The Truth about Collagen Powders & Supplements - An Orthopedic Surgeon's Opinion
Dr. Meredith Warner Here --
Many of our loyal customers ask me about collagen. Specifically, I am asked if I believe collagen supplements are helpful. Let me explain where I am on this issue. First, rest assured that I am constantly keeping up with the basic science and clinical research and as things change, I will update. The best way to answer this question is to explain what collagen is and how it is used in the body.
WHAT IS COLLAGEN?
Collagen is a protein. It is fundamental to the structure of your skeletal and connective tissue system. Collagen forms about 25-30% of all body protein. Collagen is generally formed of three strands of proteins braided together. The braids make right-handed turns and form a triple helix. Each strand has connections, or crosslinks, to the neighboring strands. The strands are formed of amino acids in repeating peptide sequences. Glycine tends to occupy each third position. The other two amino acids are often proline or hydroxyproline. Collagen has very little cysteine and no tryptophan. The different types of collagens (of which there are 28 or so) differ because of the changes in which amino acids take up the 2nd and 1st position of the repeating peptides.
HOW DOES COLLAGEN AFFECT THE MUSCULOSKELETAL SYSTEM?
Now that you understand that let’s get into the question. If you take collagen, will you increase or strengthen your own collagen? While the data is clear that ingesting amino acids or protein stimulates muscle protein synthesis, what happens with collagen is less clear. In fact, there is very little data to support this idea at all.
We used to think of collagen and most musculoskeletal tissues as inert. That is, it was long thought that once your musculoskeletal tissues formed, they did not change. Thus came the antiquated concepts of ‘wear-and-tear’ and such. Now, we know that this tissue type remodels and changes constantly. Collagen turns over up to 2% per day! Movement and exercise will stimulate collagen formation, while doing nothing will not. Fibroblasts form new collagen. These cells are located next to existing strands of collagen and are in the extracellular matrix (ECM) of the tissues. Loading collagen with movement will stimulate the fibroblasts to do their thing and make more collagen.
The strands form, line up and crosslinks connect them to provide strength. One of the key enzymes to produce crosslinks requires vitamin C to function. This is why I put Vitamin C in my connective tissue multi. I know better healing happens after orthopedic surgery (or anything really) if there is enough Vitamin C around. The reason the sailors in Mutiny on The Bounty had bleeding gums when they developed scurvy is because of this process. Vitamin C deficiency leads to scurvy. This leads to poorly crosslinked collagen, which makes it basically useless, and tissues just fall apart.
DOES THE BODY UTILIZE CONSUMED COLLAGEN?
As I said, there is not a lot of data to support the idea that eating collagen would stimulate the production of collagen. Many of these studies use sources such as casein or whey. However, you still need building blocks to make collagen. The formation of collagen seems to happen most after resistance training, during the recovery period. It may be that consuming building blocks more suitable to collagen is the key. This would imply that eating proline and lysine would make a difference. Sadly, there is nothing definitive here either. But I think it could be promising.
Collagen from fish has less lysine and proline than does that from cow or chicken. Also, the ocean is so filled with microplastic pollution at this point, one must be very careful. Collagen is extracted from the bones or skin of animals. The method of processing would affect the absorption and biologic activity of the collagen. Consuming hydrolyzed proteins seems to improve digestion as this breaks it into constituent amino acids. Most ingested collagen, peptides, or hydrolyzed collagen is broken into amino acids by our peptidases anyway. These are enzymes found in the gut. There is some evidence that hydroxyprolines and prolines have the ability to resist peptidases. Proline is modified into hydroxyproline in the body. Hydroxyproline itself cannot be incorporated into collagen. It is unclear if eating hydroxyproline matters at all.
Only one human study (of which I am aware) has looked at what happens to connective tissue when you eat collagen. In this study (Oikawa et al), there was no difference between eating whey protein or collagen supplements with regard to connective tissue formation.
COLLAGEN MAY IMPROVE RECOVERY
There is some hope, however, that collagen can still help. When looking at recovering from tendon problems, collagen does enhance recovery. Collagen can also help keep bone strong. There is conflicting data with regard to the effect on bone, so more work is needed. The trend appears to favor collagen as a way to stimulate bone formation. When compared to placebo, collagen also helps to maintain muscle mass after training. In order to produce more muscle and connective tissue the essential amino acids are more important than collagen is.
If one is going to support tendon healing and recovery, it may be that eating foods rich with proline and glycine can help. Many of us are deficient in these amino acids. Cartilage is responsive to ingested peptides in particular. But, most of this information comes from soaking connective tissues in petri dishes with massively high doses of peptides. The real-life situation is much murkier.
The best way to enhance your connective tissue and skeletal tissues is to eat all the essential amino acids along with those specific to collagen. More importantly, you must mechanically stimulate the fibroblasts. This means you have to move. Resistance exercise really helps. I don’t think it hurts to take exogenous collagen, but I am not sure it really helps. What I do is just eat homemade chicken soup with real stock I made myself.
Fill Gaps in Your Diet
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Our collection of vitamins and minerals supports healthy tissues, cartilage, nerves, bones, and joints. These capsules can help fortify your bones, promote collagen formation, and assist in wound healing.
ABOUT THE AUTHOR
Dr. Meredith Warner is the creator of Well Theory and The Healing Sole. She is a board-certified Orthopedic Surgeon and Air Force Veteran.
She is on a mission to disrupt traditional medicine practices and promote betterment physically, spiritually and mentally to many more people. She advocates for wellness and functional health over big pharma so more people can age vibrantly with more function and less pain.
At Well Theory, Our surgeon-designed products are FDA Registered and formulated to help people:
- Manage the symptoms of musculoskeletal pain
- Recover vibrantly from orthopedic related surgeries
- Fill the gaps in our daily diets
- Manage pain associated with inflammation