Magnesium Formulas PROFESSIONAL PRODUCT GUIDE

Home , Magnesium aspartate, Magnesium citrate, Magnesium glycinate, Magnesium malate

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The aim of this comprehensive product guide is to assist in building more effective and successful patient treatment strategies. The product guide is to be used as an adjunct to Seroyal Continuing Medical Education and is not intended to be utilized as a diagnostic tool nor replace any other required education. The remedies indicated in this product guide are potent medicines that can have profound therapeutic effects on patients. As with any intervention, the dosage may need to be adjusted for those with chronic conditions, very sensitive individuals and those taking multiple medications. Practitioners are solely responsible for the care and treatment provided to their own patients. The information provided by the speaker or speakers in the Seroyal Continuing Medical Education program together with any written material provided do not necessarily represent the views of Seroyal and are not intended as medical advice or an endorsement of any products. This information is for practitioner use only. Copyright © 2015 Seroyal. All rights reserved. No part of this information may be used or reproduced in any form or by any means, or stored in a database or retrieval system, or be distributed or replicated without express permission of Seroyal. Making copies of any part of this information for any purposes other than your own personal use is a violation of copyright law. 3130. Version 1. Printed 05/2015. TABLE OF CONTENTS Magnesium 101 Magnesium 101...... 1 Magnesium formulas Magnesium intake Magnesium Complex Liquid ...... 3 GENESTRA BRANDS has one of the largest portfolios of The primary dietary sources of magnesium are green Magnesium Glycinate Liquid...... 3 liquid magnesium supplements available. Great-tasting, vegetables, grains, nuts, soy beans and shell fish.3 Mag Cal Formula 2...... 4 natural flavours complement the deliciously smooth However, magnesium intakes in Western countries are Mag Cal Plus...... 4 mouth-feel, for enhanced patient compliance. Capsule and consistently declining,3 due in part to industrial food Mag Cal Vanilla Liquid...... 5 tablet-based magnesium supplements are also available. processing and agricultural soil depletion.1 Daily intake Magnesium...... 6 has declined. Cal Mag Liquid...... 6 Magnesium for Cal Mag Raspberry Liquid ...... 7 The recommended dietary allowance (RDA) for optimal health magnesium is 130 mg/day for children 4-8 years of age, Magnesium Source Comparison Chart . . . 8-9 Magnesium is the fourth most abundant mineral in the 240-410 mg in adolescents, and 310-420 mg/day human body and is a cofactor in over 300 metabolic for adults.5 Magnesium’s Physiological Effects...... 10 reactions. A 70 kg person has approximately 20-24 g of magnesium, approximately 60% of which is stored Factors that influence 1,2 Cal Mag Vanilla Liquid +...... 12 in bones, where it acts as an interchangeable storage magnesium and calcium Cal Mag + D...... 13 reservoir for the rest of the body. Around 35% of the requirements body’s magnesium is located in high tissues with high Cal : Mag Berry Liquid...... 13 Age and life stage: Net calcium absorption is as high as metabolic rates, including skeletal muscle, the brain, Multi Cal Mag...... 14 60% in infants and young children (who need substantial heart, kidneys and liver.3 Magnesium is involved in Multi Cal Mag Liquid...... 14 amounts of the mineral to build bone density). the maintenance of carbohydrate metabolism, muscle Super Cal Mag...... 14 Absorption decreases to 15%–20% in adulthood and function, and bone integrity, among several other key continues to decrease as people age. Recommended physiological roles.4 calcium intakes are higher for females older than 50 years and for men and women older than 70 years.7,8

REFERENCES: 1. Seelig MS, Rosanoff A. The magnesium factor. New York: Avery, 2003. 2. Wacker WEC, Parisi AF. Magnesium metabolism. N Engl J Med 1968; 278: 658-63. 3. Schecter M. Magnesium and cardiovascular system. Magnesium Research. 2010; 23(2): 60-72 4. Volpe S. Magnesium in Disease Prevention and Overall Health. Advances in Nutrition. 2013; 378S–383S 5. NHPD Monograph on Magnesium. November 2011 6. Health Canada.Vitamin D and Calcium: Updated Dietary Reference Intakes. March 2012 7. NHPD Monograph on Multi-Vitamin and Mineral. October 2007. 8. Straub DA. Calcium supplementation in clinical practice: a review of forms, doses, and indications. Nutr Clin Pract. 2007; 22: 286-296. Consult label for risk information. 1 Great tasting organic magnesium formulas

2 Magnesium Complex Liquid Magnesium Glycinate Liquid Natural Tart Berry Flavour Natural Apple-Pomegranate Flavour MINERAL SUPPLEMENT MINERAL SUPPLEMENT

Concentrated combination of organic magnesium sources Magnesium glycinate formulation • Includes magnesium glycinate, citrate, and malate • Helps to maintain proper muscle function • Helps to support carbohydrate metabolism • Helps to metabolize carbohydrates, protein and fat • Helps to maintain proper muscle function • Magnesium glycinate is a gentle form of magnesium that is less likely to cause • Helps to prevent magnesium deficiency loose stools1,2 • Delicious natural blueberry-raspberry flavour • Helps in the development and maintenance of bones and teeth • Helps to prevent magnesium deficiency (adults, 2 tablespoons) Magnesium Complex Liquid is a concentrated combination of three organic magnesium Dissolves completely in water sources, including magnesium glycinate, citrate and malate. Magnesium is one of the most • No cloudy residue common nutritional deficiencies in Canada: over 34% of Canadians aged 19+ don’t obtain • Great-tasting apple-pomegranate flavour the Estimated Average Requirement (EAR) for magnesium, with inadequate intakes rising 1 above 40% in older men and women. Each tablespoon serving of Magnesium Complex Magnesium is a cofactor in over 300 metabolic reactions. It is involved in the maintenance Liquid provides 500 mg of magnesium to help support macronutrient metabolism, bone of muscle function, glucose metabolism and muscle contraction, among several other health, and muscle function. important physiological roles3. Magnesium helps to maintain bone health by regulating the production of parathyroid hormone (PTH) and calcitriol, which helps to increase calcium 4,5 EACH TABLESPOON (15 ml) CONTAINS: absorption and minimize risk of calcium deficiency. In the United States, insufficient Magnesium (magnesium glycinate/citrate/malate) ...... 500 mg magnesium intake is estimated to occur in approximately 64% of men and 67% of women, Non-Medicinal Ingredients: Purified water, glycerin, xylitol, citric acid, DL-malic acid, natural with even higher levels of insufficient intake in elderly individuals.6 flavour (blueberry/raspberry), xanthan gum, potassium sorbate, sodium citrate, organic stevia leaf extract (glucosylsteviosides) Magnesium glycinate (also known as magnesium bisglycinate) is a highly water soluble amino acid chelate of magnesium and two glycine molecules. Clinical evidence indicates that magnesium glycinate has a significantly higher bioavailability than magnesium oxide, Recommended Dose 1,2 Adults (19 years and older): Take one tablespoon daily or as recommended by your healthcare and is less likely to cause a laxative effect. Supplementation with magnesium glycinate practitioner . Adolescents (9-18 years): Take ½ tablespoon daily or as recommended by your has been shown to decrease the severity of muscle cramping: in a clinical trial on 86 healthy healthcare practitioner . Risk Information: Some people may experience diarrhoea at doses greater pregnant women with recurrent muscle cramps, supplementation with 300 mg of than 351 mg per day . magnesium glycinate for 4 weeks reduced both the frequency and intensity of leg cramps.2 Size Product Code 450 ml Liquid 04235 EACH TABLESPOON (15 ml) CONTAINS: NPN 80054276 Magnesium (magnesium glycinate)...... 250 mg Non-Medicinal Ingredients: Purified water, glycerin, xylitol, DL-malic acid, concentrated apple juice, natural flavour, potassium sorbate, rebaudioside A (stevia leaf extract) REFERENCES 1. Health Canada, Statistics Canada. Canadian Community Health Survey, Cycle 2.2, Nutrition (2004) - Nutrient Intakes From Food: Provincial, Regional and National Data Tables Volumes 1, 2 & 3 Disk. 2009. Ottawa, Health Canada Publications. Recommended Dose Adults (19 years and older): Take one tablespoon one to two times daily or as recommended by your healthcare practitioner . Adolescents (9-18 years): Take one tablespoon daily or as recommended by your healthcare practitioner . If preferred, Magnesium Glycinate Liquid can be mixed with juice or water . Size Product Code 450 ml Liquid 04225 NPN 80053268

