Genestra TCO Forte- 120 tablets

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Genestra TCO Forte- 120 tablets

Suggested Retail: $36.30

• Multi-mineral, multi-vitamin and antioxidants formulation
• An antioxidant for the maintenance of good health, helps in the development and maintenance of bones, teeth and gums, helps in tissue formation, helps in wound healing, and helps to maintain proper muscle function (1)
• Convenient tablet format
• Increases patient compliance

TCO Forte provides chondroitin sulfate along with a well-balanced proportion of synergistic nutrients, selected to support the health of tissue and bones. Helps the body to metabolize carbohydrates, fats and proteins; Helps in tissue formation, helps to maintain proper muscle function; helps to maintain eyesight, skin, membranes and immune function; helps in the development and maintenance of night vision; helps in the development and maintenance of bones, cartilage, teeth and gums; helps in connective tissue formation; helps in wound healing; an antioxidant for the maintenance of good health (2).

References:
1 NHPD Monograph on Multi-Vitamin and Mineral. October 2007.
2 NHPD Monograph on Multi-vitamin and Mineral. October 2007.

Additional product info:
Adequate zinc status is critical for immune function. Zinc deficiency reduces generation of T cells, depresses humoral and cell-mediated immunity, leads to lymphopenia and thymic atrophy, and increases the frequency and number of infections (3). A prospective, randomized, controlled clinical trial was conducted involving 231 HIV-infected adults with low plasma zinc levels, who were randomly assigned to receive zinc (12 mg of elemental zinc for women and 15 mg for men) or placebo for 18 months. Zinc supplementation given to HIV-infected adults resulted in a 4-fold decrease in the likelihood of immunological failure, defined as a decrease of CD4+ cell count to Calcium and vitamin D are both essential for the development and maintenance of skeletal health. Calcium plays a vital role in neuromuscular function, many enzyme-mediated processes, blood clotting and in providing rigidity to the skeleton by virtue of its phosphate salts. Over 99% of the body’s calcium is stored in the bone, where, apart from providing mechanical strength, it serves as a mineral reservoir that can be drawn upon to maintain normal plasma calcium. Vitamin D is required to maintain normal blood levels of calcium and phosphate, which are in turn needed for the normal mineralization of bone, muscle contraction, nerve conduction and the general cellular functioning of all body cells. Vitamin D, derived from both endogenous (skin) and exogenous (diet) sources, is converted into 25OHD in the liver and then into 1,25(OH)2D in the kidneys. The latter metabolite controls calcium absorption. However, plasma 25OHD closely reflects vitamin D nutritional status, and because it is the substrate for the renal enzyme that produces 1,25(OH)2D, it could have mainly an indirect and also a direct effect on calcium absorption. A vitamin D shortage would reduce the intestinal absorption of calcium, which could worsen if the diet is deficient of this element. Osteoporosis and its clinical consequence, fragility fractures, are now recognized as major public health problems. Bone mass declines and the risk of fractures increases as people age, especially postmenopausal women. An adequate intake of calcium and vitamin D, including supplementation, has been advocated as a universal primary intervention in the prevention and treatment of high-risk patients. Evidence shows that there is still a high proportion of people with inappropriately low calcium and vitamin D intake and serum levels. For selective groups of people, such as the elderly (frequently older than 70 years), those with low solar exposure and in generally poor or inadequate nutritional condition, guaranteeing a daily intake of at least 1 g of calcium and 700–800 IU of vitamin D with supplements would have beneficial effects on bone health. In those individuals with a high risk of osteoporotic fracture, calcium and vitamin D supplements are necessary but frequently insufficient (5). The Women’s Health Initiative (WHI) clinical trial randomly assigned 36,282 postmenopausal women to receive 1000 mg of elemental calcium as calcium carbonate with 400 IU of vitamin D3 daily or placebo for an average follow-up period of 7.0 years. Significantly higher hip bone density but a non-significant reduction (12 percent) in the rate of hip fracture among those assigned to calcium with vitamin D were observed (6). A recent review discusses vitamin D status and supplementation when treating patients with osteoporosis in relation to risks and prevention of falls and fractures. The authors conclude that poor vitamin D status and low calcium intake are important determinates for osteoporosis and fracture risk. Based on evidence from literature, adequate supplementation with at least 700 IU of vitamin D, preferably cholecalciferol, is required for improving physical function and prevention of falls and fractures. Additional calcium supplementation may be considered when dietary calcium intake is below 700 mg/day, with a supplementation dose that leads to a maximum total daily calcium intake of 1000 to 1200 mg (7).

