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It Works Well But There Are Less Expensive Substitutes
on December 5, 2011
This is a review that I updated while using myself as a guinea pig to find effective lower cost alternatives to Instaflex. I first posted it on 12/5/11 because (1) I had moved past the 14-day trial period into my first full month's supply that came (with my knowledge) on the auto-fill program; and (2) I agree with the negative reviews about the cost -- $70 a month is ridiculously expensive. [Note: As of 5/25/15 the price of a 90-capsule bottle which will last 1 month is $41 -- which is still more expensive than some of the products reviewed here.] I knew a potential scam could come when I was ordering but I also knew that 14 days would not be long enough to give it a fair trial. So I used a virtual credit card available from my issuing bank that expired in 60 days. If I didn't continue to like Instaflex after a couple months I wouldn't have to cancel. There just wouldn't be a card they could bill to.
Some background: I am 68. I had an old-fashioned operation in 1966 to remove soccer-related damaged cartilege in my left knee (medial meniscectomy). By the time I reached my late 50's most of the undamaged remaining cartilege had worn away and I now have almost no cartilege in that knee (bone-on-bone contact). I have been taking various brands of Glucosamine/Chondroitin supplements for about 20 years and high quality Omega-3 separately for at least 5 years. No supplements will prevent the pain that occurs when I change position when sitting and the bones in my joint shift. But supplements have been somewhat helpful in limiting the pain in walking and climbing stairs. My orthopedist has given me injections of hyaluronic acid (Orthovisc) directly into the knee which were very effective. But they are limited to once every six months and their relief only lasted me about 20 days each time. So I was about to schedule a partial knee replacement in early 2012 when the Instaflex infomercial caught my attention.
By the end of the 14-day trial period I was experiencing almost no pain walking and climbing stairs. Then there was a delay shipping my first full bottle. During the down time my walking pain recurred. About halfway through the 90 cap bottle the pain was gone again -- just about as effectively as were the Orthovisc injections and far more effectively than any other Glucosamine/Chondroitin formulations I have been on. I am putting off the decision to have a knee replacement so I can see the long-term benefits of Instaflex or a cheaper substitute. Preliminarily I am giving this product a four-star rating because it has demonstrated to me in the short-term that it works, one star knocked off for being overpriced.
So now, the rest of the experiment. Find another product that works but less expensively. Ignoring the "natural" ingredients in the Instaflex formulation, I am going to concentrate on the two ingredients that have been missing from my past pills -- MSM and hyaluronic acid. I am already familiar with the benefits of hyaluronic acid although I rather doubt the tiny amounts of this in the Instaflex formulation could have achieved the same benefit as my injections of the substance. What I have never taken before is MSM even though a friend swore by it a long time ago. So I will be looking for a product(s) that duplicate as many of the Instaflex ingredients as possible at an affordable price.
Stay tuned for part 2 of this review coming sometime in 2012.
PART 2 [posted 2/6/2012]
Source Naturals Hyaluronic Joint Complex, 120 Tablets
The first stage of my alternate products trial commenced after I ran out of Instaflex after posting the initial review above. The product was Source Naturals Hyaluronic Joint Compound. It is available from various merchants but the least expensive I found for this $59 MSRP 30-day supply was at Swanson Vitamins where it is currently listed for $30.35. (I obtained it just before Christmas 2011 for $28.55.) It is item # SN205 at the Swanson site. You can see the product label with all its contents there. [Further note: This product is now available from Source Naturals on Amazon. Source Naturals Hyaluronic Joint Complex, 120 Tablets Its current price is $29.11 [as of 8/23/12] and is eligible for free Super Saver shipping. If you choose to let them automatically ship on a recurring basis the price drops to $27.65.]
Source Naturals description of the product states: "Give your joints the nutrient building blocks they need with Source Naturals Hyaluronic Joint Complex. This comprehensive formula combines hyaluronic acid with glucosamine, chondroitin, MSM and manganese ascorbate. Hyaluronic acid is a major component of joint tissue. It helps to hold lubricating moisture in joints and cartilage, which affects their resilience, elasticity, and strength. BioCell Collagen II is a patented hyaluronic acid, which has undergone an absorption enhancing hydrolyzation process that yields low molecular weight hyaluronic acid, chondroitin sulfate, and collagen type II peptides. Contains no yeast, dairy, egg, gluten, corn, soy or wheat. Contains no sugar, starch, preservatives or artificial color, flavor or fragrance."
