Listener/Caller (2:24)

Then what are you doing? I take two servings of collagen mixing with my coffee.

Marielle Segarra (2:27)

Collagen is everything.

Maria Godoy (2:28)

It's a little bit more pricey. But supplements, there's something in me that best decision I have ever made was.

Marielle Segarra (2:33)

To trust the stranger on Tik Tok.

Maria Godoy (2:37)

I'm already getting emotional.

Marielle Segarra (2:40)

I saw a video of a woman.

Maria Godoy (2:42)

Talking about this collagen. It's completely changed my life.

Marielle Segarra (2:46)

But do collagen supplements work? Maria has been looking into it and on this episode of Life Kit, we talk about what the research says. That's after the break.

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Marielle Segarra (4:16)

Hey Maria.

Announcer (4:17)

Hey.

Marielle Segarra (4:18)

Okay, so where do collagen supplements come from?

Maria Godoy (4:21)

Yeah, so collagen supplements generally come from animal sources like fish, pigs, chicken, cattle. And there are two main main forms. The first, which you see a lot of, is called hydrolyzed collagen. So this is collagen that's been broken down into peptides or like smaller chains of amino acids that are more easily absorbed. And the idea is that you take in these peptides and then they're absorbed by your GI tract. Dermatologist Lauren Taglia of Northwestern Medicine explained it to me like this.

Marielle Segarra (4:52)

The thought or the theory is that if you ingest it, it goes through the GI tract and gets absorbed, and then it's theoretically goes to places to support or increase collagen production.

Maria Godoy (5:07)

So hydrolyzed collagen supplements are generally what you see advertised for hair, nails, skin, but they are also sold to promote joint health. But there is another type of collagen supplement that's sold specifically for joints. It's called undenatured native type 2 collagen. And there are lots of different types of collagen in our body. Like more Than two dozen dozen different types have been identified. But type two makes up the majority of the collagen in cartilage that surrounds joints. And undenatured type 2 collagen hasn't been broken down, Unlike the peptides, it's thought to work differently. You know, so basically the idea is that it triggers an immune response that releases chemical messengers, and those chemical messengers tamp down inflammation. And so that would help alleviate joint inflammation and pain in patients with things like osteoarthritis.

Marielle Segarra (5:58)

And based on your reporting, do collagen supplements actually do what they claim? What does the research say?

Maria Godoy (6:06)

Well, let's start with skin. I spoke with Dr. Marianne McCreada Senna. She is an assistant professor of dermatology at Harvard Medical School. And she said, yeah, there is some evidence that supplements can boost skin. There have been randomized controlled trials that have shown that after 8 to 12 weeks of collagen supplementation, things like depth of wrinkles, skin elasticity, dermal thickness seems to be improved.

Marielle Segarra (6:32)

Okay, so that's promising.

Maria Godoy (6:34)

Yeah, I mean, it sounds promising. Right. And then just this fall, there was a big meta analysis that looked at 23 randomized controlled trials with more than 1,400 patients who took collagen supplements for skin over eight to 12 weeks. And it found that patients did see significant improvements in wrinkles, hydration, elasticity. But there was a big caveat. Here's Senna again. High quality studies and studies not funded by industry did not show a significant association. Right. While those funded by industry and that were a bit lower quality did find a significant association. Hmm. Yeah. When she says lower quality, that means that the study design wasn't as strong. So, for instance, maybe it was not a double blind study, so that neither the researchers nor the participants knew if they were receiving collagen supplements or placebo. Placebo. So that's considered less rigorous and less reliable. And then when it comes to industry funding a study, that doesn't mean the results shouldn't be considered at all. But, you know, it does raise the potential for bias if the people who sell the supplements are, you know, funding the finding that says, yeah, they work.

Marielle Segarra (7:42)

Yeah.

Maria Godoy (7:43)

One other thing I wanted to note is that Senna is a dermatologist, and her specialty as a researcher is actually hair loss. And you'll often see collagen supplements promoted as being good for hair. But Senna says there's basically no evidence when it comes to hair. And I wanted to note that because I have, myself in the past have purchased collagen supplements just for this to like boost hair, but, you know, she says there are no human studies she's aware of that support this. And so if that's your concern, just don't waste your money.

Marielle Segarra (8:10)

Got it. What about joint health? Is there any evidence there for joints?

