Collagen, Is It Worth It?
Earlier this year I shared with you about the ups and downs on writing about supplements. From the massive amount of information that is out there, to the nuanced debate on the effectiveness of one supplement versus the other.
Today I am going to be sharing with you about another supplement, one that I have found to be useful for myself when it comes to recovering from stiffness and soreness and one that is part of my daily routine to help my joints, ligaments, and tendons get stronger and stay stronger for longer.
This supplement is collagen.
It’s one I’ve been taking for over 6 months, and I have to say that when I don’t take it I feel overall more stiff and sore and the research backs that up. So today I’m going to walk you through what collagen is, what the research says about it, and what the research says about timing and dosages.
What is Collagen?
Collagen is one of the most abundant proteins in the human body and is crucial for maintaining the structure and integrity of various parts of our body.
Collagen is made of three polypeptide chains that coil together to form a triple helix, giving collagen its unique strength and elasticity. Collagen is naturally created by our body using specific amino acids obtained from protein-rich foods like beef, chicken, and fish. It is mainly found in connective tissues such as skin, tendons, ligaments, and bones, but is also found in other parts of the body like our eye specifically the cornea, blood vessels, and even the lining of our gut.
As we mentioned in our blog on Creatine that ATP is fundamental for cellular energy, collagen is foundational for the function, strength and resilience of our tissues.
As you can see on the right collagen is structured as a triple helix, a unique formation that arises from three polypeptide chains winding around each other. This structure is similar to a three-stranded rope, where each strand contributes to the overall strength and flexibility of the rope. When our tissues experience wear and tear, they rely on the continuous production and integration of new collagen to maintain their structure and function. This is where the body's ability to synthesize collagen becomes crucial. Using specific amino acids from our diet, our cells craft these chains, which then assemble into the triple helix formation. In essence, collagen acts as the "structural framework and rejuvenator" of our tissues. It ensures that our skin remains elastic, our tendons and ligaments stay tough, and our bones are fortified. While the process might seem straightforward, the intricate balance and coordination required to maintain our body's collagen network is a testament to its importance.
Collagen’s Pivotal Role in the Structural Integrity of our Tissues
Let's talk about the joints, ligaments, and tendons. Have you ever felt that twinge in your knee when you bend down? Or perhaps that slight discomfort in your elbow after a game of tennis? Maybe you've been working on improving your flexibility, and you've noticed that some stretches feel more challenging than others. Behind the scenes, collagen is hard at work ensuring that these vital components of our musculoskeletal system remain robust and resilient.
Joints are the meeting points of our bones, and they require a smooth, cushioned surface to function optimally. Ligaments, on the other hand, are like the body's natural ropes, connecting bone to bone, ensuring stability. Tendons act as connectors between muscles and bones, facilitating movement. Collagen is the primary protein that gives these structures their strength and elasticity. When we move, stretch, or exert force, it's the collagen-rich ligaments and tendons that bear the brunt, allowing us to move seamlessly.
Just as creatine ensures muscles have the energy for high-intensity tasks, collagen ensures that our joints, ligaments, and tendons have the structural integrity to withstand the stresses of daily activities and rigorous exercise. A sufficient supply and proper maintenance of collagen means that these structures can recover, repair, and remain resilient over time. This is why ensuring adequate collagen, either through diet or supplementation, is often associated with improved joint health, flexibility, and overall musculoskeletal health.
Collagen, as we've delved into, is not just a structural protein but also a key player in the healing and recovery process, especially after joint injuries.
Collagen’s Role in Overall Health and Injury Health
When you suffer a joint injury, the body's natural response is to initiate a healing process. The healing process follows three primary phases: the inflammatory phase, the proliferative phase, and the remodeling phase. Let's dive into each phase and explore the role of collagen in the healing of fascia, muscle, tendons, and ligaments.
1. Inflammatory Phase:
This is the initial response to injury and typically lasts a few days. It involves the release of various inflammatory mediators, which cause the classic signs of inflammation: redness, heat, swelling, pain, and decrease in function. The goal during this phase is to remove damaged tissue and prevent infection.
