The Devastating Impact of Stress on Collagen

Article at-a-glance:

  • Collagen is the most plentiful protein in your body and the key molecule that makes up bones, joints, skin and is the scaffolding for every organ in your body
  • Chronic stress leads to chronically elevated stress hormones that damage collagen and impair immune function
  • In a double whammy, stress also lowers collagen production
  • Stress has a devastating impact on collagen, and damaging bones, joints and skin.
Anxiety Word Cloud

People are frazzled, overwhelmed, and stressed. Given everything we’ve all endured this past year, it’s not surprising that the American Psychological Association’s Stress in America survey for 2020 concluded, “We are facing a national mental health crisis that could yield serious health and social consequences for years to come.”1

To rally the body’s resources to handle stress, the body alters the responses of the sympathetic nervous system, increasing the flow of stress hormones such as epinephrine, norepinephrine, and cortisol. In the process of stress, however, dangerous free radicals are also created.2

Short term, the stress response is adaptive, and helps us handle things better, enhances immune function, and helps us focus. But long-term stress has the opposite effects. It’s linked to lowered immune function, elevated blood pressure, and increased heart rate.3 Chronic stress also contributes to insomnia, heart disease, dementia, leaky gut and dysbiosis, osteoporosis, sagging skin, and arthritis.4,5,6,7 And if that weren’t enough, chronic stress shrinks your brains.

One way stress does all of this is by damaging collagen—the molecule responsible for providing strength, support, and integrity to all tissues and organs in the body.8

Your Body’s Scaffolding

Collagen is the most plentiful protein in your body, and it’s the key molecule that comprises connective tissue. Collagen is secreted by cells and assembles in networks of thick, rope-like structures called fibrils. Collagen is actually three strands of repeating amino acids wrapped around each other that create the shape and support for tissues and provides a scaffold for cell growth and movement.9 Think about collagen-like rebar used in construction that holds everything up. 

Collagen is found in your muscles, tendons, ligaments, skin, blood vessels, teeth, and even in the cornea and vitreous (a gelatinous substance) of your eye.10 It provides all these tissues with structure, strength, and flexibility, and is critical for skin, bone, and joint health.11

There are at least 16 types of collagen, but types I, II, and III are the most common.

Type I composes 90% of your body’s collagen and consists of densely packed fibers. Type I collagen gives structure and strength to skin, bones, tendons, cartilage, teeth, and connective tissue.

Type II is more loosely packed and can be found in the cartilage that cushions your joints.

Type III supports muscles, organs, and arteries.

The Stress-Collagen Connection

Chronic stress damages the collagen in two ways: directly through inflammation, and indirectly by decreasing collagen production.

Chronic stress activates your hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system (SNS), both of which regulate your response to challenges and threats—whether it’s anxiety about an upcoming test, fighting off the common cold, or creating stress simply by the stories you tell yourself about what might happen in the future. Our HPA axis is composed of the hypothalamus and the pituitary gland (in the brain), and the adrenal glands (small glands attached to the top of your kidneys). Our adrenal glands release the stress hormone cortisol, which degrades collagen.12

Stress increases pro-inflammatory molecules, such as interleukin-1 beta (IL1-beta) and tumor necrosis factor-alpha (TNF-alpha). Over the longterm, chronic stress can lead to imbalances between pro-inflammatory and anti-inflammatory molecules.13 Like cortisol, chronic elevation of inflammatory molecules also damages collagen.14 IL1-beta and TNF-alpha also reduce your body’s ability to create new collagen.15

If that weren’t enough, inflammation also makes collagen stiffer and less flexible. It does this by creating advanced glycation end-product (AGEs) bind to and damage collagen. The accumulation of AGEs is associated with poorer vision due to the lens in your eye becoming stiffer, stiffening of the arteries, a risk factor for high blood pressure and heart disease, stiffer and less supple skin and tendons, and poorer bone health.16,17

Better Bones

Collagen is crucial for bone strength. While bone minerals provide the hardness to the bone, collagen is responsible for bone quality. Bone mineral density is what’s tested when screening people for osteoporosis in a dual x-ray absorptiometry (DEXA) test, but bone mineral density (BMD) is not a good predictor of osteoporosis fractures. In fact, it’s been known since the 1990s that a DEXA test only predicts 44% of women who will break a bone and only 21% of men. 18

Collagen provides the scaffolding to which minerals bind. As the amount of collagen declines, minerals are lost from bone. A DEXA scan only measures the minerals, but it’s the collagen that gives bone its flexibility and ability to absorb the impact of a fall, disperse that impact over a larger area and not break. 19

In addition to the quantity of collagen, its quality is also important. Research suggests that part of the large variation in bone strength may be linked to differences in collagen quality. And, as noted above, that connection appears to be modulated by stress. This may explain why, for instance, chronic psychological stress, which elevates cortisol and creates free radicals, has been linked to osteoporosis, which is characterized by low bone mass and bone deterioration.20

We have a total of 213 bones in our bodies.21,22 Our bones constantly undergo remodeling—breaking down and building up—in order to remove old, damaged bone and replace it with new, stronger bone that preserves bone strength.