Consult label for risk information. 3 Mag Cal Formula 2 Mag Cal Plus CALCIUM-MAGNESIUM SUPPLEMENT CALCIUM-MAGNESIUM SUPPLEMENT

Musculoskeletal support formula with magnesium, calcium Magnesium and calcium plus vitamins and valerian root and vitamin D • 450 mg of magnesium and 300 mg of calcium per daily dose • 400 mg of magnesium, 200 mg of calcium, and 100 IU of vitamin D per daily dose • Plus 300 IU of vitamin D, 18.75 mg of niacinamide, 7.5 mg of vitamin B6, • Helps in the development and maintenance of bones and teeth and 90 mg of valerian root per daily dose • Helps to metabolize carbohydrates, proteins and fats • Helps to maintain proper muscle function • Helps to maintain proper muscle function • Helps the body to metabolize carbohydrates, fats and proteins • Calcium intake, when combined with sufficient vitamin D, a healthy diet, • Helps to prevent vitamin B6 deficiency and regular exercise, may reduce the risk of developing osteoporosis • Calcium intake when combined with sufficient vitamin D, a healthy diet, and regular exercise, may reduce the risk of developing osteoporosis Mag Cal Formula 2 supports muscle and bone health using a combination of magnesium, calcium and vitamin D. Each of these active ingredients plays an important role in Mag Cal Plus supports muscle function and macronutrient metabolism with a unique maintaining optimal muscle function and bone mineral density. Magnesium is a cofactor for combination of calcium, magnesium, vitamins B3, B6, D, and valerian root. Vitamin B6 is the enzyme creatine kinase, which generates ATP from phosphocreatine stored in muscle present in a wide variety of foods; as a result, deficiency is uncommon in North America, tissues during intense exercise (known as alactic anaerobic metabolism.) In a double-blind, although B6 status tends to be significantly lower in smokers, women and the elderly. placebo controlled clinical study conducted on 25 healthy male volleyball players with Vitamin B6 is a cofactor in over 140 metabolic enzymes, and supports protein and normal magnesium levels, supplementation with 350 mg of magnesium oxide for 4 weeks carbohydrate metabolism. However recent clinical trial results indicate that it has a supported muscle function associated with intense exercise, by improving alactic anaerobic widespread impact on protein metabolism.1, 2 metabolism. Following supplementation, lactate production during peak exercise was significantly reduced in the magnesium group in comparison with baseline measurements.1 EACH TABLET CONTAINS: Vitamin D (cholecalciferol)...... 2 .5 mcg / 100 IU Niacinamide...... 6 .25 mg EACH CAPSULE CONTAINS: Vitamin B6 (pyridoxine hydrochloride)...... 2 .5 mg Vitamin D (cholecalciferol)...... 2 .5 mcg/ 100 IU Calcium (calcium aspartate/ carbonate)...... 100 mg Calcium (calcium carbonate/ aspartate)...... 200 mg Magnesium (magnesium aspartate/ oxide)...... 150 mg Magnesium (magnesium oxide/ aspartate)...... 400 mg Valerian (Valeriana officinalis) Root ...... 30 mg Non-Medicinal Ingredients: Cellulose, hyprolose, silica, croscarmellose sodium, magnesium Non-Medicinal Ingredients: Cellulose, croscarmellose sodium, magnesium stearate, silica, stearate, hypromellose, glycerin hypromellose, glycerin

Recommended Dose Recommended Dose Adults: Take one tablet once daily, a few hours before or after taking other medications, Adults: Take one tablet three times daily with meals, a few hours before or after taking other or as recommended by your healthcare practitioner . medications, or as recommended by your healthcare practitioner .

Size Product Code Size Product Code 90 Tablets 05205 90 Tablets 05204 NPN 80015537 NPN 80034964

REFERENCES REFERENCES 1. Setaro L et al. Magnesium status and the physical performance of volleyball players: effects of magnesium supplementation. 1.`Metabolic Profile of Metabolically Obese, Normal-weight Individuals: A Randomized Double-blind Placebo-controlled Trial. Archives of Medical Journal of Sports Sciences. 2014; 32(5); 438–445 Research. 2014; 45: 388e393 2. Gregory JF, Park Y, Lamers Y, Bandyopadhyay N, Chi YY, Lee K et al. Metabolomic Analysis Reveals Extended Metabolic Consequences of Marginal Vitamin B-6 Deficiency in Healthy Human Subjects. PLoS One. 2013; 8(6): e63544

Mag Cal Vanilla Liquid

Natural Vanilla Flavour CALCIUM-MAGNESIUM SUPPLEMENT

2:1 ratio of magnesium and calcium citrate minerals EACH TABLESPOON (15 ml) CONTAINS: with added vitamin D Vitamin D (cholecalciferol)...... 25 mcg / 1000 IU Calcium (calcium citrate) ...... 250 mg • 500 mg of magnesium, 250 mg of calcium, and 1000 IU of vitamin D per dose Magnesium (magnesium citrate)...... 500 mg • Helps to maintain proper muscle function Non-Medicinal Ingredients: Purified water, xylitol, natural vanilla flavour, xanthan gum, • Helps the body to metabolize carbohydrates, fats and proteins potassium sorbate, stevia leaf extract (steviol glycosides), citric acid • Helps to prevent vitamin D and magnesium deficiency • May reduce the risk of developing osteoporosis when combined with a healthy diet Recommended Dose and regular exercise Adults: Take one tablespoon once daily with a meal, a few hours before or after taking other • Delicious natural vanilla flavour medications, or as recommended by your healthcare practitioner . Shake well before each use . Do not refrigerate .

