Download or read the abstract for period pain seaweed trial from a trial undertaken in 2020. Volunteers ate a small serving of seaweed on a daily basis to reduce impacts on lifestyle and to improve health and wellbeing.
M. Armour et al., “The prevalence and academic impact of dysmenorrhea in 21,573 young women: a systematic review and meta-analysis,” Journal of Women’s Health, vol. 28, no. 8, pp. 1161-1171, 2019 (Pubmed)
Marine Algae started its journey on growing seaweed – as we could see that seaweed stops methane from cows burping, based on work at James Cook University and the CSIRO. It this could be used, then with 1.3 billion ruminants in the world, it needed to be grown at scale.
Why the Focus on Ruminant (mostly cows) Methane Reduction
Emissions:
Agriculture is the third largest contributor to global emissions (4.7billion tonnes CO₂ per annum)
California has already legislated 40% reduction in methane from agriculture by 2030, with voluntary reductions by 2024. A carbon price already exists.
Governments around the world are looking for reductions in greenhouse gases from this sector.
Five years ago NZ had public demonstrations against the “fart tax” but now accept they need 10 to 22% reductions by 2050 to meet Paris Accord Goals.
Feeding The World
How does the World feed itself in the 21st Century?
Meat is very energy intensive. What alternatives are there?
Cows have huge methane emissions and seaweeds stops methane production.Ruminants are a major source of emissions
In 2014, Dr. Rob Kinley at James Cook University and others inc CSIRO profiled a number of native Australian seaweeds for their potential to reduce methane emissions when utilized as a feed additive for livestock. Asparagopsis taxiformis outperformed all others with 1-2% feed inclusion resulted in 99% reduction of methane in an in vitro model.
Continued research at UC Davis, Penn State, and CSIRO have shown that the methane reductions hold up in vivo and using the supplement does not pose any adverse effects on animal health, milk, or flesh. (There are some contra trials, hotly disputed) Trials are showing that 0.5% inclusion into cattle’s daily diet could result in a sustained 80% methane reduction — a true sweet spot for the industry.
IP Holders included Rob,Kinley, USC Prof Nick Paul, Rocky De Nys. Ian Tuart had worked for Marine Algae, and he had been a research assistant with the group and collected wild harvest. Leonda Mata was with the same team at JCU and is now with Greener Grazing. Nick Paul is focused on Asparogosis for fish food.
Species
A taxiformis is a tropical species. We looked at it and decided the temperate species A armata that grows in NZ and southern Australia has hooks on it and might be a better species in the life cycle.
Which Companies are Focused on Seaweed
The following are some of the startup businesses focused on methane reductions. There are 2 problems
Closing the lifecycle of the species (the reproductive cycle)
Growing at scale
Sea Forest
https://www.seaforest.com.au/ Stephen Turner and Sam Elsom initially were going to buy a northern NSW fish land farm, but ultimately raised some money and headed south to Tasmania. They grow it in races on land and getting money to expand to grow onshore. They hired Rocky van Nys ex JCU seaweed leader and co inventor, and also a long time seaweed specialist Craig Sanderson They have hooked into getting sustainable wool as first product off the rank but making inroads into partnerships.
CH4 Global
https://www.ch4global.com/ Steve Mellum is ex Silicon Valley, has raised money from global – spoken with Steve and with Rowena Pullen (ex Proctor Gamble and Pfizer). They have a heavy-hitting board and advisors and they have raised a million dollars , based out of Adelaide.
Most recently they raised $US13M as a series A see this funding PR release They worked successfully and got the Cawthorne Institute Nelson NZ and NZ Govt announced by Jacinda Adern with money $0.25m R&D to overcome lifecycle issues with A armata and recently said they had cracked the secret methodology. Work in NZ is via National Institute of Water and Atmospheric Research (NIWA) CH4 Global has estimated that the aquaculture of Asparagopsis could be worth more than NZ$500 million to seaweed farmers in NZ and Australia within seven years, and more than NZ$1 billion by 2030. Closing the lifecycle makes this figure much more realistic.
Adam Main is their key seaweed technologist and he says “have been granted over 800 hectares of water space in addition to the hectares we will access through our partnerships with Narungga Nation and with existing finfish and shellfish aquaculture operations” on Adelaide Peninsula
Symbrosia
www.symbriosia.co Partnered USDA, MIT, Hatch, CEO Alexia Akbay Akbay, a chemist by training, co-founded Symbrosia about two and a half years ago with Jonathan Simonds out of an MIT program, and has got USDA funding and collecting A taxiformis around the Hawaii Islands.
Joan Salwen is the CEO of Blue Ocean Barns. She grew up in rural Iowa in the long shadow of her family’s 100-acre farm where she harvested cherries, preserved fresh sweet corn and walked her Grandpa King’s bean fields, weeding by hand. Had 20 years as a Managing Director at Accenture, Joan managed $50M+ client relationships and led the firm’s Atlanta practice for organization and change strategy. In 2003, she helped found Atlanta Girls’ School, where she served as a teacher and Head of School. In 2015, Joan transitioned to Stanford, where she built a team that energized university, market and government interest in a particular red seaweed as a solution to climate change. She founded Elm Innovations, a non-profit platform for exploring the potential of the seaweed-livestock connection and ultimately co-founded the commercial engine for it, Blue Ocean Barns. A climate tech booter called Elemental Excelerator put in $100k recently (Forbes)
Josh Goldman is CEO from Massachusetts-based Australis Aquaculture. He has had a barramundi farm in ocean waters off Van Phong Bay, Vietnam and sells Clean Harvest Barramundi globally. For the past 4 years, they have been trying to get up Asparogopsis to seed onto ropes. They have recently raised funds. Dr Leonado Mata from Portugal is on his team, and the research is joint between Portugal and Vietnam. See https://www.greenergrazing.org/blog/2021/6/23/project-update-josh-goldman-video-tour
Greener Grazing was previously known as Australis Aquaculture / The Better Fish.
Most recently, Greener Grazing and Horimare have announced a new collaboration. The Netherlands-based company Hortimare advises, supports, and collaborates with seaweed farmers to help them achieve the scale needed to make seaweed cultivation globally competitive. The collaboration between Greener Grazing and Hortimare adds resources and expertise in breeding and hatchery operations to make ocean-based AT cultivation a reality. Dr. Phil Kerrison who trained at SAMS (Scotland Marine) has been hired to assist in the project.
