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Collagen Supplements Review
Posted: 9/28/2019 Last update: 12/7/2019
Sections:Jump to a section by clicking on its name.
What is it? Collagen is a type of protein found in the skin (types I and III collagen), joints (type II collagen) and other parts of the body. It uniquely contains the amino acid hydroxyproline, along with other amino acids. Collagen in supplements is typically hydrolyzed, i.e., broken down to amino acids and/or chains of amino acids (peptides) to improve absorption as well as the ease with which it mixes into liquids (See What It Is).
Does it help? Collagen appears to modestly reduce wrinkles and slightly improve the appearance of cellulite. It may also modestly improve joint pain and flexibility in osteoarthritis. These effects can require two to six months of daily use (see What It Does).
What did CL find? ConsumerLab's tests showed that products contained their expected amounts of collagen, ranging, per daily serving, from about 3 grams to 25 grams among powders and liquids, and from 0.01 grams (10 mg) to 6 grams for tablets, capsules, and chews. One product was Not Approved due to contamination with cadmium, a toxic heavy metal (See What CL Found).
How much to use? Typical daily dosage of hydrolyzed collagen is 1 to 9 grams. Dosing with UC-II, a cartilage-based product, is much lower. Collagen may be taken with or without food. For details see What to Consider When Buying and Using.
Cautions: Collagen supplements are generally well-tolerated, but mild side effects including gastrointestinal symptoms, headache, dizziness and rash can occur. People with allergies to specific sources of collagen (such as fish) should avoid collagen products derived from these sources (see Concerns and Cautions).
Collagen Supplements Tested and Reviewed by ConsumerLab
What It Is:
Collagen is the most abundant protein in the body. It is a main building block of connective tissue and found in skin, bone, cartilage, tendons, muscle, blood vessels and the cornea of the eye. Collagen protein is a rich source of amino acids -- especially glycine, proline, and hydroxyproline, which are used by the body to build new collagen. Hydroxyproline is unique to collagen and is not found in other types of protein. Hydroxyproline and proline make collagen particularly stable — an important attribute in its role in connective tissues.
Collagen supplements are typically derived from animal sources such as cows, pigs, chicken, or fish, and occasionally, from other sources, such as eggshell membranes.
Types of collagen:
There are many types of collagen, but the predominant types in the body are types I, II, and III. Collagen supplements for the skin typically (but not always) contain type I and/or type III collagen — the principal types of collagen found in the tendons, bone, and skin — in which they have been shown to decrease with age (Cheng, African J Biotechnol 2011; Varani, Am J Pathol 2006). Supplements for joint health typically contain type II collagen, which is found most abundantly in cartilage.
Forms of collagen: Collagen hydrolysate (also called hydrolyzed collagen or collagen peptides) is collagen that has been broken down (often with heat and enzymes) into smaller fragments of protein, or peptides. This makes the peptides more absorbable and allows them to mix into cold as well as hot liquids.
Collagen that has been only partially hydrolyzed is known as gelatin, in which the collagen fibers (made of a three strands twisted into a helix) are unraveled and become globular. However, gelatin will only dissolve in hot water and won't easily mix into cold water.
Collagen is also sold in a raw "undenatured" form. An example of this is the proprietary ingredient UC-II, which is, essentially, cartilage from chicken breast -- which is why only about 25% of UC-II is collagen, with the rest being other components of cartilage, such as glycosaminoglycans. The makers of UC-II claim that the undenatured collagen in UC-II differs from hydrolyzed or denatured collagen because it contains active immune modulators that reduce the secretion of enzymes that break down type II collagen, thereby slowing the inflammatory response.
Undenatured collagen, gelatin, and collagen hydrolysate may all be broken down in the gut to yield absorbable amino acids, although studies in mice have suggested that absorption may be greater with collagen hydrolysate, due to its smaller molecular size.However, a study in healthy young men showed the bioavailability of amino acids from hydrolyzed collagen peptide powder was not significantly greater than that from an equal amount (20 grams) of gelatin (both were mixed in about 1¼ cup of warm water). The men also found the gelatin slightly more palatable than the peptides and, considering it was only one-quarter the cost of the peptides, 93% said they would be willing to pay for the gelatin versus only 60% for the peptides if they knew the powders were beneficial.
