Do collagen supplements help with joint pain?

I’m thinking about taking collagen for my knee pain. Do you think it will work?

Before addressing that question, here are some collagen facts:

  • Collagen is a distinct type of protein, the building block of tendons, ligaments, the support structure of skin and bone, and protective covering for organs.
  • There are different types of collagen. 28 to be precise! Type I represents 90% of the collagen in the human body.
  • The individual molecules of collagen can pack tightly together, making the strands of tissue very strong. Some collagen fibers are stronger than steel.
  • It accounts for 1/3 of the protein in your body.
  • Since it’s a protein, it’s made from amino acids, primarily glycine, proline, alanine and hydroxyproline.
  • We produce less collagen as we age, particularly women after menopause.

It’s that last one that creates problems for older women. Less collagen means wrinkling skin and less protection for joints. Taking collagen supplements sounds like a simple solution — you absorb collagen and it goes where it’s needed in your body to cushion your knees and plump up your skin. Makes sense, right?

Not actually.

It’s really tempting to believe that the solution is that simple. Unfortunately it isn’t. As a large protein, collagen is not absorbed intact into your system, so that it can sail off to your knees. It’s broken down into the individual amino acids in your intestines, and those are absorbed. So at best, if you take collagen, you now have a supply of the amino acid mix used to make collagen.

But collagen production has to be firing on all cylinders, so to speak, in order to use those amino acids for collagen production. Vitamin C plays an important role in this process. In fact, in vitamin C deficiency — scurvy — collagen formation is severely impaired and tissues deteriorate. Bleeding gums and tooth loss are one sign; poor wound healing is another.

So more vitamin C should promote collagen, right? Wrong. Certainly you should maintain adequate vitamin C intake, but there’s no evidence that extra vitamin C boosts collagen production. As with any metabolic process many other nutrients have roles to play. In fact, the process is initiated by your genes. The 34-odd genes involved with collagen synthesis have to be activated before anything happens.

Does taking collagen have any benefit?

First, most of the research on collagen supplements has been done by companies making supplements. Right away, you should be skeptical.

Second, most of the research has focused on skin and wrinkles, not joint pain.

Third, not all collagen supplements are made of the same Type of collagen, or the same form. According to ConsumerLab (subscription), the better choices are hydrolyzed collagen, which means the large protein molecules have been broken down into fragments, which are more easily digested and absorbed.

Even then the evidence for relief of joint pain is not strong. In one study, some relief was seen after taking 1200 mg per day of a collagen hydrolysate supplement for 6 months. In a very small study, 5 grams/day improved pain and inflammation.

What about food sources?

Collagen is present in meat, poultry and fish, but you aren’t likely to eat large amounts with your meals. Connective tissue or cartilage that attaches meat to bones is usually trimmed off or wasted. The main source of collagen would be from so-called bone broth, traditionally called stock, which is made by simmering bones, such as a Thanksgiving turkey carcass, for several hours. The resulting stock gels up when refrigerated, a sign of the presence of gelatin derived from the collagen in the bones and connective tissues. Use that stock for soups, sauces or cooking grains. You can buy commercially prepared bone broth, but if it does not gel when refrigerated, it will not have much collagen.

Take Away

If you want to try collagen for joint pain, be aware that it may take months for a supplement to provide any benefit. You’ll need to take it every single day. This could get expensive. But you would be consuming the specific amino acid building blocks of collagen, so perhaps that helps.

I’m not going to discourage anyone from trying a food/nutrition intervention to relieve pain. Constant pain that interferes with quality of life is a terrible thing. Even if you get a placebo effect, that’s something. In the future, I expect that researchers will find genetic solutions (probably spelled $olution$) for the pain of arthritis and other problems related to decreased collagen production. Until then, supplements and bone broth may be the best we’ve got.

image of collagen model from WikiMedia by Nevit Dilmen