Fredrik Akerman is the CEO. Volta Greentech is developing an automated land-based seaweed factory on the Swedish West Coast. They have set up a lab and was in early stages of collaboration with seaweed producers in the Philippines but not sure where that has progressed. See https://youtu.be/77KozPbACI0
Seaweed stops methane, but are there other Techniques?
There are others who have started. There are other solutions such as lemon grass. Other seaweed species have some effect.
DSM – The Netherlands
https://www.dsm.com/corporate/markets/animal-feed/minimizing-methane-from-cattle.html DSM’s “clean cow” programme director Mark van Nieuwland said the company hoped to introduce trials of the compound called Bovaer® which is a 3-nitrooxypropanol (3NOP) in two stages: firstly to intensive dairy farms, and later to extensive pastoral-based farms. They face a regulatory hurdle of product in the food chain. (Link to Stuff.co.nz Article)
Feeding Seaweed to Cows Update
In 2017, Canadian cattle farmers in Alberta started slipping a special ingredient into their animals’ feed. The cows remained oblivious – their forage tasted no different – but by munching on, they had been enlisted into the fight against the climate crisis.
The feed, called Bovaer, contained 3-NOP, an organic compound that inhibits cows’ methane production. Farmers ultimately fed the enriched fodder to 15,000 animals and collectively cut their methane emissions by 30% on average and up to 80%. In September, the ingredient was approved for use in Brazil, the world’s second-largest producer of beef. (From The Guardian Emma Bryce 30-Sept-2021)
Rather than stopping methane at source, others want to catch it before it’s released. UK company Zelp has created a mask that it says can neutralize about 50% of methane as cows belch it out. It’s been backed by the food giant Cargill, which expects to start distributing the masks to European dairy farmers in 2022.
Asparagopsis – seaweed
Fodder Box
Ella Goddin’s FodderBox is essentially a ‘field in a box.’ It’s the equivalent of a 40-acre field in a 40’ container, with zero water pollution, air pollution, herbicides, pesticides, and insecticides. Reduction of land area and is more than cost competitive than growing fodder crops, and they are working with Asparagopsis as well. See this (PR and their website https://fooderbox.ie)
Natural organic seaweed does not happen automatically, as seaweed is a global industry and grown in a whole range of ocean environments. Not all areas are the same. We hear and see reports in the media that oceans are full of microplastics or pollution. (National Geographic) We have chose to grow our Pacific SeaMossTM in an area that is low in urban and rural runoff, and we regularly monitor the ocean water, and have implemented a range of practices to ensure the seaweed is organic and monitored.
Gallery of Seaweed Farm Photos
Seaweed harvested
Seaweed attached to ropes and floating just under surface
View of seaweed ready for harvest at 40 days
Whale shark
A giant form Kappaphycus alvarezii forms
Seaweed growing on lines underwater
Salps with baby Damsels
Red seaweed that is brown coloiur
Frog fish in the seaweed
Schools of small fish
Many species grow in the same habitat
Jelly fish and squid like to hide
Frog fish
The small fish eat the seaweed
Organically Certified
The seaweed has been certified by OCCP, the Philippine National Organic Certification Authority and is regularly reinspected to ensure that the seaweed is pure, natural organic seaweed.
Certified organic
Why Is there an Allergy Warning?
Seaweed farms create an environment where other fish come to live. With shelter from the open water, the ecology changes. Over the growing cycle, small fish give rise to larger fish who come to feed on them. And molluscs shellfish and sea creatures attach to the seaweed. (Seafood allergies and Seaweed)
What does Joint Cartilage have in common with Potholes?
A good analogy of joint pain is that the cartilage between your joints is like a road with potholes. The roadway starts off perfect. Over time, with wear and tear, it gets small potholes and cracks. We think our joints are perfectly fine, but actually, the car tyres are crossing over those small potholes. We don’t have pain and we are hopeful this will continue into old age.
But at some stage, and mostly unexpectedly, the potholes get so big, the car tyres cannot bridge those widening potholes and the car ride now is extremely bumpy. And painful. And no or very reduced mobility. Surgery fixes the potholes or puts in a whole new road!
Joint decline is not a straight line but most often is progressive and comes on suddenly but sometimes briefly (technically called episodic acute). It generally gets worse as the deterioration continues. Pain is not from the cartilage, but nerves that are in the bones and soft tissues (e.g. capsules, and ligaments) around the joint. Damaged cartilage itself is relatively pain insensitive. The experience of pain from damaged and degenerating joints varies widely. Pain does not affect everyone the same way. Tests with X-rays and MRI scans don’t always correlate with pain or disability. The nervous system varies between people. Some have insensitive nervous symptoms and say they have little pain. Others are labeled as having a low pain threshold. We may say someone is “stoic” but it may just be they don’t have a sensitive nervous system. And pain may not be in the joint, but might be in an area well away from the joint itself.
It is estimated the correlation between pain and measurable damage is about 65% and physiotherapists will talk about a skeletal age versus organic aging.
Degradation Curve of Joint Pain
At some stage, joints start to decline. We don’t notice for a long time but by mid thirties to mid fifties we notice aches and pains.
In our earlier years, most have healthy joints. Children have breaks, sprains, but most heal.
We will consider important factors including early diagnosis, prevention, delay and cure.
By the 50’s we are contemplating surgery. By the 70’s we are filling up hospital surgeries. This does not include the cohort who suffer damage at 15 years of age, have surgery at 25, more surgery at 35 and by 45 are surgical curiosities!
Osteoarthritis Costs You Dearly
OA costs you money. As a consequence of symptoms and activity limitations, OA leads to medical costs and costs due to productivity loss of over $1,000 per patient per month, twice as much as other chronic diseases such as diabetes (Hermans et al. 2012)
3 Options to Reduce Joint Pain
In the figure above, we really only have 3 options to reduce joint pain.
1- Prevent
2 – Delay
3 – Cure
Prevent joints declining. What are the things to do so that our joints are in good shape until we die? Taking pain killers for years is not prevention. It stops the pain but does nothing in terms of the physical damage that is occurring in the joints.
Delay – can you delay by 10 or 20 years with recommended lifestyle changes – remaining in the green zone of healthy joints, or at worse in the yellow zone, but with minor pain?
Cure – Not everyone has the money for surgery or other new medical techniques.
