Supplements

We recommend these 4 supplements:

1. Allergy Research Group, Pycnogenol 100 mg, 30 Veg Caps
   1 cap daily with food
   • ALT 1: Pure Encapsulations, Pycnogenol (pine bark extract), 100 mg, 60 cap
   • ALT 2: Now Foods, Pycnogenol, 100 mg, 60 veg caps
2. Integrative Therapeutics, Theracurmin HP, 60 or 120 Veg Caps
   2 caps daily (AM)
   • ALT 1: Bioclinic Naturals, Theracurmin 2X, 75 Veg Caps
   • ALT 2: Klaire Labs, Curcuthera, Meriva 500-SF, 60 Caps
3. Life Extension, 5-LOX Inhibitor with ApresFlex, 100 mg, 60 Cap
   1 cap daily (AM) with food
   • ALT 1: Pure Encapsulations, Boswellia AKBA, 120 Caps
   • ALT 2: Pure Encapsulations, Boswellia, 400 mg, 60 or 120 Capsules
4. Protocol for Life Balance, Glucosamine & Chondroitin, 120 Tab
   2 caps daily (AM) with food
   • ALT 1: Metabolic Maintenance, Glucosamine Chondroitin with Hyaluronic Acid, 60 Caps
   • ALT 2: Anabolic Laboratories, Glucosamine Chondroitin, 90 Tablets
   • ALT 3: Pure Encapsulations, Glucosamine HCI + Chondroitin, Shellfish-free, 120 Capsules

Purchase at www.DSSOrders.com/DrProdromos or call 877-846-7122 Option 1 (8 AM - 6 PM CST)
Registration Code: CP993

IMPORTANT: If a product is not available, one of the alternatives listed can be used instead.

Supplements

What is the Clinical Usefulness of Nutritional Supplements?

Fighting Inflammation:

• Unlike painkillers, nutritional supplements fight the inflammation that causes pain. They help block substances such as TNF-alpha & inflammatory cytokines.
• Unlike NSAID drugs (Motrin, Advil, Aleve, Ibuprofen, Meloxicam, Celebrex, etc.), they do not interfere with healing.

Other Health Benefits:

• Many of the supplements we recommend for arthritis have had studies suggesting other benefits, such as helping to prevent cancer & helping high blood pressure.

Few if Any Side Effects:

• These substances are all generally safe without the side effects that pharmaceutical drugs have (regular glucosamine should not be taken by those with a shellfish allergy, although we have a vegetarian glucosamine that is fine).

Finding the Right Supplement: Purity, Dose & GMP Certification

• Nutritional supplements are not tested & regulated the way pharmaceutical drugs are. Studies have shown that many commonly sold supplements have far different doses in the tablet than what is listed on the label. In some cases, the substances listed on the label are not present in the tablet at all. In other cases, toxic substances such as mercury have been found. The least expensive products are often the worst offenders. Be careful: you get what you pay for!
• The tablets we list on our website are all Good Manufacturing Practice (GMP) certified (recognizable by the blue label on the bottle). They are usually a little more expensive than the cheapest products available – but it is very important to make sure you know exactly what you are taking.
• Some supplements are best taken in certain forms. Curcumin is a great supplement that is found in turmeric, but unlike curcumin, turmeric has oxalates which can cause kidney stones. For this & other reasons, we recommend curcumin supplements rather than turmeric.

What About Topicals?

• Topicals can be a great idea either by themselves or in addition to oral substances. For example, substances such as Frankincense & Arnica are often very effective. Be careful though, because Arnica can be poisonous if taken orally. Frankincense is used to make Boswellic acid, which is a great oral supplement & is used to make the 5-Lipoxygenase (5-lox) oral supplement.
• Be aware that topicals such as Diclofenac cream are actually NSAID drugs which have a potential for toxicity not found in nutritional supplements.
• Be aware of substances that are just liniments which are designed to inflame the skin and “distract” the nervous system from the joint pain. Icy Hot & Bengay are examples. While they do give a sensation of pain relief, they do not treat the underlying problem. They can also cause burns to the skin if used excessively.

What About Getting the Supplement From Diet & Not Tablets?

Using your diet to take healthy supplements is a great idea. Turmeric, aged garlic, ginger & cinnamon are examples of great spices which can be used in cooking & provide health benefits.

Making Sure the Dose on the Bottle Matches the Dose in Studies

We have spent a great deal of time researching the scientific literature to find substances that are efficacious, & have recorded the doses used in these studies in our database. Manufacturers will often market an effective substance, but in a dose that has not been proven effective, usually a much smaller dose. One of the best examples of this is MSM. Many studies have shown efficacy but generally, the dose used is 5000 mg/day. However, many products include MSM in a far lower dose, often only a few hundred mg, a tenth of the proven dose. Our database also recommends the proven dose of a supplement. For MSM, which is usually sold in 1000 mg tablets when it is sold by itself, this would require 5 tablets daily. For this reason, our database lists 1500 mg tablets & recommends 3 tablets daily, providing 4500 mg, which is very close to the 5000 mg dose used in most studies.

