Several weeks ago, a client with an unusual metabolic case started sending me link after link of supplement products with the word “metabolic” in them. Some of them I had recommended over the years for various EMS and PPID horses, but others I had never taken the time to review. I wanted to explore a greater range of products on the market using the term “metabolic” and do a comparison of the companies, ingredients, guaranteed analysis, and cost per serving of this supplement category. This article reports my findings. As usual, it is beyond the scope of this comparison to argue the efficacy of each ingredient. I’ve already wasted too many hours looking for proof of efficacy that doesn’t exist so I remain ever skeptical. I’ll leave the efficacy discussions to Rate My Horse Supplement Reviews at a later time.
MARKETING CLAIMS:
What does it mean to be a “metabolic” supplement?
It’s important to define what we mean when we use the word “metabolism”, because the dictionary definition is broad as is the equestrian use of the noun. According to Wikipedia, metabolism is defined as the “set of life-sustaining chemical reactions in the organism”. That’s a lot of reactions. However, in the world of equine nutrition, we know from context that supplement companies are using the word in a much narrower fashion.
Presumably, when an equine supplement company uses the terms “metabolic” or “metabolism” they are targeting owners with horses suffering from or predisposed to insulin resistance, equine metabolic syndrome (EMS), pituitary pars intermedia dysfunction (PPID; aka Cushings) and ultimately, laminitis/founder. I say “ultimately, laminitis/founder”, because the most serious, life threatening complication of horses diagnosed with IR, EMS or PPID is their increased risk for endocrinopathic laminitis. Yes, there are other symptoms of these diseases, but they are not as deadly as laminitis. When a client tells me that they are considering a metabolic supplement, I know that their nutrition goal is to prevent laminitis, whether for the first time or repeat occurrence.
I also use the term “endocrinophathic laminitis” very specifically as this removes laminitis caused from mechanical or toxicologic reasons. Endocrinopathic laminitis relates to dysregulation of certain “metabolic” hormones such as insulin which regulate glucose (blood sugar) transport in and out of cells.
*For information about any of these diseases, I would suggest the Michigan State University website.
In the marketing claims for metabolic products, you’ll commonly come across phrases like “regulate blood sugar and insulin activity”, “support glucose tolerance”, “improve metabolism of carbohydrates”, or “help horses achieve a healthy weight”. CryptoAero is bold and makes the claim that their metabolism supplement, a 38 gram blend of plant products, “may help prevent EMS as well as reduce symptoms in horses that have IR and/or PPID”. HEIRO (Healthy Equine Insulin Rescue Organicals” by Equine Medical & Surgical Associates claims to “combat elevated insulin”. *I wish they would email me back to let me know what “organicals” are! These marketing claims support our assumption that companies are targeting owners with horses suffering from the class of “metabolic” disease listed above and managing the increased risk of laminitis. It’s a very profitable demographic to market to as the percentage of laminitis in the US and UK equid populations is at an all time high. Plus, laminitis is irreversible, and the owners must manage a heightened risk for the rest of the horses’ lives. Even more importantly, these owners are desperate for help and solutions. The unregulated supplement industry is very eager to fill this void.
COMPARISON OF FEEDING DIRECTIONS, CAUTIONS, WARNINGS
In order to compare product labels, we will start with OCEN’s 11th Commandment which is “though shall read the feed label backwards!” That means that we start with the caution, warnings and feeding directions on the supplement labels. We do this, because we cannot fairly compare guaranteed analyses or the function of the product without understanding the feeding directions first. The feeding directions put us inside the minds of the creator! If this idea is new to you, consider taking next month’s 5 Star Equine Nutrition Course. In the comparison charts below, I have stuck with the measuring unit used by the supplement company. Most use grams, but a few use ounces, so it’s important to know that there are about 28 grams in an ounce. The feeding rates for a 1,000 lb horse ranged between 9.4 grams (0.34 oz) instructed by Equine Medical and Surgical’s HEIRO and Brookside Supplement’s Command Noble to 170 grams (6.07 oz) as instructed by Life Data Lab’s Insulin R Formula. True to this single function supplement category, they all want you to feed 1 to 2 scoops which is the magic number in equine nutrition solutions. The only exception is EquiThrive Metabarol at 4 scoops per day for a 1,000 lb horse.
Out of the 18 products that I compared in my "Equine Metabolic Supplement" Google search, four of them commit a major OCEN’s supplement sin. That is the feeding directions instruct the same serving regardless of the size of the horse. As you can imagine, the less we know about how a product behaves in the horse, the more vague the feeding direction will be. Therefore, these four products immediately get discounted; Equine Medical and Surgical HEIRO, Brookside Supplements Command Noble, Uckele GTF, Command Noble, and SmartPak's Smart Metabo-Lean. HEIRO somehow fits a dozen plants into 9.4 grams (the equivalent of 9.4 paperclips) and then recommends feeding a 400 lb mini or a 1,400 lb warmblood the same amount.