1. Prevention – The Best Option
Some joint pain is inevitable. You cannot stop aging. Most physiotherapists & researchers say that the joints of the human body are good for maybe 55 years and then start to suffer measurable degradation. Joints wear out as the cartilage thins, bones reduce in strength. However, joints do not wear out in a straight line fashion. There are lifestyle choices to reduce the rate of wear.
We think of joints as simply bone on bone with a cartilage in between, but it is more complex. The joint capsule consists of two layers, an outer fibrous layer, fibrous capsule, and an inner layer called the synovial membrane. The synovial membrane is a thin, vascular lining that covers the inner surfaces of the joint capsule and intra-articular ligaments and tendons.The lining of the capsule, the synovial membrane makes synovial fluid which provides nutrition and lubrication.
There are multiple causes of joint damage, leading to joint pain. In synovial joints, cartilage separates the two bones. The cartilage can fracture, but it is the other parts of the joint that get inflamed.
Pain receptors are in the bone and the capsules that surround the joint. There are many pain receptors in these structures, but relatively few pain receptors in the cartilage itself. As the bearing surface of the joint (cartilage) wears down, inflammation and pain sets in.
2. Delay – The Next Best 5 Options.
There are 5 Simple Strategies to Delay Joint Pain
Be Active. The expression is if you don’t use it, you lose it. Walk 2 to 3 km per day, or swim, or do low impact exercises such as yoga or pilates. Low impact, consistent movement maintains not just joint health but overall health. One study showed walking more than 1 hour per day meant their medical care was $100,000 less over their lifetime and extended their life for 2 years. (Nagai et al. 2011) Adopting the popular High Intensity Technique (HIT exercise) will cause severe joint pain unless you spend months (or even up to 1 year if you are very deconditioned) getting the knees and joints strong enough to take that HIT energy. HIT is great for cardiovascular improvement but without preparation is also good for physiotherapists billing.
Avoid employment that has heavy lifting or kneeling if you want to minimise OA (Ezzat and Li 2014)
Avoid foods that cause inflammation and arthritis. There is lots of data recently that inflammation is a cause of arthritis (Kim et al. 2013) Excess added sugar is probably the primary cause of inflammation. Your diet should avoid sugar sweetened cereal, snack bars, pre-sweetened dairy products, canned fruit and condiments, particularly ketchup, BBQ sauce, honey mustard, French dressing, and similar. Do not eat any food that is more than 3% added sugar. The WHO recommendation is for less than 5% of diet or 25 grams (6 teaspoons) of added sugar in your diet per day! Purchase food from around the outside of the supermarket – fresh or frozen whole food. Avoid any centre isles. Alcohol consumption has not been reported as a cause! (Karlson et al. 2003) although excess consumption in animals is inflammatory. (Kc et al. 2015)
Manage your weight. If you become overweight or obese with metabolic symdrome, evidenced by elevated blood pressure, elevated blood glucose levels, increased waist measure and elevated lipids then 75% will have joint pain, versus 25% if you are not. (3 times more). Obesity is a sign of an inflammatory diet. A study that looked at heavy physical work confirmed kneeling or squatting, heavy lifting and arm elevation did get about 30% more arthritis, but those with higher body mass, had higher rates of arthritis (Brennan-Olsen et al. 2018)
Consume anti-inflammatory foods. In a Nature paper on animal joints (Sekar et al. 2017), the addition of anti-inflammatory foods increased the amount of cartilage. When the animals ate an inflammatory diet which included long chain fatty acids, the animals got metabolic syndrome and osteoarthritis symptoms. When they ate antiflammatory materials, they did not get metabolic syndrome and their cartilage improved!.
3. Is there a Silver Bullet for causes of Joint Pain?
There is no 100% certainty of “cure” for joint pain, especially when there has been a history of major joint trauma. There are livestyle changes that can reduce pain and allow people to live with pain if it is not too severe. But people are often left on waiting lists.. If they have money or public health they will be able to get surgery. The typical “conservative” surgery is a technique that Germany calls “re-surfacing” where some of the wear parts are resurfaced, not replaced. The joints are complex, and often the ligaments and soft tissue remains, and may cause subsequent pain. Surgery has its own health risks and is often oversold as a cure. In UK, about 16% of women, 8% of men over 80 have had hip resurfacing or replacements. Surgery is not an absolute cure for joint pain, although with greater than 95% of patients experiencing significant but variable relief from hip pain. Experts disagree what constitutes “success” – pain, movement. The success rate of hip “replacements” 10 years after surgery has been optimistically measured at 90- 95% but at 20 years is down to 80-85%. Some unfortunately experience as much pain after surgery as before.
Seaweed Reduces Joint Pain
Hundreds of customers have told us eating seaweed has reduced their joint pain. Some tell us that it has made no difference.
We suspect the improvement depends one where you are on this joint degradation curve, genetics, diet, and what specifically is wrong.
What Do the Experts Say
The CDC of USA (“5 Proven Ways to Manage Arthritis | CDC” 2019) says there are 5 Proven Ways to minimise Joint Pain.
Learn new self-management skills.
Be active.
Talk to your doctor.
Manage your weight.
Protect your joints.
Why do they recommend talking to your doctor? With over 104 different types of arthritis, it is important to know which type you have. Is there a genetic cause? Have you played competitive sports or injured joints? Are there other joint issues? There are genetic causes and there are other techniques and strategies for treatments. Their focus will be to reduce pain, minimize joint damage and improve or maintain function and quality of life. They can also assist with other chronic conditions, like diabetes or heart disease.
Note that in Europe and UK, you are likely to be referred to an inflammatory specialist, who will look at a range of conservative treatments, and who may then refer you to an orthopedic surgeon. In contrast, in USA or Australia you are likely to be directly referred to an orthopedic surgeon.
Joint Pain – You are Not Alone
Joint pain (osteoarthritis or OA) is serious, and getting worse. The numbers are staggering. A recent report (Cui et al. 2020) looking at 10 million people says over 16% for those aged 15. It increases to 23% for those aged 40, and close to 70% if over 60. That’s over 600 million people aged over 40 years in 2020 worldwide. As people age, it gets worse. For elderly of 85+, in UK (Duncan et al. 2011) 65% had joint pain and women had more pain (69%) than men (58%)
Some say that humans have a joint life of about 55 years. After that we are “the walking wounded”. But we also know joint pain is worse for anyone who does the high risk physical sports as explained below.
