NutriStart Naturally JointStart Premium - Like regular JointStart, the Premium formula also works to rebuild cartilage and connective tissue, addressing the damage causing the pain. However, Premium is a more powerful, faster working pain reliever and anti-inflammatory. In order to accomplish this, some of the re-building agents have been traded-off for more anti-inflammatory substances. This formula will serve those with aggravated inflammatory conditions, who may wish to revert to regular JointStart for ongoing rebuilding, in cases of osteoarthritis. While the Premium formula will be a better ongoing choice for those with sports injuries, bursitis, tendonitis, carpal tunnel and rheumatism.