Beware Mixed Doses Formulations:

Many mixed formulations have useful substances but in inadequate doses, because there is not room in a tablet for an adequate dose. One reason this is done is because the substances themselves cannot be patented, but the proprietary mixtures can be. For this reason, all the products we recommend (except glucosamine & chondroitin) are single-substance tablets. This allows the proper dosage - in accordance with clinical studies & also makes it easier to start & stop individual supplements to see which the effective product was.

Where & How to Purchase

You may find all the substances our research has shown to be effective on the website: www.DSSOrders.com/DrProdromos

Many supplements can be hard to find & patients often asked for help finding them before we began using this website. All recommended supplements and dosages have been aggregated here as a matter of patient convenience.

You may purchase from this website. The proper dosage & product brand is listed so that you may also use this information to purchase supplements elsewhere. Other brands may be ok, but make sure the dosages match. If you use another brand, also make sure that the product is GMP-certified or tested by an independent agency. Ensuring the product is GMP-certified can be tricky, because some GMP-certified manufacturers may produce a non-GMP-certified product, despite being produced in a GMP-certified facility.

1. Go to the website dssorders.com/Prodromos
2. Click on the “Register” button
3. Register using code CP993 (if you are already registered just login)
4. Click the favorites link
5. Find the supplements prescribed on your orders sheet and check the corresponding box online (NOTE: the supplements are listed alphabetical by company not by supplement name)
6. Click on the blue “Add to Cart” button (at the top or bottom of the page)
7. Click the “Check Out” button
8. Enter your billing & shipping information and complete your order by clicking the “Pay Now” button

Our Clinical Studies Database Showing Efficacy

Several years ago we set out to research all the commonly advertised supplements to see which actually worked using several criteria:

1. Only studies from good medical journals indexed on PubMed were used. This is the National Library of Medicine database & includes only high-quality peer-reviewed journals.
2. The clinical studies needed to demonstrate efficacy in human beings, not animals. Many substances that are effective in animals are not effective in humans.
3. Studies that showed improvement in laboratory markers without clinical data were eliminated. Many substances that improve lab tests do nothing to improve health.
4. Higher importance was placed on studies that tested supplements in comparison to other drugs such as Ibuprofen, or against placebo. These are controlled studies.
5. Less importance was given to studies that included proprietary branded products where the manufacturer was also funding the study. These studies have been shown to be sometimes tainted since there is an obvious financial incentive to bias the results to help sell product.
6. At the beginning of this research 4 years ago, 9 substances had literature showing good efficacy. Since that time, studies have shown good efficacy in 2 more so there are now 11 that we recommend.
7. We recommend these supplements to patients in order of the quality & volume of research showing efficacy.
8. This research was done in order to improve patient knowledge of research-backed supplements. However, just because a substance has not been shown to be effective in good studies does not mean it is not effective for you. So if you try a safe supplement & it works for you, by all means, keep using it, even if it is not on our list.

How to Know What to Take

• Supplement recommendations are based on a patient's particular condition. Some substances have only been shown to be effective for arthritis so we would not recommend them for tendinitis. Some have anti-inflammatory properties for almost any condition. Some supplements have been shown to be better for osteoarthritis, while others are better for inflammatory arthritis such as rheumatoid arthritis.
• Some patients can be expected to do well without any supplements. Younger people (who often have PRP injections) with partial tears of the rotator cuff or chondromalacia of the patella typically do well, so we do not recommend any supplements to avoid bother & expense. However, supplement recommendations can always be made if the patient requests. The best candidates for supplements are generally older patients with more severe arthritis.
• Patients are typically recommended anywhere from 1 to 5 supplements daily initially depending on the patient’s individual clinical condition. Supplements can be added or subtracted subsequently based on our hierarchy of effectiveness on a trial basis.

What about CBD?

At this point, we have identified no good studies showing the efficacy of CBD for musculoskeletal conditions. However, many patients report that CBD is quite helpful, and there are many anecdotal reports of efficacy. Because the anecdotal evidence is so strong we have researched CBD formulations & put both a topical & oral high-quality formulation on DSSorders.com. This is the only substance on the database that has not yet been validated by good studies. However, it is safe & therefore there is no reason not to try it. There have been more than 100 substances isolated from marijuana. Contrary to what you may have read, CBD is indeed somewhat psychoactive. Some studies have shown anti-anxiety & mild sedating properties. However, unlike THC it will not make you “high”.