Mag Cal Vanilla Liquid supports musculoskeletal health with a concentrated combination of Size Product Code organic magnesium and calcium citrate minerals, plus vitamin D. Magnesium 450 ml Liquid 05233 supplementation supports active lifestyles by aiding in the maintenance of muscle function NPN 80033673 and promoting healthy bone mineral composition.1,2 EGETARIAN

Vitamin D levels tend to be lower in overweight adults,3 and clinical trial results indicate REFERENCES 1. Veronese N, Berton L, Carraro S, Bolzetta F, De Rui M, Perissinotto E, Tofanello ED. Effect of oral magnesium supplementation on physical that higher levels of vitamin D supplementation are needed to maintain normal vitamin D performance in healthy elderly women involved in a weekly exercise program: a randomized controlled trial. The American Journal of Clinical 4 Nutrition. 2014; 100: 974–81 status in overweight individuals. In a year-long, double-blind, placebo-controlled clinical 2. Carpenter TO, DeLucia M, Zhang JH, Bejnerowicz G, Tartamella L, Dziura J et al. A Randomized Controlled Study of Effects of Dietary Magnesium trial, 1000 IU daily of vitamin D significantly attenuated hip bone mineral loss in women Oxide Supplementation on Bone Mineral Content in Healthy Girls. J Clin Endocrinol Metab. 2006 91(12): 4866–4872 3. Salehpour A, Hosseinpanah F, Shidfar F, Vafa M, Razaghi M, Dehgani S et al. A 12-week double-blind randomized clinical trial of vitamin D3 aged 60-70 with mean BMI values > 25. After 1 year of supplementation, mean hip bone supplementation on body fat mass in healthy overweight and obese women. Nutrition Journal. 2012; 11: 78 4. Blum M, Dallal GE, Dawson-Hughes B. Body size and serum 25 hydroxy vitamin D response to oral supplements in healthy older adults. J AM Coll mineral density loss was approximately 0.05% in the vitamin D treatment group, in Nutr. 2008; 27(2): 274-279 5. Macdonald HM, Wood AD, Aucott LS, Black AJ, Fraser WD, Mavroeidi A et al. Hip Bone Loss Is Attenuated With 1000 IU but Not 400 IU Daily comparison with an approximate loss of 0.60% in the placebo group. Serum calcium levels Vitamin D3: A 1-Year Double-Blind RCT in Postmenopausal Women. Journal of Bone and Mineral Research. 2013; 28(10); 2202–2213 were also significantly increased in the vitamin D group.5

Consult label for risk information. 5 also available in Magnesium Cal Mag Liquid fruit punch flavour MINERAL SUPPLEMENT Natural Mint Flavour CALCIUM-MAGNESIUM SUPPLEMENT Magnesium in a convenient vegetable capsule format • 400 mg of magnesium per daily dose • Helps the body to metabolize carbohydrates, fats and proteins Delicious mint-flavoured liquid calcium/magnesium supplement • Helps in the maintenance of bones and teeth • Provides 600 mg of calcium and 300 mg of magnesium per tablespoon dose • Helps in tissue formation and in the maintenance of proper muscle function • Includes 100 IU of vitamin D per tablespoon • Helps in the development and maintenance of bones and teeth • Helps to maintain proper muscle function and helps in tissue formation Each Magnesium capsule provides 100 mg of magnesium in the form of aspartate/oxide, to • Calcium intake, when combined with sufficient vitamin D, a healthy diet, help support macronutrient metabolism, bone health, and muscle function. Magnesium and regular exercise, may reduce the risk of developing osteoporosis plays an essential role in both muscle contraction and relaxation, and may help in the maintenance of muscle function in physically active older individuals. Older adults, especially women, tend to have lower magnesium dietary intake and absorption rates.1,2 In the first Cal Mag Liquid combines calcium and vitamin D to support bone health, plus magnesium clinical trial to assess magnesium’s impact on muscle performance in the elderly, daily to help maintain muscle function. Calcium and vitamin D’s roles in bone health are supplementation with magnesium for 12 weeks significantly improved physical well-documented; however magnesium also supports several key components of bone performance. One hundred and thirty nine healthy, physically active women aged 65+ maintenance. In vitro and animal study results indicate that magnesium improves bone were randomized to receive either placebo or 300 mg of elemental magnesium from mineralization by enhancing osteoblast activity while reducing osteoclast activity. In individuals with low magnesium status, magnesium intake improves bone mineralization magnesium oxide. Following supplementation, participants in the magnesium group had 1 clinically relevant improvements in walking speed, with an average increase of 12 metres during skeletal development, which could reduce osteoporosis risk in later years. In a per minute. Walking speed is typically used as an independent variable for the diagnosis of double-blind, placebo-controlled trial, daily magnesium supplementation for 1 year age-related muscle loss. Chair stand test scores were also significantly improved, indicating significantly improved hip bone mineral content in healthy adolescent girls with enhanced lower limb strength and balance. The authors concluded that magnesium insufficient dietary magnesium intake. Participants were randomized to receive either supplementation may help to prevent or delay age-related decline in physical performance.3 placebo treatment or 300 mg of magnesium from magnesium oxide. At the end of the treatment period, mean hip bone mineral content was approximately 3% greater in the magnesium group in comparison with the placebo group.2 EACH CAPSULE CONTAINS: Magnesium (magnesium aspartate / oxide)...... 100 mg

Non-Medicinal Ingredients: Hypromellose, cellulose, magnesium stearate, silica EACH TABLESPOON (15 ml) CONTAINS: Vitamin D (cholecalciferol)...... 2 .5 mcg / 100 IU Recommended Dose Calcium (calcium carbonate)...... 600 mg Magnesium (magnesium hydroxide)...... 300 mg Adults (19 years and older): Take two capsules two times daily or as recommended by your healthcare practitioner . Adolescents (9-18 years): Take three capsules daily or as Non-Medicinal Ingredients: Purified water, glycerin, xanthan gum, rebaudioside A (stevia), recommended by your healthcare practitioner . Children (6-8 years): Take one capsule daily or natural mint flavour as recommended by your healthcare practitioner . Recommended Dose Size Product Code Adults and Adolescents (9 years and older): Take one tablespoon daily with a meal, a 90 Vegetable Capsules 04216 few hours before or after taking other medication, or as recommended by your healthcare NPN 80007120 practitioner . Shake well before each use .

