Interactions on record — worth a quick check against your medications. Based on 10 of 12 ingredients. Check your meds →
Dietary supplement

Joint, Tendon, Ligament I Ingredients & Drug Interactions

by Douglas Laboratories

Joint, Tendon, Ligament I label
See full label image
Capsule Category: Other Combinations
Most serious interaction: Moderate
Clinical methodology reviewed by · Updated Sep 16, 2026 · Label data from the NIH DSLD
What is this page for?

First and foremost: checking Joint, Tendon, Ligament I against your medications. The heart of this page is the interaction checker and the full interaction report — how this product’s ingredients may interact with prescription and over-the-counter medicines you may be taking.

Around that, we add a pharmacist’s high-level view of the product as a whole — what’s inside, the evidence for its stated use, how transparent the label is, and what safety data exists — so you can see the full picture in one place. It’s educational information from our licensed clinical databases and the clinical staff at HelloPharmacist — not medical advice — and we don’t sell or endorse products. Our editorial policy

The interaction bottom line Most serious interaction: Moderate

Joint, Tendon, Ligament I is a dietary supplement by Douglas Laboratories with 12 active ingredients. Its ingredients are commonly taken for sleep quality and insomnia, relaxation, cognitive function.Based on those ingredients, 1,304 medications have a known interaction with it, the most serious rated moderate. The ingredients most likely to interact are ApresFlex, L-Arginine, Strawberry fruit extract. Use the checker below to test your specific medication, or read the full HelloPharmacist Interaction Report.

Jump to a section

Check Your Meds Against Joint, Tendon, Ligament I by Douglas Laboratories

Ask about any prescription or over-the-counter medication and we check it for interactions with Joint, Tendon, Ligament I by Douglas Laboratories — and tell you which ingredient is responsible.

Pharmacist-reviewed data Checks every ingredient Answer in seconds
Prefer a human? Send your question to our licensed pharmacists — free, answered by email within 24 hours.

HelloPharmacist Scorecard of Joint, Tendon, Ligament I by Douglas Laboratories

Our pharmacy team’s full take, with four database checks built into the cards below — a summary of what is known, not a grade of the product itself.

From our pharmacy team — supplement deep dive

Generated from HelloPharmacist’s pharmacist-curated databases and editorial rules · Last generated Jul 11, 2026

What’s inside

Full disclosure
Ingredient Transparency · database check
Full

Every active ingredient lists its own amount on the label.

Why this rating?
  • The label discloses an exact amount for 12 of its 12 active ingredients.
  • No proprietary blends here — you can verify the dose of every single component.

Joint, Tendon, Ligament I contains 12 active ingredients. The main amino acids are glycine, L-arginine, and L-proline — building blocks your body uses to make and repair connective tissue.

You'll also get manganese (a mineral involved in bone and cartilage formation), hyaluronic acid (a compound that holds moisture in joints), and silicon (linked to bone strength). The formula rounds out with strawberry fruit extract, Enzogenol Pine bark extract, spinach powder, and three proprietary blends: Methylsulfonylmethane, Cynatine FLX, and ApresFlex.

The product also contains inactive ingredients — hydroxypropylmethylcellulose, stearate, microcrystalline cellulose, and silica — which are fillers, binders, and capsule materials.

Does it work?

Moderate evidence
Evidence for Intended Use · database check
By FDA rules, dietary supplements can’t claim to treat, cure, or prevent disease — so labels speak in careful marketing language. We discern each product’s intended use from its name, label claims, and label statements, then grade the clinical evidence for that use. How these ratings are computed
Moderate

Some clinical evidence supports this product's ingredients for its stated purpose, but it isn't conclusive.

Why this rating?
  • The label markets this product for: Joint, tendon, and ligament support.
  • We looked for evidence on: Osteoarthritis, Fractures, Wound healing, Exercise-induced muscle soreness, Muscle strength, Physical performance — and 4 related terms.
  • The strongest evidence on file: Boswellia Serrata is rated "Possibly Effective" for Osteoarthritis (Natural Medicines).
  • Also on file: Boswellia Serrata is rated "Insufficient Reliable Evidence To Rate" for Exercise-induced muscle soreness.
  • Also on file: Manganese is rated "Insufficient Reliable Evidence To Rate" for Osteoarthritis, Wound healing.

The evidence for these ingredients in joint health is limited. L-proline, hyaluronic acid, and silicon all show insufficient evidence to support claims about fractures, osteoporosis, or osteoarthritis.

Glycine has insufficient evidence for any of its listed uses. Manganese is effective for manganese deficiency itself, but has insufficient evidence for osteoarthritis or other joint conditions.

Strawberry, spinach powder, and the pine bark extract all lack reliable evidence for the conditions listed. We hold no effectiveness data for the proprietary ingredients Methylsulfonylmethane, Cynatine FLX, or ApresFlex.

The evidence, ingredient by ingredient Glycine L-arginine Proline Manganese Hyaluronic Acid Silicon Strawberry Monterey Pine

How safe is it?

Well-documented data
Safety Information · database check
Well characterized

Adverse-effect, pregnancy, and general safety data are on file for most of these ingredients.

Why this rating?
  • We hold adverse-effect (side-effect) data for 9 of the 10 matched ingredients.
  • Pregnancy & breastfeeding safety ratings cover 9 of 10.
  • General safety write-ups exist for 10 of 10.
  • Remember: this measures how much safety information exists. Thin data is not the same as being safe.

Most of these ingredients are generally well tolerated at normal amounts. However, several carry important cautions.

Glycine is generally well tolerated, but long-term safety data are limited, and it's best avoided in pregnancy unless your doctor approves — there's not enough data on breastfeeding either. L-arginine can lower blood pressure in some people and requires medical supervision; safety data for pregnancy and breastfeeding are absent.

Manganese is safe in normal dietary amounts, but high-dose supplements carry a rare but serious risk of neurotoxicity (Parkinson-like symptoms) and liver damage — the safety data advise avoiding high-dose manganese supplements in pregnancy and breastfeeding. Hyaluronic acid supplements lack long-term safety data and are best avoided in pregnancy and breastfeeding unless your doctor advises otherwise.

Silicon has limited pregnancy and breastfeeding safety data — avoid supplements during these times. Strawberry as food is safe; concentrated supplements lack pregnancy and breastfeeding data.

Spinach as food is considered safe and likely safe in pregnancy and breastfeeding. We hold no adverse-effect data for L-proline, Methylsulfonylmethane, Cynatine FLX, ApresFlex, or Enzogenol Pine bark extract.

Side effects, ingredient by ingredient Glycine L-arginine Proline Manganese Hyaluronic Acid Silicon Strawberry Monterey Pine

Meds to double-check

Moderate interaction found
Known Interaction Concern · database check
Moderate identified

The most serious documented interaction for these ingredients is Moderate. Check your medications for a personalized result.

Why this rating?
  • 6 of the 10 matched ingredients can interact with medications — Boswellia Serrata, Manganese, Strawberry, Spinach, L-arginine, among others.
  • The most serious interaction on file is rated Moderate.
  • Some involve high-stakes drug classes: anticoagulant / antiplatelet drugs; immunosuppressants / transplant drugs; diabetes medications.
  • For scale: 1,305 individual medications appear in the full list. A big number alone doesn't make a product dangerous — what matters is whether YOUR medication is on it, so run yours through the interaction checker on this page.

Check your medications against this product if you take blood pressure drugs (antihypertensives, ACE inhibitors, or ARBs — Moderate risk of very low blood pressure), blood thinners or antiplatelet drugs like warfarin or aspirin (Moderate risk of bleeding or reduced effectiveness), diabetes medications (Moderate risk of low blood sugar), potassium-sparing diuretics (Moderate risk of high potassium), antipsychotics (Moderate risk with manganese), certain antibiotics like quinolones or tetracyclines (Moderate risk of reduced absorption), or clozapine (Clozaril) for schizophrenia (Moderate risk of worsened symptoms). If you take any of these, check with your pharmacist before using this product.