I also want to point out that several of these supplement labels recommend management and other feeding changes in their directions. Suggestions like “remove from pasture” or “stop all grain feeding” is good advice. However, because the owner will rightly make many management and feeding changes alongside the inclusion of these products, how are we supposed to know that the products are working? Is the positive online review because the product changed the horse's complex metabolic system or because several management changes were made alongside heavy medication? I think most of the time we do not know which management, feeding change, nutraceutical and pharmaceutical, or combination of all four was the magic ticket, so we give these supplements 5 star reviews and continue them indefinitely. It’s a cycle that I see many of my clients trapped in. It’s appropriate for these supplement companies to suggest management changes, but it’s also not clear if the supplement is the key factor to the horse's improvement. Would the horse have improved without the 1 or two scoops of powder or pellet?
The labels' cautions and warnings stood out to me in the metabolic supplement category. Rather than discredit the Caution's and Warnings, I think a supplement company should be applauded for using them. Suggesting that there are scenarios when this supplement should not be used is a responsible thing to communicate. For example, some of these products should not be fed to pregnant mares or to horses at risk for ulcers. The most common caution statement was “if animals’ condition worsens or does not improve, stop product administration and consult your veterinarian.” That sounds very reasonable, no?
COMPARISON OF INGREDIENTS & GUARANTEED ANALYSES
Like every equine supplement category that I’ve compared to date, the ingredients lack a central theme. In the metabolic category of equine supplements we see everything from isolated vitamins, minerals, amino acids, and fatty acids to a dozen different plants and algae. It makes it extremely difficult, if not impossible, to compare products. Where do you even start? Even if you could rate each ingredient with an effectiveness number, let’s say between 1-100 in how effective it has been shown to meet marketing claims, it would still be difficult to compare, because everyone is using different ingredients mixtures at different levels. Some products mix a dozen herbs together, another is focusing on minerals, another tosses in some amino acids, and another is blending 44 ingredients that sound ok. Obviously, no one has THE definitive answer to solving the problem of laminitis.
In order to make some reasonable sense of the metabolic supplement category, I'm doing my normal "Natalie" thing and putting each metabolic supplement into one of four categories; mineral heavy, herbal heavy, nutraceutical, and confused.
I'll start with the "mineral heavy" category, because one of the first things that I noticed was an emphasis on magnesium and chromium. This category had the longest list of products. Magnesium and chromium were the most common “active” ingredients across 18 supplements which shocked me with their low-tech nature. No magic potions here. Just plain old good trace mineral nutrition, and it makes sense seeing as both magnesium and chromium are needed in carbohydrate metabolism.
However, don't be fooled as research into chromium supplementation in horses with metabolic disease has not been conclusive according to the National Research Council's Nutrient Requirement for Horses (2007 Edition). You can find chromium in the ingredients list as chromium propionate, tripicolinate, polynicotinate, or chromium yeast, so there's that complication to consider. The highest levels of chromium in a recommended serving for a 1,000 lb horse was 5mg from Santa Cruz Animal Health Metabolic Support Supplement for Horses which is considered safe and reasonable.
Magnesium seems to be enjoying a cure-all status these days in equine nutrition, so it's not surprising that it's a common ingredient in equine metabolic supplements. It's an easy one for companies to add, because the list of enzymes that rely on magnesium is high, it's relatively safe, and it's very cheap. You can find magnesium in these supplements as either magnesium citrate, oxide, sulfate, rice chelate, or proteinate. The highest level found was 8.8 grams in a recommended serving of Uckele Glycocemic EQ Pellets. For comparison, an 1,100 lb horse in moderate work needs at least 11.5 grams of magnesium in the diet. Toxic levels of magnesium have not been determined according to the NRC 2007.
Zinc, copper, and selenium were also common mineral ingredients which makes sense, because these nutrients are strongly associated with good hoof health. In this "mineral heavy" category you'll find...(in no particular order)
D-Carb Balance by Med Vet Pharmaceuticals (MVP)
Quiessence by Foxden Equine
Metabolic Support Supplement for Horses by Santa Cruz Animal Health
Remission by AniMed
GTF Chromium Powder by Uckele
Metabolic Support by Platinum Performance
Laminex by MVP: I'm putting this product here, but it's actually, first and foremost, a trace mineral supplement and not a single function supplement. That means that it should NOT be fed with other trace mineral sources! Consult a nutritionist before using this!