Collagen is a key contributor to successful bone remodeling and bone strength and flexibility. The synthesis of bone by cells called osteoblasts depends on collagen, mostly type 1 collagen, which the osteoblasts secrete along with other molecules and proteins. These help form the bone matrix.23

Not surprisingly, research has shown that oral supplementation with hydrolyzed collagen can lead to greater accumulation of collagen in cartilage, and supplementation has been associated with relief from joint pain due to osteoarthritis.24 Similarly, research suggests that supplemental collagen may help ward off osteoporosis.25 In a study of postmenopausal women (a group who are at increased risk for thinning bone, bone loss, and fractures) collagen supplementation was associated with an increase in bone mineral density.26

More Youthful Looking Skin

We all marvel over the fresh, plump skin of a newborn, and their flawless faces, without a single wrinkle. Pinch a baby’s cheeks and their skin snaps right back into place. That’s due to their skin’s high amounts of healthy collagen. Collagen composes about 80% of your skin. 

When you look in the mirror, if your skin is getting looser, has more wrinkles, or is sagging a bit and looking dry, this is likely because you’re losing collagen. Skin health is considered one of the clues to overall “well-being”. We can’t see our internal organs aging, but skin offers us the first obvious signs of the mark of time. And what you see in the skin may also be happening in the bone.

Here, too, stress can impact skin through collagen degradation. Skin is involved in the stress response through the HPA axis discussed above. Skin mast cells, which respond to threats by releasing histamine and other pro-inflammatory molecules, are activated by stress, and they also produce stress hormones and inflammatory factors. In this environment, collagen’s contribution to skin repair and wound healing is impaired.27

Collagen supplementation improves skin elasticity and moisture. In one randomized, placebo-controlled study of 69 women who were between 35 and 55 years of age, supplementation with collagen for eight weeks led to a significant improvement in skin elasticity.28 In another study, supplementing with hydrolyzed collagen improved skin hydration.29

What You Can Do

Managing stress is important for reducing its insidious damage. Here are my top suggestions: 

  • Follow my top natural recommendations for anxiety for a whole-person approach.
  • Excellent sleep should be non-negotiable. Sleep deprivation increases inflammation and your risk for all sorts of problems, including diabetes and heart disease. Use my Checklist to Beat Insomnia as your guide, and take Sleep Relief for extra support. 
  • Eat a healthy, whole-foods diet. This dietary pattern has been shown to reduce inflammation, which is stress on your body and a real collagen killer. Follow my simple 3-Steps to Eating Healthy for Life to transition into this way of eating. 
  • Take NBI’s Collagen. Made from the purest collagen, NBI’s Collagen contains a pure mixture of non-GMO Types I and III collagen. It’s paleo and keto, derived from grass-fed cows, and mixes easily. And it doesn’t contain any of the bad stuff: antibiotics free, gluten-free, hormone-free, pesticide-free and doesn’t have any solvents. Collagen was one of the top new products NBI customers requested, so we researched the finest source and created it. NBI’s Collagen will be available for purchase in June. 

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1American Psychological Association. Stress in America 2020: A National Mental Health Crisis. October 2020 [Report]

2Harvard Health Publishing. Understanding the stress response: chronic activation of this survival mechanism impairs health. Updated July 2020. [Report]

3Dhabhar FS. Effects of stress on immune function: the good, the bad, and the beautiful. Immunol Res. 2014 May;58(2-3):193-210. [Article]

4Lebedeva A, Sundstrom A, Lindgren L, et al. Longitudinal relationships among depressive symptoms, cortisol, and brain atrophy in the neocortex and the hippocampus. Acta Psychiatr Scand. 2018;137(6):491-502. [Article]

5Dodiya HB, Forsyth CB, Voigt RM et al. Chronic stress-induced gut dysfunction exacerbates Parkinson’s disease phenotype and pathology in a rotenone-induced mouse model of Parkinson’s disease. Neurobiol Dis. 2020 Feb;135:104352. [Article]

6Kelly RR, McDonald LT, Jensen NR et al. Impacts of Psychological Stress on Osteoporosis: Clinical Implications and Treatment Interactions. Front Psychiatry. 2019;10:200. Published 2019 Apr 9. [Article]

7Lebedeva A, Sundstrom A, Lindgren L, et al. Longitudinal relationships among depressive symptoms, cortisol, and brain atrophy in the neocortex and the hippocampus. Acta Psychiatr Scand. 2018;137(6):491-502 [Article]

8Kahan V, Andersen ML, Tomimori J, Tufik S. Can poor sleep affect skin integrity? Med Hypotheses. 2010 Dec;75(6):535-7. [Article]

