It is the start of a busy Wednesday morning and I walk into treatment room #2. One of my long-time patients is sitting on the treatment table, beaming at me, and says, “Doc, that stuff you gave me last month just rocked my socks!” Not quite knowing how to take that statement, I inquired, “Umm, how do you mean?” They replied, “My chronic knee pain is significantly better, and that deep hip pain is now well enough for me to sleep through the night!”
I hear patient feedback like this nearly every day since I introduced collagen as a targeted therapeutic in my clinic. Because collagen supplements are in high demand and have become ubiquitous, it’s important to know the facts behind the collagen you’re recommending to patients.
What to Look for in a Collagen Supplement
The literature supports four key ingredients to look for in a collagen supplement. They are:
- Collagen Hydrolysate: This ingredient boasts short-chain peptides with a molecular weight ideal for maximum absorption in the body. In research, collagen hydrolysate has been found to stimulate chondrocytes to produce type II collagen and aggrecan, which are the glue of the extracellular matrix.
- Hyaluronic Acid Extract: This ingredient provides ideal support for viscoelastic, lubricating properties of synovial fluid.
- Type I Collagen and Mucopolysaccharides: Type I collagen and mucopolysaccharides provide a support for tendons, ligaments and fascial tissue. Mucopolysaccharides add to the stretch and resilience of tendons and ligaments, and support proper tendon fiber healing.
- Magnesium and Vitamin C: Magnesium is often depleted in musculoskeletal tissue, leading to soreness, and vitamin C is a vital cofactor for the gradual cross-linking of collagen and connective tissue.
The Science Behind Collagen Supplements
When connective tissue repair and/or regeneration is needed, we need type II collagen and extracellular matrix material like hyaluronic acid and other polysaccharides to help aggregate, organize and heal connective tissue fiber to maximize strength, mobility and elasticity.
Healing without this support results in type III collagen, which is randomly oriented, immature and weak.
With proper nutrition support, we can reduce rehabilitation time and stimulate chondrocytes, fibroblasts and synovial cells, while reducing cytokines.1-3
A small sampling of the research:
- Type I collagen and mucopolysaccharides antagonize up-regulation of NF-?B-regulated proteins by IL-1? and downregulate expression of matrix metalloproteinases, which are linked with tendon matrix degradation in arthritis.4,7
- At Penn State, 147 athletes took collagen hydrolysate for 24 weeks and saw major improvements in joint mobility and joint health.5
- Multiple studies on hyaluronic acid extract suggest it can significantly increase synovial fluid production and reduce degradation factors in synovial fluid.6-7
Clinical Applications of Collagen
The research behind a supplement is extremely important to consider, but what about how the supplement is best applied clinically?
In my experience, patients with joint dysfunction have benefited greatly from collagen supplementation. The formula helps restore synovial fluid production, elasticity and resiliency of ligaments and tendons. But what defines joint dysfunction? Frozen shoulder comes to mind as a primary example. Generally I have found it to be a laborious process to rehabilitate patients with this condition, but with the right collagen formula, I can safely say that the process is reduced by at least 75%. It makes sense: Collagen supports restoration of synovial fluid production, elasticity, and ligament and tendon resiliency.
Acute injury restoration is another clinical application. Severe ankle sprain (class 2) is a very trying injury. By providing all the right building blocks, recovery time is greatly reduced, and scar tissue greatly minimized. I have also seen full function restored, which is extremely uncommon in this kind of injury.
The Bottom Line
Besides chronic and acute musculoskeletal issues, collagen supplementation supports the optimization of health. Too much emphasis is put on age, profession and stresses, both physical and mental. If we bolster our resilience, resistance and elasticity, as well as our capability to combat inflammation, we can slow down and even reverse the degenerative processes that are associated with the advancement of years and injuries. Age should not be an excuse!
- Iwai K, Hasegawa T, Taguchi Y, Morimatsu F, Sato K, Nakamura Y, Higashi A, Kido Y, Nakabo Y, Ohtsuki K. Identification of food-derived collagen peptides in human blood after oral ingestion of gelatin hydrolysates. J Agric Food Chem. 2005 Aug 10;53(16):6531-6. doi: 10.1021/jf050206p. PMID: 16076145.
- Oesser S, Adam M, Babel W, Seifert J: Oral administration of 1 4C labelled gelatin hydrolysate leads to an accumulation of radioactivity in cartilage of mice (C57/ BL). Journal of Nutrition, 129 (1999), 1891 – 1895 12)
- P. Lundquist, P. Artursson. Oral absorption of peptides and nanoparticles across the human intestine. Advanced Drug Delivery Reviews, 106(2016) 256-276
- Histol Histopathol (2011) 26:1173-1185
- Clark KL, Sebastianelli W, Flechsenhar KR, Aukermann DF, Meza F, Millard RL, Deitch JR, Sherbondy PS, Albert A: Long-term use of collagen hydrolysate as a nutritional supplement in athletes with activity-related joint pain. Curr Med Res Opin. 2008 May;24(5):1485-96.
- 6. Müller I, Martinez-Puig D, Chetrit C. Oral administration of a natural extract rich in hyaluronic acid for the treatment of knee OA with synovitis: a retrospective cohort study. Clinical Nutrition Supplements 2009;4(2):171-172
- Shakibaei M, Buhrmann C, Mobasheri A. Anti-inflammatory and anti-catabolic effects of TENDOACTIVE® on human tenocytes in vitro. Histol Histopathol. 2011 Sep;26(9):1173-85. doi: 10.14670/HH-26.1173. PMID: 21751149.
Adrian den Boer, ND, DC, IFMCP
Educated in both the Netherlands and the United States, Dr. Adrian den Boer is a board-certified and licensed Naturopathic and Chiropractic physician. In addition, Dr. den Boer is fully certified as a functional medicine doctor. Dr. den Boer has treated over 10,000 patients successfully by utilizing multiple resources to manage patient care. Most recently, he joined Lifestyle Matrix Resource Center as the Clinical Expert serving the MSK Solutions Pain Recovery Program.