Check your own medication Run your meds through the checker above

The bottom line

Scorecard at a glanceFully disclosed formula with some supporting evidence for its stated purpose. Moderate medication interactions have been identified, and safety information is well characterized.

This product targets joint support with amino acids, minerals, and plant extracts, but the evidence that it works is not established in the data we hold. More importantly, if you take any blood pressure medication, blood thinner, diabetes drug, or antipsychotic, run your exact medications through the checker on this page before you start — L-arginine and other ingredients here can significantly affect how those drugs work.

Talk with your pharmacist before adding this to your routine.

Educational only — not medical advice; always confirm with your pharmacist. Our editorial policy · How we use AI

Assessment coverage: 10 of 12 active ingredients matched to our full ingredient reviews (monographs). Based on the product label dated Apr 11, 2022.

This Scorecard evaluates available label information, ingredient evidence, and known medication-safety considerations. It does not independently verify product identity, purity, potency, contamination, or manufacturing quality. How these ratings are computed

At a glance

General information

Key facts about Joint, Tendon, Ligament I, straight from the product label.

Brand Douglas Laboratories
Barcode (UPC) 310539039014
Net contents 90 Vegetarian Capsule(s)
Market status On market
Date entered into DSLD Apr 11, 2022
DSLD ID 261203
Product type Other Combinations
Supplement form Capsule
Dietary claims / uses All Other, Structure/Function
Intended target group(s) Adult (18 - 50 Years), Women (not pregnant or lactating), Gluten Free
From the label
Everything in this section is reproduced from the manufacturer’s own product label — it’s the label speaking, not HelloPharmacist. We show it so you can see exactly what the maker states; we don’t verify or endorse those statements.

Supplement Facts

The label details for Joint, Tendon, Ligament I by Douglas Laboratories, sourced from the NIH Dietary Supplement Label Database.

Supplement Facts

Daily Value (DV) Target Group(s):
Adults and children 4 or more years of age
Minimum serving Sizes:
3 Vegetarian Capsule(s)
Maximum serving Sizes:
3 Vegetarian Capsule(s)
Servings per container
30
UPC/BARCODE
310539039014
IngredientAmount% DV
Glycine250 mg--
L-Arginine400 mg--
L-Proline250 mg--
Manganese2 mg100%
Methylsulfonylmethane400 mg--
Hyaluronic Acid5 mg--
Silicon15 mg--
Cynatine FLX500 mg--
Strawberry fruit extract25 mg--
Enzogenol Pine bark extract10 mg--
ApresFlex100 mg--
Spinach, Powder25 mg--

Other ingredients: Hydroxypropylmethylcellulose, Stearate, Microcrystalline Cellulose, Silica

Tap any ingredient to jump to its full detail below.

Label statements
These statements are the manufacturer’s wording, reproduced from the product label — the label is saying it, not HelloPharmacist. We don’t verify or endorse them.
Suggested/Recommended/Usage/Directions

Suggested Use: As a dietary supplement, adults take 3 capsules daily or as directed by your health professional.

Precautions

Warning: Not to be taken by pregnant or lactating women. If you have any health condition or are taking any medication, consult your health professional before use.

Keep out of the reach of children.

Use only if safety seal is intact.

Brand IP Statement(s)

Cynatine FLX is a registered trademark of Roxlor, LLC. Enzogenol is a registered trademark of Enzo Nutraceuticals. ApresFlex is a registered trademark of Laila Nutraceuticals exclusively licensed to PL Thomas – Laila Nutra LLC. U.S. Patent #8,551,496 and other patents pending.

Storage

Store in a cool, dry place.

General

Gluten-free, Non-GMO

FDA Disclaimer Statement

This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

General Statements

Scan to learn about our manufacturing excellence Contents may not fill package in order to accommodate required labeling. Please rely on stated quantity.

FDA Statement of Identity

Dietary Supplement

Formulation

Support for joint mobility and ligaments

Is this label outdated? Report a formula or label change and our pharmacy team will review it.

See for yourself

Joint, Tendon, Ligament I by Douglas Laboratories label

The label scan from the NIH Dietary Supplement Label Database. Tap to enlarge.

Joint, Tendon, Ligament I label

Label images are published by the NIH Dietary Supplement Label Database for the version of this product on file. Always read your actual product label.

View the full label (PDF)
What’s inside

The Ingredients in Joint, Tendon, Ligament I by Douglas Laboratories

These are the 12 active ingredients this product is made of. Select any to open its full monograph.

Serving size3 Vegetarian Capsule(s) Dosage formCapsule Servings per container30 Amounts shown are per serving.

Most supplement products combine several ingredients, and a medication can interact with the product through any one of them. Each ingredient below shows whether it has known drug interactions.

Glycine

Interacts with
1 drug
250 mg per serving

Glycine is a non-essential amino acid your body makes on its own and that also appears in protein-rich foods. It is most studied for improving sleep q...

Glycine monograph & interactions

L-Arginine

Interacts with
403 drugs
400 mg per serving

L-arginine is an amino acid that the body uses to make nitric oxide, a substance that helps blood vessels relax and widen. It is popularly used for bl...

L-Arginine monograph & interactions

L-Proline

No known
interactions
250 mg per serving

Proline is a non-essential amino acid that your body can make on its own and that you also get from protein-rich foods. It is a key building block of...

L-Proline monograph & interactions

Manganese

Interacts with
83 drugs
2 mg per serving Form: Manganese Amino Acid Chelate

Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get...

Manganese monograph & interactions

Methylsulfonylmethane

400 mg per serving

Hyaluronic Acid

No known
interactions
5 mg per serving Form: Sodium Hyaluronate

Hyaluronic acid is a natural substance in the body that helps hold water in the skin, joints, and eyes. Oral and topical products are popular for skin...

Hyaluronic Acid monograph & interactions

Silicon

No known
interactions
15 mg per serving Form: Silicon Amino Acid Chelate

Silicon is a trace mineral found in the body and in foods like oats, barley, and certain fruits and vegetables, and it is popular in supplements for h...

Silicon monograph & interactions

Cynatine FLX

500 mg per serving

Strawberry fruit extract

Interacts with
316 drugs
25 mg per serving Form: Polyphenols

Strawberry is a popular, nutrient-rich fruit that supplies vitamin C, fiber, and antioxidant plant compounds. Eating strawberries as part of a balance...

Strawberry fruit extract monograph & interactions

Enzogenol Pine bark extract

No known
interactions
10 mg per serving Form: Proanthocyanidins

Monterey Pine is mainly a timber tree, and human evidence for its use as a supplement is very limited. Some pine bark extracts are studied for antioxi...

Enzogenol Pine bark extract monograph & interactions

ApresFlex

Interacts with
952 drugs
100 mg per serving Form: Boswellia serrata Gum Extract

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoart...

ApresFlex monograph & interactions

Spinach, Powder

Interacts with
88 drugs
25 mg per serving Form: Spinacia oleracea, Spinacia oleracea

Spinach is a nutrient-dense leafy green that is a healthy part of a balanced diet, providing vitamins, minerals, fiber, and antioxidants. While it is...

Spinach, Powder monograph & interactions

Other (inactive) ingredients: Hydroxypropylmethylcellulose, Stearate, Microcrystalline Cellulose, Silica. These complete the product’s ingredient list but are not active constituents.

Interaction report

Joint, Tendon, Ligament I by Douglas Laboratories Drug Interactions

Want to check YOUR meds against Joint, Tendon, Ligament I?

Ask about interactions with your drugs in plain English — “Can I take it with lisinopril?” — and we find you the answer in seconds, ingredient by ingredient.

 Go to the checker
1,304Drugs
1,301 Moderate 3 Minor

Ingredients driving the most interactions

ApresFlex 952
L-Arginine 403
Strawberry fruit extract 316
Spinach, Powder 88
Manganese 83

Individual Drug Interactions

The ingredients in Joint, Tendon, Ligament I interact with 1,304 drugs. Click any drug to see the details.