The last part was a lie because the tabs were, of all things, peppermint flavored (and smelled like it) -- which for me was rather off-putting. I am used to having all my vitamins and supplements being flavorless. However, that is the only negative thing I have to say about them. They were not quite as effective as Instaflex in alleviating my pain walking and climbing stairs, but the difference in their effectiveness to me was clearly not worth paying more than twice their price for Instaflex. And they were far more effective in alleviating my walking/climbing pain than my prior joint compounds consisting of only glucosamine/chondroitin. Having MSM and hyaluronic acid in a joint compound for me is established as a necessity by my successive use of Instaflex and Source Naturals.
I had a gap of several days between the end of the Instaflex and the commencement of the Source Naturals and between the end of those and the start of the next item to be compared: Glucosamine/Hyaluronic Acid/Chondroitin/MSM (Shellfish-Free) - 120 - Tablet by Solgar. I used my old supplements that lacked MSM and hyaluronic acid during those intervals and I had forgotten how much walking pain I was enduring when those were my supplements.
Take note: the Source Naturals 120 tab bottle will only last 30 days because the recommended dose is 2 tablets twice per day. I could see this was true because 2 tablets yield only 600 mg of chondroitin and 750 mg of glucosamine and I have long been using the recommended daily dosage of those substances at 1200 and 1500 mg respectively. I think most people would receive little benefit at less than the 1200/1500 level.
Unless I can find an unflavored compound that is equally effective, Source Naturals is likely to become my Instaflex replacement.
Part 3 will be posted sometime in March 2012 when I have finished my course of the Solgar hyaluronic compound. [or so I said back in February]
[Everything from this point forward is posted 8/23/12 except for some short updates posted 10/22/12, 11/12/12; a warning to not run out of the product you're using posted 6/7/13]; an update on 5/25/15 in which I sourced some frontal knee pain as coming from my patellar tendon and not from a failure of the joint medication; and a very important update on June 29, 2015 responding to HappyNana's message that my ultimately chosen product Flexacil Ultra is no longer being sold on Amazon. When you reach the end of this review you'll see how to find it from its distributor.]
A Public Apology
My apologies to those of you who were waiting for me to post updates since February. I became very busy with a long-term project and I never found the time to get back and post here. But that does not mean my product comparison has not been going on during the long silence. So, while I left everyone hanging for six months, at least now I am able to post the complete product comparison with no more waiting involved.
Solgar, Glucosamine Hyaluronic Acid Chondroitin MSM (Shellfish-Free), 120 Tablets
I took the Solgar compound between approximately the beginning of February until the middle of March. There are 60 tablets per bottle and the recommended daily serving is 3 tablets, so each bottle lasts 20 days. I have learned from subsequent sampling of the products to be reviewed that 40 days is perhaps not enough time to get enough supplement components into your system to have a satisfactory effect. However, when I started on the Solgar trial my system was fully loaded with the very effective Source Naturals Hyaluronic Joint Compound. There was no down time between when I ran out of Source Naturals and when I commenced taking Solgar. The decline in my joint condition and the commencement of pain, not just in my resting knee when the bones shift, but walking and stair climbing had an onset within a few days. It never got back to the level of freedom from pain that I experienced with Instaflex and Source Naturals. Truth be told, however, it was no worse than any of the joint compounds I used to take that were exclusively Glucosamine/Chondroitin. Due to that factor I will give it 3 stars when I independently post on the Solgar product page, but it falls far short of the standards set by other Gluco/Chondroitin/MSM/hyaluronic compounds. Of course, if you have to have something shellfish free then you might have to give up full effectiveness and go with a product such as this.
Flexacil Ultra - (3 bottles, 60 caps each) The Most Advanced Joint Repair and Pain Relief Formula - Premium Grade...
Flexacil Ultra - (3 bottles, 60 caps each) The Most Advanced Joint Repair and Pain Relief Formula - Premium Grade...
[Two separate Amazon listings -- same price, different sellers]
This product came with generally outstanding user reviews here on Amazon, so I was looking forward to commencing my trial and I had hopes that it would be effective enough to rescue me from consuming peppermint flavored pills if ultimately I had to return to Source Naturals. The 3-bottle pack that is sold on Amazon is enough for 60 days (or longer). The instructions say to take 3 capsules a day for the first three weeks to allow a build up of the ingredients in your system. Then you can cut back to 1-2 caps a day (which would allow stretching the 180 pills in the 3 bottles farther than two months). I did not do that during my trial, however. I chose to remain on the 3 caps daily throughout.