Damage to Joints from High Impact Sports
Previously we have talked about the need to protect your joints from damage from an early age. Competitive sports that have sudden changes of direction, particularly in spiked shoes and with body contact are demonstrably higher risk and have long term consequences.(Short and Tuttle 2020)
People who do high performance sports activities with rapid change of direction are the most susceptible. Gymnasts , footballers, basketballers who play competitive sports into their 20’s or 30’s have between 5 to 20 times more surgery. (Vogel et al. 2011)
A surprising number of knee and hip joints are replaced each year and it has been known for decades that high impact sports are a major contributor to joint pain. Sports identified as high risk include::
Gymnastics – where the gymnast is coming down at speed onto mats or floors. Tennis also has rapid change of movement.
Football – whether soccer, Rugby League (Gibbs 1994), Union, or American football.(Song et al. 2019; Gouttebarge, Aoki, and Kerkhoffs 2018). Those sports with spiked shoes and contact are the worst, so soccer is less risky than league or rugby which have both spiked shoes and body contact.
Playing competitive sports past mid 20’s.
The increase can be hundreds of times higher than the normal population. The sports bodies have been reluctant to admit the potential for injury. (Khan et al. 2019) In 2018 (Gouttebarge, Aoki, and Kerkhoffs 2018) showed current and retired professional footballers were nearly twice as likely to suffer from knee OA by every additional severe knee injury and by every additional knee surgery they they incurred during their career.
Anterior Cruciate Ligament Damage Increases OA
Cruciate ligaments are found inside your knee joint. They cross each other to form an “X” with the anterior cruciate ligament in front and the posterior cruciate ligament in back. The cruciate ligaments control the back and forth motion of your knee.
The anterior cruciate ligament (ACL) runs diagonally in the middle of the knee. It prevents the tibia from sliding out in front of the femur, as well as provides rotational stability to the knee. ACL damage is becoming more common. The damage when you do an ACL may not be just to the ligaments and surrounding tissue and ligaments. The damage may be more substantial.
Those who do an ACL, will almost certainly have osteoarthritis later in life. (Khan et al. 2019). A recent trend has seen a doubling of ACL injury in younger adults – which is thought to be a result of social drive to have young adults excel in sports (Zbrojkiewicz, Vertullo, and Grayson 2018). This will inevitably give rise to more OA in the next decades
.
Bone Bruising and Osteoarthritis Dissecans
Another cause of osteoarthritis is caused by bone bruising. ACL injuries may also occur in conjunction with bone bruising. Sometimes sports people will suffer an ACL but also have OA dissecans, fix the ACL but still have ongoing bone bruising (Bredella et al. 2000)
Bone bruising
A typical cause of this injury used to be in the military where soldiers would jump off trucks with a fully laden pack, and wonder 15 years later why all the soldiers needed knee operations. Fortunately they followed the science. It also happens with people such as high jumpers or long jumpers.
During rapid stopping, or during an ACL injury event, the scrunched bones in the joint get a “bone bruise”. The “bone bruise” is actually a fracture, results in a chalky area, and then repeated exercise opens up a hollow space in the bone. You get chronic inflammation from the irritation of the lining on the joint (the synovium) and it causes an increase of cells producing inflammatory fluid. It is called reactive synovitis or “water on the knee”.
Filling this hollow space with a lubricant (reactive synovitis) has gone out of favour but with good slow rehabilitation the risk of subsequent OA is reduced.
Cartilage – Not All the Same
Joints are complex. While babies start with 270 joints we have 206 named joints but with the inclusion of sesamoids which are are bones imbedded in tendons, but not connected to other bones. The patella (kneecap) is the largest sesamoid. These bones vary in number from person to person. So generally we have between 250 and 350 joints. (Barbe et al. 2009). Major joints – knee, ankle, elbows, wrists and shoulders are over-represented for pain.
We think about bone, and cartilage and while the bones have the nerves, the cartilage keeps the bones apart and moving freely. There are different types of cartilage. And the layers that produce the cartilage are different. Technically, cartilage is classified as a special connective tissue with mesodermal origin characterised by a cellular component immersed within ECM composed of ground substance (polysaccharides), a fibrillar component (fibrous proteins), and interstitial fluid (mainly water). There is no direct supply of blood, lymphatics and nerves; nutrition relies on diffusion from the surrounding tissues. Based on the composition and function, it is possible to distinguish three types of cartilaginous tissues: hyaline, fibro- and elastic cartilage.(Armiento, Alini, and Stoddart 2019). With that complex of various bone, cartilage and connective tissue, specific identification and causes of pain can be difficult.
From Madhero88, CC BY-SA 3.0 <https://creativecommons.org/licenses/by-sa/3.0>, via Wikimedia Commons
Early Diagnosis & Causes of joint pain
A key part of AO treatment is early and proper diagnosis. The complexity of OA means that for many wrong diagnoses means incorrect treatment. The absence or presence of pain is a poor measure. When you consider a joint has a whole raft of connective tissue, cartilage, bones, synovial fluid, synovial tissue and OA may be identified as inflammation in other joints. There are various tests the physiotherapist/doctor/rheumatologist or orthopedic surgeon will do but there are also tests that have not been developed or identified yet.
The research by Prof Lindsay Brown and Prof Xiao say that restoration of cartilage and synovial membrane can be increased with anti-inflammatory functional food including seaweed. But if the damage from previous injuries is severe, restoration may take a longer time. Given there are 360 joints in the human body, any reduction in inflammation is welcome!
More Reading
Thanks to Greg Sheather (ret), Muscular Physiotherapist, Dip Phy Grad Dip Manipulative Therapy (Sydney) for the analogy of the potholes.
“5 Proven Ways to Manage Arthritis | CDC.” 2019. February 5, 2019. https://www.cdc.gov/arthritis/basics/management.htm.
Armiento, Angela R., Mauro Alini, and Martin J. Stoddart. 2019. “Articular Fibrocartilage – Why Does Hyaline Cartilage Fail to Repair?” Advanced Drug Delivery Reviews, Wound healing and fibrosis – State of play, 146 (June): 289–305. https://doi.org/10.1016/j.addr.2018.12.015.
Barbe, Mary, Jeffrey Driban, Ann Barr, Steven Popoff, and Fayez Safadi. 2009. “Structure and Function of Joints.” In Bone Pathology, 51–60. https://doi.org/10.1007/978-1-59745-347-9_2.