Magnesium (Mg) is the second most abundant intracellular cation in vertebrates. Mg ion is a critical cofactor in more than 300 enzymatic reactions involving energy metabolism, and protein and nucleic acid synthesis. Accordingly, Mg is essential for various normal tissue and organ functions. The primary source of Mg in humans is from the diets. The dietary Mg ion is absorbed in the intestine through both active and passive transport systems. Excessive Mg is rapidly excreted into the urine. During Mg deprivation, the kidney avidly conserves Mg and excretes virtually no Mg in the urine. Approximately half of the total Mg in the body of a normal adult human is present intracellularly in soft tissues, and the other half is found in bone, either as exchangeable, surface-bound, divalent cations, which may serve as a reservoir for maintaining normal extracellular Mg level, or as an integral component of the hydroxyapatite lattice in bone matrix, which may be released during bone resorption. Thus, in addition to the intestine and kidney, the bone is involved in Mg homeostasis. Past studies with Mg depletion in both humans and animals indicate that Mg may have key regulatory roles in bone and mineral metabolism. A study examined the effects of daily oral magnesium (Mg) supplementation on bone turnover in 12 young (27–36 yr old) healthy men. The study group received orally, for 30 days, 15 mmol Mg (Magnosolv powder, Asta Medica, containing 670 mg magnesium carbonate precipitate (equivalent to 169 mg Mg) and 342 mg magnesium oxide (equivalent to 196 mg)) daily in the early afternoon with 2-h fasting before and after Mg intake. Mg supplementation reduced levels of both serum bone formation and resorption biochemical markers after 1–5 days, consistent with the premise that Mg supplementation may have a suppressive effect on bone turnover rate. The study concludes that oral Mg supplementation may suppress bone turnover in young adults. Because increased bone turnover has been implicated as a significant etiological factor for bone loss, these findings raise the interesting possibility that oral Mg supplementation may have beneficial effects in reducing bone loss associated with high bone turnover, such as age-related osteoporosis (8). In another study, twenty postmenopausal women have been divided into two groups. Ten patients were given magnesium citrate (1,830 mg/day providing 205 mg elemental magnesium) orally for 30 days. Ten postmenopausal women of matching age, menopause duration, and BMI were recruited as the control group and followed without any medication. Thirty consecutive days of oral magnesium supplementation caused significantly decrease in serum iPTH levels in the Mg-supplemented group. Serum osteocalcin levels were significantly increased and urinary deoxypyridinoline levels were decreased in the Mg-supplemented group. This study has demonstrated that oral magnesium supplementation in postmenopausal osteoporotic women suppresses bone turnover (9).

Flavonoids are polyphenolic compounds that occur in most foods of plant origin and are significant though minor constituents of the human diet (10). Bioflavonoids, which include hesperidin, citrin, rutin, flavones, flavonols, catechin and quercetin, were formerly called “Vitamin P”, and were found to be essential components in improving the permeability and integrity of the capillary linings (11). Flavonoids possess antioxidants properties while being able to modulate a number of biological functions such as anti-inflammatory and anti-microbial activities (12). Six weeks' rutin supplementation (500 mg daily) significantly elevated the levels of three plasma flavonoids (quercetin. kaempferol and isorhamnetin) (13).

Green tea (GT) and black tea (BT) are both derived from the tea leaves of Camellia sinensis. GT is manufactured by drying the leaves of C. sinensis. The manufacture of BT requires an additional fermentation step, which generates theaflavins and thearubigins. Theaflavins and thearubigins are oligomeric polyphenolic compounds synthesized from monomeric tea flavanol units. Tea flavanols are regarded as the biologically active constituents of tea. The main flavanols found in GT, and to a lesser extent in BT, are (-)-epigallocatechin-3- gallate (EGCG), (-)-epigallocatechin (EGC), (-)-epicatechin-3-gallate (ECG), and (-)-epicatechin (EC). EGCG is the most abundant and widely studied tea polyphenol. EGCG and ECG have the highest radical scavenging activity (14). Experimental studies have revealed that green tea catechins can prevent influenza infection in vitro, but clinical evidence has so far been inconclusive. A randomized, double-blind, 2-group parallel study was conducted to compare the effects of green tea catechins and theanine (catechin/theanine) capsules with those of placebo on the prevention of influenza for 5 months during the influenza season. The participants were asked to take 6 capsules per day, containing a total of 378 mg catechins (including 270 mg (-)-epigallocatechin gallate) and 210 mg theanine or placebo. The incidence of clinically defined influenza infection was significantly lower in the catechin/theanine group compared with the placebo group. The time for which the patient was free from clinically defined influenza infection was significantly different between the two groups (15). In 20 young healthy smokers, endothelial functions, defined by flow-mediated endothelium dependent vasodilation (FMD) of the brachial artery via ultrasound as well as the number of endothelial progenitor cells (EPCs) isolated from peripheral blood, were determined at baseline and at 2 weeks after green tea consumption (8 g/day). Circulating EPCs by flow cytometry and cultured EPCs increased rapidly at 2 weeks after green tea consumption. FMD was significantly improved after 2 weeks (16). Green Tea extracts providing up to 690 mg total catechins are a source of antioxidants for the maintenance of good health (17).

