For the past 10 years, I have been a primary care physician working hand in hand with my patients to achieve the best health outcomes. I also have a passion for regenerative medicine, focusing on using regenerative treatments to affect the best outcomes and longevity of those outcomes. I have tried my best to be a good listener and diagnostician navigating how to use my training and knowledge to give advice and to help patients improve their quality of life. I may not always get things perfect but I do the best to guide them to the right answer, the right outcome, and the right expectations.
I have frequently been asked about supplements and alternative treatments that may be newer, poorly researched, the latest fad, etc., and haven’t been accepted as standard of care. My patients expect that I am the expert and many of them give heavy weight to my thoughts on these various treatments. I take that obligation seriously, and I try to always research and use evidence and knowledge to inform my opinions. In my years as a primary care physician and regenerative medicine specialist, I have had more patients than I can count ask me about dietary recommendations regarding various supplements to affect various health goals. The usual question usually pertains to what they can take so that their bodies and cells work to their best, what will help them feel their best, what will lead to best long term preventative health outcomes, or some variation thereof. Another common theme is also regarding various supplements that advertise some benefit for pain, usually due to arthritis or joint issues as that is a condition that affects or will affect all of us at some point.
After having enough people ask my advice and seeing a lot of claims from various supplement makers over the years, I decided to go beyond just a cursory glance at the evidence, and to dive deep into supplements. Most of my patients in the regenerative medicine field are frequently asking what specific supplements to take to support stem cells and cellular function as well as what supplements are best to help with arthritic joints. Therefore, I narrowed my focus to the regenerative medicine, pain and joint, and inflammation topics. I spent several months, diverting an hour here and an hour there to find clinical studies that studied various supplements and certain clinical endpoints such as cellular function, metabolic activity, repair, as well as studies that were done to address the inflammation and pain related to musculoskeletal problems including common issues that I frequently see in the clinic such as knee, hip, shoulder, back pain and inflammation. Through my search, I was pleasantly surprised to find that there were actually quite a few studies done that were well designed, independent, blinded, and showed benefits with several different supplements for the above mentioned conditions.
My next step was then to find commercially available formulations that I felt addressed the concerns of my patients. I had to believe in them if I was going to put my recommendation behind it. The biggest challenge was that I wanted a supplement that took a comprehensive approach to combine several researched ingredients to create a super supplement. After researching on the most common marketplaces online and in person, a common theme presented itself. Most supplement makers only offered the ingredients that I wanted as individuals supplements. Sometimes I could find a brand that would combine 2-3 ingredients that I found evidence for but they were few and far between. This left me wanting for more, as I prefer not take pills, and if I am to take a pill, it needs to have a high perceived benefit for me. Since I found several supplements that had supporting research for benefit, such as for joint arthritis and inflammation as an example, I was looking for an all-in-one solution that combined most of the ingredients into one supplement. It did not exist. I grew frustrated because how many supplements does one truly want to take for a given benefit. The answer is a few as possible. That frustration led me to put things on the back burner for some time.
Another few years went by and the recommendation requests continued to come my way. I watched my patients try various supplements and prescriptions with varying degrees of benefits (and side effects often with prescriptions). I would occasionally perform an online search to see if any new product came on the market that met the need that was there. None did. I was left to give my patients a list of individual supplements that I found that had benefit. It was up to them to decide how many they wanted to try. The issue continued to smolder at the back of my mind. It seemed to make sense to combine the most research proven ingredients and combine them into one supplement. The need is there, but the product is not. Some people with mild to moderate arthritis may benefit from just one or two ingredients but perhaps they advance to a point where the one or two supplements they took would not have enough effect for the patient to perceive a benefit, just like when arthritis progresses beyond the point that over-the-counter ibuprofen no longer works and you have to try a stronger medication, dose, or even a prescription to get relief. The same principle applies to the supplement side. When using a researched supplement, perhaps one is enough or a higher dose will work early on but as your condition progresses it may not be enough. I say researched, because without research showing some effect or benefit for a given condition, there is the chance that the supplement is just a placebo with no actual direct benefit.
As a physician treating a large number of patients with arthritis or other musculoskeletal pain related conditions, often involving a component of inflammation, it made complete sense to me that there should be someone somewhere that surely makes a comprehensive formula combining all if not most of the best researched ingredients to treat the pain and inflammation related to joint and musculoskeletal conditions. But alas, as I mentioned, none were to be found and I became increasingly bothered by the lack of a product that should exist.
