Beneficial effects of natural eggshell membrane versus placebo in exercise-induced joint pain, stiffness, and cartilage turnover in healthy, postmenopausal women

Abstract

Purpose: Despite its many health benefits, moderate exercise can induce joint discomfort when done infrequently or too intensely even in individuals with healthy joints. This study was designed to evaluate whether NEM® (natural eggshell membrane) would reduce exercise-induced cartilage turnover or alleviate joint pain or stiffness, either directly following exercise or 12 hours post exercise, versus placebo.

Patients and methods: Sixty healthy, postmenopausal women were randomly assigned to receive either oral NEM 500 mg (n=30) or placebo (n=30) once daily for two consecutive weeks while performing an exercise regimen (50-100 steps per leg) on alternating days. The primary endpoint was any statistically significant reduction in exercise-induced cartilage turnover via the biomarker C-terminal cross-linked telopeptide of type-II collagen (CTX-II) versus placebo, evaluated at 1 and 2 weeks of treatment. Secondary endpoints were any reductions in either exercise-induced joint pain or stiffness versus placebo, evaluated daily via participant questionnaire. The clinical assessment was performed on the per protocol population.

Results: NEM produced a significant absolute treatment effect (TEabs) versus placebo for CTX-II after both 1 week (TEabs -17.2%, P=0.002) and 2 weeks of exercise (TEabs -9.9%, P=0.042). Immediate pain was not significantly different; however, rapid treatment responses were observed for immediate stiffness (Day 7) and recovery pain (Day 8) and recovery stiffness (Day 4). No serious adverse events occurred and the treatment was reported to be well tolerated by study participants.

Conclusion: NEM rapidly improved recovery from exercise-induced joint pain (Day 8) and stiffness (Day 4) and reduced discomfort immediately following exercise (stiffness, Day 7). Moreover, a substantial chondroprotective effect was demonstrated via a decrease in the cartilage degradation biomarker CTX-II. Clinical Trial Registration number: NCT02751944.

Keywords: CTX-II; breakdown; cartilage degradation; chondroprotective.

Conflict of interest statement

Disclosure KJR and MB are employees of ESM Technologies, LLC. CA is an independent distributor for ESM’s product. JT is a paid consultant for ESM Technologies, LLC. The authors report no other conflicts of interest in this work.

Figures

Figure 1

Percent change from resting in urinary CTX-II in NEM-supplemented and placebo groups after 1 week (A) and 2 weeks (B) of exercise. Notes: *P<0.05; **P<0.01 versus placebo. Abbreviations: CTX-II, C-terminal cross-linked telopeptide of type-II collagen, reported as nanograms per millimole of creatinine (ng/mmol Cr); NEM, natural eggshell membrane.

Figure 2

A plot of immediate pain (A) and 12-hour pain (B) in NEM-supplemented and placebo groups across 2 weeks of exercise. Notes: Overall trend differences were determined via rm-ANOVA. Trend differences found to have statistical significance with rm-ANOVA were then compared using a Kruskal–Wallis test for multiple independent samples to identify specific time points that differed between treatment and placebo. *P<0.05; #P<0.10 versus placebo. Abbreviations: NEM, natural eggshell membrane; rm-ANOVA, repeated-measures analysis of variance.

Figure 3

A plot of immediate stiffness (A) and 12-hour stiffness (B) in NEM-supplemented and placebo groups across 2 weeks of exercise. Notes: Overall trend differences were determined via rm-ANOVA. Trend differences found to have statistical significance with rm-ANOVA were then compared using a Kruskal–Wallis test for multiple independent samples to identify specific time points that differed between treatment and placebo. *P<0.05; #P<0.10 versus placebo. Abbreviations: NEM, natural eggshell membrane; rm-ANOVA, repeated-measures analysis of variance.