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Joint Health Supplements: Information and How to Read a Product Label

Nutrition - Feb 22nd, 13

A Nutramax brochure

Nutritional supplements abound – products for joint health support, a shiny coat, hoof care, and much, much more. And the supplement industry continues to grow. Joint health support products make up a large part of the many supplements available.

Many ingredients have been touted for joint health. Some have been shown effective alone and/or in combination in published equine research, and others have less to back their claimed benefits. Ingredients often found in supplements are listed below. Your veterinarian is an excellent source of additional information about these ingredients.


5.4-18 g/day1-3*

Supports cartilage production. Improves joint comfort. Inhibits inflammatory mediators (these contribute to cartilage breakdown and joint pain).

Equine Research: Yes

Chondroitin sulfate

1.8-6 g/day1-3*

Supports production and slows breakdown of cartilage. Improves joint comfort. Inhibits inflammatory mediators. Glucosamine and chondroitin sulfate have been shown in published equine cell research to work better together than either alone.4 Absorption of chondroitin sulfate especially can vary, so it is important to choose one that has been shown to be absorbable in horses.5

Equine Research: Yes

ASU (avocado/soybean unsaponifiables)

1-6 g/day6,8*

Supports cartilage production and slows breakdown.6 Inhibits inflammatory mediators. The combination of glucosamine and chondroitin sulfate plus ASU has been shown to work better in equine cartilage cell studies than glucosamine and chondroitin sulfate alone at inhibiting certain inflammatory mediators.7

Equine Research: Yes

HA (hyaluronic acid)

100 mg/day used in OCD study9; wide range of manufacturer-recommended doses: 20-300 mg/day*

One study found less joint effusion (swelling),compared to horses not taking HA, after arthroscopicremoval of an OCD lesion.9

Equine Research: Yes

Omega-3 fatty acids

Study evaluating stride length used 4.59 g DHA+EPA/ day11; 7.5-19 g/day recommended*

Inhibits inflammatory mediators. Slows breakdown of cartilage. May have some analgesic effects.10 An equine study noted a trend towards increased stride length at a trot.11

Equine Research: Yes

MSM (methylsulfonylmethane)

Equine study used 9 mg/kg12; 10 g/day13 recommended for joint health benefits*

Proposed anti-inflammatory activity in the joint, though exactly how is not known. A study in exercised horses given MSM reported anti-inflammatory and antioxidant benefits in the bloodstream.12

Equine Research: Yes 

Cetyl myristoleate

5-7.5 g/day14*

Said to have anti-inflammatory activity, though mechanism not known. In one study, the lameness scores of horses taking a cetyl-m product improved.14

Equine Research: Yes

Yucca and devil’s claw

Wide range of manufacturer-recommended doses for both: yucca: 100 mg-10 g/day; devil’s claw: 2-8.5 g/day*

Said to have anti-inflammatory activity, though how is not known. Manufacturers warn not to give devil’s claw to pregnant mares as can cause uterine contractions or to give devil’s claw with NSAIDs (nonsteroidal anti-inflammatory drugs.)

Equine Research: No

*Levels used in published studies and/or recommended for 1,100 lb (500 kg) horse (given orally)

All joint health supplements are not created equal, and many poor-quality products are being marketed. A published study evaluating human supplements found that only five out of 32 products tested met label claim (contained the level of active ingredient(s), in this case chondroitin sulfate, stated on the label).15 A more recent published analysis of equine joint health supplements also revealed quality problems. Nine out of 23 glucosamine products failed to meet label claim, with four products having less than 30% of the labeled amount.16

So which joint health supplement to choose for your horse? The quality issues make it very challenging to make this decision. How do you know that the product you’re selecting contains what the label says it does, plus is safe and effective? Even if the supplement contains what is listed on the label, are the levels of ingredients included those levels that have been found to be helpful? Sorting through what may seem to be an endless array of products to find the optimal product for your horse can be a difficult task.

The good news is that you can use the product label to your advantage. Just take a few minutes and use the guide below, known by the acronym ACCLAIM, when looking at a joint health supplement label to help you make your choice. This same guide can be used to evaluate other kinds of supplements, too.

A company name you recognize

Joint health supplements made by established companies that offer educational material to both you and to veterinarians are generally a better choice over companies that you’re not familiar with and that offer no educational information about their products.

Clinical experience

Look for a company that supports clinical research showing safety and efficacy of its products in horses. Results should be published in peer-reviewed journals to which your veterinarian will have access.


Ingredients should be clearly noted on the label.

Label Claims

The products should not include unrealistic claims. Stay away from products using words like “cure” or “prevent.” Testimonials aren’t necessarily a bad thing, but a company with only testimonials and no scientific data to support its claims is less likely to be producing a quality supplement.

Administration recommendations

How to administer the supplement to your horse should be clearly stated on the label. You should be able to determine how much of each active ingredient you’re giving your horse per day.

Identification of lot and expiration date

Choose a joint health supplement with a lot number and expiration date noted on the label. A lot number means that the company has a tracking system in place to ensure product quality. An expiration date shows that the company has evaluated product quality over time.

Manufacturer information

Information about the manufacturer should include name, address, phone number, and website. You should have a way to contact the company if you have a question.

