Best Collagen supplements for joints. Trendy craze or legitimate hype?

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Collagen supplementation has received a plethora of publicity over the past few years. Is it just trendy or is there legitimacy to the excitement? Collagen is flaunted as a supplement that can provide skin health, reduce wrinkles, reverse aging, help ease joint pain and increase collagen production, help improve healing from long term injury, and increase muscle mass. 

Let’s look a bit deeper at collagen’s role and then at the science to determine whether collagen should be part of your daily strategy to a healthy active life.  

Collagen-what is it?

Collagen is a vital protein; in fact, it is the most plentiful protein in all animals (1). There are 19 different amino acids present in collagen, but because it lacks tryptophan (one of the nine essential amino acids), it is considered an inadequate dietary protein source (4). There are more than 25 types of collagen, but more than 80% of all the collagen in the human body are Types I, II, and III- with Type I being the most prevalent (1). Amazingly, 30% of all proteins in the human body are collagen and consist of connective tissues (tendons, ligaments, bones, fascia, muscles, cartilage, skin, teeth, the eye, the submucosal layer of the small intestine, hair, nails, and blood vessels). As the name implies, connective tissues connect different tissue and act to hold tissue together within the body (4). In fact, the origin of the word collagen (1860-1865) comes from the Greek word, kolla which means “glue.”

The basic structural unit of collagen is a triple helical molecule forming long, thin, interlaced fiber type molecules (2,5). Glycine, proline, and hydroxyproline are highly abundant in collagen and contribute to the triple-helical structure of collagen (2,3). There is a repeating motif with these amino acids–namely Gly-Pro-X, and X can be any amino acid (2,4).  These long fiber type molecules interlace to form a type of scaffolding or glue in which other proteins, like elastin or proteoglycans, are embedded which contribute to their function of support. Sometimes this matrix is dense and structured as in ligaments and tendons, and sometimes it is irregular and loosely packed as in the thin, strong material that surrounds our organs and holds them in place (5). The triple-stranded helical structure gives collagen its structural integrity and strength. Type I has amazing tensile strength and can be stretched a lot without tearing; Type II molecules are combined within a viscous matrix of proteoglycans that resist deformity, which gives them an amazing ability to absorb shock.

Most abundant types of collagen in the human body:

Type I is the most abundant natural collagen and is found in skin, hair, ligaments and tendons, bone, fascia, nails, and dentin in teeth.

Type II is the predominant collagen of cartilage and the eye-ball (vitreous humour).

Type III is plentiful within the skin, muscles, and blood vessels and is usually found in conjunction with Type I.

Structural integrity of collagen is vital to a healthy, active human being

Certain aspects of one’s lifestyle can irreversibly damage existing collagen- namely high sugar intake (through a process called glycation), poor nutrition, smoking, UV radiation and pollution (6,7). To make matters worse, as we age, synthesis of collagen decreases dramatically. Thus, we produce less collagen in our skin and connective tissues. This decrease begins in the mid-twenties and by age 60 our collagen production can decrease by at least 50%. With the age- related decrease in collagen coupled with lifestyle collagen damage, we see the following detrimental effects: 

-Our skin care becomes less elastic and wrinkles become more prominent.

-We lose the tensile strength in our ligaments and tendons and they become prone to injury.

-Cartilage shows increase wear and tear with age and is exacerbated by intense physical activity resulting in joint pain and mobility issues (8).

-There are blood pressure changes with age due to the loss of elasticity of blood vessels due to decrease in collagen production.

-There can be a decrease in bone density and skin elasticity with age resulting in increased risk of fractures (8).

-Decline of muscle mass (sarcopenia) and weight loss which results in loss of functional physical performance, weakness and imbalance (9).

In addition, disease, poor nutrition and genetics can adversely affect the connective tissue, thereby rendering it weak and susceptible to injury with normal activity.

Where does collagen come from?

Raw collagen comes directly from the not so edible parts of animal: tendons, bones, gristle, and cartilage. These animal products are usually beef (bovine) or fish (marine) and sometimes pig (porcine) and chicken (poultry). When these parts are cooked in broth for a long period of time, to make bone broth (ancient nutrition for health and wellness), we get a gelatinous material (gelatin). Gelatin is simply collagen heated up (denatured) and is actually made up of very long peptide strings of amino acids, which are too big to be useful to improve joints, hair, skin and nails at a therapeutic or restorative level. Even though bone broth does have great nutritional value and may even be rich in vitamins, minerals, and collagen protein, it is not the most efficient way to address the need for increased collagen production in select tissues.