6 of the 12 ingredients in Joint, Tendon, Ligament I interact with drugs. Each result below shows which ingredient is responsible. ApresFlex L-Arginine Strawberry fruit extract Spinach, Powder Manganese Glycine

Each ingredient & the kinds of drugs it affects

For each ingredient in Joint, Tendon, Ligament I with known interactions, here are the types of medications they can affect. Open any type for the detail — or search your exact drug in the checker above.

ApresFlex6 drug types · 952 drugs

Cytochrome P450 1A2 (Cyp1A2) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP1A2 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP1A2 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2C19 (Cyp2C19) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2C19 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C19 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2C9 (Cyp2C9) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2C9 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2C9 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 2D6 (Cyp2D6) Substrates

Theoretically, Boswellia serrata might increase the levels of CYP2D6 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP2D6 enzymes.

Likelihood Possible Evidence D
Cytochrome P450 3A4 (Cyp3A4) Substrates

Theoretically, Boswellia serrata might increase or decrease the levels and clinical effects of CYP3A4 substrates.
In vitro research shows that Boswellia serrata gum resin inhibits CYP3A4 enzymes. Other in vitro research shows that Boswellia serrata extract inhibits CYP3A4 enzymes at most concentrations, although it may modestly induce enzyme activity at low concentrations.

Likelihood Possible Evidence D
Immunosuppressants

Theoretically, Boswellia serrata might alter the effects of immunosuppressive drugs.
Some in vitro research suggests that Boswellia serrata extracts might inhibit mediators of autoimmune disorders such as leukotrienes and reduce production of antibodies and cell-mediated immunity. However, other in vitro research suggests that, when coupled with calcium ions, boswellic acids containing the keto group have immunostimulant properties within specific cell signaling pathways.

Likelihood Possible Evidence D
ApresFlex full monograph & interactions

L-Arginine9 drug types · 403 drugs

Ace Inhibitors (Aceis)

Theoretically, concomitant use of L-arginine and ACE inhibitors may increase the risk for hypotension and hyperkalemia.
Combining L-arginine with some antihypertensive drugs, especially ACE inhibitors, seems to have additive vasodilating and blood pressure-lowering effects. Furthermore, ACE inhibitors can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ACE inhibitors with L-arginine may increases the risk of hyperkalemia.

Likelihood Probable Evidence D
Angiotensin Receptor Blockers (Arbs)

Theoretically, concomitant use of L-arginine and ARBs may increase the risk of hypotension and hyperkalemia.
L-arginine increases nitric oxide, which causes vasodilation. Combining L-arginine with ARBs seems to increase L-arginine-induced vasodilation. Furthermore, ARBs can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients. Theoretically, concomitant use of ARBs with L-arginine may increases the risk of hyperkalemia.

Likelihood Probable Evidence D
Anticoagulant/Antiplatelet Drugs

Theoretically, concomitant use of L-arginine with anticoagulant and antiplatelet drugs might have additive effects and increase the risk of bleeding.
Preliminary research suggests that L-arginine infusions reduce platelet aggregation in humans. The clinical significance of this effect is unclear.

Likelihood Possible Evidence D
Antidiabetes Drugs

Theoretically, concomitant use of L-arginine might have additive effects with antidiabetes drugs.
Preliminary clinical research shows that L-arginine decreases blood glucose levels in patients with type 2 diabetes.

Likelihood Possible Evidence D
Antihypertensive Drugs

Theoretically, concomitant use of L-arginine and antihypertensive drugs may increase the risk of hypotension.
L-arginine increases nitric oxide, which causes vasodilation. Clinical evidence shows that L-arginine can reduce blood pressure in some individuals with hypertension. Furthermore, combining L-arginine with some antihypertensive drugs seems to have additive vasodilating and blood pressure-lowering effects.

Likelihood Probable Evidence D
Isoproterenol (Isuprel)

Theoretically, concurrent use of isoproterenol and L-arginine might result in additive effects and hypotension.
Preliminary clinical evidence suggests that L-arginine enhances isoproterenol-induced vasodilation in patients with essential hypertension or a family history of essential hypertension.

Likelihood Probable Evidence D
Potassium-Sparing Diuretics

Theoretically concomitant use of potassium-sparing diuretics with L-arginine may increases the risk of hyperkalemia.
Potassium-sparing diuretics can increase potassium levels. Use of L-arginine has been associated with hyperkalemia in some patients.

Likelihood Possible Evidence D
Sildenafil (Viagra)

Theoretically, concurrent use of sildenafil and L-arginine might increase the risk for hypotension.
In vivo, concurrent use of L-arginine and sildenafil has resulted in increased vasodilation. Theoretically, concurrent use might have additive vasodilatory and hypotensive effects. However, in studies evaluating the combined use of L-arginine and sildenafil for erectile dysfunction, hypotension was not reported.

Likelihood Possible Evidence D
Testosterone

Theoretically, concomitant use of L-arginine and testosterone might have additive effects.
In clinical research, L-arginine increases the level of testosterone in male patients with erectile dysfunction. The clinical significance of this finding is unclear.

Likelihood Possible Evidence D
L-Arginine full monograph & interactions

Strawberry fruit extract2 drug types · 316 drugs

Anticoagulant/Antiplatelet Drugs

In vitro and animal research suggests that strawberry extract can inhibit platelet aggregation due to its phenolic content. Theoretically, strawberry might increase the risk of bleeding when used with antiplatelet or anticoagulant drugs.
Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.

Likelihood Possible Evidence D
P-Glycoprotein Substrates

In vitro research suggests that strawberry extract can inhibit p-glycoprotein efflux. Theoretically, strawberry might inhibit p-glycoprotein mediated drug efflux and potentially increase levels of drugs that are substrates of p-glycoprotein. Until more is known, strawberry should be used cautiously in people taking p-glycoprotein substrates.
Drugs that might be affected include some chemotherapeutic agents (etoposide, paclitaxel, vinblastine, vincristine, vindesine), antifungals (ketoconazole, itraconazole), protease inhibitors (amprenavir, indinavir, nelfinavir, saquinavir), H2 antagonists (cimetidine, ranitidine), some calcium channel blockers (diltiazem, verapamil), corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.

Likelihood Possible Evidence D
Strawberry fruit extract full monograph & interactions

Spinach, Powder2 drug types · 88 drugs

Antidiabetes Drugs

There are claims that spinach leaves have hypoglycemic effects. Evidence from clinical research suggests that consumption of a spinach-rich meal reduces post-meal blood glucose levels. Theoretically, spinach might have additive effects with antidiabetes drugs and increase the risk of hypoglycemia. Monitor blood glucose levels closely. Dose adjustments might be necessary. Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), and others.

Likelihood Possible Evidence D
Warfarin (Coumadin)

Spinach contains vitamin K, which can interfere with the activity of warfarin.
In human research, although eating spinach with one meal does not result in coagulation test results outside the therapeutic range, daily consumption for one week necessitates dose adjustment of warfarin. Individuals using anticoagulants should consume a consistent daily amount of spinach to maintain the effect of anticoagulant therapy.

Likelihood Possible Evidence D
Spinach, Powder full monograph & interactions

Manganese3 drug types · 83 drugs

Antipsychotic Drugs

Theoretically, the risk for manganese toxicity might increase when taken with antipsychotic drugs.
Hallucinations and behavioral changes have been reported in a patient with liver disease who was taking haloperidol and manganese. Researchers speculate that taking manganese along with haloperidol, phenothiazine-derivatives, or other antipsychotic medications might increase the risk of manganese toxicity in some patients.

Likelihood Possible Evidence D
Quinolone Antibiotics

Theoretically, manganese might reduce the absorption of quinolone antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced quinolone absorption have been reported between quinolones and other multivalent cations, such as calcium and iron.

Likelihood Probable Evidence D
Tetracycline Antibiotics

Theoretically, manganese might reduce the absorption of tetracycline antibiotics.
Manganese is a multivalent cation. Interactions resulting in reduced tetracycline absorption have been reported between tetracyclines and other multivalent cations, such as calcium and iron.