Finally, 3-4 years after I initially embarked on my search, and getting stuck behind the problem, I decided to focus on identifying possible solutions. The best solution for the problem was taking matters into my own hands and to create that product that I could not find. After all, I already had the ideal formula from researching the various supplements as well as the most effective doses as shown in the research. Therefore, I put together the preliminary formulation for two new comprehensive all-in-one supplements. One to help those with joint pain due to inflammation and arthritis and another to help promote stem cell and cellular function.
My next step was to identify a manufacturer that I could trust and that would work with a small volume supplement brand. I had no idea what I was in store for. They exist, but I got an education. There are a number that refused to even return my call, despite advertising that they help low volume brands get started. There were others who did return my call but their sales agents came off as the proverbial used car salesman and their tactics matched. I found 2-3 companies that were respectful, and that were very transparent and forthcoming about expectations. I learned from them that there are a lot of reputable supplement brands but even more that are not. These less than reputable often rely on lack of transparency and gimmicks and suggestive inferences to benefits that aren’t
there. They skirt around things, knowingly misleading their consumers, in search of maximizing profits. For example, a specific ingredient may be advertised but it may be only a powder as opposed to an extract, and furthermore, no documentation as to what percentage/concentration and standard to which it was extracted. In this way, two products can have vastly different outcomes. It can be the difference between what works and what doesn’t. In each case, they advertise the same ingredient with different outcomes, The other gimmick employed is the proprietary blend gambit. We assume they are trying to protect their intellectual property, but often they will list a total MG dose and maximize the cheapest ingredient while minimizing the amount of the more expensive ingredients. In other words, the cheapest ingredient is what makes up most of the product, even though a consumer may have purchased it because it listed another product combination that has only a trace amount included. How is anyone to know? Other manufacturers are transparent about dosages, so kudos to them, but as a physician I often know or research the appropriate dose that led to a specific benefit in the research. Often times, these manufacturers provide doses so low, that there can be no possible benefit. Most have no incentive to combine the individuals supplements into a comprehensive formula to minimize that number of pills, because the profit margin is much higher when you are required to purchase and try the supplements individually. The list goes on, you now begin to understand the issue. I designed my formulas very precisely and the dosages of the individual ingredients were those that were shown to have effect. I could not compromise.
The next problem that presented itself was to combine all the ingredients at their respective dosages into one tablet. You can only get so many milligrams into one tablet and the more the milligrams the larger the tablet. I had to find the perfect balance of tablet size and the number of tablets per serving to accomplish the ideal dose. Unfortunately, despite telling each sales rep what my goal was, most never listened. The other issue was pricing. I had to be diligent as the pricing quotes would often change (more expensive) for no reason. I did my best to research the individual wholesale pricing of each ingredient, so I would be armed with knowledge, thereby limiting my exposure of being taken advantage of. A number of manufacturers assumed I had limited knowledge being a newbie into the supplement market, and their sales quotes often reflected that. Fortunately, I had done some market research and I soon realized that I had to just walk away from these companies. They were after short term gain sacrificing even longer term benefit that comes from repeat business and there was no negotiating with them. The next challenge was getting all the ingredients into one pill. Many of the sales reps suggested to just lower the dosage to get everything into the tablet. Obviously, despite hearing my goal behind the supplement and why I was creating the supplement, they didn’t listen. I had to repeatedly tell them that I could not lower the dose, as it would then be subtherapeutic and that would defeat the entire premise behind the supplement. I have to have a product that I can stand behind.
The next learning curve is to figure out how to market the product so that those people who would benefit from it will find it. Today’s marketing environment is unique and challenging. I had to obtain a UPC barcode for each product which was it’s own learning curve. I had planned to sell on Amazon but after researching this medium, I have found that it is an expensive endeavor, as there are challenges just to list on amazon, and even greater challenges to get seen. I am a small brand and do not have the resources to compete with the distribution and marketing of the larger brands. It will be a longer and harder road for me to gain traction. I have had to create my own website, negotiate payment processing, perform as my R&D department and many other responsibilities to make this product come to life. The advantage that I have is that my product is a one-of-a-kind supplement line that meets an unmet need.
It will also be a first of its kind truly comprehensive supplement that seeks to maximize benefit using the fewest pills possible. Not all people respond the same way to different medications, and some conditions are so advanced that they are beyond supplements and even the strongest prescriptions, injections, etc, For those reasons, I cannot not guarantee that my supplement will work for everyone. I can tell them that if my supplement doesn’t get the job done for them, then nothing else on the shelf will. As a physician, this is a product that I can believe in.