Bredella, M. A., P. F. Tirman, T. K. Wischer, J. Belzer, A. Taylor, and H. K. Genant. 2000. “Reactive Synovitis of the Knee Joint: MR Imaging Appearance with Arthroscopic Correlation.” Skeletal Radiology 29 (10): 577–82. https://doi.org/10.1007/s002560000259.
Brennan-Olsen, Sharon L., Svetlana Solovieva, Eira Viikari-Juntura, Ilana N. Ackerman, Steven J. Bowe, Paul Kowal, Nirmala Naidoo, et al. 2018. “Arthritis Diagnosis and Symptoms Are Positively Associated with Specific Physical Job Exposures in Lower- and Middle-Income Countries: Cross-Sectional Results from the World Health Organization’s Study on Global AGEing and Adult Health (SAGE).” BMC Public Health 18 (June). https://doi.org/10.1186/s12889-018-5631-2.
Cui, Aiyong, Huizi Li, Dawei Wang, Junlong Zhong, Yufeng Chen, and Huading Lu. 2020. “Global, Regional Prevalence, Incidence and Risk Factors of Knee Osteoarthritis in Population-Based Studies.” EClinicalMedicine 29–30 (December): 100587. https://doi.org/10.1016/j.eclinm.2020.100587.
Duncan, Rachel, Roger M. Francis, Joanna Collerton, Karen Davies, Carol Jagger, Andrew Kingston, Tom Kirkwood, Louise Robinson, and Fraser Birrell. 2011. “Prevalence of Arthritis and Joint Pain in the Oldest Old: Findings from the Newcastle 85+ Study.” Age and Ageing 40 (6): 752–55. https://doi.org/10.1093/ageing/afr105.
Ezzat, Allison M., and Linda C. Li. 2014. “Occupational Physical Loading Tasks and Knee Osteoarthritis: A Review of the Evidence.” Physiotherapy Canada. Physiotherapie Canada 66 (1): 91–107. https://doi.org/10.3138/ptc.2012-45BC.
Gibbs, Nathan. 1994. “Common Rugby League Injuries.” Sports Medicine 18 (6): 438–50. https://doi.org/10.2165/00007256-199418060-00007.
Gouttebarge, Vincent, Haruhito Aoki, and Gino M. M. J. Kerkhoffs. 2018. “Knee Osteoarthritis in Professional Football Is Related to Severe Knee Injury and Knee Surgery.” Injury Epidemiology 5 (1): 26. https://doi.org/10.1186/s40621-018-0157-8.
Hermans, Job, Marc A. Koopmanschap, Sita M. A. Bierma-Zeinstra, Joost H. van Linge, Jan A. N. Verhaar, Max Reijman, and Alex Burdorf. 2012. “Productivity Costs and Medical Costs among Working Patients with Knee Osteoarthritis.” Arthritis Care & Research 64 (6): 853–61. https://doi.org/10.1002/acr.21617.
Karlson, Elizabeth W, Lisa A Mandl, Gideon N Aweh, Oliver Sangha, Matthew H Liang, and Francine Grodstein. 2003. “Total Hip Replacement Due to Osteoarthritis: The Importance of Age, Obesity, and Other Modifiable Risk Factors.” The American Journal of Medicine 114 (2): 93–98. https://doi.org/10.1016/S0002-9343(02)01447-X.
Kc, Ranjan, Robin Voigt, Michael B Ellman, Xin Li, Keith C. Summa, Christopher B Forsyth, Ali Keshavarzian, Fred W. Turek, Jae-Sung Kim, and Hee-Jeong Im. 2015. “Chronic Alcohol Consumption Induces Osteoarthritis-Like Pathological Changes in an Experimental Mouse Model.” Arthritis & Rheumatology (Hoboken, N.J.) 67 (6): 1678–80. https://doi.org/10.1002/art.39090.
Khan, Tanvir, Abtin Alvand, Daniel Prieto-Alhambra, David J. Culliford, Andrew Judge, William F. Jackson, Brigitte E. Scammell, Nigel K. Arden, and Andrew James Price. 2019. “ACL and Meniscal Injuries Increase the Risk of Primary Total Knee Replacement for Osteoarthritis: A Matched Case-Control Study Using the Clinical Practice Research Datalink (CPRD).” British Journal of Sports Medicine 53 (15): 965–68. https://doi.org/10.1136/bjsports-2017-097762.
Kim, Jae-Sung, Michael B. Ellman, Dongyao Yan, Howard S. An, Ranjan Kc, Xin Li, Di Chen, et al. 2013. “Lactoferricin Mediates Anti-Inflammatory and Anti-Catabolic Effects via Inhibition of IL-1 and LPS Activity in the Intervertebral Disc.” Journal of Cellular Physiology 228 (9): 1884–96. https://doi.org/10.1002/jcp.24350.
Nagai, Masato, Shinichi Kuriyama, Masako Kakizaki, Kaori Ohmori-Matsuda, Toshimasa Sone, Atsushi Hozawa, Miyuki Kawado, Shuji Hashimoto, and Ichiro Tsuji. 2011. “Impact of Walking on Life Expectancy and Lifetime Medical Expenditure: The Ohsaki Cohort Study.” BMJ Open 1 (2): bmjopen. https://doi.org/10.1136/bmjopen-2011-000240.
Sekar, Sunderajhan, Siti Raihanah Shafie, Indira Prasadam, Ross Crawford, Sunil K. Panchal, Lindsay Brown, and Yin Xiao. 2017. “Saturated Fatty Acids Induce Development of Both Metabolic Syndrome and Osteoarthritis in Rats.” Scientific Reports 7 (46457): 11. https://doi.org/10.1038/srep46457.
Short, Steven, and Matthew Tuttle. 2020. “THE GAP BETWEEN RESEARCH AND CLINICAL PRACTICE FOR INJURY PREVENTION IN ELITE SPORT: A CLINICAL COMMENTARY.” International Journal of Sports Physical Therapy 15 (6): 1229–34. https://doi.org/10.26603/ijspt20201229.
Song, Kyeongtak, Erik A. Wikstrom, Joshua N. Tennant, Kevin M. Guskiewicz, Stephen W. Marshall, and Zachary Y. Kerr. 2019. “Osteoarthritis Prevalence in Retired National Football League Players With a History of Ankle Injuries and Surgery.” Journal of Athletic Training 54 (11): 1165–70. https://doi.org/10.4085/1062-6050-421-18.