Likelihood Probable Evidence D
Manganese full monograph & interactions

Glycine1 drug type · 1 drug

Clozapine (Clozaril)

Theoretically, glycine might decrease the effectiveness of clozapine.
One small clinical study in patients with schizophrenia shows that adding glycine to clozapine therapy worsens symptoms of schizophrenia when compared with clozapine alone. The mechanism of this interaction is unclear.

Likelihood Probable Evidence B
Glycine full monograph & interactions
The maker

Brand information

Manufacturer and brand details for Joint, Tendon, Ligament I, from the product label.

Douglas Laboratories

See all Douglas Laboratories products
Name
Douglas Laboratories
Street Address
600 Boyce Road
City
Pittsburgh
State
PA
ZipCode
15205
Phone Number
1.800.245.4440
Web Address
www.douglaslabs.com
Pharmacist Counseling Corner

Joint, Tendon, Ligament I by Douglas Laboratories: Common Questions

Does Joint, Tendon, Ligament I by Douglas Laboratories interact with any medications?
Yes. Based on its ingredients, Joint, Tendon, Ligament I has a known interaction with 1,304 medications. Use the checker to see how it interacts with a specific drug.
How can one product interact with so many drugs?
Joint, Tendon, Ligament I contains 12 active ingredients, and an interaction can come from any of them. We check every ingredient, combine the results into one list per medication, and show which ingredient and mechanism is responsible.
Where does this information come from?
The product label data comes from the NIH Dietary Supplement Label Database (DSLD); the interaction data is built on the Natural Medicines database and reviewed by HelloPharmacist pharmacists.
Can I take this if I'm pregnant or breastfeeding?
It depends on which ingredient you're concerned about. Spinach powder is considered safe both during pregnancy and while breastfeeding. Glycine, manganese, hyaluronic acid, silicon, and strawberry extract all have insufficient or no safety data in pregnancy and breastfeeding — avoid high-dose manganese and silicon supplements during these times. L-arginine and L-proline lack pregnancy and breastfeeding data. Talk with your doctor or pharmacist for personalized advice.
Does this product actually work for joints and tendons?
The evidence we hold shows insufficient reliable data for most of these ingredients — we can't confirm they work for joint, tendon, or ligament health. L-proline, hyaluronic acid, and silicon have been studied for bone strength and wound healing, but the evidence is not established.
What are the side effects?
Glycine may rarely cause mild sedation, irritability, insomnia, soft stools, nausea, or dry mouth — these are uncommon and resolve if you stop. L-arginine commonly causes abdominal pain, bloating, nausea, diarrhea, headache, insomnia, and flushing. Strawberry may rarely trigger nausea or allergic reactions. Manganese at high doses carries a rare risk of Parkinson-like nerve damage and liver harm. We don't have side-effect data for three of the proprietary ingredients.
Is this safe to take long-term?
Glycine and hyaluronic acid lack long-term safety data. L-arginine requires medical supervision for safe use. Manganese at normal supplement doses is generally safe, but high-dose long-term use poses a rare but serious risk of nerve and liver toxicity. Spinach as a food is safe long-term; silicon's long-term safety from supplements is not well studied.
What is L-arginine doing in a joint supplement?
L-arginine is an amino acid your body uses to make proteins and nitric oxide, which may support blood flow and tissue repair. However, we hold no effectiveness data showing it actually helps joints or tendons.
Why is there manganese in this, and is it dangerous?
Manganese is a mineral involved in bone and cartilage formation. At normal dietary amounts and the doses in most supplements, it's safe. High-dose manganese supplements (100 mg or more daily over years) have caused irreversible Parkinson-like nerve damage and liver disease in rare cases — stay well below high doses and avoid long-term use without medical monitoring.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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Label information is sourced from the NIH Dietary Supplement Label Database and reflects the product version on file; always read your actual product label. This page is for education only and is not a substitute for professional medical advice. Confirm with your pharmacist or doctor before combining supplements and medications.

Joint, Tendon, Ligament I label
Go deeper

The Full Monographs Behind Joint, Tendon, Ligament I’s Ingredients

Every ingredient we hold a full HelloPharmacist monograph for — uses, evidence, safety, and the complete interaction list.

Herb & supplement monograph

Glycine

Interacts with 1 drug

Glycine is a non-essential amino acid your body makes on its own and that also appears in protein-rich foods. It is most studied for improving sleep quality, where early research is promisin...

Read the full Glycine monograph → Herb & supplement monograph

L-arginine

Interacts with 403 drugs

L-arginine is an amino acid that the body uses to make nitric oxide, a substance that helps blood vessels relax and widen. It is popularly used for blood pressure, erectile dysfunction, and...

Read the full L-arginine monograph → Herb & supplement monograph

Proline

Proline is a non-essential amino acid that your body can make on its own and that you also get from protein-rich foods. It is a key building block of collagen, but strong human evidence that...

Read the full Proline monograph → Herb & supplement monograph

Manganese

Interacts with 83 drugs

Manganese is an essential trace mineral your body needs in small amounts for bone formation, metabolism, and antioxidant defense, and most people get enough from a normal diet. Supplements m...

Read the full Manganese monograph → Herb & supplement monograph

Hyaluronic Acid

Hyaluronic acid is a natural substance in the body that helps hold water in the skin, joints, and eyes. Oral and topical products are popular for skin moisture and joint comfort, and the evi...

Read the full Hyaluronic Acid monograph → Herb & supplement monograph

Silicon

Silicon is a trace mineral found in the body and in foods like oats, barley, and certain fruits and vegetables, and it is popular in supplements for hair, skin, nail, and bone health. Some s...

Read the full Silicon monograph → Herb & supplement monograph

Strawberry

Interacts with 316 drugs

Strawberry is a popular, nutrient-rich fruit that supplies vitamin C, fiber, and antioxidant plant compounds. Eating strawberries as part of a balanced diet is healthy for most people, but c...

Read the full Strawberry monograph → Herb & supplement monograph

Monterey Pine

Monterey Pine is mainly a timber tree, and human evidence for its use as a supplement is very limited. Some pine bark extracts are studied for antioxidant effects, but most claims specific t...

Read the full Monterey Pine monograph → Herb & supplement monograph

Boswellia Serrata

Interacts with 952 drugs

Boswellia serrata is a tree resin used in traditional medicine, mainly for joint pain and inflammation. Some studies suggest it may help with osteoarthritis symptoms, but the overall evidenc...

Read the full Boswellia Serrata monograph → Herb & supplement monograph

Spinach

Interacts with 88 drugs

Spinach is a nutrient-dense leafy green that is a healthy part of a balanced diet, providing vitamins, minerals, fiber, and antioxidants. While it is very safe as a food, concentrated supple...

Read the full Spinach monograph →
Sources

Sources & How We Checked

Joint, Tendon, Ligament I's label data comes from the NIH Dietary Supplement Label Database; the ingredient interaction data is from the Natural Medicines database, reviewed by our pharmacists.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

The 160 references behind this product’s interaction data

Every citation that drives the interaction findings for this product’s ingredients, from the evidence-graded Natural Medicines (TRC Healthcare) database. Open an ingredient to browse its citations — links open the study on PubMed or the publisher’s site.

