What You Need to Know Before Taking Osteo Bi-Flex for Osteoarthritis

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Osteo Bi-Flex is an over-the-counter dietary supplement marketed for the relief of joint pain caused by osteoarthritis. It contains ingredients naturally found in bones, bone marrow, shellfish, and fungus that are thought to support joint health.

Although there is some evidence that ingredients like glucosamine can help, Osteo Bi-Flex is not approved by the U.S. Food and Drug Administration (FDA) to treat any medical condition. Some health experts, including the American College of Rheumatology, have issued warnings that there are risks associated with this popular but largely unproven alternative remedy.

This article explains what Osteo Bi-Flex is, including its list of active ingredients. It then describes some of the key side effects, risks, and interactions associated with this popular over-the-counter arthritis remedy.

Man with knee joint pain
ljubaphoto / Getty Images

What's In Osteo Bi-Flex?

Osteo Bi-Flex is a dietary supplement used for people with arthritis. Like all dietary supplements, it is not strictly regulated by the FDA and is not approved for the prevention or treatment of any medical condition.

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

  • 5-Loxin Advanced: This is Osteo Bi-Flex's main proprietary ingredient, comprised of an enriched version of Boswellia serrata that is thought to reduce joint inflammation and pain. Boswellia is commonly used in Ayurvedic medicine to treat arthritis.
  • Glucosamine: This is a compound found in human cartilage that creates synovial fluids that lubricate joints. The type used in Osteo Bi-Flex is derived from shellfish shells.
  • Chondroitin: This is another compound found in human cartilage that helps joints retain synovial fluids. The type used in Osteo Bi-Flex is derived from animal cartilage.
  • UC-II collagen: This protein complex is the primary building block for cartilage in joints. The type used in Osteo Bi-Flex is derived from chicken sternums (breastbones).
  • Methylsulfonylmethane (MSM): This naturally occurring sulfur-based compound is thought to fight inflammation and ease pain. The type used is Osteo Bi-Flex is created in a lab.

What Is Osteo Bi-Flex Used to Treat?

According to the manufacturer, Osteo Bi-Flex is used to support joint health. Among other things, it is said to help with occasional joint flare-ups and improve joint comfort in seven days.

Although the manufacturer does not directly say so, they are referring to relief from a form of arthritis called osteoarthritis (OA).

Also known as "wear-and-tear arthritis," OA is the most common form of arthritis in the United States, affecting over 32 million people. OA causes the gradual deterioration of joints, leading to cartilage loss, joint deformity, and chronic pain and stiffness.

Osteo Bi-Flex is said to provide joint discomfort by reducing inflammation and providing the body with the substances it needs to maintain joint cartilage.

Does Osteo Bi-Flex Work?

Generally speaking, the evidence supporting the manufacturer's claims is limited. Many of the studies involve animals, which don't necessarily confer the same effects in humans. Others are limited by the small study size or by results that are largely subjective and vulnerable to bias.

Here are some of the key findings:

  • 5-Loxin Advanced: A 2008 study, promoted by the manufacturer, reported that pain scores were better among 38 adults with OA who were given 5-Loxin for 90 days than 37 adults given a placebo (sham drug). Further research is needed to support the limited findings.
  • Glucosamine and chondroitin; The landmark Glucosamine/Chondroitin Arthritis Intervention Trial (GAIT) involving 1,600 adults with OA reported that glucosamine and chondroitin improved pain and function but no better than a placebo or the drug Celebrex (celecoxib).
  • UC-II collagen: Based on an analysis of 41 studies, a 2020 review of studies in Rheumatology and Therapy concluded that undenatured collagen supplements like UC-II "show some potential" in improving joint health but a definitive conclusion could not be made.
  • Methylsulfonylmethane (MSM): A review of studies published in Osteoarthritis and Cartilage reported that, based on the analysis of six clinical trials, there is positive but not definitive evidence that MSM is superior to a placebo in the treatment of OA.

Expert Opinion

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

Contact your healthcare provider before using Osteo Bi-Flex or other any over-the-counter product marketed for joint health. Your healthcare provider can determine if the ingredients are safe and won't interact with any medications you are taking.

