Osteo Bi-Flex Uses and Effectiveness

Osteo Bi-Flex is an over-the-counter (OTC) line of supplements containing ingredients like glucosamine, chondroitin, and collagen that may help ease joint pain caused by osteoarthritis. While Osteo Bi-Flex is not approved by the Food and Drug Administration (FDA) to treat any medical condition, there is some evidence to support its use as well as possible risks to be aware of.

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What Is Osteo Bi-Flex Used For?

Osteo Bi-Flex is a well-known brand of joint supplements designed to improve joint mobility, flexibility, and comfort in people with osteoarthritis (OA).

Also known as “wear-and-tear arthritis,” OA is characterized by the progressive loss of joint cartilage which exposes underlying bones and causes them to remodel (renew themselves) abnormally. This eventually causes bone to rub against bone, causing swelling, pain, and the loss of joint mobility.

Osteo B-Flex is thought to work by providing the body with tools to rebuild cartilage (or at the very least to slow or prevent further cartilage loss).

What Is It Made Of?

Osteo Bi-Flex comes in a variety of formulations with different combinations of ingredients, but the seven active ingredients most commonly found in the different formulations include:

Glucosamine: This compound is a building block for glycosaminoglycans, which are part of cartilage. The type used in Osteo Bi-Flex is derived from shellfish shells.
Chondroitin: This compound is a component of cartilage that helps with its resistance to compression. The type used in Osteo Bi-Flex is derived from animal cartilage.
Methylsulfonylmethane (MSM): This naturally occurring sulfur-based compound is thought to fight inflammation and ease pain. The type used in Osteo Bi-Flex is created in a lab.
5-Loxin Advanced: Osteo Bi-Flex’s main proprietary ingredient is comprised of an enriched form of Boswellia serrata, an herb used in Ayurvedic medicine to reduce joint inflammation.
Vitamin D: This essential vitamin, derived mainly from UV sun exposure, helps build and maintain healthy bones.
Undenatured collagen II (UC-II): This protein complex potentially modulates the immune response to prevent the breakdown of cartilage. The type used solely in the Osteo Bi-Flex Ease formulation is derived from chicken sternums (breastbones).

Algal oil: This oil from algae is rich in omega-3 fatty acids, including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), both of which help ease joint inflammation. It is used as an active ingredient in the Osteo Bi-Flex Advanced Omega 3 Joint Complex formulation.

How Effective Is It?

As with all dietary supplements sold in the United States, Osteo Bi-Flex has no medically approved use by the FDA. Even so, there is evidence of a modest benefit to people living with OA:

According to a 2019 review of 69 studies, joint supplements containing glucosamine, chondroitin, undenatured collagen, and Boswellia serrata offer “moderate and clinically meaningful treatment of hand, hip, or knee osteoarthritis.” Even so, the quality of research was “very low.”
Of all the ingredients in Osteo Bi-Flex, glucosamine and chondroitin are by far the most studied. According to the landmark Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) involving 1,600 adults with OA, both supplements were no better than a placebo (sham) drug at improving joint pain or function.
Similarly, a 2020 review of 41 studies concluded that undenatured collagen supplements like UC-II “show some potential” in improving joint health, but a definitive conclusion cannot be made.

Expert Opinion

American College of Rheumatology recommends against the use of glucosamine and chondroitin due to lack of a proven benefit.

Possible Side Effects and Risks

Common side effects of Osteo Bi-Flex include bloating, constipation, diarrhea, gas, hair loss, nausea, puffy eyelids, and stomach pain. Rare but serious side effects include cardiac arrhythmia (irregular heartbeats), peripheral edema (swelling in the legs), and allergic reactions.

Other potential concerns include:

High blood sugar: Glucosamine can increase blood sugar. People with diabetes should monitor their blood sugar more closely while taking Osteo Bi-Flex.
Liver toxicity: Glucosamine can slightly elevate liver enzymes, a concern for people with cirrhosis and other forms of chronic liver disease.
Drug interactions: MSM, Boswellia serrata, glucosamine, and chondroitin can all interact with blood thinners like Coumadin (warfarin), leading to easy bruising and bleeding.

Who Should Avoid It

There are a few absolute contraindications to Osteo Bi-Flex, but certain groups need to avoid the supplement, including individuals with:

If you are vegan, avoid Osteo Bi-Flex as animal products are used in the manufacturing of chondroitin and UC-II.

As a general rule, dietary supplements should be avoided in children as well as people who are pregnant or breastfeeding unless under the supervision of a healthcare provider.

Dosage and How to Take It

Osteo Bi-Flex has been sold in the United States for over 25 years and remains among the top-selling brands of joint health supplements. There are today 10 different Osteo Bi-Flex formulations with the following active ingredients and dosages in milligrams (mg):

Brand	Dosage	Main ingredients
Regular Strength	6 tablets per day	1500 mg glucosamine, 1,200 mg chondroitin
One Per Day	1 coated tablet per day	1,500 mg glucosamine, 100 mg 5-Loxin Advanced, 400 IU vitamin D
Ease	1 mini tablet per day	40 mg UC-II, 100 mg 5-Loxin Advanced, 400 IU vitamin D
One Per Day Inflammatory Response	1 capsule per day	100 mg 5-Loxin Advanced, 400 IU vitamin D, fenugreek, turmeric
Triple Strength	2 coated tablets per day	1,500 mg glucosamine, 1,100 mg chondroitin, 100 mg 5-Loxin Advanced, 60 mg vitamin C, 2 mg manganese sulfate, 35 mg sodium
Triple Strength With Vitamin D	2 coated tablets per day	1,500 mg glucosamine, 275 mg chondroitin/MSM complex, 100 mg 5-Loxin Advanced, 2,000 IU vitamin D, 25 mg sodium
Triple Strength Plus Turmeric	2 coated tablets per day	1,500 mg glucosamine, 100 mg 5-Loxin Advanced, 450 mg turmeric
Triple Strength MSM	2 coated tablets per day	1,500 mg glucosamine, 100 mg 5-Loxin Advanced, 1,500 mg MSM, 20 mg sodium
Triple Strength + Magnesium	2 coated tablets per day	1,500 mg glucosamine, 100 mg 5-Loxin Advanced, 420 mg magnesium
Advanced Omega 3 Joint Complex	2 softgels per day	700 mg algal oil, 100 mg 5-Loxin Advanced