-41.
     2. Macknin ML. Zinc lozenges for the common cold. Cleve Clin J Med 1999;66:27-32 [review].
     3. Hirt M, Nobel S, Barron E. Zinc nasal gel for the treatment of common cold symptoms: a double-blind, placebo-controlled trial. Ear Nose Throat J 2000;79:778-80.
     4. Belongia EA, Berg R, Liu K. A randomized trial of zinc nasal spray for the treatment of upper respiratory illness in adults. Am J Med 2001;111:103-8. BB.
   • Supplementing with magnesium may reverse poor magnesium status and improve diabetic peripheral neuropathy, but does not appear to be helpful for preventing or treating chemotherapy-induced neuropathy.
     1. Zhang Q, Ji L, Zheng H, et al. Low serum phosphate and magnesium levels are associated with peripheral neuropathy in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract 2018;146:1–7.
     2. Zhang Y, Li Q, Xin Y, et al. Association between serum magnesium and common complications of diabetes mellitus. Technol Health Care 2018;26:379–87.
     3. Joy S, George T, Siddiqui K. Low magnesium level as an indicator of poor glycemic control in type 2 diabetic patients with complications. Diabetes Metab Syndr 2019;13:1303–7.
     4. De Leeuw I, Engelen W, De Block C, Van Gaal L. Long term magnesium supplementation influences favourably the natural evolution of neuropathy in Mg- depleted type 1 diabetic patients (T1dm). Magnes Res 2004;17:109–14.
     5. Wesselink E, Winkels R, van Baar H, et al. Dietary Intake of Magnesium or Calcium and Chemotherapy-Induced Peripheral Neuropathy in Colorectal Cancer Patients. Nutrients 2018;10.
     6. Jordan B, Jahn F, Beckmann J, et al. Calcium and Magnesium Infusions for the Prevention of Oxaliplatin-Induced Peripheral Neurotoxicity: A Systematic Review. Oncology 2016;90:299–306.
   • Supplementing with magnesium has been shown to stop bone loss or increased bone mass in people with osteoporosis.
     1. Cohen L, Laor A, Kitzes R. Magnesium malabsorption in postmenopausal osteoporosis. Magnesium 1983;2:139-43.
     2. Cohen L, Kitzes R. Infrared spectroscopy and magnesium content of bone mineral in osteoporotic women. Isr J Med Sci 1981;17:1123-5.
     3. Geinster JY, Strauss L, Deroisy R, et al. Preliminary report of decreased serum magnesium in postmenopausal osteoporosis. Magnesium 1989;8:106-9.
     4. Dimai H-P, Porta S, Wirnsberger G, et al. Daily oral magnesium supplementation suppresses bone turnover in young adult males. J Clin Endocrinol Metab 1998;83:2742-8.
     5. Stendig-Lindberg G, Tepper R, Leichter I. Trabecular bone density in a two year controlled trial of peroral magnesium in osteoporosis. Magnesium Res 1993;6:155-63.
     6. Carpenter TO, DeLucia MC, Zhang JH, et al. A randomized controlled study of effects of dietary magnesium oxide supplementation on bone mineral content in healthy girls. J Clin Endocrinol Metab 2006;91:4866-72.
     7. Abraham GE, Grewal H. A total dietary program emphasizing magnesium instead of calcium. J Reprod Med 1990;35:503-7.
   • Magnesium deficiency can reduce exercise performance and contribute to muscle cramps. Studies suggest that taking magnesium might improve performance, although possibly only for those who are deficient or who are not highly trained athletes.
     1. McDonald R, Keen CL. Iron, zinc and magnesium nutrition and athletic performance. Sports Med 1988;5:171-84 [review].
     2. Lukaski HC. Magnesium, zinc, and chromium nutriture and physical activity. Am J Clin Nutr 2000;72:585S-93S [review].
     3. Golf SW, Bohmer D, Nowacki PE. Is magnesium a limiting factor in competitive exercise? A summary of relevant scientific data. In: Golf S, Dralle D, Vecchiet L, eds. Magnesium 1993. London: John Libbey & Company, 1993:209-20.
     4. Ripari P, Pieralisi G, Giamberardino MA, Vecchiet L. Effects of magnesium picolinate on some cardiorespiratory submaximal effort parameters. Magnes Res 1989;2:70-4.
     5. Weller E, Bachert P, Meinck HM, et al. Lack of effect of oral Mg-supplementation on Mg in serum, blood cells, and calf muscle. Med Sci Sports Exerc 1998;30:1584-91.
     6. Brilla LR, Haley TF. Effect of magnesium supplementation on strength training in humans. J Am Coll Nutr 1992;11:326-9.
     7. Golf SW, Bender S, Gruttner J. On the significance of magnesium in extreme physical stress. Cardiovasc Drugs Ther 1998;12(Suppl 2):197-202.
     8. Manore M, Merkel J, Helleksen JM, et al. Longitudinal changes in magnesium status in untrained males: effect of two different 12-week exercise training programs and magnesium supplementation. In: Kies CV, Driskell JA, eds. Sports nutrition: minerals and electrolytes. Boca Raton, FL: CRC Press, 1995:179-87.
     9. Brilla LR, Gunter KB. Effect of magnesium supplementation on exercise time to exhaustion. Med Exer Nutr Health 1995;4:230-3.
     10. Finstad EW, Newhouse IJ, Lukaski HC, et al. The effects of magnesium supplementation on exercise performance. Med Sci Sports Exerc 2001;33:493-8.
     11. Finstad EW, Newhouse IJ, Lukaski HC, et al. The effects of magnesium supplementation on exercise performance. Med Sci Sports Exerc 2001;33:493-8.