Size Product Code 360 ml Liquid 05202 REFERENCES 1. Barbagallo M, Belvedere M, Dominguez LJ. Magnesium homeostasis and aging. Magnes Res 2009;22: 235-246 1000 ml Liquid 05202960 2. Rude RK, Singer FR, Gruber HE. Skeletal and hormonal effects of magnesium deficiency. J Am Coll Nutr 2009;28:131–41. 3. Veronese N, Berton L, Carraro S, Bolzetta F, De Rui M, Perissinotto E, Tofanello ED. Effect of oral magnesium supplementation on physical NPN 80008115 performance in healthy elderly women involved in a weekly exercise program: a randomized controlled trial. The American Journal of Clinical Nutrition. 2014; 100: 974–81 EGETARIAN

REFERENCES 1. Castiglioni S, Cazzaniga A, Albisetti W, Maier JAM. Magnesium and Osteoporosis: Current State of Knowledge and Future Research Directions. Nutrients. 2013; 5: 3022-3033 2. Carpenter TO, DeLucia M, Zhang JH, Bejnerowicz G, Tartamella L, Dziura J et al. A Randomized Controlled Study of Effects of Dietary Magnesium Oxide Supplementation on Bone Mineral Content in Healthy Girls. J Clin Endocrinol Metab. 2006 91(12): 4866–4872

Cal Mag Raspberry Liquid CALCIUM-MAGNESIUM SUPPLEMENT

Calcium and magnesium citrate formula with vitamin D EACH TABLESPOON (15 ml) CONTAINS: Vitamin D (cholecalciferol)...... 25 mcg / 1000 IU • Helps in the development and maintenance of bones and teeth Calcium (calcium citrate) ...... 500 mg • Helps in tissue formation and in maintaining proper muscle function Magnesium (magnesium citrate)...... 200 mg • Helps to prevent vitamin D deficiency Non-Medicinal Ingredients: Purified water, xylitol, natural raspberry flavour, citric acid, xanthan High bioavailability formula gum, stevia leaf extract (glucosylsteviosides), potassium sorbate • Calcium and magnesium are delivered in citrate form, providing superior bioavailability1,2 Recommended Dose Adults: Take one tablespoon daily with a meal, a few hours before or after taking other Great-tasting natural raspberry flavoured liquid format medication, or as recommended by your healthcare practitioner . Shake well before each use . • Ideal for vegetarians Do not refrigerate .

Cal Mag Raspberry Liquid supports bone health with a combination of calcium, magnesium Size Product Code and vitamin D. Calcium citrate is an organic form of calcium that is significantly better 450 ml Liquid 05227 absorbed in postmenopausal women than inorganic calcium oxide.1 Magnesium citrate is a NPN 80029511 2 highly bioavailable form of magnesium that helps to maintain bone mineral density: in EGETARIAN healthy young men, regular magnesium supplementation has been shown to suppress bone turnover rates.3 REFERENCES 1. Heller HJ, Greer LG, Haynes SD, Poindexter JR, Pak CY.Pharmacokinetic and pharmacodynamic comparison of two calcium supplements in postmenopausal women.J Clin Pharmacol.2000 Nov;40(11):1237-44. Vitamin D improves the absorption of calcium and phosphorous, and helps in the 2. Walker AF, Marakis G, Christie S, Byng M. Mg citrate found more bioavailable than other Mg preparations in a randomised, double-blind study. maintenance of bone health.4 Osteoporosis Canada’s guideline statements recommend a Magnes Res. 2003; Sep;16(3): 183-91 3. Dimai HP, Porta S, Wirnsberger G, Lindschinger M, Pamperl I, Dobnig H, Wilders-Truschnig M, Lau KH. Daily oral magnesium supplementation daily vitamin D intake of 400–1000 IU for low-risk adults under 50 years of age and suppresses bone turnover in young adult males. J Clin Endocrinol Metab. 1998; Aug;83(8): 2742-8 5 4. NHPD Monograph on Vitamin D. August 2007 800–2000 IU for high-risk and older adults. Vitamin D intakes of 700-800 IU/day are 5. Hanley DA et al. Vitamin D in adult health and disease: a review and guideline statement from Osteoporosis Canada. Canadian Medical 6 Association Journal. 2010 associated with a decreased risk of bone fracture, in comparison with 400 IU/day. 6. Bischoff-Ferrari H, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture prevention with vitamin D supplementation a meta-analysis of randomized controlled trials. JAMA. 2005; 293: 2257–64

One tablespoon equals up to 8 tablets

Consult label for risk information. 7 Magnesium source comparison chart

Magnesium Salt % Magnesium Additional Information O Magnesium Glycinate OOOO ~ 10% • Improved water solubility and bioavailability compared to magnesium oxide and other 1-4 (amino acid chelate) - inorganic magnesium salts H2N O 1 --- - - Absorbed intact through small intestine cells HHH2NHNN2N OOOO • 22 Mg2+ 2+2+ 2+ • Highest magnesium yield possible for an amino acid chelate MgMgMgMg2+2+ - 5,6 O NH2 • Glycine is a conditionally essential amino acid --- - - OOOO NNNHHNH2H2 22 • Less likely to cause loose stools1,2,7,8 compared to magnesium oxide and magnesium citrate O • May help relieve pregnancy-related leg cramps2 OOOO

O OOOO O Magnesium Malate 2+ OOOO ~ 11% • Malate is a key component in the citric acid cycle, Mg 2+ O Mg2+2+2+- 2+ OO O - MgMgMg O- Mg 2+ OO - O- (organic salt) -O-- - OMgMg2+2+2+- OO-- -O which is used to generate ATP within cells OO MgMg- O- OO O--O-OO OH O OHOHOHOHO OOOHOO O • More water soluble than magnesium oxide OOOOOHOHOHOH OOOO OOOOO OOO Magnesium Citrate OOOO OO ------~11% • Greater water solubility and bioavailability than HHH2H2NNNN2N MMOOgMO=gOg=O=OO 22 MMgg==OO magnesium oxide3 (organic salt) HHHHHOOOO- - H H2+O O ---O------HH HNNH2+2+HN2+OO O O OOOOHMgMgHHMg222MgN2N2 OOOOOOO 8 MgOOOO Acts as an osmotic laxative: ideal for those with -- - • 2+2+ 2+ 2+ OO-O- - MgMgMg2+2+2+ 2+2+2+ -- - OOO MgMg - - MgMgMg O -O------MgMg OOO occasional constipation OO--- -O NNHHN2H2 OOO-OOO NH222 OOOO - - The most commonly used organic magnesium supplement O O --O- NHNH • OO NNNHH2H22 2 HOHOHOHO 2 OHOHOHOH O O OO O O NHNH2 OO NHNH22 OMgOMgMg NH2 2 MgOMg 9 Magnesium Aspartate (EP) 2 NHMgO O ~ 7% • Better absorbed than magnesium oxide O NHNH22 2 OO OO NHNH2 2 HOHOHOHO OO NH O HO O 2 O (amino acid chelate) HOHOHOHO O O OOO Soluble in water NHNHNH2 2 OO • NHNH22 2 O HONH O OOOO OOOO 2 O 10 HOHOHOHO 2+2+2+2+ • Helps to support healthy carbohydrate metabolism O OOOO MgMgMgMg HO NH O O O O 2+ NHNH22 2 OO OO MgMgMg NHNH2 2O O MgMgMg NHNH2 2 OO NHNH22 OO NH2 O2 O Mg HOHOHOO O NH O HOHO OOHO HO 2 HOHO O O HO O OO O O NH2 OO O OO NHNHHONH22 OO 2 2 O OO O O O OO NHOO2 O HOHOHOHO OO O O HO O OOO O OOOMMOMgMgg==g=OO=OO O Mg=O 4 Magnesium Oxide (USP) MMMgMgg==g=OO=OO ~ 58% • Practically insoluble in water (inorganic salt) Mg=O • Substantially decreased bioavailability compared to organic magnesium salts • Strong laxative effect,7 commonly used in milk of magnesia products Magnesium Hydroxide (USP) HOHOHOHO OHOHOHOH ~ 40% • The most commonly used inorganic magnesium supplement (inorganic salt) HO OH HOHOHOHOMgMgMgMg OHOHOHOH HOMg OH USP – U.S. Pharmacopeial Convention Reference Standard. EP – European Pharmacopeia Standard.