800-1,200 mg per day of chondroitin sulfate helps to relieve joint pain associated with osteoarthritis and helps to relieve pain associated with osteoarthritis of the knee (18).

References:
3 Baum MK, Lai S, Sales S, Page JB, Campa A. Randomized, controlled clinical trial of zinc supplementation to prevent immunological failure in HIV-infected adults. Clin Infect Dis. 2010 Jun 15;50(12):1653-60.
4 Baum MK, Lai S, Sales S, Page JB, Campa A. Randomized, controlled clinical trial of zinc supplementation to prevent immunological failure in HIV-infected adults. Clin Infect Dis. 2010 Jun 15;50(12):1653-60.
5 Díaz-López B, Cannata-Andía JB. Supplementation of vitamin D and calcium: advantages and risks. Nephrol Dial Transplant. 2006 Sep;21(9):2375-7.
6 Jackson RD, LaCroix AZ, Gass M, Wallace RB, Robbins J, Lewis CE, Bassford T, Beresford SA, Black HR, Blanchette P, Bonds DE, Brunner RL, Brzyski RG, Caan B, Cauley JA, Chlebowski RT, Cummings SR, Granek I, Hays J, Heiss G, Hendrix SL, Howard BV, Hsia J, Hubbell FA, Johnson KC, Judd H, Kotchen JM, Kuller LH, Langer RD, Lasser NL, Limacher MC, Ludlam S, Manson JE, Margolis KL, McGowan J, Ockene JK, O'Sullivan MJ, Phillips L, Prentice RL, Sarto GE, Stefanick ML, Van Horn L, Wactawski-Wende J, Whitlock E, Anderson GL, Assaf AR, Barad D; Women's Health Initiative Investigators. Calcium plus vitamin D supplementation and the risk of fractures. N Engl J Med. 2006 Feb 16;354(7):669-83.
7 van den Bergh JP, Bours SP, van Geel TA, Geusens PP. Optimal use of vitamin D when treating osteoporosis. Curr Osteoporos Rep. 2011 Mar;9(1):36-42.
8 Dimai HP, Porta S, Wirnsberger G, Lindschinger M, Pamperl I, Dobnig H, Wilders-Truschnig M, Lau KH. Daily oral magnesium supplementation suppresses bone turnover in young adult males. J Clin Endocrinol Metab. 1998 Aug;83(8):2742-8.
9 Aydin H, Deyneli O, Yavuz D, Gözü H, Mutlu N, Kaygusuz I, Akalin S. Short-term oral magnesium supplementation suppresses bone turnover in postmenopausal osteoporotic women. Biol Trace Elem Res. 2010 Feb;133(2):136-43.
10 Boyle SP, Dobson VL, Duthie SJ, Hinselwood DC, Kyle JA, Collins AR. Bioavailability and efficiency of rutin as an antioxidant: a human supplementation study. Eur J Clin Nutr. 2000 Oct;54(10):774-82.
11 Garg A, Garg S, Zaneveld LJ, Singla AK. Chemistry and pharmacology of the Citrus bioflavonoid hesperidin. Phytother Res. 2001 Dec;15(8):655-69.
12 Boyle SP, Dobson VL, Duthie SJ, Hinselwood DC, Kyle JA, Collins AR. Bioavailability and efficiency of rutin as an antioxidant: a human supplementation study. Eur J Clin Nutr. 2000 Oct;54(10):774-82.
13 Boyle SP, Dobson VL, Duthie SJ, Hinselwood DC, Kyle JA, Collins AR. Bioavailability and efficiency of rutin as an antioxidant: a human supplementation study. Eur J Clin Nutr. 2000 Oct;54(10):774-82.
14 Henning SM, Niu Y, Lee NH, Thames GD, Minutti RR, Wang H, Go VL, Heber D. Bioavailability and antioxidant activity of tea flavanols after consumption of green tea, black tea, or a green tea extract supplement. Am J Clin Nutr. 2004 Dec;80(6):1558-64.
15 Matsumoto K, Yamada H, Takuma N, Niino H, Sagesaka YM. Effects of green tea catechins and theanine on preventing influenza infection among healthcare workers: a randomized controlled trial. BMC Complement Altern Med. 2011 Feb 21;11:15.
16 Kim W, Jeong MH, Cho SH, Yun JH, Chae HJ, Ahn YK, Lee MC, Cheng X, Kondo T, Murohara T, Kang JC. Effect of green tea consumption on endothelial function and circulating endothelial progenitor cells in chronic smokers. Circ J. 2006 Aug;70(8):1052-7.
17 NHPD Monograph on Green Tea Extracts. April 2008.
18 NHPD Monograph on Chondroitin Sulfate. July 2007.

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