Glycine 5 references
  1. Heresco-Levy U, Javitt DC, Ermilov M, et al. Efficacy of high-dose glycine in the treatment of enduring negative symptoms of schizophrenia. Arch Gen Psychiatry 1999;56:29-36.. PubMed
  2. Potkin SG, Jin Y, Bunney BG, Costa J, Gulasekaram B. Effect of clozapine and adjunctive high-dose glycine in treatment-resistant schizophrenia. Am J Psychiatry 1999;156:145-7.. PubMed
  3. Gusev EI, Skvortsova VI, Dambinova SA, et al. Neuroprotective effects of glycine for therapy of acute ischaemic stroke. Cerebrovasc Dis 2000;10:49-60. PubMed
  4. Inagawa K, Kawai N, Ono K, Sukegawa E, Tsubuku S, Takahashi M. Assessment of acute adverse effects of glycine ingestion at a high dose in human volunteers. Seikatsu Eisei. 2006; 50:27-32.
  5. Woods SW, Walsh BC, Hawkins KA, Miller TJ, Saksa JR, D'Souza DC, Pearlson GD, Javitt DC, McGlashan TH, Krystal JH. Glycine treatment of the risk syndrome for psychosis: report of two pilot studies. Eur Neuropsychopharmacol. 2013 Aug;23(8):931-40. PubMed