REFERENCES 1. Schuette S, Lashner B, and Janghobani M. Bioavailability of Magnesium Diglycinate vs Magnesium Oxide in Patients with Ileal Resection. Journal of Parenteral and Enteral Nutrition. 1994; 18: 430 2. Supakatisant C and Phupong V. Oral magnesium for relief in pregnancy-induced leg cramps: a randomised controlled trial. Maternal and Child Nutrition. 2012 3. Rylander R. Bioavailability of Magnesium Salts – A Review. Journal of Pharmacy and Nutrition Sciences. 2014; 4: 57-59 4. Food and Agricultural Organization of the United Nations. Magnesium Oxide Monograph. 2001 5. National Research Council. Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). Washington, DC: The National Academies Press, 2005. 6. Wang W, Wu Z, Dai Z, Yang Y, Wang J, and Wu G. Glycine metabolism in animals and humans: implications for nutrition and health. Amino Acids. 2013; 45(3): 463-77 7. Yamasaki M, Funakoshi S, Matsuda S, Imazu T, and Takeda Y et al. Interaction of magnesium oxide with gastric acid secretion inhibitors in clinical pharmacotherapy. European Journal of Clinical Pharmacology. 2014; 70:921–924 8. J Love, E-J Bernard, A Cockeram, et al. A multicentre, observational study of sodium picosulfate and magnesium citrate as a precolonoscopy bowel preparation. Canadian Journal of Gastroenterology. 2009; 23(10): 706-710 9. Magnesium-L-aspartate-HCl and magnesium-oxide: bioavailability in healthy volunteers. Muhlbauer, B., et al. 4, 1991, European Journal of Clinical Pharmacology, Vol. 40, pp. 437-438 10. Oral magnesium supplementation reduces insulin resistance in non-diabetic subjects - a double-blind, placebo-controlled, randomized trial. Mooren, F.C., et al. 3, March 2011, Diabetes, Obesity and Metabolism, Vol. 13, pp. 281-284

8 Stock Product Name Format Magnesium Source(s) Magnesium / Dose Code NPN

Magnesium Complex Liquid Liquid Magnesium glycinate/ citrate/ malate 500 mg / tablespoon 10235 80054276

Mag Cal Vanilla Liquid Liquid Magnesium citrate 500 mg / tablespoon 05233 80033673

Cal Mag Liquid (mint) Liquid Magnesium hydroxide 300 mg / tablespoon 05202 80008115

Cal Mag Liquid 2 Liquid Magnesium hydroxide 300 mg / tablespoon 05221 80008628

Magnesium Glycinate Liquid Liquid Magnesium glycinate 250 mg / tablespoon 04225 80053268

Multi Cal Mag Liquid Liquid Magnesium hydroxide 250 mg / tablespoon 05218 80027613

Cal : Mag Berry Liquid + (blueberry) Liquid Magnesium citrate 200 mg / tablespoon 05378 80028682

Cal Mag Raspberry Liquid Liquid Magnesium citrate 200 mg / tablespoon 05227 80029511

Cal Mag Vanilla Liquid + Liquid Magnesium citrate 200 mg / tablespoon 05230 80029496

Magnesium Capsule Magnesium aspartate/ oxide 100 mg / capsule 04216 80007120

Super Cal Mag Capsule Magnesium aspartate/ oxide 75 mg / capsule 05212 80009536

Mag Cal Formula 2 Tablet Magnesium oxide/ aspartate 400 mg / tablet 05205 80015537

Multi Cal Mag Tablet Magnesium aspartate/ oxide 150 mg / tablet 05203 80012912

Mag Cal Plus Tablet Magnesium aspartate/ oxide 150 mg / tablet 05204 80034964

Cal Mag + D Tablet Magnesium aspartate/ oxide 85 mg / tablet 05201 80027168

Consult label for risk information. 9 Magnesium’s physiological effects

Magnesium plays an important role in maintaining the function of numerous physiological systems . Vitamin D and calcium provide additional support for bone and muscle health .

Magnesium Nitric oxide release

Magnesium & Vitamin D Muscle output

Calcium, Magnesium & Vitamin D Bone mineral density

Osteoclast activity

Vitamin D Calcium absorption

10 Support for an Active Lifestyle

NEW

Delicious natural blueberry-raspberry flavour

Magnesium helps to maintain glucose metabolism and EACH TABLESPOON (15 ml) CONTAINS: Magnesium proper muscle function, but over one-third of Canadians (magnesium glycinate/citrate/malate) ...... 500 mg Non-Medicinal Ingredients: Purified water, glycerin, xylitol, do not obtain enough magnesium from their diet. citric acid, DL-malic acid, natural flavour (blueberry/raspberry), xanthan gum, potassium sorbate, sodium citrate, organic stevia GENESTRA BRANDS Magnesium Complex Liquid is a concentrated leaf extract (glucosylsteviosides) Recommended Dose: Adults (19 years and older): Take combination of three organic water-soluble magnesium sources; magnesium one tablespoon daily or as recommended by your healthcare practitioner. Adolescents (9-18 years): Take ½ tablespoon daily glycinate, citrate and malate. Each tablespoon serving includes 500 mg of or as recommended by your healthcare practitioner. magnesium to help prevent magnesium deficiency and to provide support for an Product Size: 450 ml liquid Product Code: 04235 active lifestyle. NPN 80054276

