Can Collagen Supplements Help Arthritis?
Research suggests they may have benefits for osteoarthritis and bone health. Learn what to look for.
Collagen is the glue that holds your body together. This critical protein gives structure and support to connective tissues, including your skin, bones, ligaments, tendons and the cartilage that protects your joints.
It is made up of three amino acids — often a combination of glycine, proline and hydroxyproline. Types of collagen vary, depending on how the molecules are arranged and where collagen is used in the body. Scientists have identified 28 types of collagen, but four or five usually make it into dietary supplements.
- Type I — by far the most abundant — is found in your skin, teeth, bones, tendons and ligaments.
- Type II makes up about 90% of the collagen in cartilage.
- Type III is in the skin’s middle layer (dermis), muscles and blood vessels.
- Type IV is a thin layer of tissue supporting cells in the kidneys, lungs, intestines and eyes.
- Type V is in hair and cell surfaces.
Type X collagen, found in bone and joint cartilage, is a potential biomarker for osteoarthritis (a biological indicator that the condition is present). In studies, people with osteoarthritis (OA) were more likely to have high levels of this type of collagen.
Hydrolyzed vs. Undenatured Collagen
There are two main types of collagen dietary supplements:
- Hydrolyzed collagen (also called collagen peptides or collagen hydrolysate). This type of collagen is easier for your body to absorb and use. It’s often in powder form and dissolves in liquids like smoothies and coffee. Much of the quality of hydrolyzed collagen depends on how it’s processed.
- Undenatured type II collagen (UC-II). Undenatured collagen hasn’t been broken down or exposed to heat, acids and enzymes. It’s almost always derived from chicken breastbone cartilage, whereas hydrolyzed collagen can come from a variety of animal sources, including hides, hooves, bones and scales from cows, pigs or fish.
Your body makes collagen when it breaks down the protein you eat into amino acids. The problem is that the process slows with age. Collagen starts declining by age 25 or 30; after age 40, about 1% a year is lost. By age 80, your body has a fraction of the collagen it had when you were young. Smoking, drinking alcohol, getting too much sun, and too little exercise and sleep speed up the loss. So do menopause and autoinflammatory forms of arthritis like rheumatoid arthritis and lupus. Not only does the body make less collagen, its quality isn’t as high as it is in younger bodies. Collagen supplements, which generate $2 billion in annual revenue in the U.S., are marketed as helping to restore youthfully smooth skin and flexible, pain-free joints. While these supplements aren’t the fountain of youth, they do have cosmetic and health benefits.
What the Research Says
Collagen supplements have been investigated as treatment for a host of problems, including aging skin, wound healing, OA, RA, bone health (osteoporosis) and high cholesterol. Most trial results have been at least modestly positive, although some studies lack in quality.
- Skin health. Most of the hoopla about collagen is its rejuvenating effect on skin. A recent review and meta-analysis of 19 studies involving more than 1,000 people looked at collagen for skin health and wound healing and found excellent results for both. Collagen supplements taken for three months significantly improved skin hydration, elasticity and density. Many other studies, some dating back decades, have had similar findings. One 2018 randomized controlled trial compared a daily dose of 1,000 mg collagen peptides with placebo. After 12 weeks, collagen users not only had more elastic and hydrated skin, they also had fewer wrinkles. A 90-day study of a liquid fish collagen reported equally glowing results. None of the studies reported any side effects, though some real-world collagen users have complained of stomach upset.
- Osteoarthritis. Collagen has been extensively studied as a potential OA treatment. Research quality varies, but most findings are positive.
- One small observational study found that a hydrolyzed collagen called Promerim significantly reduced pain and stiffness in people with knee OA. Patients were only followed for a month, however, and there was no control group.
- A more robust randomized trial compared 40 mg a day of UC-II collagen to glucosamine plus chondroitin and to placebo. After six months, people taking UC-II had significantly less pain and stiffness and better function than did the other two groups.
- An analysis of 41 animal and human studies, including 25 clinical trials, found that collagen benefited OA and aided cartilage repair, no matter what the dose, type or brand of collagen.
- Rheumatoid arthritis. Collagen is anti-inflammatory, so scientists reason that it may help RA and other inflammatory forms of the disease. As yet, there’s no clear evidence it does, mainly due to a lack of well conducted trials.
- Osteoporosis. Bone is mostly collagen, but it’s not certain that collagen can rebuild lost bone. To put doubts to rest, a year-long randomized controlled trial of more than 100 postmenopausal women with low bone mineral density (BMD) reported that 5 grams of collagen peptides a day significantly increased BMD in the spine and upper thigh compared to placebo. High blood pressure also dropped considerably in those taking collagen supplements.
Collagen is derived from food, so even if you don’t get spectacular results, it won’t cause any harm. But here are a few things to consider:
- If you’re vegetarian or vegan, understand that collagen is always derived from animals. You can buy plant-based products that contain nutrients needed to make collagen like vitamin C and zinc, but plants don’t contain collagen.
- The best amount of collagen to take depends on the source, your pocketbook and what you’re trying to achieve. Stick with about 40 mg a day of UC-II; studies of hydrolyzed collagen have used 2.5 to 15 grams a day, but some experts think more may be better.
- Bone broth and gelatin have been touted as good sources of collagen. But commercial bone broth varies in quality and what is often marketed as bone broth may not be. (Vinegar should be in the ingredient list.) Pure, unflavored gelatin is a cooked, less robust form of collagen and is more challenging to use.
- ConsumerLab, an independent organization that tests and reviews supplements, found that most collagen products contain exactly what the label says. Only one was found to contain a contaminant, a toxic metal called cadmium.
- Think of collagen supplements as a life-time commitment. As you get older, your body gobbles collagen up just as fast or faster than you can replace it.