See these in context on the Glycine monograph →

L-arginine 66 references
  1. Sapienza MA, Kharitonov SA, Horvath I, et al. Effect of inhaled L-arginine on exhaled nitric oxide in normal and asthmatic subjects. Thorax 1998;53:172-5.
  2. Clarkson P, Adams MR, Powe AJ, et al. Oral L-arginine improves endothelium-dependent dilation in hypercholesterolemic young adults. J Clin Invest 1996;97:1989-94. PubMed
  3. Tenenbaum A, Fisman EZ, Motro M. L-arginine: Rediscovery in progress. Cardiology 1998;90:153-9.
  4. Brittenden J, Park KGM, Heys SD, et al. L-Arginine stimulates host defenses in patients with breast cancer. Surgery 1994;115:205-12.
  5. Korting GE, Smith SD, Wheeler MA, et al. A randomized double-blind trial of oral L-arginine for treatment of interstitial cystitis. J Urol 1999;161:558-65. DOI
  6. Rector TS, Bank AJ, Mullen KA, et al. Randomized, double-blind, placebo-controlled study of supplemental oral L-arginine in patients with heart failure. Circulation 1996;93:2135-41.
  7. Siani A, Pagano E, Iacone R, et al. Blood pressure and metabolic changes during dietary L-arginine supplementation in humans. Am J Hypertens 2000;13:547-51. PubMed
  8. Cheng JW, Balwin SN. L-arginine in the management of cardiovascular diseases. Ann Pharmacother 2001;35:755-64. PubMed
  9. Wallace AW, Tom WL. Interaction of L-arginine and phosphodiesterase inhibitors in vasodilation of the porcine internal mammary artery. Anesth Analg 2000;90:840-6. DOI
  10. Huynh NT, Tayek JA. Oral arginine reduces systemic blood pressure in type 2 diabetes: its potential role in nitric oxide generation. J Am Coll Nutr 2002;21:422-7.. PubMed
  11. Staff AC, Berge L, Haugen G, et al. Dietary supplementation with L-arginine or placebo in women with pre-eclampsia. Acta Obstet Gynecol Scand 2004;83:103-7.
  12. Resnick DJ, Softness B, Murphy AR, et al. Case report of an anaphylactoid reaction to arginine. Ann Allergy Asthma Immunol 2002;88:67-8. PubMed
  13. Anon. Arginine hydrochloride injection (marketed as R-Gene 10). FDA Drug Safety Newsletter 2009;2(2):16-18. Available at: www.fda.gov/Drugs/DrugSafety/DrugSafetyNewsletter/default.htm.
  14. Higashi Y, Oshima T, Sasaki S, et. al. Angiotensin-converting enzyme inhibition, but not calcium antagonism, improves a response of the renal vasculature to L-arginine in patients with essential hypertension. Hypertension. 1998 Jul;32(1):16-24.
  15. Facchinetti, F., Longo, M., Piccinini, F., Neri, I., and Volpe, A. L-arginine infusion reduces blood pressure in preeclamptic women through nitric oxide release. J Soc Gynecol.Investig. 1999;6(4):202-207. DOI
  16. de Gouw, H. W., Verbruggen, M. B., Twiss, I. M., and Sterk, P. J. Effect of oral L-arginine on airway hyperresponsiveness to histamine in asthma. Thorax 1999;54(11):1033-1035. PubMed
  17. Komers, R., Komersova, K., Kazdova, L., Ruzickova, J., and Pelikanova, T. Effect of ACE inhibition and angiotensin AT1 receptor blockade on renal and blood pressure response to L-arginine in humans. J Hypertens. 2000;18(1):51-59. PubMed
  18. Cartledge, J. J., Davies, A. M., and Eardley, I. A randomized double-blind placebo-controlled crossover trial of the efficacy of L-arginine in the treatment of interstitial cystitis. BJU.Int. 2000;85(4):421-426.
  19. Sozykin, A. V., Noeva, E. A., Balakhonova, T. V., Pogorelova, O. A., and Men'shikov, M. I. [Effect of L-arginine on platelet aggregation, endothelial function adn exercise tolerance in patients with stable angina pectoris]. Ter.Arkh. 2000;72(8):24-27.
  20. Nagaya, N., Uematsu, M., Oya, H., Sato, N., Sakamaki, F., Kyotani, S., Ueno, K., Nakanishi, N., Yamagishi, M., and Miyatake, K. Short-term oral administration of L-arginine improves hemodynamics and exercise capacity in patients with precapillary pulmona
  21. Stokes, G. S., Barin, E. S., Gilfillan, K. L., and Kaesemeyer, W. H. Interactions of L-arginine, isosorbide mononitrate, and angiotensin II inhibitors on arterial pulse wave. Am J Hypertens. 2003;16(9 Pt 1):719-724.
  22. Park, K. G., Heys, S. D., Blessing, K., Kelly, P., McNurlan, M. A., Eremin, O., and Garlick, P. J. Stimulation of human breast cancers by dietary L-arginine. Clin.Sci.(Lond) 1992;82(4):413-417.
  23. Palloshi, A., Fragasso, G., Piatti, P., Monti, L. D., Setola, E., Valsecchi, G., Galluccio, E., Chierchia, S. L., and Margonato, A. Effect of oral L-arginine on blood pressure and symptoms and endothelial function in patients with systemic hypertension,
  24. Schlaich, M. P., Ahlers, B. A., Parnell, M. M., and Kaye, D. M. beta-Adrenoceptor-mediated, nitric-oxide-dependent vasodilatation is abnormal in early hypertension: restoration by L-arginine. J Hypertens. 2004;22(10):1917-1925. PubMed
  25. Neri, I., Blasi, I., and Facchinetti, F. Effects of acute L-arginine infusion on non-stress test in hypertensive pregnant women. J Matern.Fetal Neonatal Med. 2004;16(1):23-26. PubMed
  26. Rytlewski, K., Olszanecki, R., Korbut, R., and Zdebski, Z. Effects of prolonged oral supplementation with l-arginine on blood pressure and nitric oxide synthesis in preeclampsia. Eur.J Clin.Invest 2005;35(1):32-37.
  27. Mansoor, J. K., Morrissey, B. M., Walby, W. F., Yoneda, K. Y., Juarez, M., Kajekar, R., Severinghaus, J. W., Eldridge, M. W., and Schelegle, E. S. L-arginine supplementation enhances exhaled NO, breath condensate VEGF, and headache at 4,342 m. High Alt.M
  28. Neri, I., Jasonni, V. M., Gori, G. F., Blasi, I., and Facchinetti, F. Effect of L-arginine on blood pressure in pregnancy-induced hypertension: a randomized placebo-controlled trial. J Matern.Fetal Neonatal Med. 2006;19(5):277-281.
  29. Lucotti, P., Setola, E., Monti, L. D., Galluccio, E., Costa, S., Sandoli, E. P., Fermo, I., Rabaiotti, G., Gatti, R., and Piatti, P. Beneficial effects of a long-term oral L-arginine treatment added to a hypocaloric diet and exercise training program in
  30. Savoye, G., Jemaa, Y., Mosni, G., Savoye-Collet, C., Morcamp, P., Dechelotte, P., Bouin, M., Denis, P., and Ducrotte, P. Effects of intragastric L-arginine administration on proximal stomach tone under basal conditions and after an intragastric diet. Dig PubMed
  31. Facchinetti, F., Saade, G. R., Neri, I., Pizzi, C., Longo, M., and Volpe, A. L-arginine supplementation in patients with gestational hypertension: a pilot study. Hypertens.Pregnancy. 2007;26(1):121-130. PubMed
  32. Jovanovic, A., Gerrard, J., and Taylor, R. The second-meal phenomenon in type 2 diabetes. Diabetes Care 2009;32(7):1199-1201. PubMed
  33. Fontanive P, Saponati G, Iurato A, et al. Effects of L-arginine on the Minnesota Living with Heart Failure Questionnaire quality-of-life score in patients with chronic systolic heart failure. Med.Sci.Monit. 2009;15:CR606-11.
  34. Doutreleau, S., Rouyer, O., Di, Marco P., Lonsdorfer, E., Richard, R., Piquard, F., and Geny, B. L-arginine supplementation improves exercise capacity after a heart transplant. Am J Clin.Nutr. 2010;91(5):1261-1267. PubMed
  35. Ast, J., Jablecka, A., Bogdanski, P., Smolarek, I., Krauss, H., and Chmara, E. Evaluation of the antihypertensive effect of L-arginine supplementation in patients with mild hypertension assessed with ambulatory blood pressure monitoring. Med.Sci.Monit. 2
  36. Saleh, A. I., Abdel Maksoud, S. M., El-Maraghy, S. A., and Gad, M. Z. Protective effect of L-arginine in experimentally induced myocardial ischemia: comparison with aspirin. J Cardiovasc.Pharmacol.Ther 2011;16(1):53-62. PubMed
  37. Dong, J. Y., Qin, L. Q., Zhang, Z., Zhao, Y., Wang, J., Arigoni, F., and Zhang, W. Effect of oral L-arginine supplementation on blood pressure: a meta-analysis of randomized, double-blind, placebo-controlled trials. Am.Heart J 2011;162(6):959-965. PubMed
  38. Hertz, P. and Richardson, J. A. Arginine-induced hyperkalemia in renal failure patients. Arch.Intern.Med. 1972;130(5):778-780. DOI
  39. Bushinsky, D. A. and Gennari, F. J. Life-threatening hyperkalemia induced by arginine. Ann.Intern.Med. 1978;89(5 Pt 1):632-634. PubMed
  40. Adams, M. R., Forsyth, C. J., Jessup, W., Robinson, J., and Celermajer, D. S. Oral L-arginine inhibits platelet aggregation but does not enhance endothelium-dependent dilation in healthy young men. J Am Coll.Cardiol 1995;26(4):1054-1061. PubMed
  41. Dell'Omo, G., Catapano, G., Ebel, M., Gazzano, A., Ducci, M., Del, Chicca M., Clerico, A., and Pedrinelli, R. [Pressor, renal and endocrine effects of systemic infusion of L-arginine in hypertensive patients]. Ann.Ital Med.Int. 1995;10(2):107-112.
  42. Higashi, Y., Oshima, T., Ozono, R., Watanabe, M., Matsuura, H., and Kajiyama, G. Effects of L-arginine infusion on renal hemodynamics in patients with mild essential hypertension. Hypertension 1995;25(4 Pt 2):898-902.
  43. Bode-Boger, S. M., Boger, R. H., Creutzig, A., Tsikas, D., Gutzki, F. M., Alexander, K., and Frolich, J. C. L-arginine infusion decreases peripheral arterial resistance and inhibits platelet aggregation in healthy subjects. Clin.Sci.(Lond) 1994;87(3):303
  44. Marfella, R., Acampora, R., Verrazzo, G., Ziccardi, P., De, Rosa N., Giunta, R., and Giugliano, D. Metformin improves hemodynamic and rheological responses to L-arginine in NIDDM patients. Diabetes Care 1996;19(9):934-939. PubMed
  45. Giugliano, D., Marfella, R., Verrazzo, G., Acampora, R., Coppola, L., Cozzolino, D., and D'Onofrio, F. The vascular effects of L-Arginine in humans. The role of endogenous insulin. J Clin.Invest 2-1-1997;99(3):433-438. PubMed
  46. Khan, F., Litchfield, S. J., McLaren, M., Veale, D. J., Littleford, R. C., and Belch, J. J. Oral L-arginine supplementation and cutaneous vascular responses in patients with primary Raynaud's phenomenon. Arthritis Rheum. 1997;40(2):352-357.
  47. Wolf, A., Zalpour, C., Theilmeier, G., Wang, B. Y., Ma, A., Anderson, B., Tsao, P. S., and Cooke, J. P. Dietary L-arginine supplementation normalizes platelet aggregation in hypercholesterolemic humans. J Am Coll.Cardiol 3-1-1997;29(3):479-485. PubMed
  48. Schellong, S. M., Boger, R. H., Burchert, W., Bode-Boger, S. M., Galland, A., Frolich, J. C., Hundeshagen, H., and Alexander, K. Dose-related effect of intravenous L-arginine on muscular blood flow of the calf in patients with peripheral vascular disease
  49. Marietta, M., Facchinetti, F., Neri, I., Piccinini, F., Volpe, A., and Torelli, G. L-arginine infusion decreases platelet aggregation through an intraplatelet nitric oxide release. Thromb.Res 10-15-1997;88(2):229-235. PubMed
  50. Bauer JD, Isenring E, Waterhouse M. The effectiveness of a specialised oral nutrition supplement on outcomes in patients with chronic wounds: a pragmatic randomised study. J Hum Nutr Diet. 2013 Oct;26(5):452-8. PubMed
  51. Vadillo-Ortega F, Perichart-Perera O, Espino S, et al. Effect of supplementation during pregnancy with L-arginine and antioxidant vitamins in medical food on pre-eclampsia in high risk population: randomised controlled trial. BMJ. 2011 May 19;342:d2901. PubMed
  52. Camarena Pulido EE, García Benavides L, Panduro Barón JG, et al. Efficacy of L-arginine for preventing preeclampsia in high-risk pregnancies: A double-blind, randomized, clinical trial. Hypertens Pregnancy. 2016;35(2):217-25. PubMed
  53. Yokota T, Hamauchi S, Yoshida Y, et al. A phase II study of HMB/Arg/Gln against oral mucositis induced by chemoradiotherapy for patients with head and neck cancer. Support Care Cancer. 2018;26(9):3241-3248. PubMed
  54. Binet Q, Dufour I, Agneessens E, et al. The second case of a young man with L-arginine-induced acute pancreatitis. Clin J Gastroenterol. 2018;11(5):424-427. PubMed
  55. El Taieb M, Hegazy E, Ibrahim A. Daily oral l-arginine plus tadalafil in diabetic patients with erectile dysfunction: A double-blinded, randomized, controlled clinical trial. J Sex Med. 2019;16(9):1390-1397.
  56. Gallo L, Pecoraro S, Sarnacchiaro P, Silvani M, Antonini G. The daily therapy with L-arginine 2,500 mg and tadalafil 5 mg in combination and in monotherapy for the treatment of erectile dysfunction: A prospective, randomized multicentre study. Sex Med. 20 PubMed
  57. de la Parra PR, González-Cruz MÁ, Ferreiro-Marin A, Casaubón-Garcín PR. L-arginine-induced esophagitis, report of six cases. Bol Med Hosp Infant Mex. 2020;77(1):38-41. PubMed
  58. El-Wakeel LM, Fouad FA, Saleem MD, Saber-Khalaf M. Efficacy and tolerability of sildenafil/l-arginine combination relative to sildenafil alone in patients with organic erectile dysfunction. Andrology. 2020;8(1):143-147.
  59. Abu El-Hamd M, Hegazy EM. Comparison of the clinical efficacy of daily use of L-arginine, tadalafil and combined L-arginine with tadalafil in the treatment of elderly patients with erectile dysfunction. Andrologia. 2020;52(7):e13640. PubMed
  60. Liao SY, Showalter MR, Linderholm AL, et al. l-Arginine supplementation in severe asthma. JCI Insight. 2020;5(13):e137777. PubMed
  61. Yousefi Rad E, Nazarian B, Saboori S, Falahi E, Hekmatdoost A. Effects of l-arginine supplementation on glycemic profile: Evidence from a systematic review and meta-analysis of clinical trials. J Integr Med. 2020;18(4):284-291. PubMed
  62. Xu Z, Liu C, Liu S, Zhou Z. Comparison of efficacy and safety of daily oral L-arginine and PDE5Is alone or combination in treating erectile dysfunction: A systematic review and meta-analysis of randomised controlled trials. Andrologia. 2021:e14007. PubMed
  63. Goto E. Effects of prenatal oral L-arginine on birth outcomes: a meta-analysis. Sci Rep 2021;11(1):22748. PubMed
  64. Monari F, Menichini D, Pignatti L, Basile L, Facchinetti F, Neri I. Effect of L-arginine supplementation in pregnant women with chronic hypertension and previous placenta vascular disorders receiving Aspirin prophylaxis: a randomized control trial. Minerv PubMed
  65. Li H, Liu Q, Zou Z, et al. L-arginine supplementation to mitigate cardiovascular effects of walking outside in the context of traffic-related air pollution in participants with elevated blood pressure: A randomized, double-blind, placebo-controlled trial. PubMed
  66. Shiraseb F, Asbaghi O, Bagheri R, Wong A, Figueroa A, Mirzaei K. The Effect of L-arginine Supplementation On Blood Pressure in Adults: A Systematic Review and Dose-response Meta-analysis of Randomized Clinical Trials. Adv Nutr 2021. PubMed