Consult label for risk information. 11

Cal Mag Vanilla Liquid +

Natural Vanilla Flavour CALCIUM-MAGNESIUM SUPPLEMENT

Organic calcium and magnesium citrate minerals plus vitamins D and K EACH TABLESPOON (15 ml) CONTAINS: • 500 mg of calcium and 200 mg of magnesium per tablespoon dose Vitamin D (cholecalciferol)...... 25 mcg / 1000 IU Vitamin K1 (phylloquinone)...... 40 mcg • With 1000 IU of vitamin D, 40 mcg of vitamin K1 and 60 mcg of vitamin K2 Vitamin K2 (menaquinone-7)t...... 60 mcg • Helps in the maintenance of bones, teeth, and proper muscle function Calcium (calcium citrate) ...... 500 mg Magnesium (magnesium citrate)...... 200 mg • Helps to prevent vitamin D deficiency t Naturally derived from fermented soybeans • Calcium intake, when combined with sufficient vitamin D, a healthy diet Non-Medicinal Ingredients: Purified water, xylitol, natural vanilla flavour, citric acid, xanthan and regular exercise, may reduce the risk of developing osteoporosis gum, potassium sorbate, stevia leaf extract (glucosylsteviosides) • Great-tasting natural vanilla flavour Recommended Dose Adults: One tablespoon taken once daily with a meal, a few hours before or after taking other Cal Mag Vanilla Liquid + helps to maintain bone health and muscle function using a medication, or as recommended by your healthcare practitioner . Shake well before each use . combination of organic calcium and magnesium citrate minerals, plus vitamins D and K. Do not refrigerate . Osteoporosis is the primary cause of bone fractures in postmenopausal women 50 years Size Product Code and older, with an estimated 80% of all fractures in this group being osteoporosis- 450 ml Liquid 05230 related.1 Regular physical activity helps to maintain bone mass during aging, as bone NPN 80029496 metabolism is stimulated by the mechanical stress generated from impacts.2-5 However, supplementation with calcium and vitamin D may support bone formation even when EGETARIAN incorporated into a low-impact physical exercise program. In a randomized clinical trial, REFERENCES 64 healthy postmenopausal women received 500 mg of calcium and 1000 IU of vitamin D 1. Bessette L, Ste-Marie LG, Jean S, Davison KS, Beaulieu M, Baranci M, Bessant J, Brown JP. The care gap in diagnosis and treatment of women with a fragility fracture. Osteoporos Int. 2008; 19: 79–86 daily while undergoing 6 months of low-impact aquatic exercise. At the end of the study 2. Yamazaki S, Ichimura S, Iwamoto J, Takeda T, Toyama Y. Effect of walking exercise on bone metabolism in postmenopausal women with osteopenia/osteoporosis. J Bone Miner Metab. 2004; 22: 500–508 period, there was a 15.8% increase in bone formation biomarker P1NP (precollagen type 1 3. Chien MY, Wu YT, Hsu AT, Yang RS, Lai JS. Efficacy of a 24-week aerobic exercise program for osteopenic postmenopausal women. Calcif Tissue 6 Int. 2000; 67: 443–448 amino-terminal propeptide) compared to baseline measurements. P1NP has been 4. Bemben DA, Bemben MG. Dose-response effect of 40 weeks of resistance training on bone mineral density in older adults. Osteoporos Int. 2011; 22: 179–186 identified as a clinically relevant osteoporosis risk biomarker by the Bone Marker Standards 5. Vainionpää A, Korpelainen R, Leppäluoto J, Jämsä T. Effects of high-impact exercise on bone mineral density: a randomized controlled trial in Working Group.7 premenopausal women. Osteoporos Int. 2005; 16: 191–198 6. Moreira LDF, Fronza FCAO, dos Santos RN, Zach PL, Kunii IS, Hayashi LF et al. The benefits of a high-intensity aquatic exercise program (HydrOS) for bone metabolism and bone mass of postmenopausal women. J Bone Miner Metab. 2014; 32: 411–419 Vitamin K helps to maintain bone health, partly via the activation of gamma-carboxyglutamic 7. Wheater G, Elshahaly M, Tuck SP, Datta H, Van Laar JM. The clinical utility of bone marker measurements in osteoporosis. Journal of Translational Medicine. 2013, 11: 201 acid (GLA) proteins involved in skeletal mineralization, such as matrix Gla protein (MGP) 8. Price P. Gla-containing proteins of bone. Connect Tissue Res. 1989; 21:51–57 8,9 9. Loeser R, Varnum B, Carlson C, et al. Human chondrocyte expression of growth-arrest-specific gene 6 and the tyrosine kinase receptor axl: and osteocalcin. Low vitamin K status may impair the function of Gla proteins involved in potential role in autocrine signaling in cartilage. Arthritis Rheum. 1997; 40:1455–1465 10 10. Misra D, Booth SL, Tolstykh I, Felson DT, Nevitt MC, Lewis CE et al. Vitamin K Deficiency Is Associated with Incident Knee Osteoarthritis. Am J regulation of bone mineralization. Med. 2013; 126(3): 243-248

12 Cal Mag + D Cal : Mag Berry Liquid + CALCIUM-MAGNESIUM SUPPLEMENT VITAMIN-MINERAL SUPPLEMENT

Bone support formula with a 2:1 ratio of calcium to magnesium Comprehensive bone support formula with 100% citrate minerals • Provides 680 mg of calcium and 340 mg of magnesium per daily dose • Calcium and magnesium along with therapeutic dosages of vitamins A, D and K to • Plus 280 IU of vitamin D help in the development and maintenance of bones • Helps in the development and maintenance of bones and teeth • Calcium intake may reduce the risk of developing osteoporosis when combined with • Helps in the absorption and use of calcium sufficient vitamin D, a healthy diet, and regular exercise • Calcium and vitamin D may reduce the risk of developing osteoporosis when High bioavailability potential combined with a healthy diet and regular exercise • Calcium and magnesium are delivered in citrate form, providing superior bioavailability1,2 Cal Mag + D provides calcium and magnesium to support bone health, with added • Includes boron citrate vitamin D to improve calcium absorption and utilization. In a dietary analysis of 502 adults Natural blueberry flavour aged 50+ with a recent fracture, it was estimated that supplementation with 500 mg of • Great taste for excellent patient compliance calcium per day would allow the majority of participants to meet the recommended daily intake of 1000 mg of calcium.1 However, as nearly 90% of skeletal mass is accumulated by Cal : Mag Berry Liquid + supports bone health with a combination of calcium and age 18, adolescence is a critical period for developing and maintaining peak bone mineral magnesium, plus boron and vitamins A, D and K. Calcium citrate is an organic form of density. In a recent cohort study of 195 physically active children and adolescents, serum calcium that is significantly better absorbed in postmenopausal women than inorganic vitamin D levels were found to be a major determinant of overall bone mineral density, calcium oxide.1 Magnesium citrate is a highly bioavailable form of magnesium2 that helps to with an even greater impact on bone mineralization than physical activity. In addition, maintain bone mineral density: in healthy young men, regular magnesium higher vitamin D status was associated with lower levels of parathyroid hormone (PTH), supplementation has been shown to suppress bone turnover rates.3 which plays a role in bone turnover.2 In vitro osteoblast studies indicate that boron stimulates production of several proteins involved in maintaining bone structure, including type 1 collagen, osteocalcin and EACH TABLET CONTAINS: Vitamin D (cholecalciferol)...... 1 .8 mcg / 70 IU osteopontin. In human participants with osteroporosis, supplementation with the Calcium (calcium carbonate/ aspartate)...... 170 mg plant-based boron compound calcium fructoborate was found to improve bone density.7 Magnesium (magnesium aspartate/ oxide)...... 85 mg Insufficient vitamin K intake may increase bone fracture risk, and vitamin K supplementation Non-Medicinal Ingredients: Cellulose, croscarmellose sodium, magnesium stearate, has been shown to reduce bone turnover and improve bone strength.8,9 hypromellose, glycerin

