Are There Benefits to Collagen Supplements?

October 26, 2023

Collagen products have taken the supplement industry by storm.  It is a top-selling supplement with claims of improving joints, skin, hair and nails.  In fact, in 2022, the collagen supplement market size surpassed 1 billion and is estimated to expand its annual growth rate to more than 6.5% over the next ten years.  The projected revenue for collagen supplements in 2032 is approximately 2.3 billion US dollars.

How do the claims regarding collagen supplementation stack up?  Is there supportive evidence for its use or is it all hype?

What is Collagen?

Collagen is touted as the most important protein produced by the body, accounting for about 25%-40% of protein in the body!  The word “collagen” is derived from the Greek word for glue.  Amino acids are the building blocks of protein.  Collagen protein contains 19 amino acids, 8 of which are essential amino acids.  Collagen protein consists of three strands of these amino acids, more than 1,400 amino acids long.  These strands weave together to create connective tissue and function in many different ways within the body.

Collagen is multi-functional in the following ways:

  • Joint function
  • Structure of tendons and ligaments (65-80% of protein in a ligament, 70% of protein in a tendon)
  • Lining the gut
  • Healthy skin, hair and nails (75% of protein of skin)
  • Wound healing
  • Structure of fascia
  • Structure of teeth and bones (60% of protein in bones)

There are nearly 28 types of collagen serving various purposes with types I, II and III being the most common in the human body.  Collagen type I is most common in bone, teeth, skin, ligaments, organs, whereas type II is found in cartilages.  Type III is most commonly found in muscle, blood vessels and skin.

Loss of collagen in the body begins around ages 18-29 with a loss of 1% per year after age 40 and a decrease of 75% by the age of 80 compared to young adults.  While a natural decline occurs with time, other factors also lead to decreased collagen production such as poor diet, alcoholism, smoking and disease.

Collagen Supplements

It is clear collagen is important, so supplementing with it should support all of these functions, right?  It may not be as straightforward as this after all.

Collagen supplements come in powder and pill form, typically sold as hydrolyzed collagen, collagen hydrolysate or collagen peptides.  Collagen is a complex protein that cannot be absorbed by the body.  Hydrolyzed collagen supplements are broken down components of whole collagen called collagen peptides, to increase absorption.

When components of collagen are digested in the stomach, amino acids released are sent to areas in the body where protein synthesis is most needed.  Collagen peptides could be used to produce more collagen but they may not as the body prioritizes how to use the amino acids.

The source for collagen supplements varies and therefore the type of collagen varies.  Supplements are typically extracted from bovine, porcine, marine and chicken sources.

Collagen Products Not a Source of Complete Protein  

While the body requires twenty different amino acids to function properly, only nine are considered essential: leucine, methionine, histidine, lysine, phenylalanine, threonine, valine and tryptophan.

A complete protein contains all nine essential amino acids the body cannot produce and therefore, must be attained from food.  Foods containing all nine essential amino acids include animal protein, eggs, dairy, quinoa, buckwheat, soy, pistachios, walnuts.

Collagen supplements contain 8 essential amino acids.  Collagen, therefore, is not a complete protein.  The missing essential amino acid in collagen is tryptophan.  Collagen does contain the amino acid hydroxyproline which does not occur in other proteins.

Be aware some collagen products may be fortified to contain tryptophan which requires heavy processing.  This process can break apart the fragile amino acid and generate toxins.  It is better to avoid products with fortified tryptophan.

To date most studies have been done with animal sources of collagen.  Although vegan/vegetarian sources of collagen are now available, they are not considered “true” collagen and their efficacy cannot be assured until further research is completed.

Does the Research Support Collagen Supplementation Claims?

There are potential conflicts of interest in the research surrounding collagen supplementation as most is funded or driven by the industry itself which could elicit bias.

Most research has been assessing collagen use for skin and joint health.  Larger human studies are warranted to fully assess the potential benefits though small studies have shown promising results:

