Collagen for Healthy Bones and Joints
- Collagen peptides have been shown to be safe and highly bioavailable. They have shown a benefit for bone metabolism and function.
- A key biomarker associated with osteoporosis and fracture risk CTX, which can be decreased by collagen supplementation.
- Collagen has been shown to support healthy knees, by reducing pain and stiffness.
- Collagen also promotes more youthful, healthy-looking skin by increasing skin elasticity and reducing the number of visible pores.
- A form of vitamin K called MK4 is an important building block for bone and promotes healthy collagen production and has been shown in studies to reduce fracture risk.
Collagen has been a cherished food since the early middle ages when visionary and Saint Hildegard of Bingen first recommended gelatin for joint pain.1 Collagen peptides are a blend of molecules created by hydrolysis of the collagen that comes from animal connective tissues. Collagen peptides have been shown to be safe and highly bioavailable.2 They have shown a benefit for bone metabolism and function.3
Today, collagen is widely consumed in foods and supplements and has been popularized as well in recipes for bone broth.
We know that collagen is the most abundant protein in our body, and a critical building block for the matrix of molecules that support cells, connective tissue, organs, and bones. It’s found in our skin, hair, and nails as well. Collagen comprises 90% of the organic matrix of bone.4 Healthy bones are made of a matrix of collagen that is hardened by calcium phosphate.
Collagen Is both Padding and Scaffold
Collagen plays a key role in joint health because it is a major component in our ligaments, cartilage, and tendons—the scaffolds, cushions, and pulleys that allow us to move our joints with ease.5 Collagen keeps cartilage healthy so the joints are cushioned. It keeps ligaments strong and flexible so they can hold joints together while letting them move easily and smoothly. Collagen helps form meniscuses, the small C-shaped structures inside a joint that act as padding.6
Healthy ligaments are critical to joint health and they actually work to create the joint space. The ligaments exhibit tensile strength, which is the kind of strength that keeps a rope from breaking when you pull on it. When you’re standing up and your body weight is pushing down on the ligaments, your joints don’t collapse because the ligaments are counteracting your body weight by pushing back up against it.7 When ligaments are healthy they can withstand the pressure of a wide range of activities, including running and jumping. But when joint ligaments begin to wear away and are damaged, they’re simply not as strong as they used to be. They aren’t as good at pushing back up and the joint space starts getting smaller. If cartilage—which covers the bones’ surfaces in a joint—is also degrading, bone can rub against bone and joint pain can develop.8
This is critical because around the world, the human population is aging. In 2009, 10% of humans were 60 years and older and by 2050 it’s estimated that 20% of the world population will be older than 60 years.9 With age comes degeneration of joints, osteoarthritis, and pain. Currently, osteoarthritis cannot be cured by mainstream medicine and the treatments offered are mostly analgesic—painkillers such as Tylenol or ibuprofen, for instance.
Collagen for Bone Health
When collagen degrades, and old bone is broken down and assimilated, breakdown products are released.10 One of these is C-terminal telopeptide (CTX). It can be measured in 24-hour urine, early morning spot urine, and blood samples. One benefit of measures like CTX is that they show changes much faster than can be detected on a DEXA scan.
Research has shown how closely allied this marker is with osteoporosis and fracture risk. High levels have been shown to predict fracture risk in postmenopausal women.11 A 2000 study published in the Journal of Bone and Mineral Research followed 435 women ages 31-89 years old for an average of five years. The highest urinary and serum CTX results were associated with increased fracture risk. If someone also had low bone mineral density and low levels of estrogen, their risk was even higher.12 A different study published the same year in the journal Bone found that elevated CTX is strongly associated with fractures in elderly women.13
The International Osteoporosis Foundation (IOF) and the International Federation of Clinical Chemistry (IFCC) recommend the CTX blood test as a marker to predict fracture risk and to monitor osteoporosis treatment.14
The great news is that a clinical trial showed that taking collagen can lower CTX, indicating that collagen reduces bone breakdown. In a study of 51 postmenopausal women with osteopenia (pre-osteoporosis) CTX was decreased by taking 5 grams of collagen peptides daily, plus 500 mg calcium and 400 IU vitamin D3, for three months. A control group received only calcium and vitamin D3. CTX decreased almost four times as much in the collagen + calcium + vitamin D3 group as the group receiving calcium and vitamin D3 alone.
In those women taking collagen, CTX decreased 11.4% compared to 3.5% in the volunteers who only took calcium and vitamin D3. This means that significantly less bone was breaking down and being resorbed when taking collagen.15 Given the importance of CTX for evaluating fracture risk, significantly decreasing this test result is an important step in doing all you can to protect your bones.
On the one hand, while taking collagen can support bone health, taking MK4 (45 mg/day) can promote collagen production and has been shown in clinical trials to reverse bone loss and reduce fracture risk up to 80%.16, 17, 18, 19 The benefits of MK4 for bone health in people with osteoporosis have been studied in 28 clinical trials with more than 7,000 volunteers.
Collagen for Knee Pain
Research shows that supplementing with 10 grams daily collagen hydrolysate improves knee and hip pain caused by osteoarthritis and pain created by strenuous exercise even when people don’t have degenerative joint disease. According to a review of several studies, collagen was significantly superior to egg albumin (a ‘control’ powder) in reducing pain for fifty-two volunteers with hip or knee degeneration.20
One particular study mentioned in the review article found a statistically significant advantage of collagen peptides over placebo for pain and physical function in osteoarthritis of the knee. The study was a multicenter, randomized, double-blind, placebo-controlled trial that followed 389 patients in 20 different centers for six months.
