Ionic Minerals Joint Support by Eidon Inc.

POSSIBLY EFFECTIVE

• Osteoporosis. Higher dietary intakes of silicon in males and premenopausal females seem to be associated with higher bone mineral density (BMD), but it is unclear whether silicon supplements reduce the risk of osteoporosis. Details: Males and premenopausal females who have dietary intakes of silicon of at least 40 mg daily seem to have higher BMD than those with lower intakes. This could reduce the risk of osteoporosis (10470,12425). However, it is unclear if silicon supplements can reduce the risk for osteoporosis. Silicon intake has also been evaluated in postmenopausal females. Clinical and population-based research suggests that higher silicon intake does not seem to benefit postmenopausal females in general, although it may benefit those on hormone replacement therapy (10470,12425,75118,92135). Bone loss in postmenopausal females is primarily due to bone resorption. Silicon seems to affect only bone formation (12425).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aging skin. It is unclear if oral silicon is beneficial in patients with aging skin. Details: A small preliminary clinical study in healthy volunteers aged 40-60 years shows that taking a specific product (Exsynutriment by Biotec) containing organic silicon 600 mg in hydrolyzed marine collagen once daily, 15 minutes before breakfast, for 90 days improves skin firmness, hydration, and texture, but not wrinkles, brightness, or softness, when compared with placebo (100837).
• Alzheimer disease. Although there has been interest in using oral silicon for Alzheimer disease, there is insufficient reliable information about the clinical effects of silicon for this condition.
• Androgenic alopecia. Although there has been interest in using oral silicon for androgenic alopecia, there is insufficient reliable information about the clinical effects of silicon for this condition.
• Cardiovascular disease (CVD). Although there has been interest in using oral silicon for CVD, there is insufficient reliable information about the clinical effects of silicon for this condition.
• Dental peri-implantitis. It is unclear if oral silicon is beneficial in patients with peri-implantitis. Details: A small, preliminary clinical study in patients aged 18-75 with peri-implantitis shows that a specific choline-stabilized orthosilicic acid product (BioSil, Bio Minerals NV) containing silicon 5 mg and choline 100 mg, taken twice daily for 12 months, does not improve markers of inflammation and periodontal disease (i.e. probing pocket depth, bleeding on probing) when compared with placebo (110028). However, this study may not have been adequately powered to detect a difference between groups. More evidence is needed to rate silicon for these uses.