Role of Collagen: At this stage, collagen doesn't play a significant role yet. The primary focus is on controlling the inflammation and preparing the site for the next phase of healing.
2. Proliferative Phase:
This phase involves the formation of granulation tissue, which is a combination of collagen, new blood vessels, and extracellular matrix. Think of the granulation tissue as a temporary framework or scaffolding that future tissue is going to be built upon. This phase typically lasts a few weeks.
Role of Collagen:
Fascia: The fascia, a band or sheet of connective tissue, begins to repair by laying down new collagen fibers. These fibers are initially disorganized and are primarily Type III collagen, which is thinner and more delicate.
Muscle: Damaged muscle fibers release signals that attract satellite cells (muscle stem cells) to the injury site. These cells help regenerate muscle tissue. Meanwhile, collagen forms within the muscle to repair any tears, creating a temporary framework for muscle regeneration.
Tendons and Ligaments: Both these structures are primarily made up of collagen (mainly Type I). During the proliferative phase, fibroblasts produce collagen to bridge the gap of the injury. Like in fascia, the initially produced collagen is Type III, which over time will be replaced by the stronger Type I collagen.
3. Remodeling Phase:
This is the final phase of healing and can last anywhere from several months to years. The primary goal during this phase is to strengthen the healing tissue.
Role of Collagen:
Fascia: The initially laid down Type III collagen is gradually replaced by the stronger and more organized Type I collagen. This transition helps restore the fascia's strength and flexibility.
Muscle: The collagen framework laid down in the proliferative phase becomes more organized, allowing for the restoration of muscle strength. However, scar tissue (dense collagen) may remain, which can reduce the muscle's overall flexibility and function which is the reason why motion and working to regain full movement of a joint is key in the healing process .
Tendons and Ligaments: The remodeling phase is crucial for these structures. The initially disorganized collagen fibers become more aligned in the direction of tension, increasing the strength of the tendon or ligament. The transition from Type III to Type I collagen also continues, further enhancing the tissue's tensile strength.
Throughout the healing phases collagen plays a pivotal role acting as a scaffold during the proliferative phase and then undergoing remodeling to restore strength and function in the final phase.
As we mentioned above collagen is central to this process. Similar to how increasing the amount of protein we consume can lead to an increase in strength, muscle, and lean body mass, increasing the amount of collagen we consume can also lead to beneficial effects such as increased collagen synthesis. In fact one study that looked at the effect of supplementing with 5 and 15 grams of gelatin - the food version of a collagen supplement, think a measured version of bone broth - they found that individuals who consumed 15g of gelatin an hour before working out had twice the amount of a markers in their blood that indicates increased collagen production. One thing to note in this study is that the the supplement that was taken in this study was also enriched with vitamin C a vitamin that is key in the process of creating collagen.
What Does the Research Say?
There have been dozens of studies that have looked at how supplementing with collagen effects our pain, our movement and our recovery from an injury.
Let’s look at what the research has to say.
Part 1: Joint Pain & Collagen Synthesis
A systematic review looked at over a dozen studies to look at what we know from the research on collagen supplementation. It looked at how collagen supplementation affected: (i) joint pain and recovery from joint injuries, (ii) body composition, (iii) muscle soreness and recovery from exercise, and (iv) muscle protein synthesis (MPS) and collagen synthesis. COL=collagen.
The Research Found:
Strong evidence of 5–15 g/day dose of COL in improving joint pain and functionality.
Changes in body composition and strength with 15 g/ day COL and resistance training were not as prominent in young recreationally active participants as they were in elderly sarcopenic men (when it comes to building strength a protein supplement like whey will be more beneficial since collagen doesn’t contain all the essential amino acids.).
Exercise and vitamin C seemed to aid collagen synthesis. 15 g/day COL was more effective than 5 g/day COL in elevating collagen synthesis, 15 g/day may be a more effective dose. COL should be consumed prior (~ 60 min) to exercise to maximise collagen synthesis, but more research is need to be done before timing is a hard and fast rule.
Muscle recovery had a modest but significant improvement with COL.