EACH TABLESPOON (15 ml) CONTAINS: Recommended Dose Vitamin A (vitamin A acetate)...... 300 mcg RAE / 1000 IU Adults and Adolescents (12 years and older): Take two tablets two times daily with meals, a Vitamin D (cholecalciferol)...... 25 mcg / 1000 IU few hours before or after taking medications, or as recommended by your healthcare practitioner . Vitamin K1 (phylloquinone) ...... 80 mcg ♦ Vitamin K2 (menaquinone-7) ...... 20. mcg Calcium (calcium citrate) ...... 500 mg Size Product Code Magnesium (magnesium citrate) ...... 200 mg 90 Tablets 05201 Boron (boron citrate)...... 2000 mcg ♦ Naturally derived from fermented soybeans NPN 80027168 Non-Medicinal Ingredients: Purified water, xylitol, natural blueberry flavour, xanthan gum, EGETARIAN potassium sorbate, stevia leaf extract (glucosylsteviosides), ascorbic acid REFERENCES 1. Van den Bergh JJPW, Bidar SS, Bours S, Van Geel TACM, Geusens PPMM. Need of Calcium and Vitamin D in Patients after a Recent Fracture. Food and Nutrition Sciences. 2012; 3, 539-547 Recommended Dose 2. Pekkinen M, Viljakainen H, Saarnio E, Lamberg-Allardt C, Mäkitie O. Vitamin D Is a Major Determinant of Bone Mineral Density at School Age. Adults: Take one tablespoon daily with a meal, a few hours before or after taking other PLoS One. 2012; 7(7): e40090 medications, or as recommended by your healthcare practitioner . Shake well before each use . Do not refrigerate .

Size Product Code 450 ml Liquid 05378 NPN 80028682

EGETARIAN

REFERENCES 1. Heller HJ, Greer LG, Haynes SD, Poindexter JR, Pak CY.Pharmacokinetic and pharmacodynamic comparison of two calcium supplements in postmenopausal women.J Clin Pharmacol. 2000; 40(11): 1237-44. 2. Walker AF, Marakis G, Christie S, Byng M. Mg citrate found more bioavailable than other Mg preparations in a randomised, double-blind study. Magnes Res. 2003; Sep;16(3): 183-91 3. Dimai HP, Porta S, Wirnsberger G, Lindschinger M, Pamperl I, Dobnig H, Wilders-Truschnig M, Lau KH. Daily oral magnesium supplementation suppresses bone turnover in young adult males. J Clin Endocrinol Metab. 1998; Aug;83(8): 2742-8 4. NHPD Monograph on Vitamin D. August 2007 5. Hanley DA et al. Vitamin D in adult health and disease: a review and guideline statement from Osteoporosis Canada. Canadian Medical Association Journal. 2010 6. Bischoff-Ferrari H, Willett WC, Wong JB, Giovannucci E, Dietrich T, Dawson-Hughes B. Fracture prevention with vitamin D supplementation a meta-analysis of randomized controlled trials. JAMA. 2005; 293: 2257–64 7. Nielsen FH. 8. National Academy of Sciences. A Report of the Panel on Micronutrients. 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 2001. 9. Bügel S. Vitamin K and bone health in adult humans. In: Litwack G, Ed. Vitamins and Hormones: Vitamin K. London: Elsevier 2008; 393-416

Consult label for risk information. 13 Multi Cal Mag Multi Cal Mag Liquid CALCIUM-MAGNESIUM SUPPLEMENT CALCIUM-MAGNESIUM SUPPLEMENT

Calcium and magnesium supplement with added Combination calcium, magnesium, and essential mineral supplement vitamins and minerals • 1200 mg of calcium and 500 mg of magnesium per daily dose • 450 mg each of calcium and magnesium per daily dose • With 200 IU of vitamin D3, 10 mg of iron and 200 mcg of chromium per daily dose

• With 300 IU of vitamin D, 1.5 mg of vitamin B6, and essential trace minerals • Helps in the development and maintenance of bones and teeth per daily dose • Provides support for healthy glucose metabolism and red blood cell formation • Helps in the maintenance of bones and teeth • Calcium intake, when combined with sufficient vitamin D, a healthy diet, • Helps to maintain healthy skin, immune function and proper muscle function and regular exercise, may reduce the risk of developing osteoporosis • Calcium intake when combined with sufficient vitamin D, a healthy diet, • Delicious natural almond flavour and regular exercise, may reduce the risk of developing osteoporosis Multi Cal Mag combines concentrated doses of calcium and magnesium, plus vitamin D and Multi Cal Mag helps to support bone health with a combination of calcium and magnesium, essential trace minerals. Long term supplementation with high doses of calcium and vitamin