See these in context on the L-arginine monograph →

Proline 4 references
  1. Jennings A, MacGregor A, Spector T, Cassidy A. Amino acid intakes are associated with bone mineral density and prevalence of low bone mass in women: Evidence from discordant monozygotic twins. J Bone Miner Res. 2016;31(2):326-35. PubMed
  2. Gracia-Marco L, Bel-Serrat S, Cuenca-Garcia M, et al. Amino acids intake and physical fitness among adolescents. Amino Acids. 2017;49(6):1041-1052. PubMed
  3. Jamdar J, Rao B, Netke S, et al. Reduction in tibial shaft fracture healing time with essential nutrient supplementation containing ascorbic acid, lysine, and proline. J Altern Complement Med. 2004;10(6):915-6.
  4. Mehl AA, Damião AO, Viana SD, Andretta CP. Hard-to-heal wounds: a randomised trial of an oral proline-containing supplement to aid repair. J Wound Care 2021;30(1):26-31. PubMed

See these in context on the Proline monograph →

Manganese 21 references
  1. Hansten PD, Horn JR. Hansten and Horn's Drug Interactions Analysis and Management. Vancouver, CAN:Appl Therapeut, 1999.
  2. Barrington WW, Angle CR, Willcockson NK, et al. Autonomic function in manganese alloy workers. Environ Res 1998;78:50-8. PubMed
  3. Hauser RA, Zesiewicz TA, Martinez C, et al. Blood manganese correlates with brain magnetic resonance imaging changes in patients with liver disease. Can J Neurol Sci 1996;23:95-8. PubMed
  4. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
  5. Lee JW. Manganese intoxication. Arch Neurol 2000;57:597-9.. PubMed
  6. Powers KM, Smith-Weller T, Franklin GM, et al. Parkinson's disease risks associated with dietary iron, manganese, and other nutrient intakes. Neurology 2003;60:1761-6.. PubMed
  7. McMillan, D. E. A brief history of the neurobehavioral toxicity of manganese: some unanswered questions. Neurotoxicology 1999;20(2-3):499-507.
  8. Gerber, G. B., Leonard, A., and Hantson, P. Carcinogenicity, mutagenicity and teratogenicity of manganese compounds. Crit Rev Oncol Hematol. 2002;42(1):25-34. PubMed
  9. Jiang, Y. and Zheng, W. Cardiovascular toxicities upon manganese exposure. Cardiovasc.Toxicol 2005;5(4):345-354. PubMed
  10. Mehta, R. and Reilly, J. J. Manganese levels in a jaundiced long-term total parenteral nutrition patient: potentiation of haloperidol toxicity? Case report and literature review. JPEN J Parenter.Enteral Nutr 1990;14(4):428-430. PubMed
  11. Nemery, B. Metal toxicity and the respiratory tract. Eur Respir.J 1990;3(2):202-219. DOI
  12. Vanek VW, Borum P, Buchman A, et al. A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products. Nutr Clin Pract. 2012;27:440-491.doi: 10.1177/0884533612446706 PubMed
  13. Schuh MJ. Possible Parkinson's disease induced by chronic manganese supplement ingestion. Consult Pharm. 2016;31(12):698-703. doi: 10.4140/TCP.n.2016.698. PubMed
  14. Baker B, Ali A, Isenring L. Recommendations for manganese supplementation to adult patients receiving long-term home parenteral nutrition: an analysis of the supporting evidence. Nutr Clin Pract 2016;31(2):180-5. doi: 10.1177/0884533615591600. PubMed
  15. Ho CSH, Ho RCM, Quek AML. Chronic manganese toxicity associated with voltage-gated potassium channel complex antibodies in a relapsing neuropsychiatric disorder. Int J Environ Res Public Health 2018;15(4). pii: E783. doi: 10.3390/ijerph15040783. PubMed
  16. Yamamoto M, Sakurai K, Eguchi A, et al.; Japan Environment and Children's Study Group: Association between blood manganese level during pregnancy and birth size: the Japan environment and children's study (JECS). Environ Res 2019;172:117-26. PubMed
  17. Li D, Ge X, Liu Z, et al. Association between long-term occupational manganese exposure and bone quality among retired workers. Environ Sci Pollut Res Int 2020;27(1):482-9. PubMed
  18. Martin KV, Sucharew H, Dietrich KN, et al. Co-exposure to manganese and lead and pediatric neurocognition in East Liverpool, Ohio. Environ Res 2021;202:111644. PubMed
  19. Racette BA, Nelson G, Dlamini WW, et al. Depression and anxiety in a manganese-exposed community. Neurotoxicology 2021;85:222-33. PubMed
  20. Ruiz-Azcona L, Fernández-Olmo I, Expósito A, et al. Impact of environmental airborne manganese exposure on cognitive and motor functions in adults: a systematic review and meta-analysis. Int J Environ Res Public Health 2021;18(8):4075. PubMed
  21. Uyar E, Gurkas E, Aksu AU, et al. Can therapeutic plasma exchange be life-saving in life-threatening manganese intoxication?. Transfus Apher Sci 2022;61(4):103417. PubMed

See these in context on the Manganese monograph →

Hyaluronic Acid 4 references
  1. Park Y, Song JS, Choi CY, Yoon KC, Lee HK, Kim HS. A randomized multicenter study comparing 0.1%, 0.15%, and 0.3% sodium hyaluronate with 0.05% cyclosporine in the treatment of dry eye. J Ocul Pharmacol Ther. 2017;33(2):66-72. PubMed
  2. U.S. Food and Drug Administration. Do Not Use Needle-Free Devices for Injection of Dermal Fillers - FDA Safety Communication. October 8, 2021. Available at: https://www.fda.gov/medical-devices/safety-communications/do-not-use-needle-free-devices-injection
  3. Disphanurat W, Srisantithum B. Efficacy and safety of 0.15% isobutylamido thiazolyl resorcinol combined with hyaluronic acid vs 0.15% isobutylamido thiazolyl resorcinol or hyaluronic acid alone in melasma treatment: A randomized evaluator-blind trial. J C PubMed
  4. Humbert P, Mikosinki J, Benchikhi H, Allaert FA. Efficacy and safety of a gauze pad containing hyaluronic acid in treatment of leg ulcers of venous or mixed origin: a double-blind, randomised, controlled trial. Int Wound J 2013;10(2):159-66. PubMed