A study in China of 100 women between the age of 40 and 70, all of whom suffered from knee joint pain or discomfort, found a highly significant improvement of knee osteoarthritis after 6 months of treatment with collagen peptides, compared to placebo.21
A recent study published in 2015 provided 10 grams of bovine collagen daily for 13 weeks to 30 men and women with diagnosed knee osteoarthritis.22 The study was a randomized, placebo-controlled clinical trial. The age range of the study volunteers was 30-65 years old. People taking the collagen experienced significant improvement of more than 60% in knee pain, stiffness, and quality of life.
Better Looking Skin
Not to be left out, your largest organ—your skin—also benefits from supplemental collagen. In a double-blind, randomized, placebo-controlled clinical trial published in 2015 in the journal Clinical Pharmacology and Biopharmaceutics, 60 women ages 40-60 years old supplemented with 10 grams per day of hydrolyzed collagen for 90 days. 23 At the end of the study, the collagen improved skin elasticity, reduced the number of visible pores, and increased skin collagen production.
NBI Bone and Joint Health Formulas
Joint Relief contains clinically validated nutrients to support joint health and healthy joint mobility and promote joint comfort. Backed by more than 25 studies, clinical trials in volunteers with arthritis confirm that Joint Relief’s nutrients promote joint health by reducing joint swelling and pain and increasing joint range of motion and pain-free activity.
NBI’s Collagen dietary supplement provides 10 grams of hydrolyzed collagen per serving. Our collagen was specifically formulated for bone, joint, and skin health. Collagen powder will be available for purchase in June.
For bone support, I recommend Osteo-K or Osteo-K Minis plus NBI’s Collagen dietary supplement. For joint support, I recommend Joint Relief plus NBI’s Collagen.
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3Guillerminet F, Beaupied H, Fabien-Soulé V. Hydrolyzed collagen improves bone metabolism and biomechanical parameters in ovariectomized mice: an in vitro and in vivo study. Bone. 2010 Mar;46(3):827-34. [Article]
4Tzaphlidou M. Bone architecture: collagen structure and calcium/phosphorus maps. J Biol Phys. 2008;34(1-2):39-49. [Article]
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6Sun Y, Mauerhan DR, Kneisl JS, et al. Histological examination of collagen and proteoglycan changes in osteoarthritic menisci. Open Rheumatol J. 2012;6:24-32. [Article]
7Cyron BM, Hutton WC. The tensile strength of the capsular ligaments of the apophyseal joints. J Anat. 1981;132(Pt 1):145-150. [Article]
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10Spine-Health. Resorption Definition. [Report]
11Vasikaran S, Eastell R, Bruyère O, et al; IOF-IFCC Bone Marker Standards Working Group. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int. 2011 Feb;22(2):391-420. [Article]
12Garnero P, Sornay-Rendu E, Claustrat B et al. Biochemical markers of bone turnover, endogenous hormones and the risk of fractures in postmenopausal women: the OFELY study. J Bone Miner Res. 2000 Aug;15(8):1526-36. [Article]
13Chapurlat RD, Garnero P, Bréart G. Serum type I collagen breakdown product (serum CTX) predicts hip fracture risk in elderly women: the EPIDOS study. Bone. 2000 Aug;27(2):283-6. [Article]
14Vasikaran S, Eastell R, Bruyère O et al; IOF-IFCC Bone Marker Standards Working Group. Markers of bone turnover for the prediction of fracture risk and monitoring of osteoporosis treatment: a need for international reference standards. Osteoporos Int. 2011 Feb;22(2):391-420 [Article]
15Argyrou C, Karlafti E, Lampropoulou-Adamidou K, et al. Effect of calcium and vitamin D supplementation with and without collagen peptides on bone turnover in postmenopausal women with osteopenia. J Musculoskelet Neuronal Interact. 2020;20(1):12-17. [Article]
16Cockayne S, Adamson J, Lanham-New S, Shearer MJ, Gilbody S, Torgerson DJ. Vitamin K and the Prevention of Fractures: Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Intern Med. 2006;166(12):1256-1261. [Article]
17Iwamoto J, Takeda T, Ichimura S. Effect of menatetrenone on bone mineral density and incidence of vertebral fractures in postmenopausal women with osteoporosis: a comparison with the effect of etidronate. J Orthop Sci. 2001;6(6):487-492. [Article]
18Huang ZB, Wan SL, Lu YJ, Ning L, Liu C, Fan SW. Does vitamin K2 play a role in the prevention and treatment of osteoporosis for postmenopausal women: a meta-analysis of randomized controlled trials. Osteoporosis International. 2015;26(3):1175-1186. [Article]
19Hara K, Akiyama Y. Collagen-related abnormalities, reduction in bone quality, and effects of menatetrenone in rats with a congenital ascorbic acid deficiency. J Bone Miner Metab. 2009;27(3):324-32. [Article]
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22Kumar S, Sugihara F, Suzuki K, Inoue N, Venkateswarathirukumara S. A double-blind, placebo-controlled, randomized, clinical study on the effectiveness of collagen peptide on osteoarthritis. J Sci Food Agric. 2015;95(4):702-707. [Article]
23Mbg PMC, Melo MO, Calixto LS, Fossa MM. An Oral Supplementation Based on Hydrolyzed Collagen and Vitamins Improves Skin Elasticity and Dermis Echogenicity: A Clinical Placebo-Controlled Study. Clinical Pharmacology & Biopharmaceutics. 2015;2015:1-6. [Article]
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