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POSSIBLY EFFECTIVE

• Dandruff. Sulfur is an FDA-permitted ingredient of over-the-counter (OTC) topical products to treat dandruff (88107). However, efficacy data from clinical trials is limited. In a study of 48 adults using shampoos containing sulfur 2%, salicylic acid 2%, or both ingredients twice weekly for 5 weeks, reductions in scaling and the number of desquamating cells per square centimeter were greater with any of the active treatments compared with the shampoo base alone. However, the combination of both ingredients produced significantly greater and earlier reductions than either active ingredient alone (88108).
• Scabies. Applying topical preparations of 5% to 20% precipitated sulfur in petrolatum appears to be effective for the treatment of scabies in some patients. Response occurs in 24% to 97% of patients, but is unpleasant due to the smell. Sulfur preparations are applied overnight (10-12 hours) for between 3 and 6 nights, with reduced efficacy when used for only 24 hours (27846,27847,88124,98205,98207). Concentrations should be limited to between 2% and 6% for infants, children, adolescents, and pregnant women (27846,27847,98207). Sulfur ointments have also been compared with other treatments for scabies. Clinical research and a meta-analysis of the available research show that topical sulfur is less effective and has a higher risk of adverse effects when compared with topical permethrin or topical or oral ivermectin (98205,100735). Sulfur ointment also seems to be more expensive when compared with topical permethrin or oral ivermectin (98207). Preliminary clinical trials and a meta-analysis have reported similar efficacy rates for topical sulfur and lindane, and for topical sulfur and benzyl benzoate (27848,100735).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Acne. Sulfur in concentrations of 3% to 10% is an FDA-permitted ingredient in over-the-counter (OTC) topical products to treat acne (88107,88123). However, efficacy data is mainly anecdotal (88122). Creams and ointments containing 1% to 10% sulfur have been used to treat acne for many decades, but sulfur is now generally found in combination with benzoyl peroxide, salicylic acid, or sodium sulfacetamide (88120,88121).
• Allergic rhinitis (hay fever). A preliminary clinical study suggests that using a homeopathic nasal spray containing sulfur, luffa, Galphimia glauca, and histamine for 42 days has similar efficacy to cromolyn sodium nasal spray for relief of symptoms of allergic rhinitis (60080).
• Chronic obstructive pulmonary disease (COPD). Preliminary clinical research shows that inhalation of aerosolized sulfurous water (Acqua Breta, Terme di Riolo) 5 mL once daily for 12 days does not improve lung function when compared with baseline in patients with COPD (98206).
• Common cold. A preliminary clinical study suggests that taking a homeopathic product containing sulfur and German ipecac (Engystol, Heel GmbH) orally for up to 2 weeks during a cold provides similar symptomatic relief to conventional over-the-counter remedies such as antihistamines, antitussives, and NSAIDs (27849).
• Hyperlipidemia. A preliminary clinical study suggests that drinking 50 mL of water from a sulfurous spring three times daily for 4 weeks reduces total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride levels, and decreases platelet aggregability. However, the study has methodological problems, including the lack of a control group, and does not address the effects of sulfur alone (91101).
• Rosacea. Preliminary clinical research shows that applying sulfur 10% in an emollient base (Diprobase, Merck Sharp and Dohme) once daily for 4 weeks is as effective as oral tetracycline (300 mg twice daily for 1 week, then 150 mg twice daily for 3 weeks) for reducing rosacea papules and pustules (88113). Using a combination of sulfur 5% and sodium sulfacetamide 10% in a topical emollient foam (Clarifoam EF, Onset Dermatologics) twice daily also seems to reduce the severity of rosacea (88111,88112). Other clinical research shows that using this same product for 8 weeks reduces inflammatory lesions by an additional 42% and erythema by an additional 52% when compared with placebo (88112). In another study, using foam containing sulfur 5% and sodium sulfacetamide 10% for 8 weeks reduced papules, pustules, and overall severity of rosacea more than topical metronidazole 0.75% gel (88112). More evidence is needed to rate sulfur for these uses.

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LIKELY SAFE ...when used orally and appropriately in amounts commonly found in foods (7135,10470,92135). It is estimated that the average dietary intake of silicon is 20-50 mg daily (110029); however, there is currently no established recommended dietary allowance or tolerable upper intake level for silicon (7135,92136,95009,110029).

PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in amounts commonly found in foods (7135,10470). It is estimated that the average dietary intake of silicon is 20-50 mg daily (110029). There is insufficient reliable information available about the safety of silicon when used in larger, medicinal amounts; avoid using.

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POSSIBLY SAFE ...when used topically and appropriately, short-term. Topical products containing sulfur in concentrations up to 10% have been used safely in clinical research for up to 8 weeks (27846,27847,88107,88112,88123,88124,98205,98207,100735). There is insufficient reliable information available about the safety of using sulfur orally.

CHILDREN: POSSIBLY SAFE
when used topically and appropriately, short-term. Topical products containing sulfur in concentrations up to 6% have been used safely when applied nightly in children and adolescents for up to 6 nights (27846,27847). In infants, topical products containing sulfur in concentrations up to 2% have been safely applied for 3 hours daily for up to 6 days (27847).

PREGNANCY AND LACTATION: POSSIBLY SAFE
when applied topically and appropriately, short-term. Topical products containing sulfur in concentrations up to 6% have been safely applied nightly for up to 6 nights (27846,27847). There is insufficient reliable information available about the safety of sulfur when used orally; avoid using.

