Fall 2001<\/p>\n\n\n\n
As the kosher consumer crosses Maryland’s spectacular Chesapeake Bay Bridge, it is hard to imagine that glucosamine, one of the most widely used arthritis remedies, is derived from the seafood shells found deep in the waters below. Sea shells are not the only surprising source of muscle and joint remedies. The levona<\/i> (frankincense) used in the Beis Hamikdash, deer antlers, and an array of animals \u2013 including sharks and bees \u2013 also contain the raw materials of over-the-counter arthritis supplements.<\/p>\n\n\n\n
STAR-K receives numerous inquiries regarding these products. This is no wonder, as over 40 million Americans suffer from some form of arthritis, and billions of dollars are spent each year on prescriptions and remedies. The following is an overview of how these products are manufactured and their kashrus<\/i> status. Note: See disclaimer below.1<\/sup><\/a><\/p>\n\n\n\n The raw material for most glucosamine comes from crab, shrimp or lobster shells. Unlike oyster shells which are rock hard, these shells are softer and can impart flavor. “Shellfish broth” is made by simmering these shells in water or oil, thereby extracting the flavor from the shells.2<\/sup><\/a> This broth is used as a flavorful base by chefs in fine restaurants. Halacha states that any part of the body of a non-kosher species that has flavor and is not rock hard may not be consumed. This is unlike atzamos yeveishos<\/i> \u2013 bones that are completely dry and brittle.<\/p>\n\n\n\n To produce glucosamine, crab, shrimp or lobster shells first go through a hydrochloric acid bath, a process known as de-calcification. The protein is then removed resulting in a product called chitin. Chitin, a polysaccharide (a combination of various sugars) is the second most abundant organic substance in nature after cellulose.<\/p>\n\n\n\n Chitin is also commercially produced in New Zealand from a squid tissue called pen. Squid pens are connective tissue that bend like stiff plastic and can emit a fishy odor. Squid pens are obviously not kosher.<\/p>\n\n\n\n Depending on how the chitin is further processed, the resulting material is either glucosamine or chitosan. Glucosamine is primarily used to treat joint and bone disorders including osteoarthritis. Chitosan, a dietary fiber, is used as a fat absorber for those interested in weight loss.<\/p>\n\n\n\n Halacha states that a product derived from non-kosher material is also non-kosher. Hence, glucosamine, chitosan, and chitin, which are currently derived exclusively from non-kosher seafood derivatives, are non-kosher3<\/a><\/sup>. Nonetheless, as will be discussed below, there are instances when these products may be taken.<\/p>\n\n\n\n Every year males in the deer family shed their large antlers and grow a new set. The ability to re-grow something so large year after year so quickly is unique in nature and is an example of the wonders of our Creator. As these antlers grow, increased blood flow helps form cartilage which is covered by soft velvety fur. The antlers then begin to harden and transform into bone, similar to a shofar.<\/i>4<\/sup><\/a> At the time when the antler is rich in nutrients, it is harvested from the deer and processed into a powder supplement. The velvet is also extracted to form Pantocrin found in anti-aging and athletic performance products. All deer velvet is derived from the cartilage of animals that have not been slaughtered. Therefore, this product is not kosher as it is yotzai min hachai<\/i>.5<\/sup><\/a> In addition, the blood content would also prohibit this product.<\/p>\n\n\n\n Collagen is the most abundant protein in the animal kingdom. There are various types of collagen which have many known uses ranging from food additives (e.g., gelatin is refined collagen) to the biomedical industry (e.g., to treat wounds). Type 2 collagen, derived from the sternum (breast bone) of chickens, is used to treat arthritis.