9Burla F, Dussi S, Martinez-Torres C, Tauber J, van der Gucht J, Koenderink GH. Connectivity and plasticity determine collagen network fracture. Proc Natl Acad Sci U S A. 2020 Apr 14;117(15):8326-8334. [Article]

10Lodish H, Berk A, Zipursky SL, et al. Molecular Cell Biology. 4th edition. New York: W. H. Freeman; 2000. Section 22.3, Collagen: The Fibrous Proteins of the Matrix. [Article

11Moskowitz RW. Role of collagen hydrolysate in bone and joint disease. Semin Arthritis Rheum. 2000 Oct;30(2):87-99 [Article]

12Kucharz EJ. Hormonal control of collagen metabolism. Part II. Endocrinologie. 1988 Oct-Dec;26(4):229-37. Kucharz EJ. Hormonal control of collagen metabolism. Part II. Endocrinologie. 1988 Oct-Dec;26(4):229-37. [Article]

13Golovatscka V, Ennes H, Mayer EA et al. Chronic stress-induced changes in pro-inflammatory cytokines and spinal glia markers in the rat: a time course study. Neuroimmunomodulation. 2012;19(6):367-76. [Article]

14Cui SJ, Fu Y, Liu Y, et al. Chronic inflammation deteriorates structure and function of collagen fibril in rat temporomandibular joint disc. Int J Oral Sci. 2019;11(1):2. Published 2019 Feb 20. [Article]

15Siwik DA, Chang DL, Colucci WS. Interleukin-1beta and tumor necrosis factor-alpha decrease collagen synthesis and increase matrix metalloproteinase activity in cardiac fibroblasts in vitro. Circ Res. 2000 Jun 23;86(12):1259-65. [Article]

16Viguet-Carrin S, Garnero P, Delmas PD. The role of collagen in bone strength. Osteoporos Int. 2006;17(3):319-36. [Article]

17Wang X, Shen X, Li X, Agrawal CM. Age-related changes in the collagen network and toughness of bone. Bone. 2002 Jul;31(1):1-7 [Article]

18Liu H, Paige NM, Goldzweig CL. Screening for Osteoporosis in Men: A Systematic Review for an American College of Physicians Guideline. Ann Intern Med. 2008;148(9):685-701. [Article]

19Viguet-Carrin S, Garnero P, Delmas PD. The role of collagen in bone strength. Osteoporos Int. 2006;17(3):319-336. [Article]

20Kelly RR, McDonald LT, Jensen NR, Sidles SJ, LaRue AC. Impacts of Psychological Stress on Osteoporosis: Clinical Implications and Treatment Interactions. Front Psychiatry. 2019;10:200. [Article]

21Clarke B. Normal bone anatomy and physiology. Clin J Am Soc Nephrol. 2008 Nov;3 Suppl 3(Suppl 3):S131-9 [Article]

22Summers A. Accessory ossicles and sesamoid bones: recognition and treatment. Emerg Nurse. 2015 Mar;22(10):27-32 [Article]

23Aszódi A, Bateman JF, Gustafsson E, et al. Mammalian skeletogenesis and extracellular matrix: what can we learn from knockout mice? Cell Struct Funct. 2000 Apr;25(2):73-84 [Article]

24Bello AE, Oesser S. Collagen hydrolysate for the treatment of osteoarthritis and other joint disorders: a review of the literature. Curr Med Res Opin. 2006 Nov;22(11):2221-32 [Article]

25Moskowitz RW. Role of collagen hydrolysate in bone and joint disease. Semin Arthritis Rheum. 2000 Oct;30(2):87-99. [Article]

26König D, Oesser S, Scharla S ,et al. Specific Collagen Peptides Improve Bone Mineral Density and Bone Markers in Postmenopausal Women-A Randomized Controlled Study. Nutrients. 2018;10(1):97. [Article]

27Chen Y, Lyga J. Brain-skin connection: stress, inflammation and skin aging. Inflamm Allergy Drug Targets. 2014;13(3):177-190. [Article]

28Proksch E, Segger D, Degwert J et al. Oral supplementation of specific collagen peptides has beneficial effects on human skin physiology: a double-blind, placebo-controlled study. Skin Pharmacol Physiol. 2014;27(1):47-55. [Article]

29Inoue N, Sugihara F, Wang X. Ingestion of bioactive collagen hydrolysates enhance facial skin moisture and elasticity and reduce facial ageing signs in a randomised double-blind placebo-controlled clinical study. Journal of the Science of Food and Agriculture. 2016;96(12):4077-4081. [Article]


Collagen for Healthy Bones and Joints

Collagen for Healthy Bones and Joints

Collagen plays a key role in joint health, preserving bone, cartilage, and ligaments. It can be a key supplement to preserve joint health as we age. 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. With age comes joint degeneration, pain, and stiffness, and also increased risk for osteoporosis. Fortunately, supplementing with collagen has been shown to improve joint and bone health, which can help you stay active and healthy well into your later years.

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