We need to make these long peptides easier to absorb in our bodies. By making them easier to absorb like a protein powder as a dietary supplement, we are making them more bioavailable and therefore more useful. Hydrolyzation is simply cutting up these long peptide chains into very small particles that can be absorbed intact and taken to where they are needed, such as to the skin and joints to help produce new collagen. 

Why Hydrolyzed collagen?

This is where the bioactive quality of collagen hydrolysates are noteworthy.  These peptides have a few valuable functions. First, they can be absorbed, broken down into individual amino acids and used in the production of collagen or any other protein needed in the body. Second, the high prevalence of proline and glycine amino acids in collagen contributes to very strong bonds allowing a small percentage to be absorbed intact. Remarkably, these whole peptides can, then, bind to receptors on specific collagen-producing fibroblasts, thereby stimulating them to produce collagen. Finally, the peptides can also act as an antioxidant due to the hydrophobic amino acids in the peptide, preventing oxidative damage to existing collagen (6, 10). Thus, hydrolysates may be able to both increase collagen production and prevent collagen damage.

Undenatured collagen-What’s the difference?

Undenatured collagen (UC-II) has a very different function from hydrolyzed collagen peptides. It is not meant to rebuild collagen or be used as a substrate for rebuilding collagen like bioactive collagen hydrolysates. UC-II is often taken in the hopes of improving symptoms of osteoarthritis. This supplement is meant to be taken in very small doses (20-40mg/day) as a small external inoculation of cartilage protein to help stop the body’s immune system from attacking its’ own cartilage. By taming the immune response, one can effectively reduce the inflammatory response that causes damage and pain. This process is called “oral tolerance” (15).

Are there Real benefits to oral collagen supplementation? What the science says…

Collagen is brandished as a supplement that can increase muscle mass, improve joint pain, increase collagen production, reduce wrinkles, increase bone density, speed healing and recovery from injury. Lofty claims or valid science?

Since athletes subject themselves and their bodies to repetitive and often extreme strain, soft tissue injuries to muscles, ligaments, and tendons are commonplace.

Two, randomized, placebo-controlled, double-blind studies were conducted at two different universities looking at activity related joint pain among athletes. The first was conducted at Penn State University in University Park, Pennsylvania between 9/2005 and 6/2006 where 97 athletes received either 10 grams collagen hydrolysate (CH) or placebo for 24 weeks. Outcome measurement for efficacy was change in visual analog scales (VAS) from baseline, in reference to inflammation, pain, and changes in mobility. Compared to the group receiving placebo, the CH group had definite clear improvements but not statistically measurable because of the many VAS outcome measurements. One issue with this study is the athletes were from different sports and had different athletic abilities, so the conclusions were a bit subjective. With that said, the study shows that supplementation may reduce joint wear and tear among the athletic population at large and may have a positive effect on athletic performance overall, but more research must be done (11).

The second of these studies was conducted at the University of Freiburg in 2016/2017. This study evaluated the effects of supplementing 5 grams of oral collagen hydrolysate (bioactive collagen) or placebo among college athletes aged 18-30 years for 12 weeks to determine whether or not collagen supplementation improved activity related knee pain. Study participants engaged in greater than 3 hours training/exercise per week and had no disease or existing joint damage at the time of the study.  Knee joint pain was measured by VAS (visual analog scale) and the collagen group showed significant improvement in knee pain with activity and at rest (12). The efficacy of collagen peptide supplementation in reducing physical stress related joint pain was demonstrated in this study and did show statistical significance. Accordingly, collagen peptides may be a conceivable alternative in treating stress related joint pain. This also suggests that collagen peptides may help act as a safeguard to protect collagen among the very physically active population (12).

In another randomized, double-blind, placebo-controlled trial, 80 patients with joint pain related to hip and/or knee osteoarthritis were evaluated to see if supplementation with chicken sternal cartilage (Type II) collagen for 70 days could improve joint discomfort and improve quality of daily activities. Findings were promising, as there was a roughly 30% improvement in pain in more than half of those taking the collagen supplement compared with placebo. The collagen supplement in this case was not a hydrolysate of mixed collagen powder; rather it was in a capsule form called Bio cell which contains about 570mg Type II hydrolyzed chicken sternal collagen along with 190mg chondroitin and 95mg hyaluronic acid. Studies like this one have shown that Type II collagen may stimulate the chondrocytes (cells that make cartilage) in the joints and fibroblasts (cells in skin that make collagen) to increase collagen production (13).