<\/p>\n\n\n\n Although the collagen currently on the market is non-kosher and may not be eaten, other medical benefits from it are permissible. An example of this is collagen replacement therapy for facial implants. In this non-surgical procedure, Zyderm or Zyplant, types of bovine collagen derived from oxen, is implanted beneath the skin to remove wrinkles, smooth scars, and make lips appear fuller. The insertion of non-kosher collagen beneath one’s skin is permissible.6<\/sup><\/a><\/p>\n\n\n\n It should be noted that although one can inject collagen into one’s lips, applying permanent lipstick and other permanent cosmetics is not permissible. During this procedure, also known as micro pigmentation and cosmetic tattooing, a needle deposits colored pigments made from iron oxide below the top layer of skin. This procedure performed on lips and around the eyes is a form of tattooing and is thus prohibited because of the Torah’s prohibition of tattooing (ksoves ka’aka<\/i>). Even “semi-permanent makeup” which lasts for several years is prohibited for this reason.<\/p>\n\n\n\n There are numerous other arthritis remedies on the market that are non-kosher, including the following: Chondroitin<\/b>, often sold together with glucosamine, is derived from bovine trachea cartilage (oxen windpipes). CMO<\/b> (cis-9-cetylmyristoleate) is derived from non-kosher beef tallow. Bee Venom<\/b>, a non-kosher derivative of the bee7<\/sup><\/a> which contains mellitin, an anti-inflammatory agent, may not be taken orally but may be applied topically or by injection. Shark Cartilage<\/b>, from the elastic tissue in the spine and skeleton of the shark, Shark Liver Oil<\/b>, Green Lipped Mussel Extract<\/b>, and skin and muscle extracts of Sea Cucumbers<\/b> are all derived from non-kosher species.<\/p>\n\n\n\n Although the above products are non-kosher, there are times when one who is ill may take these products orally. The following guidelines are based on the psak<\/i> of HaRav Moshe Heinemann, Rabbinic Administrator of STAR-K.<\/p>\n\n\n\n Someone who is ill and whose life may be in danger may take these items. If an expert says these products may help, they may be taken even if this method is non-conventional and is not recognized by the medical profession. A Rav<\/i> should be consulted if these products only alleviate pain and suffering of a choleh sheyaish bo sakana<\/i> and are taken derech achila<\/i> (i.e. one chews and swallows something which tastes good).8<\/sup><\/a><\/p>\n\n\n\n Someone ill whose life is not in danger but who is noticeably not functioning up to par due to pain or illness (e.g. advanced arthritis) may take these products shelo k’derech achila<\/i>, in an uncommon manner, if a kosher alternative is not available. This allowance includes items which are meant to be swallowed without chewing (swallow tablets and caplets, or even gelatin capsules), poor tasting chewable tablets, and poor tasting liquids. For example, Celebrex<\/b>, a prescription drug taken for arthritis, is currently available only in gelatin capsules. This product may be swallowed by someone suffering from chronic debilitating arthritis pain.<\/p>\n\n\n\n If an individual only has a minor discomfort (e.g. slight joint pains) there are various opinions as to whether these supplements may be taken shelo k’derech achila<\/i>. A rav<\/i> should be consulted.