  • Osteoarthritis: A review of 4 open-label studies and 3 double-blind studies.  Oral collagen hydrolysate supplementation increased extracellular matrix macromolecules via chondrocytes, or cells that form cartilage.  Measures of pain and function in those with OA improved but did not show statistical significance.
  • Skin Health: 2.5-5g daily oral intake of collagen peptides led to improvement in skin elasticity after 8 weeks more pronounced in women >50 yrs. There was no difference in skin hydration or roughness.
  • Skin Health: 1g daily oral intake of collagen peptides for 12 weeks among women aged 40-60 led to improvement in skin hydration, wrinkling and elasticity also showing a protective effect on joint health.
  • Skin Health Systematic Review: Reviewed 11 randomized controlled trials with a total of 804 patients.  8 trials assessed 2.5g to 10g daily oral collagen hydrolysate for 8-12 weeks for treatment of pressure ulcers, skin aging, and cellulite.  Two studies assessed oral collagen tripeptide 3g/day for 4-12 weeks with notable improvement in skin elasticity and hydration.  One study used oral collagen dipeptide suggesting anti-aging effects.  Results are promising for wound healing and skin aging, increased skin elasticity, hydration, and dermal collagen density.
  • Joint pain: 5g daily oral intake of collagen peptides among athletes with functional knee pain for 12 weeks led to statistically significant improvement in activity related pain compared to placebo.  There was improvement in pain at rest though not statistically significant.
  • Bone Mineral Density: 5g daily oral intake of collagen peptides for 12 months among postmenopausal women with reduced bone mineral density showed improvement in bone mineral density of the spine and femoral neck of the hip.
  • Antimicrobial and Antioxidant Potential: Hydrolyzed collagen may demonstrate antioxidant and antimicrobial activity as demonstrated in vitro, and since collagen hydrolysate can attach to calcium, increasing its bioavailability, it can potentially be used in the management of mineral deficiencies.

Could it Be Bad for You?

Prolonged collagen supplementation has been shown to be safe taken orally even up to higher doses of 60 grams daily.  The usual oral dosing is 5-15g daily taken an hour before exercise over 3 months to be potentially beneficial for joint health.  As with any supplement you are taking, ensuring it is clean and pure is essential.  There is concern regarding collagen products being contaminated with heavy metals.  Ensuring heavy metal testing is important when considering supplementing.

A 2020 Collagen Heavy Metals Study was conducted by Clean Label Project assessing 30 collagen products.  The following was found:

  • 64% had measurable arsenic levels
    • Garden of Life Unflavored Collagen Peptides contained the highest amount
  • 17% had measurable cadmium levels
    • BulletProof Collagen Protein Chocolate contained the highest amount
  • 34% had measurable mercury levels though in trace amounts
  • 37% had measurable lead levels
    • Orgain Collagen Peptides contained the highest amount followed by Ancient Nutrition Keto Collagen Chocolate and Preferred Elements Keto Collagen Chocolate

In choosing a collagen product, ensure it is:

  • Wild-caught
  • Grass-fed pasture raised
  • Hormone and antibiotic free
  • Heavy metal free

No Conclusive Research Shows Collagen from Supplementation Is Superior to Collagen from Food Sources

Our diet is one of the cornerstones of our health.  It is always best to look at a diet higher in protein and collagen sources.  However, collagen supplementation could be a good adjunct to our diet.  Food sources containing collagen include red meat, bone broth and soups involving boiling of animal bones for several hours.  Be aware store-bought bone broth and supplementation can be contaminated with heavy metals as well.

Other high protein foods supporting production of collagen within the body are eggs, dairy, fish and poultry.  Consuming foods high in protein, copper, zinc and vitamin C will all drive collagen synthesis including eggs, beans, nuts, seeds, greens and fruits.

A 2019 study looked at utilizing collagen peptides as a protein source in the standard diet.  The study was based on “results of 20 years of research indicating the inclusion of collagen peptides in the diet can lead to various improvements in health.”  The authors concluded collagen peptides may benefit people as an adjunct to a diet that fulfills the RDA protein requirements.  “Recent studies suggest that protein intakes higher than the RDA help promote healthy aging, weight management, and adaptation to exercise” and using collagen peptide supplementation as a protein substitute “does not pose a problem of overconsumption.”  Note, the authors view collagen peptides as an adjunct to diet, not a substitute for diet.

It is also important to note, adequate protein intake may produce the same results and the benefits may not be from collagen peptides but from the increase in protein itself.

What’s the Bottom Line?

Though there are small studies showing promising benefits of collagen supplementation, it is unclear if adequate or increased protein intake would produce similar results.  It is plausible increasing protein in the diet would result in similar benefits.  Collagen is not a complete protein and the amino acids may or may not be used by the body to create collagen.

Bottom line is:

  • Collagen supplementation may be beneficial for joint and skin health as demonstrated in reviewed small studies.
  • Increasing protein intake from dietary sources and attaining collagen from food sources may be most beneficial.
  • No protein supplementation can substitute healthy dietary and lifestyle changes.
  • If you opt for collagen supplementation, ensure it is wild-caught, grass-fed, hormone, antibiotic and heavy metal free.

Have an Awesome Day!  Dr D and Drew Chernisky, PA-C

 

Posted in Collagen, Supplements