The exact mechanism of clinical effectiveness of collagen supplementation is still not clear and is the subject of ongoing research. One possibility is that bioactive collagen peptides may stimulate Type II collagen synthesis and supporting structural proteins, like the proteoglycans in articular cartilage. Another possible mechanism might be a decrease in pro-inflammatory mediators and a decrease in degradation pathways, controlling inflammation and catabolism (breakdown) of collagen structures (7). It has also been demonstrated that bioactive collagen peptides increase in the plasma after ingestion. Studies conducted with in vivo mouse models have shown that these functional peptides do indeed increase in the skin, suggesting an increase in collagen production after ingestion of these peptides (14). In vitro cell culture models also show an increase in collagen production fibroblast and a decrease in degradation when collagen is added (10).

It is worth mentioning the results of two other randomized controlled trials with Type I collagen supplementation. In one, sarcopenic men experienced improved muscle strength and body composition after 12 weeks collagen supplementation coupled with resistance training (9). In another study, bone mineral density (BMD) improved in postmenopausal women who had age related decline in BMD after 12 months supplementation (8).

UC-II collagen may also benefit active individuals, but in a very different manner than collagen hydrolysates. Many clinical studies have evaluated the effects of UC-II supplementation in those patients with moderate to severe osteoarthritis (OA) and have demonstrated significant improvement in pain and discomfort after continuous supplementation of at least 40 days. Interestingly, UC-II has been shown to have better results when taken at bedtime on an empty stomach (16).

After reviewing these few studies, there appears to be some real promise to collagen supplementation. This review stuck to only a handful of the many touted benefits of collagen supplementation- namely, improved joint pain, decreased collagen degradation, improved muscle strength, increased bone density, increased production of chondrocytes and increased production of fibroblasts. To fully understand the mechanisms of the aforementioned benefits, more studies will need to be conducted. However, with the promising results of these studies, a high quality supplement may prove to be beneficial, especially among both the active and aging population. If supplementation has the possible benefit of extending the life of our joint cartilage or even decreasing age related degradation of our connective tissues, we may be able to decrease the preponderance of injuries associated with activity and aging.

Should a collagen supplement be a part of your health strategy for an active lifestyle?

As with all supplements, it is important to discuss new supplements with your health care provider. It’s also pertinent to read the labels and be aware of potential allergens.  

Avoid artificial flavors, colors, sweeteners, and added fillers like gluten. 

Since Types I, II, and III are the most common collagen types in our bodies, it makes sense to focus on these supplements and not dilute a collagen supplement with a large mixture of other types of collagen. It is also important to stick with hydrolyzed collagen, as this will be more bioavailable than whole collagen proteins, as in bone broth. Most collagen hydrolysate powders come with Type 1 and III since they are usually found in tissues together and make up the vast majority of collagen in our bodies.

We know collagen comes from the bones and connective tissue of animals and that metals tend to collect in bones. When manufacturers extract collagen from these tissues, heavy metals may be collected along with it. For this reason, stick with grass-fed and or pasture-raised, and organic collagen sources. If you choose marine collagen, look for wild-caught marine sources. This will ensure a high-quality source. Bovine is not better than marine or vice versa; it is the quality of the source that matters.

Supplements come in powder or capsule form and is simply a matter of personal preference. For example, Biocell is a trademarked type including Type II (hydrolyzed chicken sternal collagen), hyaluronic acid, and chondroitin in a capsule form and is used to improve joint cartilage and collagen in skin and other connective tissues.

Only choose undenatured collagen, UC-II, if you are trying to decrease your body’s inflammatory degradation of joint collagen or improve symptoms of osteoarthritis. UC-II comes in capsule form.

Finally, a well-balanced, clean diet with whole foods and plenty of protein is essential to keeping your body healthy and operating at its full potential. Your body knows where to use the amino acids from protein and where repair is necessary, so a nutritious diet is the most important aspect to a healthy active body. Since collagen synthesis requires other nutrients besides amino acids and collagen peptides (specifically vitamin C, zinc, and sulfur), a well-balanced diet cannot be understated for joint health.

With that said, a high-quality collagen supplement just may help to fend off injury or possibly help to restore damage.  As with all nutritional supplementation, consistency is key and results do not happen overnight. The latest research shows promise for advocating collagen supplementation. Collagen supplementation could be an advantageous part in the “staying healthy and active game-plan.” For these reasons, the hype surrounding collagen supplementation is more than reasonable!

About Cheryl Fernandez MS, ERYT

Cheryl’s life focus has been on the science of wellness. She is an avid researcher with a bachelors degree in Biochemistry and Master’s of Science in Nutrition and currently working as a freelance blog writer. She has been practicing yoga for 26 years and teaching yoga for 12 years. As a very active, athletic person who began downhill skiing at the age of 3, Cheryl enjoys working with a variety of students; including, athletes, musicians, and those with injuries to help improve their performance in their craft and their quality of life.