Flexacil has a little bit different set of ingredients beyond the main four on which I have been concentrating in selecting the products in this trial. It also includes Ginger Root, Horsetail Extract, Boswellia Extract, and Omega-3 fish oil. As I mentioned earlier, I already take a superior Omega-3 supplement, so I was not looking for the latter in a joint compound. At first I was concerned I might have too much Omega-3 if took Flexacil on top of my regular dose, but upon reconsidering I supposed it's probably not possible to get too much Omega-3 fatty acid. (Not so, for those who have blood clotting problems. There is evidence that massive doses of Omega-3 can inhibit clotting which would be of concern to those already on blood thinners and hemophilia sufferers.) But even if there were a concern for the average person, I don't see how there could be enough Omega-3 in the mix in these tiny caps that would make a difference. (My 3-per day Omega-3 caps are HUGE and filled with undiluted oil.)
There are two complaints about the labeling of Flexacil. As one reviewer on the Amazon product page observes, it's impossible to determine who makes it. There is a distributor listed on the label but no word of a manufacturer. If that is a real concern to you, then move on to something else -- the peppermint flavored Source Naturals unless you find something better. Flexacil, no matter by whom it is manufactured, labels itself as using only pharmaceutical grade ingredients. For now at least I'll accept that at face value. The slightly more concerning thing for me is that, unlike most of its competitors, Flexacil lists the ingredients but does not give a breakdown of how many milligrams or units there are of each. But if its "proprietary blend" works, it's something I can overlook. (It would be hard to believe that there is much of a variance in the percentage of any of the main ingredients in any of the Glucosamine/Chondroitin based joint medications on the market regardless of how jealously guarded a "proprietary blend" might be.)
I just spoke of the necessity to stick with a product for awhile before giving up on it. It was Flexacil that taught me that. I started the trial with only the ineffective Solgar in my system. It took me a bit longer than the three weeks the manufacturer (distributor?) of Flexacil advises for the product build-up to kick in. I was very disappointed during the first weeks of my consumption of Flexacil because I was experiencing pain walking, climbing stairs, and sitting, and it didn't seem to be getting any better as the three-week mark rolled past. Then overnight somewhere around the one-month mark the pain was not there any more. Walking and stair climbing were comfortable and not something I needed to have lurking in the back of my mind (e.g., "do I take care in how I place my foot on a stair? do I shift my weight to one side while climbing/descending?" etc). From then until I ran out of caps knee pain was just not an issue (save when my whole joint would shift while sitting and moving position -- that which no supplement has cured or ever will).
Flexacil's little gel caps look almost identical to Instaflex (I don't know who's copying whom). What's more important is that they work just about as well as Instaflex for 57 cents for a daily dose rather than $1.83-$2.33 per daily dose (based on the $55-$70 per bottle range that Instaflex currently sells for on Amazon as of this writing on 8/23/12). When I rate Flexacil separately on their Amazon page I would give them 4½ stars if possible (½ star reduction for the labeling issue described above). Since half-stars are not possible, I am going to give them 5 stars and not unfairly reduce them to 4.
Sundown Osteo Bi-Flex Advanced MSM, 120 Coated Caplets
Because of the generally excellent customer reviews for this product I decided to include it in my trial. However, if you want to duplicate the product I tested, you're going to have to exercise some care because Rexall Sundown, the manufacturer, has 8 pill formulations and 2 powder formulations that all bear the Osteo Bi-flex brand. I linked this part of the review to the exact product I purchased from Amazon. However, even that is not the end of the story because differently labeled or named versions of Osteo Bi-Flex have many of the same ingredients -- so you'll actually have to read the "Supplement Facts" portion of the label to make sure that you are getting one with Glucosamine/Chondroitin/MSM/hyaluronic acid (if that is your desire as it was mine in conducting my personal guinea pig study). I am not saying that other formulations of Osteo Bi-Flex might not work for you. It's just that I have not tried them and had no interest in trying them. The osteobiflex dot com products page lists the 8 pill formulations currently being manufactured and for each one you can download a .pdf image of the box which includes all the hype and variations for each one. Then you can transport that back to Amazon to find the specific one you want. There is a Rexall warning that those with shellfish allergies should not take any of them. (Tip: 6 of the 8 formulations display "5-Loxin" on the label which is Rexall Sundown's proprietary name for their Boswellia extract ingredient. You won't want the two that do not even have that [One per Day (which also does not even have chondroitin sulfate as an ingredient) and Regular Strength]. The remaining six -- Double Strength, Triple Strength, Triple Strength with Vitamin D, MSM, Energy Formula, and Advanced -- are all different versions of the same thing: a Glucosamine HCl pill with 5-Loxin (Boswellia extract) and Joint Shield proprietary blend of Chondroitin sulfate, MSM, manganese, and hyaluronic acid. The "strengths" are b.s. -- the daily levels listed on the "Supplement Facts" are the same. It's just how many pills do you take each day to reach those levels. What is different with the one I took, which emphasizes MSM on the label, is that Rexall Sundown says it has increased levels of MSM -- which for me is key. Don't be fooled by there being 120 pills in a bottle. At 4 per day that's a month's supply.)