plus essential trace minerals and vitamins D and B6. Health Canada’s Food Guide recommends D may help to reduce incidence of facture risk. In the Women’s Health Initiative clinical trial regular dairy consumption for the promotion of bone health,1 with 3 servings per day and cohort study, 36,282 postmenopausal women were randomized to receive either recommend for adults aged 51+.2 Dairy products are rich in nutrients that support placebo or 1000 mg of calcium plus 400 IU of vitamin D3 daily for an average trial period of musculoskeletal health, such as calcium, magnesium, phosphorous, vitamin D and protein,3,4 7 years. In the calcium and vitamin D3 treatment group, hip fracture risk was significantly however few clinical trials have found an association between dairy consumption and reduced reduced in comparison with the placebo group. Hip fracture risk was further reduced in the osteoporosis or fracture risk.5 In a controlled clinical trial conducted on 71 healthy approximately 42% of participants that had no history of calcium or vitamin D supplement postmenopausal women aged 50-65 with low calcium intakes, consumption of calcium and usage at the start of the trial. After 5 years of calcium/vitamin D supplementation, hip vitamin D-fortified dairy product improved bone turnover biomarkers. For 6 weeks, fracture risk was reduced by approximately 38% in this participant subset.1 participants were randomized to either maintain their normal diet, or to receive an additional 2 servings of a calcium/vitamin D-fortified dairy product that provided a total of 400 mg of EACH TABLESPOON (15 ml) CONTAINS: calcium and 100 IU of vitamin D. Serum levels of the bone resorption biomarker isoform 5b Vitamin D (cholecalciferol)...... 2 .5 mcg / 100 IU (TRAP 5b) were significantly reduced in the dairy group, while serum levels of the Calcium (calcium carbonate)...... 600 mg 4 Iron (iron gluconate) ...... 5 mg bone-building protein insulin-like growth factor 1 (IGF-1) levels were significantly increased. Iodine (potassium iodide)...... 75 mcg Magnesium (magnesium hydroxide)...... 250 mg Zinc (zinc gluconate)...... 5 mg EACH TABLET CONTAINS: Selenium (sodium selenite)...... 100 mcg Vitamin D (cholecalciferol)...... 2 .5 mcg / 100 IU Copper (copper gluconate)...... 500 mcg Manganese (manganese gluconate)...... 0 .5 mg Vitamin B6 (pyridoxine hydrochloride)...... 0 .5 mg Calcium (calcium carbonate/ bovine bone meal/ Chromium (chromium polynicotinate)...... 100 mcg dibasic calcium phosphate dihydrate)...... 150 mg Molybdenum (sodium molybdate [VI])...... 25 mcg Phosphorus (bovine bone meal/ dibasic calcium phosphate dihydrate)...... 37 .5 mg Vanadium (vanadyl sulfate [IV])...... 35 mcg Magnesium (magnesium aspartate/ oxide)...... 150 mg Non-Medicinal Ingredient Zinc (zinc aspartate)...... 1 mg Sodium Montmorillonite t ...... 15 mg Copper (copper HVPp chelate)...... 1250 mcg t A source of 49 colloidal minerals Manganese (manganese citrate)...... 0 .5 mg Other Non-Medicinal Ingredients: Purified water, glycerin, natural almond flavour, xanthan Molybdenum (molybdenum glycinate chelate) ...... 12 .5 mcg Vanadium (vanadyl sulfate) ...... 6 .25 mcg gum, potassium sorbate, stevia leaf extract (rebaudioside A) p Hydrolyzed vegetable (rice) protein Non-Medicinal Ingredients: Cellulose, magnesium stearate, croscarmellose sodium, silica, Recommended Dose hypromellose, glycerin Adults: Take one tablespoon two times daily with meals, or as recommended by your healthcare Contains: Egg practitioner . Take a few hours before or after taking other medications . Shake well before each use .

Recommended Dose Size Product Code Adults (19 years and older): Take one tablet three 360 ml 05218 times daily with meals, a few hours before or after NPN 80027613 taking other medications, or as recommended by your healthcare practitioner . EGETARIAN

REFERENCES Size Product Code 1. Prentice RL, Pettinger MB, Jackson RD, Wactawski-Wende J, LaCroix AZ, Anderson GL et al. Health risks and benefits from calcium and vitamin D 90 Tablets 05203 supplementation: Women’s Health Initiative clinical trial and cohort study. Osteoporos Int. 2013; 24:567–580 NPN 80012912

REFERENCES 1. Health Canada. Milk and Alternatives – Canada’s Food Guide. January 2008 2. Health Canada. How Many Food Guide Servings of Milk and Alternatives Do I Need? January 2008 3. Bonjour JP, Kraenzlin M, Levasseur R, Warren M, Whiting S. Dairy in Adulthood: From Foods to Nutrient Interactions on Bone and Skeletal Muscle Health. Journal of the American College of Nutrition. 2013; 32(4): 251–263 4. Bonjour JP, Benoit V, Rousseau B, Souberbielle JC. Consumption of Vitamin D-and Calcium-Fortified Soft White Cheese Lowers the Biochemical Marker of Bone Resorption TRAP 5b in Postmenopausal Women at Moderate Risk of Osteoporosis Fracture. J. Nutr. 2012; 142: 698–703 5. Weaver CM. How sound is the science behind the dietary recommendations for dairy? The American Journal of Clinical Nutrition. 2014; 99(suppl): 1217S–1222S

Super Cal Mag CALCIUM-MAGNESIUM SUPPLEMENT

Calcium and magnesium bone support formula EACH CAPSULE CONTAINS: Vitamin D (cholecalciferol)...... 1 .9 mcg / 75 IU • 150 mg of calcium and 75 mg of magnesium per dose Calcium (bovine bone meal/ dibasic calcium phosphate/ calcium carbonate)...... 150 mg • Plus 75 IU of vitamin D, 25 mcg of vanadium and 15 mcg of molybdenum Phosphorus (bovine bone meal/ dibasic calcium phosphate dihydrate)...... 75 mg Magnesium (magnesium aspartate/ oxide)...... 75 mg • Helps in the maintenance of bones and teeth Manganese (manganese citrate)...... 5 mg • Calcium intake, when combined with sufficient vitamin D, a healthy diet, Molybdenum (molybdenum Krebs t complex)...... 15 mcg and regular exercise, may reduce the risk of developing osteoporosis Vanadium (vanadyl sulfate)...... 25 mcg Non-Medicinal Ingredients: Hypromellose, cellulose, magnesium stearate, silica t Citrate / fumarate / malate / succinate / glutarate Super Cal Mag supports bone health with a mixture of calcium sources, magnesium, vitamin D, Contains: Egg and trace minerals. In healthy participants, a calcium carbonate supplement was found to have an equivalent bioavailability to calcium from skim milk or fortified orange juice.1 Vitamin Recommended Dose D provides additional bone health support by enhancing intestinal calcium absorption.2 Adult: Take one capsule daily with a meal, a few hours before or after taking other medications, or as recommended by your healthcare practitioner Vandium’s impact on bone health is an emerging research area, although preliminary in vitro and animal studies indicate that it may play a key role in bone formation osteogenesis. Size Product Code Vanadium is highly concentrated in bone tissue, due in part to its ability to substitute for 90 Vegetable Capsules 05212 phosphate in the bone mineral hydroxyapatite. Cell tissue studies demonstrate that vanadium 180 Vegetable Capsules 05212180 stimulates collagen synthesis in osteoblasts, which may support collagen levels in the NPN 80009536 extracellular matrix of bone tissue.3

REFERENCES 1. Martini L and Wood RJ. Relative bioavailability of calcium-rich dietary sources in the elderly. Am J Clin Nutr.2002; 76: 1345–1350 2. Castiglioni S, Cazzaniga A, Albisetti W, Maier JAM. Magnesium and Osteoporosis: Current State of Knowledge and Future Research Directions. Nutrients. 2013; 5: 3022-3033 3. Barrio DA and Etcheverry SB. Vanadium and bone development: putative signaling pathways. Canadian Journal of Physiology and Pharmacology. 2006; 84: 677-686

Consult label for risk information. 15 Notes

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