Part 2: Joint Pain & Osteoarthritis
Another group of researchers performed a Meta-Analysis on the effect of collagen supplementation on osteoarthritis symptoms, this specific research, Effect of collagen supplementation on osteoarthritis symptoms: a meta-analysis of randomized placebo-controlled trials, looked at research where a placebo was used as a control. This means that one group received collagen and the other took something that should not cause any changes. This is done to control for the placebo effect.
These researchers specifically wanted to see if the research done on collagen had found improvement as it relates to osteoarthritis. They did this by looking at studies that specifically utilized the Western Ontario and McMaster Universities (WOMAC) index. The WOMAC index is the most common used clinical tools for evaluating patients with knee OA. It includes five questions about pain, two about stiffness, and 17 questions on degree of disability of activities of daily living. The also wanted to look at the effect on pain so they included studies that also looked at the Visual Analog Scale, the (VAS) is a validated, subjective measure for acute and chronic pain.
The Research Found:
Collagen Supplementation helped with osteoarthritis symptoms by the reducing both the total WOMAC index and VAS score.
A decrease in stiffness was the main factor of the improvement to the WOMAC Index.
Subjective measurement for chronic and acute pain showed the greatest improvement (VAS).
10 grams of collagen a day was the dose that showed the most consistent improvement compared to 2 grams a day and 40 grams a day possibly exposing that their is an upper limit and lower limit that shows benefits
Part 3
The last study we are going to look at is a study that recently came out this year titled, Collagen peptides supplementation improves function, pain, and physical and mental outcomes in active adults. This study set out to find how daily supplementation of either 10 grams or 20 grams affected pain, function, physical and mental health at 3, 6, and 9 months in middle aged active adults.
The Research Found:
Both 10 g/d and 20 g/d doses improve physical function/ADLs, pain, mental, and physical component scores when supplemented for at least 6 months.
Individuals who are more sedentary may require a larger dose (20 g/d) to protect against declines in Quality of life.
10 g/d of CP supplementation may be more effective in active individuals than 20 g/d in improving various health scores, but both doses are better than no supplementation.
Females might benefit more from higher doses than males, and frequent exercisers see enhanced benefits compared to sedentary individuals.
Tying It All Together
Collagen supplementation has gotten significant attention in recent years and for good reason. The research consistently shows its potential benefits, especially in the realms of joint health, pain management, and overall physical and mental well-being. Here's are the 5 main takeaways.
Optimal Dosage: A daily intake of 5–15 g of collagen seems to be the sweet spot for most individuals, particularly in improving joint pain and functionality. However, the optimal dose can vary based on individual factors such as activity levels and biological sex.
Collagen vs. Other Proteins: While collagen has proven benefits, it's essential to note that for muscle building and strength, other protein supplements like whey might be more effective due to their complete amino acid profile.
Exercise and Timing: Combining collagen supplementation with exercise, especially when taken about an hour before a workout, can maximize collagen synthesis. However, the exact timing still requires more definitive research.
Osteoarthritis Relief: For those suffering from osteoarthritis, collagen supplementation can be make a significant impact. It not only reduces overall symptoms but specifically aids in decreasing stiffness and pain, as evidenced by the WOMAC index and VAS score.
Quality of Life and Demographics: Middle-aged active adults can expect improvements in physical function, pain, and overall well-being with consistent collagen supplementation. However, sedentary individuals might need a higher dose to see similar benefits. Additionally, biological sex and exercise frequency can influence the effectiveness of collagen doses.
Collagen supplementation looks to offers a myriad of benefits, but as with all research more research needs to be done. Questions still remain about timing, optimal dosage, and effects on certain population. Overall, collagen is a supplement that I find beneficial for myself and recommend to many of my patients who suffer from joint discomfort or are actively engaged in an exercise regiment to help maintain the health of their joints. Remember if you’re a patient here at Optimize Chiropractic you get 35% off all Thorne supplements.
I hope you enjoyed this blog and as always if you have any questions feel free to reach out to me at drcoffman@optimizecolumbus.com and I hope you have a wonderful day!
-Dr. Jake