Vogel, Laura A., Giuseppe Carotenuto, John J. Basti, and William N. Levine. 2011. “Physical Activity After Total Joint Arthroplasty.” Sports Health 3 (5): 441–50. https://doi.org/10.1177/1941738111415826.
Some additional food for thought: seaweed at the best with this recipe for seaweed cake – from the late Prof Isabelle Abbott who was a pioneer in seaweed from the University of Hawaii.
Ingredients
1 1/2 cups salad oil
2 cups sugar
3 eggs
2 cups grated or chopped seaweed: sea palm (Nereocystis), ogo (Gracilaria coronopifoloia), guso (Eucheuma or Kappaphycus) which is a local species from Hawaii and many tropical seas, including the Philippines. You could use a local equivalent. For this recipe, use about 1 tablespoon of dry Pacific Seamoss powder – as it swells up 15 x it is about the same as 2 cups)
2 cups grated carrots
1 cup crushed, drained pineapple (or 1 cup grated coconut, fresh)
preferably 2 1/2 cups flour
1 teaspoon baking soda
1 teaspoon salt
1 teaspoon cinnamon
1 cup chopped walnuts (optional)
Method for Seaweed Cake
Mix well the sugar and salad oil.
Add the eggs, one at a time, beating well after each egg is added.
Add the seaweed, carrots, and pineapple (or coconut).
Sift together the flour, baking soda, salt, mix well.
Add the chopped walnuts.
Bake in oblong pan or loaf pan at 350 degrees 45-50 minutes.
Serve plain or with buttercream frosting. A moist cake which keeps very well.
Recipe source
Marine algae expert Isabella Aiona Abbott broke barriers during her long career as a scientist, author, and university professor. She is thought to be the first Native Hawaiian person to earn a PhD in science. She was the first woman and first person of color to become a full Professor of Biology at Stanford University. After teaching at Stanford from 1960–1982, she retired and pursued a second career as professor of botany at the University of Hawaiʻi at Mānoa. Abbott established the University’s undergraduate major in Ethnobotany.
Sleep is a complex process, but we have many customers who say they sleep better with Seaweed. What? Why? So we dug back through our customer referrals and data from our trials and it turns out there may improvement in sleep. Sleep is not just duration – importantly the patterns of sleep determine how you feel about sleep.
What Customers Say
My new neighbour is an 72 year old engineer with dodgy knees. After a month he says his knees “might” be better, but he has been sleeping better. Not waking at 3am. And that’s enough for him to keep going for another couple of months.
We saw a 50% improvement score in our dysmenorrhea trial but did not think too much about. It made sense if period pain was reduced. It was not something we had really focused on, but participants reported that after seaweed they did not loose work or social activities and it may be that they actually slept better.
Data from 150 women after 8 weeks of eating seaweed.
A number of our testimonials say they feel better on seaweed
Does More Exercise Improve Sleep
The data shows the women in the trial had more energy, and found it easier to exercise. And there are many studies that show more exercise helps sleep patterns -just don’t do the exercise immediately prior to sleep! We don’t know if they had small incremental changes in exercise.
Reduced inflammation
Seaweed is a powerful anti-inflammatory functional food. Does the improvement in inflammation help sleep?
Neuronal Effect
We know from seaweed studies that it builds better brain pathways for people with dementia and may have some action with diseases such as Parkinsons? Do the improvement neural pathways led to better sleep.
Sleep Better with Seaweed – The Role of Vitamins and Minerals
A number of vitamins and minerals help sleep – and check out our vitamins (here) and minerals (here) of things we know help sleep.
Iron. Iron is a major component in our blood that provides oxygen to our cells and tissues. Seaweed is a good source of naturally available Fe.
Magnesium. Magnesium is a mineral that works wonders when it comes to releasing tension and helping you and your muscles to relax. Pacific Seamoss has some.
Vitamin D Other kelps and brown seaweeds have Vitamin D but Pacific Seamoss does not.
Melatonin, but melatonin is not in seaweed.
Tryptophan – in reasonable amounts – helps sleep
B vitamins. Seaweed is chock full of B3.
Calcium. There is not much Ca in Seaweed.
Vitamin E. Our Pacific
Potassium. K helps smooth muscle relax. Over 95% of westerners are deficient in K.
In a novel study published in March 2021, a team of Chinese researchers looked at 32,000 men and women and showed that seaweed reduces gout (hyperuricemia or HUA) in men. The association was not shown for women.
What is Gout?
Gout is a common and complex form of arthritis that can affect anyone. It’s characterized by sudden, severe attacks of pain, swelling, redness and tenderness in one or more joints, most often in the big toe.
An attack of gout can occur suddenly, often waking you up in the middle of the night with the sensation that your big toe is on fire. The affected joint is hot, swollen and so tender that even the weight of the bedsheet on it may seem intolerable.
Gout symptoms may come and go, but there are ways to manage symptoms and prevent flares. One of the markers looked at are levels of uric acid, as uric acid is the end product of purine metabolism. Increased production or reduced excretion of serum uric acid level causes hyperuricemia (HUA) and gout [2]. Gout is related to age and BMI and there are many societal behaviours that appear to change incidence and severity of gout.
For the past 30 years, it is known that most patients with HUA are asymptomatic and do not receive treatment. As Zang and the team point out, HUA is the causative agent of gout [3], and is an independent risk factor for cardiovascular events [4, 5], hypertension [6], diabetes [7], cancer [8] and renal disease [9], and independently predicts myocardial infarction and premature death [10].
A study of 32,365 adults in Tianjin in China, published in Mar 2021 [1] looked at the food that the men and women ate, the frequency of seaweed eaten and the correlation with hyperuricemia.
Hyperuricemia was defined as serum uric acid levels ≥7.0mg/dL in men and ≥6mg/dL in women.
The prevalence of HUA was 21% in men and 6% in women. Men had higher BMI, more likely to be smokers and drinkers, had elevated cholesterol markers, ate more sweet food and more meat. Compared with females, males were more highly educated, were more likely to be managers, had a higher income, and had a higher prevalence of hypertension, hyperlipidemia, and diabetes
What they found was for men that the more seaweed eaten, the lower the uric acid levels.
Eat more seaweed – it will help reduce gout.