(Adapted from Oke SL, McIlwraith CW. Review of the potential indications and contraindications for equine oral joint health supplements, in Proceedings. 54th Annual AAEP Convention 2008.)

Don’t forget to talk to your veterinarian when thinking about starting the use of a joint health supplement. Your veterinarian will often have recommendations, depending on discipline, age of your horse, and medical history, etc., on which ingredients or specific products may be most helpful. Your veterinarian may suggest combining a particular supplement with something else, such as NSAIDs (by mouth or injectable), other injectables (e.g., polysulfated glycosaminoglycans and hyaluronic acid), and/or an exercise program. It is always a good idea to manage your horse’s health as a team with your veterinarian.

And there are some things that you can do to promote overall wellness and prevent joint injuries:

• Maintain a healthy weight for your horse to avoid undue stress on the joints

• Ensure your horse is receiving a balanced diet to prevent nutritional deficiencies

• Warm up and cool down your horse with every ride to allow your horse’s body to prepare for and recover from exercise

• Schedule regular hoof trimmings with a proficient farrier to maintain balance in your horse’s feet, which will help prevent stress to the joints.

If an injury or lameness occurs, you should always consult your veterinarian.


 1. Hanson RR, Smalley LR, Huff GK, et al. Oral treatment with a glucosamine-chondroitin sulfate compound for degenerative joint disease in horses: 25 cases. Eq Practice 1997;19(9):16-22.

2. Forsyth RK, Bridgen CV, Northrop AJ. Double blind investigation of the effects of oral supplementation of combined glucosamine hydrochloride (GHCL) and chondroitin sulphate (CS) on stride characteristics of veteran horses. Equine Vet J Suppl 2006;36:622-625.

3. Gupta RC, Canerdy TD, Skaggs P, et al. Therapeutic efficacy of undenatured type-II collagen (UC-II) in comparison to glucosamine and chondroitin in arthritic horses. J Vet Pharmacol Therap 2009;32(6):577-584.

4. DeChant JE, Baxter GM, Frisbie DD, et al. Effects of glucosamine and chondroitin sulphate, alone and in combination, on normal and interleukin-1 conditioned equine articular cartilage explant metabolism. Equine Vet J 2005;37(3):227-231.

5. Du J, White N, Eddington ND. The bioavailability and pharmacokinetics of glucosamine hydrochloride and chondroitin sulfate after oral and intravenous single dose administration in the horse. Biopharm Drug Dispos 2004;25:109-116.

6. Kawcak CE, Frisbie DD, McIlwraith CW, et al. Evaluation of avocado and soybean unsaponifiable extracts for treatment of horses with experimentally induced osteoarthritis. Am J Vet Res 2007;68:598-604.

7. Au R, Au A, Rashmir-Raven A, et al. Inhibition of pro-inflammatory gene expression in chondrocytes, monocytes, and fibroblasts by the combination of avocado soybean unsaponifiables, glucosamine, and chondroitin sulfate. FASEB J 2007;21(6):A736.

8. Kettenacker RW, Griffin D. Safety profile evaluation of an equine joint health supplement containing avocado/soybean unsaponifiables (ASU), glucosamine, chondroitin sulfate and methylsulfonylmethane (MSM). 2007 AAVPT 15th Biennial Symposium; poster presentation.

9. Bergin BJ, Pierce SW, Bramlage LR, Stromberg A. Oral hyaluronan gel reduces postoperative tarsocrural effusion in the yearling Thoroughbred. Equine Vet J 2006;38(4) :375-378.

10. Munsterman A, Bertone A, Zachos T, et al. Effects of the omega-3 fatty acid, linolenic acid, on lipopolysaccharide-challenged synovial explants from horses. Am J Vet Res 2005;66;1503-1508.

11. Woodward AD, Nielson BD, O’Connor CI, et al. Supplementation of dietary long-chain polyunsaturated omega-3 fatty acids high in docosahexaenoic acid (DHA) increases plasma DHA concentration and may increase trot stride lengths in horses. Equine Comp Exerc Physiol 4(2):71-78.

12. Marañón G, Muñoz-Escassi B, Manley W, et al. The effect of methyl sulphonyl methane supplementation on biomarkers of oxidative stress in sport horses following jumping exercise. Acta Vet Scand 2008; 50:45.

13. Oke S. Oral joint health supplements: chemistry, pharmacology, and administration guidelines.Compendium Equine 2009; May: 177-185.

14. Keegan KG, Hughes FE, Lane T, et al. Effects of an oral nutraceutical on clinical aspects of joint disease in a blinded, controlled clinical trial: 39 horses, Proceedings. 53rd Annual AAEP Convention 2007;53:252-255.

15. Adebowale A, Cox D, Liang Z, Eddington N. Analysis of glucosamine and chondroitin sulfate content in marketed products and the Caco-2 permeability of chondroitin sulfate raw materials. JANA 2000; 3(1):37-44.

16. Oke S, Aghazadeh-Habashi A, Weese JS, Jamali F. Evaluation of glucosamine levels in commercial equine oral supplements for joints. Equine Vet J 2006; 38(1):93-95.