Rheumatoid arthritis (RA) is a systemic autoimmune inflammatory disease characterized by chronic, symmetrical synovitis that leads to progressive destruction of joint structures, deformity, and severe disability. Classified as a chronic degenerative disease, one of RA's main pathogenic drivers is the gastrointestinal tract. The presence of intestinal dysbiosis (with an overrepresentation of pro-inflammatory species) and increased intestinal barrier permeability trigger local immune activation that is reflected systemically, fueling low-grade chronic inflammation (low-grade inflammation).
Recent clinical evidence also shows that patients with systemic autoimmune diseases have a significantly higher susceptibility to urinary tract infections (UTIs). This vulnerability is caused by both immunosuppressive therapies and alterations in the barrier microbiota, which serves as a reservoir for the migration of uropathogenic strains.
The use of probiotic microorganisms and standardized live yeasts is part of the clinical rationale to restore the balance of the intestinal and vaginal barriers to attenuate systemic immune hyperactivation. A major randomized, double-blind, placebo-controlled clinical study conducted by a research team from the Department of Nutrition, Biochemistry and Diet Therapy at the Tabriz University of Medical Sciences evaluated the impact of probiotic supplementation on 46 patients with RA (Vaghef-Mehrabany et al., 2014). Participants took one capsule daily for 8 weeks containing a minimum of CFU of Lactobacillus casei 01 or a placebo. At the end of the intervention, the probiotic-treated group showed a statistically significant reduction in the score related to disease activity (Disease Activity Score, ) compared to the placebo arm. The immunological analysis documented a clear improvement in the circulating cytokine profile: levels of pro-inflammatory cytokines Tumor Necrosis Factor alpha (TNF-), Interleukin-6 (IL-6), and Interleukin-12 (IL-12) decreased significantly (), while there was a targeted increase in the anti-inflammatory cytokine Interleukin-10 (IL-10) ().
This study confirms that intestinal microbiota modulation is able to mitigate the systemic inflammatory state in RA, positioning it as a fundamental pillar of adjuvant treatment.
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Daily Dosage Schedule
To optimize the bioavailability of the active biological compounds, respect the colonization times of probiotics, and ensure a constant anti-inflammatory and alkalizing barrier, the following daily intake schedule is recommended:
Morning (on an empty stomach, about 20 minutes before breakfast)
· 4 capsules of Bioalcalino 19 (with a large glass of water).
· 1 ml of Bioalcalino D (pure sublingually or diluted in a little water).
Lunch (during or immediately before the meal)
· 1 tablet of MOLTITUDO® LUNAE.
· 1 capsule of Aspaloe.
· 1 capsule of Cistaloe.
Dinner (during or immediately before the meal)
· 1 tablet of MOLTITUDO® LUNAE.
· 1 capsule of Aspaloe.
· 1 capsule of Cistaloe.
Integrated Rationale for Use and Moltitudo Product Characteristics
The Moltitudo therapeutic protocol is entirely formulated on a 100% vegan basis, using exclusively plant-based capsules (free from animal gelatin), naturally derived excipients, and standardized botanical active ingredients with high biological tolerability.
1. MOLTITUDO® LUNAE (1 tablet at lunch and 1 at dinner) – Pain and Joint Inflammation Control
The twice-daily intake corresponding to the main meals ensures constant coverage against the mediators of joint inflammation.
· Biological mechanism of action: Combines Pineapple Bromelain (1000 mg/day, 2500 GDU), with anti-edema and peri-articular interstitial fluid drainage action, with Boswellia serrata (500 mg/day titrated to 65% in boswellic acids), a powerful selective inhibitor of 5-lipoxygenase (5-LOX) that reduces the synthesis of leukotrienes responsible for swelling and joint stiffness. Tetrahydrocurcuminoids (140 mg/day), active metabolites of curcumin characterized by superior stability and intestinal absorption, act on the transcription factor NF-kB, blocking the activation of the low-grade inflammatory cascade upstream.
2. ASPALOE (1 capsule at lunch and 1 at dinner) – Joint Support and Collagen Synthesis
Concomitant administration with Lunae amplifies the synergistic effect on connective tissues thanks to the contribution of natural salicylates and antioxidant cofactors.
· Biological mechanism of action: Provides dry extract of White Willow (630 mg/day, titrated to in salicin, equal to 95 mg of pure salicin). Salicin is converted in the liver to salicylic acid, exerting an anti-inflammatory and analgesic action through the inhibition of cyclooxygenases (COX), reducing localized tension states without inducing the typical gastrointestinal damage of synthetic salicylates. Highly titrated extracts of Rosehip and Acerola (which provide a total of 133 mg of natural Vitamin C, equal to 165% of the NRV) are essential biological cofactors for the synthesis of type II collagen, a structural element of cartilage and bones, and work in synergy with Vitamin E to preserve cell membranes from oxidative damage.
3. CISTALOE (1 capsule at lunch and 1 at dinner) – Microbiota Integrity and Urogenital Protection
The intake of Cistaloe at lunch and dinner, in synergy with Aspaloe and Lunae, responds to the clinical need to stabilize the enteric barrier and prevent uropathogenic colonization.