The second largest category was the "herbal heavy" products. These products contained a long lists of plants and algae in their ingredients list such as fenugreek, spirulina, kelp, cinnamon, ginger, willow, peppermint, milk thistle, jiaogulan, chia seeds, chaste berry, yarrow, and turmeric. We don't know what part of the plant, at what levels, or what nutrients the plants are rich in, but this category is one of the best sellers. It includes products such as...
HEIRO by Equine Medical and Surgical
Command Noble by Brookside Supplements
Laminitis Ease by V-Point Premium Vet Powder
Metabolism by Crypto-Aero
The next metabolic supplement category, I'm calling "nutraceuticals", because the main ingredient, resveratrol, belongs in its own category. Some serious attempts have been made to show positive effect in overweight/insulin resistant horses with promising results. Kentucky Performance Products Wiser Concepts actually requires a veterinarian prescription to use their product Insulin-Wise. The EquiThrive Metaboral product does not require a prescription, but it has similar levels of resveratrol. Since I've already dived into the efficacy of this product on Rate My Horse Supplement, I will leave the LINK HERE.
The final category, I'm calling "confused", because they don't fit into the other three categories. They include SmartPak's Smart Metabo-Lean and Smart-Lamina Pellets, Insulin R by Life Data Labs, and Glycocemic EQ by Uckele. The Smart Metabo-Lean is guilty of one of my top supplement sins which is trying to fit an unrealistic number of ingredients into one 60 gram scoop. In just over 2 oz, you can find no fewer than 33 ingredients and they include vitamins, minerals, herbs, and lots of sound-good ingredients. I do not recommend products that try to be everything in one, because by diluting so many ingredients into a few grams of product, the value of each ingredient is diminished. The Life Data Labs Insulin R Formula appears to be on theme for this company, mixing a blend of amino acids with vitamins and a couple trace minerals. The Uckele Glycocemic EQ Pellets really threw me for a loop with no theme at all. I applaud some company's attempts to throw a bunch of anti-inflammatories together, but I wouldn't recommend these mixes at the recommended feeding rates and guaranteed levels. When I add anti-inflammatories to a horse's diet (and I do most of the time), I want them to be much harder hitting!
COMPARISON OF COST
And finally, we come to the end-all-be-all discussion of cost where the supplements with the greatest promise get their feet held to the fire! Can they make sense, be effective, AND affordable? That is the question!
The winner of the Highest Daily Cost Award goes to EquiThrive Metabarol at $5.88 per 50 gram serving as of March 2024 (3.3 lb bucket sourced at equithrive.com). This is disappointing for two reasons; first because it contains one of the only ingredients backed by research, but also because this supplement is more convenient than Wiser Concepts InsulinWise which must be purchased through a veterinarian. The other high rollers were Insulin R by Life Data Labs, Glycocemic EQ Pellets by Uckele, and Metabolism by Cryto-Aero. Since all four of those products committed OCEN supplement sins, I won't worry about their high cost.
The lowest costing equine metabolic supplement that I compared was the GTF Chromium Powder by Uckele at $0.48 per 10 gram serving (2 lb container from smartpakequine.com). If If I was absolutely certain that the other feeds and supplements in my program did not already contain chromium, I would consider this product. Other equine metabolic supplements costing less than (or very near) $1.00 per day are Remission by AniMed and Command Noble by Brookside Supplements. One is in the "mineral heavy" category and the other is in the "herbal heavy" category. Pick your potion.
If you want to listen to some research backed advice about HUMAN obesity, diabetes, and metabolism like I do to inform my equine decisions, you might find this YouTube video interesting..."Eating Precisely: Merging Nutrition with Individualized Factors to Optimize Metabolic Health" with Dr. Suneil Koliwad, Endocrinologist and an expert in Diabetes, Obesity, and Metabolism. His free presentation, hosted by University of California in 2020, can be found on THIS LINK HERE.
SUMMARY
What did my search for "metabolic support" supplements reveal.
The most common ingredients are the minerals magnesium and chromium which are shockingly simple and low tech. You don't need to spend much to add these to your horse's diet, and they are likely to be in your fortitifed products alresdy.
Out of all the herbal ingredients, the fenugreek stood out as the most common. According to the NCCIH, "a small number of studies have suggested that fenugreek may help lower blood sugar levels in people with diabetes or prediabetes, but most of these studies were not of high quality" (NCCIH, 2020).
The cost of a nutraceutical called resveratrol is reasonable when purchasing Wiser Concepts InsulinWise through your veterinarian.
An already well-balanced, anti-inflammatory diet does not require the addition of these metabolic supplements.
REFERENCES
United States Department of Health & Human Services. National Institute of Health. National Center for Complementary and Integrative Health. August 2020. Fenugreek. Accessed on April 5, 2024 at https://www.nccih.nih.gov/health/fenugreek#:~:text=Potential%20side%20effects%20of%20fenugreek,allergic%20reactions%20in%20some%20people.
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