(Alcock, Front Nutr 2019).
What It Does:
As with other proteins, most of the collagen you consume will be broken down into individual amino acids during digestion. In addition to being a source of protein, there is preliminary evidence that some collagen peptides may remain intact as they are absorbed, and can accumulate in skin and cartilage (Iwai, J Agric Food Chem 2005; Oesser, J Nutr 1999). As discussed below, there is some evidence to suggest that certain types of collagen may modestly help to improve the appearance of aging skin or reduce the pain of knee osteoarthritis.
For aging skin and wrinkles:
Adults lose about 1% of the collagen in their skin each year, which contributes to thinning and wrinkling in aging skin. This loss of collagen may be more evident at an earlier age in women, who have lower collagen density in their skin than men (Shuster, Br J Dermatol 1975).
Studies in people suggest that collagen can provide a very modest benefit (10-20% improvement) in improving wrinkles by increasing skin volume and elasticity, while there is less evidence of a benefit for improving skin hydration and reducing skin roughness.
The best evidence supporting the use of collagen in aging skin is with Verisol (Gelita AG), a collagen peptide made of hydrolyzed, porcine-derived (from pigs) type I collagen. Several studies have been conducted, all of which used Verisol as a powder mixed with water. The most notable study focused on crow's feet wrinkles around the eyes of women ages 45 to 65. At 4 weeks of treatment with 2.5 grams of Verisol daily, eye wrinkle volume was reduced by 7.2% in comparison to placebo and, at 8 weeks, by 20.1%. Even 4 weeks after treatment, wrinkle volume had decreased 11.5% more than placebo. In addition, fluid extracted from skin (of the inner arm) showed that procollagen type I content increased by 65% compared to placebo after 8 weeks of treatment and elastin increased by 18%. All of these findings were statistically significant (Proksch, Skin Pharmacol Physiol 2014).
Another study among women (average age 48) found those who took 2.5 grams or 5.0 grams of Verisol daily for two months had a modest improvement in skin elasticity of the inner forearms, but no improvement in skin roughness or increase in hydration, compared to placebo. Among those who took the collagen supplement, increased skin elasticity was greatest in women who were over age 50; both doses were equally effective (Proksch, Segger, Skin Pharmacol Physiol 2014). The collagen was given as a powder and added to water. (Although not focused on aging skin, a third study with Verisol among women averaging 40 years of age, found that taking 2.5 grams daily for six months reduced the appearance of thigh cellulite as measured by a "pinch test" by 9% and skin "waviness" by 8% compared to placebo (Schunck, J Med Food 2015). Verisol is an ingredient in many "skin" supplements that appear to provide the proper dose of 2.5 grams (2,500 mg) per daily serving.
A small study among men and women in Japan found that 3 grams of collagen peptides taken daily for three months modestly improved skin hydration and elasticity compared to placebo (Choi, J Cosmet Laser Ther 2014). The addition of 500 mg of vitamin C to the collagen peptides did not enhance these effects. The source of the collagen was not identified but was described as a "highly advanced-collagen tripeptide" which contained "3% glycine — proline — hydroxyproline."
A three-month placebo-controlled study in the summer/fall among 113 Caucasian women (average age 50) found that taking one capsule of BioCell Collagen (by BioCell Technology, LLC, which arranged and funded the study and largely authored the study report) taken twice daily for three months significantly increased collagen content in facial skin, increasing it by 12% versus a 12% decrease in collagen among those taking the placebo. There was no significant difference in skin moisture between the two groups. The collagen and placebo groups reported similar amounts of improvement in skin tone, texture, and dryness but the collagen group reported a greater improvement in facial lines/wrinkles — although this was only an 8% improvement. The collagen group reported an 11% improvement in crow's feet, but this was not significantly greater than the 4% improvement reported by the placebo group. Each capsule contained 500 mg of BioCell Collagen, a blend of 300 mg of hydrolyzed type II collagen derived from chicken sternal cartilage, 100 mg of chondroitin sulfate and 50 mg of hyaluronic acid; participants were instructed to take it with a full glass of water, preferably on an empty stomach (Schwartz, Altern Ther Health Med 2019). Interestingly, an earlier study (not placebo-controlled) using the same dose of BioCell Collagen did not find it to increase collagen content of facial skin when taken for three months (Schwartz Clin Interv Aging 2012). BioCell is found in many products.