References
Zhang, T., Wang, Y., Gu, Y., Meng, G., Zhang, Q., Liu, L., Wu, H., Zhang, S., Wang, X., Sun, S., Wang, X., Zhou, M., Jiao, H., Jia, Q., Song, K., Wu, Y., Wu, X. H., & Niu, K. (2021). Title: Relationship between seaweeds consumption and hyperuricemia in general adults: A Population-based Study from the TCLSIH Cohort Study. The British journal of nutrition, 1–31. Advance online publication. https://doi.org/10.1017/S0007114521000891
Garrel DR, Verdy M, PetitClerc C, Martin C, Brule D, Hamet P. Milk- and soy-protein ingestion: acute effect on serum uric acid concentration. Am J Clin Nutr. 1991;53(3):665-9. Epub 1991/03/01. doi: 10.1093/ajcn/53.3.665. PubMed PM ID: 2000819
Choi HK, Mount DB, Reginato AM, American College of P, American Physiological S. Pathogenesis of gout. Ann Intern Med. 2005;143(7):499-516. Epub 2005/10/06. doi: 10.7326/0003-4819-143-7-200510040-00009. PubMed PMID: 16204163.
Hoieggen A, Alderman MH, Kjeldsen SE, Julius S, Devereux RB, De Faire U, et al. The impact of serum uric acid on cardiovascular outcomes in the LIFE study. Kidney international. 2004;65(3):1041-9. doi:10.1111/j.1523-1755.2004.00484.x. PubMed PMID: 14871425.
Holme I, Aastveit AH, Hammar N, Jungner I, Walldius G. Uric acid and risk of myocardial infarction, stroke and congestive heart failure in 417,734 men and women in the Apolipoprotein MOrtality RISk study (AMORIS). Journal of internal medicine. 2009;266(6):558-70. doi: 10.1111/j.1365-2796.2009.02133.x. PubMed PMID: 19563390.
Sundstrom J, Sullivan L, D’Agostino RB, Levy D, Kannel WB, Vasan RS. Relations of serum uric acid to longitudinal blood pressure tracking and hypertension incidence. Hypertension. 2005;45(1):28-33. doi: 10.1161/01.HYP.0000150784.92944.9a. PubMed PMID: 15569852.
Bhole V, Choi JW, Kim SW, de Vera M, Choi H. Serum uric acid levels and the risk of type 2 diabetes: a prospective study. Am J Med. 2010;123(10):957-61.
Strasak AM, Rapp K, Hilbe W, Oberaigner W, Ruttmann E, Concin H, et al. Serum uric acid and risk of cancer mortality in a large prospective male cohort. Cancer causes & control : CCC. 2007;18(9):1021-9. doi: 10.1007/s10552-007-9043-3. PubMed PMID: 17665312.
Obermayr RP, Temml C, Gutjahr G, Knechtelsdorfer M, Oberbauer R, Klauser-Braun R. Elevated uric acid increases the risk for kidney disease. Journal of the American Society of Nephrology : JASN. 2008;19(12):2407-13. doi: 10.1681/ASN.2008010080. PubMed PMID: 18799720; PubMed Central PMCID: PMC2588108.
Fang J, Alderman MH. Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey. Jama. 2000;283(18):2404-10. doi: 10.1001/jama.283.18.2404. PubMed PMID: 10815083.
Uaratanawong S, Suraamornkul S, Angkeaw S, Uaratanawong R. Prevalence of hyperuricemia in Bangkok population. Clinical rheumatology. 2011;30(7):887-93. doi: 10.1007/s10067-011-1699-0. PubMed PMID: 21302126
Most cold medicines only treat the symptoms; however, seaweed nasal spray attacks a cold at its source and is clinically proven to shorten the duration of a cold and help reduce the severity of cold symptoms. The are formulated to be preservative & steroid free, and can used during pregnancy, breastfeeding and kids from 12 months.
These solutions often have the natural ingredient iota-carragenan sourced from red seaweeds such as Eucheuma cottonii . Some may use the carrageenan Kappaphycus alvarezii . The carrageenan forms a barrier in the nasal passage that traps cold viruses, helping to reduce their multiplication and spread, allowing your body’s natural defences to sweep the viruses away from the nasal lining.
Seaweed Nasal Spray is in Multiple Products
These come in from a range of providers.
The Austrian company from Vienna Marinomed AG has produced a carrageenan product used by various called Carrogelose and that product is sold for colds and flus.
Mundicare® Cold Defence Nasal Spray from Mundipharma and they also sell a range of other natural products including melaleuca.
Sinomarin Plus Algae from Sinomarin from Greece, which uses the brown seaweed fucoidan extract Undaria pinnatifida and Spirulina plantensis/ Their product is for rhinitis, allergies and colds and flus.
Marinome published work in 2021 showing efficacy on SARS-COVID-2 with trials in Argentina. See this preliminary press release and the report from the Argentina hospital here
A range of products from Sinomarin as part of seaweed extracts in nasal sprays.
Is Whole Seaweed Effective?
For over 50 years, seaweed has been known to be effective as an antiviral compound and even tested against remdesivir in 2021. But the introduction and widespread sale of commercial products is a welcoming sign.
Marinome say a particular advantage of their carrageenan type product is the broad activity of the polymer against different virus strains, such as rhinovirus and colds and flus. They also show activity against coronaviruses. In clinical trials with more than 600 patients suffering from early symptoms of the common cold they show great improvement. Products containing their extracts, such as nasal sprays, lozenges or a throat spray have been marketed in Austria since 2008 and now have been established as the first causative treatment of common cold and flu-like diseases worldwide and are distributed in more than 40 countries.
Biosea Health suspects that the consumption of seaweed as a daily food will be effective in reducing the impact of viruses. That it reduces disease load in pigs and chickens in meat broiler and egg production is demonstrated. Research is needed to confirm.
A recent study published in PLOS showed a healthy heart reduces dementia in a cohort of about 1500 Finish people. Improvements in heart health in midlife reduced dementia risk. It was the latest study finding people with better cardiovascular health metrics scores in midlife had a significantly lower risk of late-life dementia.
More than 5 million adults aged 65 years and older in the United States are predicted to have dementia, with projected increases to nearly 14 million people by 2050. In Australia, it affects about 1 in 15 over the age of 65. The cost is more than $15 billion and costs about $35,000 per sufferer. [4] It is not a “normal” part of aging. Lifestyle makes a big difference.
Severe cognitive dysfunction involving difficulties with memory, recognition, language, decision making, attention, and problem-solving accompanies dementia. This can interfere with a person’s daily functioning.
