DrG's Medisense Feature Article
19111-Collagen_Supplement
Collagen Supplement Fad
by Ann Gerhardt, MD
November 2019
Print Version
Bottom Line at the Top: There
are many health claims for collagen supplements, but the most they
likely do is add protein to the diet.
Collagen supplement sales have doubled since 2016, generating billions
of dollars for their manufacturers every year. And why not?
It’s a natural protein, made by our bodies in large amount.
There are at least 16 types of collagen. As a group they are the
most abundant proteins in the animal kingdom.
Collagen is largely responsible for
the body’s structural support in skin, bones and joints.
We make less of it with age, contributing to saggy skin, weak bones and
degenerated joints.
Some people lose more collagen than others. Sun-damaged skin
cells have much less capacity to make collagen, making skin loose and
papery thin. Smoking and air pollution exposure prematurely age
skin also, likely due to excess collagen break-down caused by
inflammation.
Hoping to fend off aging, people gravitate to supplements to undo the
effects of too many birthdays. Americans like supplements and
Boomers will pay to mitigate the appearance of aging.
Commercial interests have obliged with a slew of collagen
supplements. Their marketing promotes it for athletic success,
joint health, shiny hair, strong nails and firm skin with fewer
wrinkles.
Science so far doesn’t justify
these claims. Most studies have been small, uncontrolled
and funded by collagen supplement manufacturers, likely introducing
bias. Some tested products are mixtures, making it impossible to
know which ingredient was responsible for any observed effects.
Supplement users assume that a product is absorbed into the body
unchanged, tracks to body parts where it is needed and corrects the
problem.
None of this is true
for collagen.
Collagen is a large protein that doesn’t dissolve in water.
That’s why it doesn’t leach out of our skin and bones over
time. Our intestine cannot absorb any large intact protein, let
alone one that is insoluble in digestive fluids and blood.
Supplements consist of collagen chemically reduced to smaller
pieces. The label will say ‘hydrolyzed.’ Even
these partial protein pieces require digestion into even shorter pieces
called peptides that the intestine is capable of absorbing.
What eventually makes it into our bloodstream are tiny sections of the
collagen protein. There is no guarantee that they will magically
find each other and re-bond into intact collagen and home in on
degenerated skin and joints, making them young again.
Ingesting collagen doesn’t lead to
depositing collagen where it is needed.
Perhaps there is an alternative – something special about
collagen peptides that boosts the body’s own collagen
production. Collagen consists of most of the usual amino acids,
minus cysteine and tryptophan. What makes it special is its
hydroxy-proline content. This amino acid is absent from almost
every other protein in the body. It is crucial for collagen
function in that it enables the twists that make collagen a stiff
fibril (a sort of stringy piece).
So, might collage supplements be effective by boosting our readily
available supply of hydroxyproline? The answer is No. There
is no circulating supply of hydroxyproline, even after eating meat or
taking a supplement, because it is very quickly degraded in the
body.
There is also no way for skin, bone or cartilage cells to incorporate
preformed hydroxyproline into collagen. Here’s how it is
normally accomplished: Cells make immature collagen protein
containing a lot of amino acids called proline. While still
inside the cell, enzymes convert those prolines into
hydroxyproline. The collagen proteins then twist together into a
helix and are extruded out of the cell, where further modifications
make the collagen solid.
Hydroxyproline from meat or a collagen
supplement can’t boost collagen synthesis.
There ARE ways to optimize your cells’ capacity to make
collagen. Avoid sun, tobacco, pollution and oxidant damage.
Optimize the diet with the nutrients necessary to make mature
collagen. These are vitamins C, A and K, amino acids from protein
foods, adequate calories and basic nutrients to fuel the process and
enable protein synthesis, oxygen and iron. These are all
necessary but, by themselves, will not boost collagen production unless
their deficiency was causing the collagen deficiency.
Are collagen supplements safe? Most supplements contain collagen
from cows and fish. Plants don’t make collagen. So
far, reported side effects from these supplements include stomach upset
and rash. If the product comes from fish it may contain
excess calcium, a potential risk for some.
Some dermatologists and consumer groups worry that ground up hooves,
hides and body parts may contain heavy metals, toxic contaminants or
viruses like the one that causes mad cow disease. The Food and
Drug Administration has restricted collagen production from certain
high-risk body parts, but, as with all “natural”
supplements, there is no mandated testing or guaranteed safety.
I usually suggest that people eat the foods that we need to make
collagen, like meat, fish, eggs, gelatin, poultry, fruits and
vegetables. These, rather than spending extra money on
supplements, also provide additional nutrients necessary for a healthy
body. Avoiding exposure to inflammation triggers, like sun,
tobacco products and air pollution will also help.