A study cited as evidence for the benefits of NeoCell Derma Matrix Collagen Skin Complex did not include a placebo control. NeoCell is a supplement in powder form which contains type I and type III collagen (source of collagen not listed), hyaluronic acid, and vitamin C. The label claims that its clinically tested formula "promotes reduction of fine lines and wrinkles," and "increases hydration by 21%." The label also states that "92% of people had increased skin hydration" and "65% of people experienced firmer and softer skin." However, these claims are based on an unpublished study which, as noted above, had no placebo control and for which only a summary (provided by NeoCell upon email request) appears to be available.
According to the summary provided by NeoCell, 26 women (ages 30 to 50) consumed tablets containing 6 grams of NeoCell Super Collagen+C daily for three months (it's not clear if this is exactly the same formula as sold as a supplement). Skin hydration was measured and compared to measurements before supplementation (areas of the body where measurements were taken are not specified in the summary) and the women reported their observations on changes in their skin. The summary indicates the results stated on the product label (noted above) but does not provide the underlying data which supposedly supports the promoted findings. [Note: The label for this product warns it may contain trace amounts of naturally occurring sulfite residue. People with a sulfite allergy should not take this product].
A 3-month study among 40 women (40 to 50 years old) in Brazil found that 9 grams of hydrolyzed collagen taken daily for three months significantly increased moisture retention, skin density (which decreases with age and sun damage), and skin elasticity in the area around the nose and mouth, and compared to placebo. There was also a reduction in the appearance of wrinkles and the number of enlarged pores compared to before supplementation, but these changes were not compared to placebo, making it impossible to determine the actual benefit of the formula on these parameters. In addition to hydrolyzed collagen, the daily supplement contained modest amounts of vitamins and minerals, including vitamins A (600 mcg), C (45 mg), E (10 mg), and zinc (7 mg) (Campos, J Cosmet Dermatol 2019).
Joint Pain: Collagen supplementation may help reduce joint pain and/or stiffness according to preliminary studies, although benefits may not be apparent for at least three months.
Perhaps the most studied collagen product for joint pain is UC-II which, as noted above, is actually undenatured cartilage and contains only a small amount of collagen that has not been hydrolyzed -- about 10 mg of collagen in a 40 mg daily dose of UC-II. In a randomized, double-blind clinical study of 55 people who experienced joint discomfort after physical activity (but did not have arthritis, or joint pain at rest) daily supplementation with UC-II for 4 months was found to significantly improve average knee extension but did not appear to reduce pain compared to placebo (Lugo, J Int Soc Sports Nutr 2013).
Another clinical study compared daily supplementation with either UC-II (40 mg) or glucosamine and chondroitin (1,500 mg glucosamine HCl and 1,200 mg chondroitin sulfate) in people with knee osteoarthritis. After 3 months, UC-II significantly improved measures of pain, stiffness and physical function while the combination of glucosamine and chondroitin did not (Crowley, Int J Med Sci 2009). A similar, but longer (6 month) study that included a placebo control found that average pain scores decreased by 24 points among those who took UC-II compared to decreases of 19.2 points and 17 points among those who took glucosamine and chondroitin or placebo, respectively. Those who took UC-II also had a significant reduction in stiffness (a decrease of 23.8 points) compared to decreases of 19.4 and 17.8 points, respectively, for those who took glucosamine/chondroitin or placebo. There were no improvements in knee flexion (Lugo, Nutr J 2016).