Are There Warnings and Interactions With Osteo Bi-Flex?

Just because a dietary supplement is sold over the counter does not necessarily mean that it's safe.

Potential 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 irregular heartbeats, 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 liver disease.
  • Glaucoma: Glucosamine can also increase eye pressure. If you have glaucoma, talk to your doctor before using Osteo Bi-Flex.
  • 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 Not Take Osteo Bi-Flex?

There are a few absolute contraindications to the ingredients in Osteo Bi-Flex, but certain groups should avoid the supplement.

This includes:

  • People with severe shellfish allergies: Shellfish allergies can occur in response to the glucosamine used in OsteoBi-Flex (which is derived from shellfish).
  • People with chronic venous insufficiency: MSM can increase swelling and pain in people with varicose veins and other forms of chronic venous insufficiency.

Do not take other products containing glucosamine or chondroitin while using Osteo Bi-Flex. Doing so can increase the risk of stomach upset, nausea, or diarrhea. The same may occur if MSM is taken in excess.

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

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.

Summary

Osteo Bi-Flex is an over-the-counter supplement used to support joint health and ease pain and inflammation caused by osteoarthritis. While the evidence supporting the health claims is generally weak, some studies show benefits. Further research is needed.

Osteo Bi-Flex can cause gastrointestinal side effects like bloating, constipation, diarrhea, gas, and stomach pain. It should be avoided in people with severe shellfish allergies and chronic venous insufficiency.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and kneeArthritis Rheumatol. 2020;72(2):220-233. doi:10.1002/art.41142

  2. Osteo Bi-Flex. The science behind Osteo Bi-Flex ingredients.

  3. Al-Saadi HM, Pang K-L, Ima-Nirwana S, et al. Multifaceted protective role of glucosamine against osteoarthritis: Review of its molecular mechanismsScientia Pharmaceutica. 2019; 87(4):34. doi:10.3390/scipharm87040034

  4. National Institute on Aging. Osteoarthritis.

  5. Sengupta K, Alluri KV, Satish AR, et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin for treatment of osteoarthritis of the kneeArthritis Res Ther. 2008;10(4):R85. doi:10.1186/ar2461

  6. Sawitzke AD, Shi H, Finco MF, et al. Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAITAnn Rheum Dis. 2010;69(8):1459-64. doi:10.1136/ard.2009.120469

  7. Honvo G, Lengele L, Charles A, Reginster JY, Bruyere O. Role of collagen derivatives in osteoarthritis and cartilage repair: a systematic scoping review with evidence mapping. Rheumatol Ther. 2020 Dec;7(4):703–740. doi:10.1007/s40744-020-00240-5

  8. Brien A, Prescott P, Bashir N, Lewith H, Lewith G. Systematic review of the nutritional supplements dimethyl sulfoxide (DMSO) and methylsulfonylmethane (MSM) in the treatment of osteoarthritis. Osteoarthritis Cartilage. 2008;16(11):1277-1288. doi:10.1016/j.joca.2008.03.002

  9. National Center for Complementary and Integrative Health. Glucosamine and chondroitin for osteoarthritis.

  10. Cerda C, Bruguera M, Parés A. Hepatotoxicity associated with glucosamine and chondroitin sulfate in patients with chronic liver disease. World J Gastroenterol. 2013;19(32):5381–4. doi:10.3748/wjg.v19.i32.5381

  11. Arthritis Foundation. Glucosamine and chondroitin for osteoarthritis pain

  12. American College of Rheumatology. Herbal remedies, supplements & acupuncture for arthritis.

  13. Pedrosa M, Boyano-martínez T, García-ara C, Quirce S. Shellfish allergy: A comprehensive review. Clin Rev Allergy Immunol. 2015;49(2):203-16. doi:10.1007/s12016-014-8429-8

  14. MedlinePlus. Methylsulfonylmethane (MSM).

Carol Eustice

By Carol Eustice
Carol Eustice is a writer who covers arthritis and chronic illness. She is the author of "The Everything Health Guide to Arthritis."