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FACT SHEET - EVERFLEX
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It has long been known that arthritis is one of the biggest causes of disability in the UK, affecting people of all ages, in particular older people.

Little is known about how people are affected by arthritis. For that reason, 18 months ago the Arthritis Research Campaign embarked on an exercise to find out how big the problem really is, and what, if anything, could be done to relieve their suffering.
The size of the problem
Arthritis Research Campaign (ARC| commissioned two separate studies, one from MORI, and one from the Epidemiology Unit in Manchester.
"What we found was that anhritis represents a much more serious, significant and widespread problem than was previously thought. It also showed that almost twice as many people believe they have arthritis than report their condition to their GP."
"In our MORI poll. 13 million people say they are currently affected by arthritis and joint pain. Yet according to the report by the Epidemiology Unit, this figure is nearer 7 million."
"What there is little doubt about is that the number of people with arthritis in the UK is rising as the population ages, and as a result, the problem is becoming an increasing drain on the NHS and on society."
Rise in number of people with osteoarthritis
According to the Epidemiology Unit report, more than 7 million adults in the UK have long-term health problems associated with arthritis and related conditions. Nearly 9 million visited their GP in the past year for arthritis and related conditions. Such conditions are the second most common cause of days off work in both men and women, after mental disorders. The number of people visiting their GP for arthritis and related conditions rose by almost 39% between 1981 and 1991.
Much of the increase is probably accounted for by a rise in the number of people with osteoarthritis (OA). the most common type of anhritis which tends to affect people as they get older. Around 2 million adults consult their GPs about symptoms of OA each year.
The reasons for this increase in the number of people with OA arc two-fold. One is that the prevalence of OA rises with age. and as the population ages so the number and the proportion of OA rises. Secondly, one of the major risk factors for OA. especially of the knee, is obesity, and the UK has the highest prevalence of obesity in Europe.

The preferred conventional medical treatment for arthritis, particularly osteoarthritis (also known as degenerative joint disease, the most common type of arthritis associated with a breakdown of joint cartilage, especially in the hips, knees and spine), has been nonsteroidal anti-inflammatory drugs (NSAIDs). which include over-the-counter medications such as:
Relafen (nabumetone)
Lodine (etodolac)
Feldene (piroxicam)
Naprosyn (naproxen)
Ansaid (tlurbiprofen)
Indocin (indomethacin)
Vioxx (rofecoxib)
Arthrotec (diclofenuc/misoprostol)
Motrin (ibuprofen)
Daypro (oxaprozin)
Clinoril (sulindac)
Voltaren (diclofenac)
Niilfon (fenoprofen)
Orudis (ketoprofen)
Celebrex (celecoxib)
NSAIDs are used to reduce pain associated with osteoarthritis... however, like most pharmaceutical treatments, they do not address the underlying causes. Further more. NSAIDs have a history of significant side effects. Side effects could include:
• hypertension (high blood pressure) • indigestion
• blood pressure changes • difficulty breathing
• irregular heartbeat • dizziness
• nervousness • drowsiness
• depression • tremor
• light-headedness • rash
• menstrual disorders • eczema
* impotence • heartburn
• ulcer • aslhma
• muscle weakness • leg cramps
• visual disturbances • irritated eyes
• UTI (urinary trad infections) • chest pain
* influenza-like symptoms • fatigue
• elevated liver enzymes • insomnia
• weight increase or decrease • amnesia
• breast pain •cough