See these in context on the Hyaluronic Acid monograph →

Silicon 19 references
  1. Food and Nutrition Board, Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2002.
  2. Jugdaohsingh R, Anderson SH, Tucker KL, et al. Dietary silicon intake and absorption. Am J Clin Nutr 2002;75:887-93. PubMed
  3. Ichiyanagi O, Sasagawa I, Adachi Y, et al. Silica urolithiasis without magnesium trisilicate intake. Urol Int 1998;61:39-42. PubMed
  4. Levison DA, Crocker PR, Banim S, Wallace DM. Silica stones in the urinary bladder. Lancet 1982;1:704-5. PubMed
  5. Lee MH, Lee YH, Hsu TH, et al. Silica stone--development due to long time oral trisilicate intake. Scand J Urol Nephrol 1993;27:267-9. PubMed
  6. Cruz Guerra, N. A., Gomez Garcia, M. A., Lovaco, Castellano F., Saez Garrido, J. C., Garcia, Cuerpo E., and Escudero, Barrilero A. [Silica urolithiasis: report of a new case]. Actas Urol.Esp 2000;24(2):202-204.
  7. Merget, R., Bauer, T., Kupper, H. U., Philippou, S., Bauer, H. D., Breitstadt, R., and Bruening, T. Health hazards due to the inhalation of amorphous silica. Arch Toxicol. 2002;75(11-12):625-634. PubMed
  8. Khuder, S. A., Peshimam, A. Z., and Agraharam, S. Environmental risk factors for rheumatoid arthritis. Rev Environ Health 2002;17(4):307-315. PubMed
  9. McLaughlin, J. K., Chow, W. H., and Levy, L. S. Amorphous silica: a review of health effects from inhalation exposure with particular reference to cancer. J Toxicol.Environ Health 4-25-1997;50(6):553-566. DOI
  10. Pelucchi, C., Pira, E., Piolatto, G., Coggiola, M., Carta, P., and La, Vecchia C. Occupational silica exposure and lung cancer risk: a review of epidemiological studies 1996-2005. Ann.Oncol. 2006;17(7):1039-1050. PubMed
  11. Gillissen, A., Gessner, C., Hammerschmidt, S., Hoheisel, G., and Wirtz, H. [Health significance of inhaled particles]. Dtsch.Med Wochenschr. 3-24-2006;131(12):639-644.
  12. Hu, J. F., Qu, H., and Wang, J. Z. [Meta analysis for relationship between exposure of free silicon dioxide and lung tumor]. Zhonghua Lao.Dong.Wei Sheng Zhi.Ye.Bing.Za Zhi. 2006;24(7):415-417.
  13. Jugdaohsingh, R. Silicon and bone health. J Nutr Health Aging 2007;11(2):99-110.
  14. Lacasse, Y., Martin, S., Gagne, D., and Lakhal, L. Dose-response meta-analysis of silica and lung cancer. Cancer Causes Control 2009;20(6):925-933. PubMed
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Strawberry 18 references
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  13. Hadi A, Askarpour M, Miraghajani M, Symonds ME, Sheikhi A, Ghaedi E. Effects of strawberry supplementation on cardiovascular risk factors: a comprehensive systematic review and meta-analysis of randomized controlled trials. Food Funct 2019;10(11):6987-98. PubMed
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  15. Basu A, Izuora K, Hooyman A, Scofield HR, Ebersole JL. Dietary Strawberries Improve Serum Metabolites of Cardiometabolic Risks in Adults with Features of the Metabolic Syndrome in a Randomized Controlled Crossover Trial. Int J Mol Sci 2023;24(3):2051. PubMed
  16. Huang L, Xiao D, Zhang X, et al. Strawberry Consumption, Cardiometabolic Risk Factors, and Vascular Function: A Randomized Controlled Trial in Adults with Moderate Hypercholesterolemia. J Nutr 2021;151(6):1517-1526. PubMed
  17. Basu A, Izuora K, Betts NM, et al. Dietary Strawberries Improve Cardiometabolic Risks in Adults with Obesity and Elevated Serum LDL Cholesterol in a Randomized Controlled Crossover Trial. Nutrients 2021;13(5):1421. PubMed
  18. Wilken MR, Lambert MNT, Christensen CB, Jeppesen PB. Effects of Anthocyanin-rich Berries on the Risk of Metabolic Syndrome: A Systematic Review and Meta-analysis. Rev Diabet Stud 2022;18(1):42-57. PubMed

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Monterey Pine 1 reference
  1. Burry, J. N. Environmental dermatitis: contact dermatitis from Pinus radiata. Med J Aust. 7-2-1977;2(1):13-14. DOI

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Boswellia Serrata 16 references
  1. Gupta I, Gupta V, Parihar A, et al. Effects of Boswellia serrata gum resin in patients with bronchial asthma: results of a double-blind, placebo-controlled, 6-week clinical study. Eur J Med Res 1998;3:511-4.
  2. Electronic Code of Federal Regulations. Title 21. Part 182 -- Substances Generally Recognized As Safe. Available at: https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=182
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  4. Liu JJ, Nilsson A, Oredsson S, et al. Boswellic acids trigger apoptosis via a pathway dependent on caspase-8 activation but independent on Fas/Fas ligand interaction in colon cancer HT-29 cells. Carcinogenesis 2002;23:2087-93. PubMed
  5. Wildfeuer A, Neu IS, Safayhi H, et al. Effects of boswellic acids extracted from a herbal medicine on the biosynthesis of leukotrienes and the course of experimental autoimmune encephalomyelitis. Arzneimittelforschung 1998;48:668-74.
  6. Gupta I, Parihar A, Malhotra P, et al. Effects of gum resin of Boswellia serrata in patients with chronic colitis. Planta Med 2001;67:391-5. PubMed
  7. Sengupta K, Alluri KV, Satish AR, et al. A double blind, randomized, placebo controlled study of the efficacy and safety of 5-Loxin. Arthritis Res Ther 2008;10:R85.
  8. Sengupta K, Krishnaraju AV, Vishal AA, et al. Comparative efficacy and tolerability of 5-Loxin and Aflapin against osteoarthritis of the knee: a double blind, randomized, placebo controlled clinical study. Int J Med Sci 2010;7:366-77.
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  11. Frank A, Unger M. Analysis of frankincense from various Boswellia species with inhibitory activity on human drug metabolising cytochrome P450 enzymes using liquid chromatography mass spectrometry after automated on-line extraction. J Chromatogr A 2006;111 PubMed
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  13. El Fortia, M., Badi, H., Elalem, Kh, Kadiki, O., and Topov, Y. Olibanum bezoar: complication of a traditional popular medicine. East Mediterr.Health J 2006;12(6):927-929.
  14. Meshkat S, Mahmoodi Baram S, Rajaei S, et al. Boswellia serrata extract shows cognitive benefits in a double-blind, randomized, placebo-controlled pilot clinical trial in individuals who suffered traumatic brain injury. Brain Inj 2022;36(4):553-559. PubMed
  15. Haron MH, Dale O, Martin K, et al. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022. PubMed
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Spinach 6 references
  1. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  2. Karlson, B., Leijd, B., and Hellstrom, K. On the influence of vitamin K-rich vegetables and wine on the effectiveness of warfarin treatment. Acta Med Scand. 1986;220(4):347-350. PubMed
  3. Roller, E., Meller, S., Homey, B., Ruzicka, T., and Neumann, N. J. [Contact dermatitis caused by spinach, hedge mustard and chives]. Hautarzt 2003;54(4):374-375.
  4. Schuller, A., Morisset, M., Maadi, F., Kolopp Sarda, M. N., Fremont, S., Parisot, L., Kanny, G., and Moneret-Vautrin, D. A. Occupational asthma due to allergy to spinach powder in a pasta factory. Allergy 2005;60(3):408-409. PubMed
  5. Gustafsson, K., Asp, N. G., Hagander, B., and Nyman, M. Satiety effects of spinach in mixed meals: comparison with other vegetables. Int.J.Food Sci.Nutr. 1995;46(4):327-334. PubMed
  6. Schreiber, J., Muller, E., Becker, W. M., Zabel, P., Schlaak, M., and Amthor, M. [Spinach powder-induced exogenous allergic alveolitis]. Pneumologie 1998;52(1):61-65.

See these in context on the Spinach monograph →

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DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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