<\/p>\n\n\n\n If a person has minor arthritis and his physician advises that this condition may progress to a severe form of arthritis, this person is considered a choleh she’ain bo sakana<\/i>9<\/sup><\/a> and may take non-kosher supplements shelo k’derech achila<\/i>, in an uncommon manner. Similarly, if a person is healthy and his physician advises that there is a high risk of developing a choleh sheyaish bo sakana<\/i> or a choleh she’ain bo sakana<\/i> condition, this person may take non-kosher supplements shelo k’derech achila<\/i>. For example, if a doctor advises Hormone Replacement Therapy (HRT)10<\/sup><\/a> to a middle aged woman to avoid osteoporosis,11<\/sup><\/a> which often develops as women age, she may swallow a non-kosher capsule or tablet if an equally effective kosher substitute is unavailable. However, if a healthy individual wishes to take non-kosher supplements to prevent an illness unlikely to occur, a Rav<\/i> should be consulted, as the halacha<\/i> is similar to one who has a mechush<\/i>.<\/p>\n\n\n\n Ideally, one should use arthritis remedies with a reliable kosher certification. Unfortunately, this is often not possible. The following is an overview of available products and their kosher status:<\/p>\n\n\n\n Cataflam<\/b> tablets are kosher and pareve. Arava<\/b>, Arthrotec<\/b>, Fosamax<\/b>, Mobic<\/b>, and Vioxx<\/b> tablets are kosher and dairy. If necessary, one may swallow these dairy products one hour after eating meat.12<\/sup><\/a> As indicated above, non-kosher prescription medication (e.g., gelcaps) for advanced arthritis may be taken shelo k’derech achila<\/i>.<\/p>\n\n\n\n Boswellia<\/b> is a type of tree found in India, the Middle East, and Africa. The tree secretes a gummy resinous substance called frankincense or olibanum and is used for arthritis. Frankincense is levona<\/i> which was brought with the korban mincha<\/i> and was used in the ketores<\/i> in the Beis Hamikdash<\/i>.13<\/sup><\/a> It is no coincidence that the name olibanum<\/i> is similar to levona<\/i>. Other herbal derivatives that are kosher are DHEA<\/b> (dehydroepiandrosterone) when derived from Mexican yams, evening primrose oil<\/b>, cats claw herb<\/b>, and white willow bark<\/b>. One, however, must determine that the inactive ingredients in these products are also kosher.<\/p>\n\n\n\n Pain relievers, including aspirin<\/b>, ibuprofen<\/b>, and acetaminophen<\/b>, are usually kosher.14<\/sup><\/a> One should ensure that the inactive ingredients of a specific brand are kosher. One can assume stearates which may be non-kosher are batel<\/i>.<\/p>\n\n\n\n Other treatments for arthritis, including Vitamins, Minerals, and Supplements, are often kosher: MSM<\/b>, methyl sulfonyl methane, is a sulfur compound and is kosher (provided that the inactive ingredients in the finished product are also kosher). Sam-E<\/b>, S-adenosylmethionine, a naturally produced compound, is commercially manufactured synthetically and is available with kosher certification. Calcium<\/b>, commonly produced from limestone, and magnesium<\/b>, a mineral, are available with Star-K kosher certification from Shaklee and Amway\/Quixtar. There are numerous other brands that are kosher. Malic acid<\/b>, taken for fibromyalgia, a muscle disorder, is also available as kosher. Vitamin D<\/b> is often taken with calcium and is available with kosher certification. It requires kosher certification because of two concerns. First, Vitamin D is often derived from non-kosher fish oil.15<\/sup><\/a> Second, Vitamin D is often processed with non-kosher gelatin, a technique known as micro-encapsulation.<\/p>\n\n\n\n On Shabbos Mevorchim<\/i> we daven for a chaim shel chilutz atzamos<\/i>, literally “a life of healthy bones.” The Gemara describes this blessing as me’ula she’bebrachos<\/i>, prominent among the blessings.16<\/sup><\/a> It is apparent that sturdy bones and joints hold a vital key to good health. Gaining a deeper understanding and awareness of both the ailments and the wide range of effective acceptable remedies will allow sufferers of arthritis to hopefully obtain this prominent blessing of chaim shel chilutz atzamos<\/i>. May all arthritis and pain sufferers merit this special bracha.<\/p>\n\n\n\n The author wishes to thank Dr. Yossi Scheller, Dr. Avrohom Becker, Dr. Chong Lee and Mrs. Elaine Lepow for their assistance in the preparation of this article.