EverFlex is a comprehensive nutritional supplement for healthy joints and connective tissues using 4 key natural ingredients. EverFlex is formulated to help reduce pain and inflammation and improve joint mobility, while also providing important nutrients that serve as the building blocks for articular (Joint) cartilage.
As with all Nature's Sunshine products. Everflex is manufactured to the highest standards in the world. Nature's Sunshine uses over 300 quality control tests and manufacture to pharmaceutical standards. Their manufacturing also complies with the Good Manufacturing Practices (GMP) and od Laboratory Practices (GLP) set forth by the USA government and monitored by the FDA.
Two Tablets of EverFlex provides
• Glucosamine hydrochloride (800mg)
• MethyIsnlfonylmethane (MSM) (800mg)
• Chondroitin sulfate (200mg)
• Devil's Claw root (Harpagophytum procumbens) (l(K)mg)
Glucosamine, hydrochloride v sulfate
Most glucosamine supplements use glucosamine sulfate however Nature's Sunshine use glucosamine hydrochloride for optimal results.
• Glucosaminc hydroehloride has a 99% purily (as the specific salt) compared to only 74c/c in glucosamine sulfate.
•The level of active glucosamine (as the free base) is 81. Y/c with glucosaniine hydrochloride, compared to only 47.8%
• with glucosamine sulfate.
• Based on active levels L,500mg of glucosamine hydrochloride is equivalent to 2.608mg of glucosamine sulfatc. Therefore you need far less glucosamine hydrochloride to achieve the same results with glueosamine sulfate.
• Based on one tablet containing 750mgof glucosamine, a person would use one bottle (60 tablets) of glucosamine hydrochloride compared to 1.73 bottles of glucosamine sulfate to achieve the same effects (based on the activity of glucosamine).
GLUCOSAMINE is naturally produced in the body as a key Component of cartilage production and maintenance, which decrease with age. Studies show that glucosamine supplementation improves joint mobility and helps relieve pain, swelling and other symptoms of arthritis, even up to several weeks after discontinuing use. In addition, recent research suggests that glucosamine may actually slow the progression of osleoarthritis by improving the degenerative condition of the joint - glucosamine helps improve the integrity of connective tissue and joint space lubricant, which promotes healing and regeneration of the affected joint.
• For example, a randomised, placebo-controlled clinical trial, published in the prestigious medical journal Lancet, found that osteoarthritis patients taking a placebo exhibited a mean joint space loss of 0.31 mm over the course of the 3-year study, whereas patients receiving glucosamine demonstrated no significant joint space narrowing. Furthermore, while symptoms worsened slightly in patients taking the placebo, those in the glucosamine group actually experienced improvements.
• A 3-month double-blind, placebo-controlled study using glucosamine hydrochloride and chondroilin sulfate found that the combination improved pain and joint tenderness and decreased the number of daily over-the-counter medications needed by paiients suffering from temporomandibular joint (TMJ} disorders, including painful osteoarihrilis of the TMJ.
• One study in Portugal involving 252 doctors and 1.506 patients resulted in 95 percent of the patients achieving noticeable benefit from glucosamine supplementation. These results were belter than any previous treatment including NSAlDs (anti-inflammatory drugs), vitamin therapy and cartilage extracts.
• Another clinical trial compared glucosamine head-to-head with ibuprofen (a commonly prescribed NSAID for the treatment of arthritis). Pain scores decreased more quickly in the ibuprofen group, however by the fourth week the glucosamine group was doing significantly better than the ibuprolen group.
METHYLSULFONYLMETHANE (MSM), a naturally-occurring source of organic sulfur, is found in every cell in the body, with the highest concentrations in the joints, nails, hair and skin. MSM is utilized in the production of connective tissue, including cartilage. Since sulfur is an essential component in all connective tissues, some researchers theorize that sulfurous compounds such as MSM may have potential benefits in the treatment of articular cartilage degeneration, especially considering research which has shown that the sulfur concentration in "arthritic" cartilage is reduced to about one-third the amount found in normal cartilage.
• In support of this theory, a preliminary double-hlind study involving 16 patients with degenerative arthritis showed that those who look MSM daily for 6 weeks experienced an 80% reduction in pain, while patients given a placebo reported only a minimal reduction (approximately 20%) in pain.14-17
CHONDROITIN SULFATE. a major component of articular (joint) cartilage, draws and maintains fluids within the cartilage. These fluids provide "shock absorption" for surrounding bones and supply essential nutrients that not only protect cartilage from being destroyed by certain enzymes, but also support healthy cartilage regeneration and growth. Glucosamine is a smaller compound than Chondroilin. Chondroitin is made up of Glucosamine molecules.

Chondroitin sulfate improves joint function and mobility and reduces pain and inflammation. In fact, the pain-relieving effects of chondroitin sulfate have been shown to be equal to those of anti-inflammatory drugs, even after only one month of use. Furthermore, some studies have found that chondroitin sulfate can slow the progression of osteoarthritis, indicating that it may actually protect joints from damage. Based on the results of preliminary double-blind studies, chondroitin sulfate is widely used in Europe as a treatment for osteoarthritis. For example, a meta-analysis of 4 randomised, double-blind, placebo-controlled studies on chondroitin sulfate. involving a total of 227 patients, found that palients receiving chondroiiin sulfate averaged 50% greater improvement in pain and joint motion than placebo groups after 60 days, with improvements continuing through the end of the studies (150-180 days).
DEVIL'S CLAW has been shown to be an effective anti-inflammatory agent in chronic arthritis, including both osteoarthritis and rheumatoid arthritis. Clinical studies show devil's claw reduces pain and improves motility and range of motion, with anti-inflammatory and analgesic effects comparable to most NSAIDs. For example, a 4-month, double-blind, randomised, multicenter clinical study involving 122 patients suffering from osteoarthritis of the knee and hip showed that devil's claw was comparable in efficacy and superior in safety to diacerhein (a drug used in Europe for the relief of osteoarlhritis pain). In fact, at the end of the study, participants taking devil's claw were using significantly less NSAIDs (diclofenacl and analgesic (aectaminophen-caffeine) drugs than those taking diacerhein; and furthermore, the frequency of adverse events was significantly lower in the devil's claw group-the most frequent complaint was diarrhoea, which occurred in only 8.1% of devil's claw users, compared to 26.7% of those taking diacerhein.

• In another 4 week randomised, double-blind placebo controlled study, devil's claw was found to have a highly significant clinical efficacy in cases of slight to moderate muscular pain of the back, neck and shoulder. For topical use Nature's Sunshine have produced EverFlex Cream which features the cooling relief of menthol plus unique combination of cetylated fatty acid esters (cety. myrsitoleate, myristate. palmitoleate. oleate, palmitate and laurate), olive oil and MSM. Clinical studies have shown that cetylated fatty acid esiers help promote joint mobility and flexibility. MSM is a great source of sulfur, an important structural component, while menthol is an approved active ingredient in many pain-relieving topical creams. This cream is easily absorbed through the skin for fast-acting structural support.
• Enhances joint mobility and flexibility
• Relieves muscle and joint pain
• Provides penetrating, fast-acting help
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