[Note: The 2016 study above reported that 40 mg of UC-II provided 1.2 mg of undenatured type II collagen as determined by a "newly developed and validated extraction" protocol, while the earlier studies reported that 40 mg of UC-II provided 10 mg of undenatured type II collagen (as we confirmed in this Review). A subsequently published letter by the author (who works for the manufacturer, Lonza) explained that the material in the study (and in UC-II in supplements) did not change: The 2016 study applied a modified testing procedure that provides less extraction time before the collagen is measured, so a lower amount of collagen is reported (Lugo, J Int Soc Sports Nutr 2019).]
One of the largest studies with collagen hydrolysate found, after six months of taking 1,200 mg daily (as Genacol), a statistically significant difference in the percentage of patients reporting a reduction in pain: 51.6% of those taking the collagen versus 36.5% of those taking placebo, although after only 3 months, there was no significant difference. (Bruyere, Comp Ther in Med 2012).
A small study published in 2014 in people with knee osteoarthritis found that taking 5 grams of collagen hydrolysate (collagen peptide) dissolved in a cup of water or milk in the morning and at night after food daily for 13 weeks significantly improved symptoms compared to taking a placebo (Kumar, J Sci Food Agric 2014). Another 13-week study suggested greater benefit with collagen hydrolysate (also 10 grams daily) than with a more common supplement for osteoarthritis, glucosamine sulfate (Trc, Intl Orthop 2011). However, there was no placebo control, so it is not possible to know if either treatment was truly effective.
Reductions in joint pain have been modest at best with eggshell membrane hydrolysates, which naturally contain type I collagen, elastin, and small amounts of glucosamine and chondroitin. A study among 80 men and women (average age 53) with self-reported knee pain found that, overall, 450 mg per day of a chicken eggshell membrane hydrolysate (BiovaFlex by Biova LLC, which funded the study) was no more effective than placebo in improving pain, stiffness or function, as there were similar improvements in both groups. However, the researchers then performed a sub-analysis showing that those who began the study with the most difficulty walking experienced somewhat more improvement with BiovaFlex versus placebo in knee stiffness and walking distance. According to Biova'swebsite, BiovaFlex is >15% collagen, >20% elastin, and >5% glycosaminoglycans (Hewlings, J Med Food 2019). One product tested in this review, Ancient Nutrition Multi Collagen Protein, is listed as containing collagen from eggshell membrane.
A double-blind, randomized study in Turkey in which another hydrolyzed eggshell membrane supplement, NEM (Natural Eggshell Membrane, ESM Technologies, LLC), was given to 161 men and women (average age 57) with mild to moderate knee osteoarthritis for one month found that it modestly improved knee function and reduced pain and stiffness, but did not improve flexion or range of motion, or reduce the use of pain medication (Tylenol) compared to placebo. The supplement was given as one 500-mg capsule of eggshell membrane hydrolysate taken with water once daily at breakfast. Supplements that contain this ingredient include Healthy Origins Natural Eggshell Membrane and Natural Factors NEM. Mild side effects such as rash and nausea were reported in three participants who took NEM (Eskiyurt, J Arthritis 2019).
Building muscle and muscle strength:
There is some evidence collagen may help to build muscle and increase muscle strength in older adults when combined with exercise — although this is not surprising considering that other sources of protein can achieve the same effect . In a study among older men (average age 72) with sarcopenia (age-related muscle loss) who participated in a strength training program three days per week for 3 months, those who consumed a daily drink containing 15 grams of collagen peptides (BODYBALANCE, GELITA AG) had significantly greater increases in lean muscle mass and muscle strength compared to those who consumed a placebo drink (Zdzieblik, Br J Nutr 2015).
However, if you are looking to supplement to build muscle, you may be better off with a protein powder because collagen is not particularly high the in branched chain amino acids (valine, leucine, and isoleucine) that are needed for muscle maintenance. Collagen also tends to be more expensive than a protein powder: Our Protein Powder Review shows that you can get 20 grams of a good protein powder for as little as 40 to 50 cents, while the lowest cost for 20 grams of collagen is at least $1.