<\/i><\/p>\n See here<\/a> for related articles and Medication Lists.<\/i><\/p>\n<\/div>\n\n\n\n 1. <\/a>The purpose of this article is to address the kosher status and halachos of arthritis medications, remedies, and supplements. It is in no way intended to advise consumers as to whether a specific product is effective. One should consult with his physician or health advisor regarding the effectiveness and side effects of each product as there are numerous cases of fraudulent claims.<\/p>\n 2. <\/a> A question arises, does the actual shell (which is the raw material for glucosamine) possess flavor or is all the flavor derived only from residual meat on the shell. STAR-K contacted Dr. Chong Lee, a professor in the Department of Food and Science at the University of Rhode Island, who has conducted research in the isolation and characterization of flavor compounds from a variety of shellfish processing byproducts. He explained that the shell contains flavorants which are extracted during the course of extended cooking. Shells contribute much less than the residual meat and juice. However, even if one were to totally remove all meat residue, one could still extract a fish “reaction flavor” from the soft shell. The Lobster Institute at the University of Maine also provided us with information indicating that the shell itself possesses flavor.<\/p>\n 3. <\/a>Note: In mid-2003, less than two years after this article was first published in Kashrus Kurrents<\/i>, kosher certified glucosamine, produced through fermentation of corn, became available to the general public. However, most glucosamine on the market is still derived from shell fish and is not kosher.<\/p>\n 4. <\/a> Although a deer antler looks like a shofar, l’halacha<\/i>, the antler is not kosher for shofar on Rosh Hashana. It is categorized in halacha as a keren<\/i> (horn) and not a shofar since a deer antler is not hollow (see Shulchan Aruch, Orach Chaim<\/i> 586:1 and Mishna Berurah<\/i> 586:7).<\/p>\n 5.<\/a> From a living<\/i> animal, which is forbidden to eat.<\/p>\n 6.<\/a> There are various other halachic issues one must consider before undergoing cosmetic surgery. For a full discussion, see Igros Moshe CM<\/i> 2:66.<\/p>\n 7.<\/a> For a full discussion of other bee derivatives, see “A Halachic Guide to Bee and Honey Derivatives.”<\/a><\/p>\n 8.<\/a> See Biur Halacha<\/i> 328:4, Kol Sherigilim<\/i>.<\/p>\n 9.<\/a> This person is a choleh she\u2019ein bo sakana<\/i> in regard to taking medication. For purposes of other halachos, his status may be different.<\/p>\n 10.<\/a> For a full discussion regarding these and similar products, see “A Kashrus Guide for the OB-GYN Patient.”<\/a><\/p>\n 11.<\/a> One who has developed osteoporosis may be considered a choleh sheyeish bo sakana<\/i>.<\/p>\n 12.<\/a> Those who keep Cholov Yisroel may also take these items, based on various reasons.<\/p>\n 13.<\/a> See Siddur Otzer Hatefilos<\/i> at the end of Mussaf for Shabbos who says this in the name of the Shiltai Giborim<\/i>.<\/p>\nGlucosamine<\/b><\/span><\/h2>\n\n\n\n
Deer Antler Velvet<\/b><\/span><\/h2>\n\n\n\n
Collagen<\/b><\/span><\/h2>\n\n\n\n
Other Arthritis Remedies<\/b><\/span><\/h2>\n\n\n\n
Choleh Sheyeish Bo Sakana<\/i><\/b><\/span>: Someone Whose Life Is\/May Be in Danger<\/h2>\n\n\n\n
Choleh She’ein Bo Sakana<\/i><\/b><\/span>: Someone Whose Life Is Not in Danger<\/h2>\n\n\n\n
Mechush<\/i> (Slight Discomfort) and Bahree<\/i><\/b><\/span> (Healthy)<\/h2>\n\n\n\n
Prevention<\/b><\/span><\/h2>\n\n\n\n
Prescription Drugs For Arthritis<\/b><\/span><\/h2>\n\n\n\n
Herbal Arthritis Remedies<\/b><\/span><\/h2>\n\n\n\n
OTC Non-Prescription Drugs<\/b><\/span><\/h2>\n\n\n\n
Vitamins, Minerals, and Supplements<\/b><\/span><\/h2>\n\n\n\n
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