The Healthy Heart Reduces Dementia Study
Dementia is a long term disease and this cohort study included 1,449 participants from the Finnish Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study, who were followed from midlife (baseline from1972 to 1987; mean age 50.4 years; 62.1% female) to late life (1998), and then 744 dementia-free survivors were followed further into late life (2005 to 2008). (30 year study)
Outcomes
The dementia rate was about 3.8% over a 20-year cumulative incidence for a healthy heart regime. If you had an unhealthy profile the risk of increase of dementia by about 3 times (to 9% over those 20 years)
Some lifelong modifiable risk factors identified in epidemiological studies, including cardiovascular risk factors from mid to late life, play a crucial role in the onset and progression of dementia. Seaweed reduces blood pressure and decreases heart inflammation in animal studies.
In fact, simulation research estimates that up to 35% of dementia cases may be due to modifiable risk factors across the life span. These risk factors include social and mental health factors such as education, social engagement, hearing loss, and depression.
Epidemiological studies also show the importance of cardiovascular health in the prevention of dementia. Factors such as smoking, diabetes, heart failure, atrial fibrillation, high blood pressure, obesity, and high cholesterol are all associated with an increased risk of dementia.
The American Heart Association’s (AHA) has 7 cardiovascular health metrics and four are behavioral:
physical activity
diet
smoking
body weight
Three components are biological:
blood cholesterol
blood pressure
blood glucose
Scientists have associated having ideal cardiovascular health metrics in midlife with a reduced incidence of dementia in later life.
Seaweed Reduces Dementia
In animal studies seaweed reduces dementia – but the translation from lab to human use is not direct. However there is enough evidence that the models are sound. This study concluded a healthy heart reduces dementia and there is data that seaweed reduces hypertension and diabetes – both major risk factor to dementia.
Dementia
References
[1] Liang Y, Ngandu T, Laatikainen T, Soininen H, Tuomilehto J, Kivipelto M, et al. (2020) Cardiovascular health metrics from mid- to late-life and risk of dementia: A population-based cohort study in Finland. PLoS Med 17(12): e1003474. https://doi.org/10.1371/journal.pmed.1003474
[2] [1] Wanyonyi, S; du Preez, R; Brown, L; Paul, N; Panchal, S 2017 Kappaphycus alvarezii as a Food Supplement Prevents Diet-Induced Metabolic Syndrome in Rats. Nutrients (9) 11 DOI:10.3390/nu9111261 (Click for Abstract) (Click to download full paper)
[3] Bogie, J et al (Including Monique Mulder) 2019 Dietary Sargassum fusiforme improves memory and reduces amyloid plaque load in an Alzheimer’s disease mouse model. Scientific Reports 9 (1) DOI 10.1038/s41598-019-41399-4 (Click for Abstract) (Click to download full paper)
The question is can you stop Arthritis with seaweed. We have many customers who report their symptoms have reduced and that seaweed is very effective. This may be due to the type of arthritis, and the amount of Pacific Seamoss seaweed that customers are consuming.
Is seaweed good for Arthritis
Seaweded is packed full of a large number of nutrients and vitamins which probably reduce the symptoms of arthritis. Nutrients such as potassium (K) are in high quantities and improve smooth muscle
Does seaweed work for All Types of arthritis
Arthritis is over 100 different types, and a large number of causes with not enough research done on the type of arthritis and the beneficial effects of seaweed.
Is Seaweed inflammatory
Seaweed is highly anti-inflammatory. In an animal experiment in 2017 and 2020, Brown looked at various markers such as hypertension, heart inflammation, gut inflammation, fatty liver inflammation and gut microbiota and glucose intolerance and seaweed reduced the the markers. Along with blood serum markers, the histological evidence was conclusive.
Effectiveness of Whole Seaweed versus Seaweed Extracts
The seaweed extract nutrient complex when taken orally over twelve weeks decreased the symptoms of osteoarthritis in a dose-dependent manner in 2007, and 2010,
How Common is Osteoarthritis
Osteoarthritis (OA) is the most frequent cause of disability among adults in the developed world. Arthritis affects around 15% in Australia (3 million people). More than 20 million people in the United States have the disease. The lifetime risk of knee OA for males and females aged over 45 years is between 45% (nonobese) to 70% for obese. The cost in USA is more than $60 billion per year.It is second only to ischemic heart disease as a cause of work disability for men over 50 years.
Can osteoarthritis Be Cured?
The progressive deterioration of articular cartilage which occurs in OA results in pain, stiffness and difficulty with physical activities. The disease is managed rather than cured, with a focus on pain relief.
What Natural Medicines are Used?
A number of herbal medicines in clinical trials show beneficial effects in reduction of OA symptoms. These include advocado, soybean unsaponifiables, lipids from green-lipped mussels, calcified seaweed extracts, and Pycnogenol (French maritime pine bark extract). Boswellia serrata extracts have also show clinical promise as do preparations of Harpagophytum procumbens (Devil’s Claw). In vitro studies polyphenols such as epigallocatetchin (from green tea) and phlorotannin-rich extracts of the seaweed Ecklonia cava show potential.
Can you Stop Arthritis with Seaweed
Previous studies focused on seaweed extracts, not whole seaweed. The study by Myers was with a fucoidan extract and showed promise in Phase 1 / II trials but did not in phase 3 trials. When you look further, there is a strong dose rate up to 1g per day. Pacific Seamoss (see seaweed species here) is consumed at 2 to 5 grams per day. This consumption equivalent to a bowl of salad provides nutrients and vitamins, changes gut microbiota.
Types of arthritis in hand. Seaweed appears to have an anti-inflammatory effect on osteo-arthritis and gout.Types of arthritis in knees. Seaweed anti-inflammatory seems to reduce pain but may be in earlier stage.Various types of arthritis in the ankleFig 3 from Myers et al [1] showing dose effects over time. The COAT Score is a comprehensive arthritis test comprised of four sub-scales: pain, stiffness, difficulty with physical activity and overall symptom severity,
References
[1] Myers, S. P., O’Connor, J., Fitton, J. H., Brooks, L., Rolfe, M., Connellan, P., Wohlmuth, H., Cheras, P. A., & Morris, C. (2010). A combined phase I and II open label study on the effects of a seaweed extract nutrient complex on osteoarthritis. Biologics : targets & therapy, 4, 33–44. https://doi.org/10.2147/btt.s8354