So, with that introduction out of the way what happened when I took it? I commenced my two-month test of Osteo Bi-Flex Advanced MSM with no gap between the end of my Flexacil trial and its commencement. The drop off in effectiveness was noticeable and fairly rapid. I use the word "noticeable" because I don't want to give the impression that Osteo Bi-Flex does not work. It does. Now that I have just a few days worth left of the product I am in no appreciable pain, but once in awhile there will be a twinge or a moment or two of instability when walking or climbing. It was far more "noticeable" about a week after I changed product -- less so now that I have been on it for two months. Again a reminder that all of these products need some patience before one makes conclusions about them. I give it a straight 4 stars for effectiveness. At $20.97 per bottle currently on Amazon that is 70 cents for a day's dose compared to 2 to 3 times that much for Instaflex. In a moment I will present my wrap-up conclusions and state why I think Osteo Bi-flex Advanced MSM is less effective than Instaflex, Source Naturals, and Flexacil.
I am neither a medical professional nor a biochemist. I am going to give my lay person's conclusion based on what I have learned from this 8-month trial, from my experience with supplements before I ever tried Instaflex and the reviewed alternatives, and from medical advice about joint medicine ingredients I have received previously.
As noted at the beginning of this review in December 2011 I have suffered from bone-on-bone contact in my left knee for a very long time. For much of that time I was taking supplements that were composed of two main ingredients: Glucosamine HCl and Chondroitin sulfate. Over time whatever brand I was taking at the time became less and less effective at managing the pain -- although any joint medication is better than none at all. About two years ago my primary care physician -- a renowned internist who is quite interested in supplements and alternative medicine as well as being an expert in her field in traditional medicine -- told me that studies showed that the hydrochloride form of glucosamine is almost ineffective compared to the sulfate form. So I switched to compounds containing the sulfates of glucosamine and chondroitin in combination. It was much better, but not so much better that I did not need to experiment with my orthopedist's injecting my damaged joint with hyaluronic acid. As I stated at the outset of this review, a patient is prohibited from having injections more frequently than six months apart and the effects of the injections disappear a long, long time before the next injection can be administered. I was ready to schedule a knee replacement when I saw the Instaflex infomercial and decided I should try something else before electing surgery.
As previously noted, in about 2003 a colleague who suffered joint pain was comparing notes with me and another colleague in the same boat. He swore by his supplements that contained MSM and stated that ingredient made all the difference. Foolishly I never acted on his advice until my purchase of Instaflex and needlessly suffered partially effective supplements for 8 years. My lay conclusion based on my trial of Instaflex and the four other products compared in this review is that MSM indeed is the "miracle ingredient." I think all the ingredients in a supplement are of value, particularly hyaluronic acid and boswellia extract which seem to be present in the ones I have taken over the past 8 months. However, I don't think there is enough hyaluronic acid in any of these (except perhaps the 100 mg in Source Naturals) to have any effect that separates these formulations from the gluco/chondroitins I used previously. It is the MSM which is present in sufficient quantity to have a marked effect -- 500 mg in Instaflex, 1500 mg in Solgar, 450 mg in Source Naturals (unknown quantities in the "proprietary formulae" of both Flexacil and Osteo Bi-flex). But everything still has to work together. Why do I conclude that Osteo Bi-flex and particularly Solgar were less effective even though they both contained high levels of MSM and had hyaluronic acid? I didn't notice it when I ordered them, but they both use Glucosamine HCl instead of sulfate.
And for the three that worked the best -- Instaflex, Source Naturals, and Flexacil -- I don't think anyone's "proprietary formula" is markedly superior to another's. Instaflex has to be graded down because of their sleazy marketing practices and unjustifiably high price. Take your pick from Source Naturals and Flexacil. I did. Now that my Osteo Bi-flex is about finished I just placed my reorder of Flexacil, my personal winner since it doesn't taste and smell of peppermint as does Source Naturals.