     12. Lukaski HC. Magnesium, zinc, and chromium nutriture and physical activity. Am J Clin Nutr 2000;72:585S-93S [review].
     13. Jeroen H F de Baaij 1, Joost G J Hoenderop 1, René J M Bindels 1. Magnesium in man: implications for health and disease. https://pubmed.ncbi.nlm.nih.gov/25540137/
     14. Forrest H Nielsen 1. Effects of magnesium depletion on inflammation in chronic disease. https://pubmed.ncbi.nlm.nih.gov/25023192/
     15. M Barbagallo 1, L J Dominguez. Magnesium and aging. https://pubmed.ncbi.nlm.nih.gov/20388094/
     16. Forrest H Nielsen 1. Magnesium, inflammation, and obesity in chronic disease. https://pubmed.ncbi.nlm.nih.gov/20536778/
8. Vitamin K
   • Vitamin K is needed for bone formation, and supplementing with it may be a way to maintain bone mass.
     1. Hart JP. Circulating vitamin K1 levels in fractured neck of femur. Lancet 1984;2:283 [letter].
     2. Tamatani M, Morimoto S, Nakajima M, et al. Decreased circulating levels of vitamin K and 25-hydroxyvitamin D in osteopenic elderly men. Metabolism 1998;47:195-9.
     3. Feskanich D, Weber P, Willett WC, et al. Vitamin K intake and hip fractures in women: a prospective study. Am J Clin Nutr 1999;69:74-9.
     4. Booth SL, Tucker KL, Chen H, et al. Dietary vitamin K intakes are associated with hip fracture but not with bone mineral density in elderly men and women. Am J Clin Nutr 2000;71:1201-8.
     5. Knapen MHJ, Hamulyak K, Vermeer C. The effect of vitamin K supplementation on circulating osteocalcin (Bone Gla protein) and urinary calcium excretion. Ann Intern Med 1989;111:1001-5.
     6. Orimo H, Shiraki M, Fujita T, et al. Clinical evaluation of Menatetrenone in the treatment of involutional osteoporosis—a double-blind multicenter comparative study with 1-alpha- hydroxyvitamin D3. J Bone Mineral Res 1992;7(Suppl 1):S122.
     7. Iwamoto I, Kosha S, Noguchi S, et al. A longitudinal study of the effect of vitamin K2 on bone mineral density in postmenopausal women a comparative study with vitamin D3 and estrogen-progestin therapy. Maturitas 1999;31:161-4.
     8. Shiraki M, Shiraki Y, Aoki C, Miura M. Vitamin K2 (menatetrenone) effectively prevents fractures and sustains lumbar bone mineral density in osteoporosis. J Bone Miner Res 2000;15:515-21.
     9. Ronn SH, Harslof T, Pedersen SB, Langdahl BL. Vitamin K2 (menaquinone-7) prevents age-related deterioration of trabecular bone microarchitecture at the tibia in postmenopausal women. Eur J Endocrinol 2016;175:541–9.
     10. Knapen MHJ, Drummen NE, Smit E, et al. Three-year low-dose menaquinone-7 supplementation helps decrease bone loss in healthy postmenopausal women. Osteoporos Int 2013;24:2499–507.
     11. Debra Sullivan, Brett Smiley. Understanding Vitamin K deficiency. https://www.healthline.com/health/vitamin-k-deficiency#prevention
     12. Committee on Fetus and Newborn. (2003). Controversies concerning vitamin K and the newborn. https://pediatrics.aappublications.org/content/112/1/191.long
     13. Facts about vitamin K deficiency bleeding. (2014). cdc.gov/ncbddd/vitamink/facts.html
     14. Harris N. (2012). The international normalized ratio: How well do we understand this measurement? aacc.org/community/national-academy-of-clinical-biochemistry/scientific-shorts/2012/the-international-normalized-ratio-how-well-do-we-understand-this-measurement
     15. Johnson LE. (2016). Vitamin K. https://www.merckmanuals.com/professional/nutritional-disorders/vitamin-deficiency,-dependency,-and-toxicity/vitamin-k-deficiency?redirectid=564
     16. Nutrient intakes from food and beverages: mean amounts consumed per individual, by gender and age, in the United States, 2013-2014. (2016). https://ars.usda.gov/ ARSUserFiles/80400530/pdf/1314/Table_1_NIN_GEN_13.pdf
     17. Pazirandeh S, et al. (2016). Overview of vitamin K. https://uptodate.com/contents/overview-of-vitamin-k
     18. Vitamin K [Fact sheet]. (2016). https://ods.od.nih.gov/factsheets/VitaminK-HealthProfessional/
     19. Why do parents decline vitamin K for their newborns? (2014). DOI: 10.1001/jama.2013.285355
     20. Martin J Shearer 1, Xueyan Fu, Sarah L Booth. Vitamin K nutrition, metabolism, and requirements: current concepts and future research. https://pubmed.ncbi.nlm.nih.gov/22516726/
     21. Devyani Misra 1, Sarah L Booth, Irina Tolstykh, David T Felson, Michael C Nevitt, Cora E Lewis, James Torner, Tuhina Neogi. Vitamin K deficiency is associated with incident knee osteoarthritis. https://pubmed.ncbi.nlm.nih.gov/23410565/
     22. Sarah Cockayne 1, Joy Adamson, Susan Lanham-New, Martin J Shearer, Simon Gilbody, David J Torgerson. Vitamin K and the prevention of fractures: systematic review and meta-analysis of randomized controlled trials. https://pubmed.ncbi.nlm.nih.gov/16801507/

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