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General ...Orally, silicon in the amounts found in food and water is not associated with adverse effects.
Serious Adverse Effects (Rare):
Inhaled: Crystalline silicon dioxide in the form of quartz dust found in industrial and occupational settings is associated with an increased risk of diseases such as silicosis, tuberculosis, chronic bronchitis, chronic obstructive pulmonary disease (COPD), lung cancer, glomerulonephritis, vasculitis, and rheumatoid arthritis.

Cardiovascular ...Case control studies have shown that occupational exposure to silicon dioxide-containing compounds may cause vasculitis (75114). Patients with occupational pulmonary silicosis may develop microscopic polyangiitis (inflammation of the blood vessels in the nose, sinuses, throat, lungs, and kidneys, also known as Wegener's granulomatosis).

Dermatologic ...Occupational silica exposure may be a risk factor for scleroderma, particularly in males (75099).

Genitourinary ...Limited reports in humans indicate that long-term use of large amounts of antacids containing magnesium trisilicate may be associated with urolithiasis and silicon-containing stones (11760,11861,75075,75103). However, fewer than 30 cases associated with antacids containing silicates have been reported, despite these products being commercially available since the 1930s. Although exceptionally rare, silicon dioxide kidney stones can also occur without magnesium trisilicate ingestion (11556). Their formation is caused by an acidic urinary pH. In at least one case, urine alkalinization resulted in resolution of the symptoms (75075).
Case-control studies have shown that occupational exposure to silicon dioxide is related to antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (75114). High silicon levels in patients undergoing chronic hemodialysis have been associated with nephropathy (75089).

Hepatic ...High silicon levels in patients undergoing chronic hemodialysis have been associated with liver disease (75089).

Musculoskeletal ...High silicon levels in patients undergoing chronic hemodialysis have been associated with bone disease (75089). A meta-analysis suggests that the risk of rheumatoid arthritis is elevated with occupational exposure to silicon dioxide (75078).

Neurologic/CNS ...High silicon levels in patients undergoing chronic hemodialysis have been associated with neuropathy (75089).

Pulmonary/Respiratory ...Occupational exposure to crystalline silicon dioxide dust is associated with an increased risk of pulmonary diseases such as silicosis, tuberculosis, chronic bronchitis, chronic obstructive pulmonary disease (COPD), and lung cancer (75076,75081,75084,75114). Patients with occupational pulmonary silicosis may develop microscopic polyangiitis (inflammation of the blood vessels in the nose, sinuses, throat, lungs, and kidneys, also known as Wegener's granulomatosis). Meta-analyses suggest that occupational exposure to silicon dioxide increases the risk of lung cancer (75085,75095,75115). An analysis of 19 studies shows that lung cancer risk is approximately 2 times higher for those with silicosis (75115). It is not clear whether silicon dioxide is carcinogenic in the absence of silicosis (75083).

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General ...Topically, sulfur is generally well tolerated when used in concentrations of up to 10%. Adverse effects include skin dryness, irritation, and pruritus (27846,88112,88120,88121,88126). Orally, sulfur has been reported to cause diarrhea and metabolic acidosis (27845).

Dermatologic ...Topically, application of sulfur preparations can cause dryness, leading to local irritation and pruritus in up to 28% of patients (27846,88112,88120,88121,88126).

Gastrointestinal ...Orally, sulfur is converted to sulfide in the gastrointestinal tract, causing intestinal irritation which can lead to diarrhea (27845).

Renal ...There is one case report of metabolic acidosis occurring in a 57-year-old woman who had consumed approximately 250 grams of flowers of sulfur, a form of sulfur prepared by sublimation, over a 6-day period (27845). Underlying conditions, including diabetes and renal failure, may have contributed to the acidosis. Sulfur is converted to sulfide by colonic bacteria and then to sulfate in various tissues, generating hydrogen ions which can lead to acidosis when clearance mechanisms are overwhelmed (27845).

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