For me the trial is over. But I am happy to consider recommendations of any other product that contains the sulfate forms of Glucosamine and Chondroitin along with MSM as long as you have tried it in comparison to at least one of these three. Comment on this review and I'll try to respond.
UPDATE (10/22/12) -- Now that I've been on Flexacil Ultra for awhile I have found that -- for me -- 2 caps doesn't make it. So I am sticking to the 3-pill per day regimen with pretty good continuing success.
UPDATE (11/11/12) == I forgot to include in my review of the products that I also have arthritis in my neck introduced by whiplash in a car accident in the 1970's. It used to crackle like Rice Crispies. Now it doesn't at all. My attention was so focused on the bad knee in this review and my relief from neck symptoms has been so complete that I literally forgot to include that result in the review.
UPDATE (6/9/13) == An unintended guinea pig experience just befell me during the last few weeks. About 3-4 weeks ago I was a little lax in reordering my Flexacil Ultra thinking I had another bottle beyond the one I was close to finishing. I didn't. I was off my product for about 8 days before the next shipment arrived. By the 4th day I had begun hobbling around due to the increased pain in my left knee. Once I started taking Flexacil again it took almost two weeks before the pain went away. A nice reaffirmance for me that for me Flexacil makes the difference and a reminder to everyone: Whichever product you find to be your favorite joint supplement DON'T FORGET TO CHECK YOUR SUPPLY AND REORDER BEFORE YOU RUN OUT. You will regret it if you don't.
Maureen Kenney's 2/23/15 comment asking me for an update on my condition in the two years since the 2013 update was posted prompted me to provide this:
UPDATE (5/25/15) == My wife and I take walks down the hill from our home to the beach a half mile below. Even though I wear a McDavid brace with a patella opening and side pads on the walks I was experiencing significant pain on the downhill portion of the walk to the point of having to gingerly do the downhill while placing the majority of my weight on my right foot and carefully bringing my left along. (Yes, I guess it's called "limping.")
I was considering whether I needed to update this review to confess that perhaps joint supplements lose their effectiveness over time. However, before doing that I put my thinking cap on. I considered that I experienced no pain in the knee walking back uphill and that I experienced no increased pain when walking on level ground without a knee brace. That in turn led me to the conclusion that the downhill pain was not caused by ineffective joint supplements but by the stress that downhill walking puts on the patella tendon. Easy solution: switched out my open patella brace for a patella tendon strap that puts pressure directly on the tendon (located just below the kneecap [patella]).
So, happy to report that Flexacil Ultra is still working for me three years after this review was posted.
UPDATE June 29, 2015 == HappyNana just advised me that Flexacil Ultra is no longer being sold on Amazon. That was such astounding news that I had to check for myself because I couldn't believe it since it has been sold on Amazon for years. All is not lost though. Vivid Health is the distributor who had been selling it on Amazon and fulfilling the orders. You can still get Flexacil from them at flexacilultra dot com at the same prices they have been selling on Amazon.
UPDATE February 24, 2016 (to my June 29, 2015 update) == I should have been back several months ago to report that Flexacil Ultra has been back on Amazon since the fall of 2015. There are two essentially identical listings, the only difference being a different seller is listed in each. However, both listings make it clear that the product is shipped by Fast Shipping Supplements which is Flexacil's distributor's (Vivid Nutrition) identity on Amazon. Flexacil Ultra - (3 bottles, 60 caps each) The Most Advanced Joint Repair and Pain Relief Formula - Premium Grade... and Flexacil Ultra - (3 bottles, 60 caps each) The Most Advanced Joint Repair and Pain Relief Formula - Premium Grade...
I further report that Flexacil's general manager sent me a six months' supply without cost not because of my past reviews on Amazon but because I called to Flexacil's attention that, during the summer period when it was not available on Amazon, Flexacil's own website showed listings for single bottle and several multiple bottle options on which everything except the single bottle option returned a message that it was out of stock. I questioned how that could be if it were available at the single bottle price for as many bottles as one desired to order and suggested that they eliminate their multiple bottle discount online options if they no longer intended to discount for multiples. Flexacil's GM called me to thank me for calling that to his attention. He stated he had just been on the job for less than a month and the employee who was in charge of the website was also new and no one noticed what was happening on the ordering page. They corrected it immediately and the multiple bottle discounts took effect.
Incidentally, the only ordering choice currently on Amazon is the 3-bottle purchase for $38.95 ($12.99 per bottle). On Flexacil's own website a single bottle costs $19.95; two bottles cost $29.95; three bottles cost $37.95; and five bottles cost $59.95. Shipping is free unless you want a rush shipment.