· Biological mechanism of action: Provides a massive concentration of vital probiotics (equal to 31.7 billion microorganisms per daily dose of 2 capsules), specifically selected for their gastric resistance and mucosal adhesion capacity: Lactobacillus acidophilus (20 billion), Lactobacillus plantarum (10 billion), Lactobacillus rhamnosus (10 billion), the transit-resistant yeast Saccharomyces boulardii (1 billion) and the sporogen Bacillus coagulans (700 million). This pool restores intestinal eubiosis and reduces the translocation of pathogens to the urinary tract. The formula is completed by 200 mg of Cranberry (titrated to in PACs, equal to 80 mg of active proanthocyanidins), which inhibits the bacterial adhesion of type A fimbriae of Escherichia coli to the urothelium, and by 200 mg of Turmeric (titrated to in curcuminoids), which exerts a local antioxidant action and promotes an eubiotic intestinal microenvironment.
4. BIOALCALINO 19 (4 capsules in the morning) – pH Regulation and Multitarget Support
The morning intake on an empty stomach ensures the activation of the body's buffering systems, countering the latent metabolic acidosis induced by the chronic inflammatory state.
· Biological mechanism of action: Provides a multifactorial phytocomplex that combines alkalizing minerals and standardized dry extracts such as Devil's Claw (standardized to arhagoside, the phytotherapeutic of choice for joint function) and Spirea ulmaria (a source of salicylic derivatives for joint comfort). The synergistic action of Cranberry (an additional 60 mg of PACs, which in clinical studies on patients with RA have shown a clear reduction in DAS28 clinical disease activity and anti-CCP antibody titers), combined with the structural organic silicon from Bamboo and Horsetail, and microcirculation extracts (Scots pine and Vitis vinifera rich in proanthocyanidins), counters bone resorption mediated by osteoclasts induced by the acidic inflammatory environment.
5. BIOALCALINO D (1 ml in the morning) – Immunomodulatory Support and Mineral Metabolism
Morning administration, together with Bioalcalino 19, ensures the optimal supply of Vitamin D3 and essential fatty acids that are precursors to anti-inflammatory pathways.
· Biological mechanism of action: Provides natural Vitamin D3 extracted from Icelandic lichen (Cladonia rangiferina), 2000 IU per ml, 1000% NRV), a key molecule for immunomodulation capable of inhibiting the differentiation of autoreactive Th1/Th17 lymphocytes responsible for joint damage in RA, while simultaneously stimulating regulatory T lymphocytes (Tregs). The lipid fraction consists of Flaxseed Oil, Borage Oil and Evening Primrose Oil, which provide a balanced profile of Omega-3 polyunsaturated fatty acids (alpha-linolenic acid), Omega-6 (linoleic acid and gamma-linolenic acid - GLA, 95 mg) and Omega-9. GLA and Omega-3s divert arachidonic acid metabolism toward the synthesis of anti-inflammatory prostaglandins of the 1 and 3 series (PGE1, PGE3), protecting the integrity of cell membranes and improving synovial mobility.
PLEASE NOTE: The information provided in the product sheets on this website is for informational and educational purposes only and does not represent medical advice. The published content is not intended to replace the relationship with a doctor or any medical advice, diagnosis, or prescriptions. The information provided describes the ingredients and characteristics of food supplements, designed to support the balance and well-being of the body within a healthy lifestyle. Food supplements are not medicines and must not be used to prevent, diagnose, treat, or alleviate diseases or pathological conditions.
Bibliographic References
· Vaghef-Mehrabany, E., Alipour, B., Homayouni-Rad, A., Sharif, S. K., Asghari-Jafarabadi, M., & Zavvari, S. (2014). Probiotic supplementation improves inflammatory status in patients with rheumatoid arthritis. Nutrition, 30(4), 430-435. (Randomized controlled clinical study on the effects of probiotics in RA).
· Thimóteo, N. S. B., Iryioda, T. M. V., Alfieri, D. F., et al. (2019). Cranberry Juice Decreases Disease Activity in Women With Rheumatoid Arthritis. Nutrition, 60, 112-117. (Evidence on the clinical efficacy of cranberry in reducing DAS28 and anti-CCP autoantibodies).
· Howell, A. B., Reed, J. D., Krueger, C. G., et al. (2005). A-type cranberry proanthocyanidins and uropathogenic bacterial anti-adhesion activity. Phytochemistry, 66(18), 2281-2291. (Anti-adhesion mechanism of action of A-type PACs).
· Chrubasik, S., Eisenberg, E., Balan, E., Weinberger, T., Luzzati, R., & Künzel, O. (2000). Treatment of low back pain exacerbations with willow bark extract: a randomized double-blind placebo-controlled trial. American Journal of Medicine, 109(1), 9-14. (Clinical study on the efficacy of White Willow extract).
· Rein, E., Kharazmi, A., & Winther, K. (2004). A herbal remedy, Rosa canina, reduces pain and improves flexibility in patients with osteoarthritis. Phytomedicine, 11(5), 383-391. (Clinical action of Rosa canina galactolipids and polyphenols on joint mobility).
· Ammon, H. P. (2016). Boswellic acids and their role in chronic inflammatory diseases. Advances in Experimental Medicine and Biology, 928, 291-327. (Biochemical inhibition of 5-LOX by Boswellia).
· Majeed, M., et al. (2015). A randomized, double-blind, placebo-controlled, comparative clinical study on the evaluation of safety and efficacy of tetrahydrocurcuminoids. Journal of Dietary Supplements, 12(4), 371-389. (Superior stability and bioavailability of tetrahydrocurcuminoids).
· Reed, G. W., Leung, K., Rossetti, R. G., Vanbuskirk, S., Sharp, J. T., & Zurier, R. B. (2014). Treatment of rheumatoid arthritis with marine and botanical oils: An 18-month, randomized, and double-blind trial. Evidence-Based Complementary and Alternative Medicine, 2014. (Clinical efficacy of botanical oils rich in GLA and essential fatty acids in controlling joint pain).
