Recommendations for use

It is strongly recommended that CosaminDS be taken only in conjunction with advice from your physician or other health professionals. CosaminDS is a nutraceutical not a drug. There are no known contraindications for its use or interactions with other compounds, but responsible health care management for degenerative joint conditions should include seeking advice and a consideration of all the other factors that help management of the condition.

Recommended Dosage Regime as a Dietary Supplement

• Adults weighing under 90kg (200lbs) should take three (3) capsules daily, preferably with meals followed by a glass of water; (2) in the morning, (1) in the evening.
• Individuals weighing over 90kg (200lbs) should take two (2) capsules twice a day, preferably with meals followed by a glass of water.
• After 60 days, the number of capsules taken can be gradually decreased to a level that maintains the individual. The number of capsules may be increased at any time.
• For individuals who have difficulty swallowing, capsules may be pulled apart and mixed with food or dissolved in non-acidic juice or liquid.

How to use CosaminDS

The abovedosage regime has been found to meet the needs of most people. It is not advisable to take any higher dosage to try and accelerate the intake of ingredients and shorten the time to onset of benefits. The body can only assimilate the nutrients at a certain rate, so excess dosages are merely wasteful. Should you miss taking the capsules for a day or so, do not take extra capsules to compensate. Just resume the usual dosage.

If you do not like swallowing capsules, they may be broken apart and the powdery ingredients mixed with food or a drink. This will not affect their uptake or effect.

Some people may experience flatulence or mild diarrhoea when first taking CosaminDS. This can be avoided by taking the capsules with meals, followed by a glass of water. However, should flatulence occur, it may be advisable to spread the dosage out by taking one capsule three times daily, rather than two in the morning and one or two in the evening. Any flatulence is usually a temporary problem and does not occur with maintenance dosages.

Once the benefits of CosaminDS become apparent, just one capsule daily generally maintains the effect. The dose that best suits you may be higher or lower than this however.

Benefit from CosaminDS is generally experienced after 4-8 weeks of usage. In some cases, longer periods, even up to 4 months of regular usage, have been required to help cartilage achieve structural and functional improvement.

List of Contents

Each Capsule Contains:

Glucosamine HCl 99+%	500mg
Sodium Chondroitin Sulphate 95%	400mg
Mixed Glycosaminoglycans	5%
Ascorbate (as Manganese Ascorbate)	66mg
Manganese (as Manganese Ascorbate)	10mg

OA Management Programme

The aims of osteoarthritis management are to reduce pain, optimise mobility and flexibility and to avoid or minimise joint deformity. 
Our general recommendations are:

1. Consult a physician for evaluation and assessment of your arthritic condition.
2. It is well-documented that weight reduction significantly reduces the risk of developing osteoarthritis. Weight loss is encouraged if obesity has already caused stress to weight-bearing joints such as the hips and in particular, the knees.
3. Eat a joint-healthy diet containing fresh fruit; raw or lightly cooked vegetables; whole grain breads and cereal; fish and chicken. Drink plenty of water especially when taking medication.
4. Exercise a little but often to strengthen joint-supporting muscles, tendons and ligaments. Stretch regularly for flexibility. Learn relaxation techniques. Water exercise and swimming, especially in warm water, allows arthritic joints to work without impact loading and pain. If necessary consult a physiotherapist to design an exercise programme tailored for your needs. This will help preserve the function of the joints and protect them from further damage.
5. Take precautions to prevent injury. If the joints are inflamed rest them. If a joint is injured rest, treat and recover before resuming vigorous exercise. Always warm up before exercise, stretch when warm and take time to cool down.
6. Counteract stress to damaged joints with the use of aids such as walking sticks, neck collar, splints, brace, bath and shower grab bars. Physicians, physiotherapists and occupational therapists can provide appropriate advice.
7. Use the support and information provided by the Arthritis Foundation, read the recommended books and consult the websites listed on the Biocel Webpage to gain a better understanding of osteoarthritis.

Additional Considerations

Degenerative joint disease is often associated with the ageing process. In women especially, development of osteoporosis (weakening of the bones) may accompany the condition.
Where osteoporosis accompanies osteoarthritis, or reduced physical activity may be contributing to an increased resorption of bone, it may be advisable to consider other supplements in addition to CosaminDS.

Supplemental calcium, magnesium, ipriflavone, antioxidants, and appropriate vitamins, can all help to manage or reduce the onset of osteoporosis and osteoarthritis. Your physician can advise on the use of additional supplements.

As well, urinary testing for levels of pyridinium and deoxypyridinium (diagnostic markers that indicate increased rates of bone resorption and cartilage matrix degeneration), can indicate when nutritional supplements or other measures may be helpful in the early stages of degeneration.

Compatibility with Other Medications

There is no evidence that CosaminDS interacts with any drug or other medication. However, some questions that have been raised, are answered below:

Can CosaminDS be taken with Anti-coagulants?

From clinical studies and user experience there is no evidence that CosaminDS affects blood clotting. However, as many factors influence clotting, we recommend that individuals taking anti-coagulant therapy (e.g. warfarin) have their clotting times monitored when first taking CosaminDS.

I am a diabetic. Can I take CosaminDS?

Yes. Although glucosamine and chondroitin sulphate are classed as carbohydrates (sugars), the body is not able to break them down into glucose. These compounds do not raise blood sugar by providing an additional source of glucose. However, many factors can affect insulin secretion and blood glucose levels, and we recommend that diabetic patients monitor their blood glucose levels more closely when first taking CosaminDS.

Is CosaminDS safe to take during pregnancy?

No studies have specifically address this question, so the use of CosaminDS during pregnancy should be an individual decision made by the individual in consultation with a physician.

I am allergic to sulpha drugs. Can I take CosaminDS?

Yes! Chondroitin sulphate has no molecular similarity to the antibacterial “sulpha” drugs. The sulphate part of chondroitin sulphate refers to its salt form and comprises sulphur and oxygen atoms. Sulpha drugs are entirely different in structure to chondroitin sulphate.