Maria Godoy (8:15)

The state of evidence is pretty similar. There are studies that show benefits, especially when it comes to osteoarthritis in the knees. And osteoarthritis is like when the cartilage that cushions the end of your bone wears down so you get pain and stiffness and loss of movement with age. It's the most common form of arthritis in the world. And several studies have shown improvements in pain reduction and knee function when using either hydrolyzed collagen or undenatured type 2 collagen. So that sounds promising, but again, the problem is that many of the studies are industry funded, so it's really hard to disentangle the potential for bias. And the studies that do exist are pretty small and a lot of them are considered low quality. I also spoke with Dr. David Felson, he's a longtime osteoarthritis researcher at Boston University, and he said that, yeah, collagen supplements could potentially help treat people with joint pain. But his stance is really just this. There's no large scale studies here and.

Marielle Segarra (9:11)

There need to be. Okay, so what's the bottom line here? You think, should we be using collagen supplements or not?

Maria Godoy (9:18)

Well, you know, when it comes to joints, he says the evidence isn't there for him to recommend it. But if he has a patient, you know, who's taking these supplements and they feel like they're help with joint pain and it's not costing them an arm and a leg and they don't have kidney problems, he's okay with that. But just make sure to talk to your doctor first to make sure the supplements aren't interfering with any medication you're on. And one thing I want to note is that whenever you're buying any supplement, you want to make sure to buy ones that are tested by a third party.

Marielle Segarra (9:48)

Yeah. How can you know if a supplement is tested by a third party? Do you just like look at the label?

Maria Godoy (9:52)

So products that have been certified by a third party will often have a verification seal on the label. And there are third party certifications to look for. There's NSF certified for sport. That's one inform, Sport is another. And USP Verified Mark from the US Pharmacopoeia. You can also go to these groups websites to look up a product and see if they certified it. And even if a product has one of these labels on the bottle, I'd recommend cross checking it on the website anyway just to make sure. The bottom line I wanted to know is like, is this gonna help me? And I asked dermatologist Lauren Taglia and she told me without large randomized controlled trials funded independent industry doctors like her just can't confidently recommend collagen supplements for skin either.

Marielle Segarra (10:37)

That's kind of where we all stand. We're kind of, you know, just oh, could be helpful, but not a ton of strong evidence to support at this point.

Maria Godoy (10:44)

Now she and other doctors, dermatologists specifically that I spoke with said, you know, if you decide to take collagen supplements on your own, they may help you. Anecdotally they've had patients say their skin or even their nails look better, but they can't recommend them based on the current science.

Marielle Segarra (11:00)

After the break, we'll have more on collagen supplements with Maria Godoy.

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Marielle Segarra (12:19)

All right, we're back with Life Kit. Maria, I imagine these collagen supplements could also be expensive, right? Like you've said, it's a multi billion dollar industry. So there's also this question of is this worth the money, right?

Maria Godoy (12:32)

That was actually my big question because I know I've paid like over $30 a bottle for collagen supplements in the past when I tried them. And so I asked this like if you have 30 bucks to spend, is this where you spend it? And like no. When it comes to skin, at least all the doctors I spoke with stressed that there are things you can do to help boost Collagen that do have science behind them. And that's really. Especially if you're on a limited budget, that's where you should be spending your money.

Marielle Segarra (12:58)

Okay, love that. What are those?

Maria Godoy (13:00)

One of the people I spoke with is Dr. Maya Jonas. She's an assistant professor of dermatology at the Ohio State University. And she said, start with the things we know are safest and have the most robust evidence behind them. We always talk about diet, making sure patients are eating a healthy Mediterranean diet that's well balanced. Avoiding alcohol, not smoking, avoiding secondhand smoke. We always talk about sun protection. We talk about retinol and using vitamin A. Retinol, for those who don't know, is a topical vitamin A derivative, and it basically boosts collagen production. There are lots of different kinds of vitamin A based products that you might have heard of. You know, there's tretinoin, or you might hear of things like retinaldehyde. And these are all in the retinoid family. And some of them are stronger than others. Some people are more sensitive to some formulations than others. So you might have to try different formulations to figure out which one works for you. Or you can talk to a dermatologist so that they can steer you in the right direction. And, you know, another dermatologist I spoke with said if you polled like a hundred dermatologists, 99 of them would tell you that retinoids are the number one thing you should be using to boost collagen and use it at night. You don't wanna actually use it during the day because it makes you a little more sun sensitive, and UV exposure can actually make it a little less effective. So two reasons to use it at night. Okay, so that's my public service announcement on retinol and sunscreen. You know, sunscreen every day, right? Because as we talked about at the beginning, sun exposure will accelerate the decline of that collagen production in your skin. And, you know, when it comes to diagnosis, diet, Jonas says eating lots of fresh fruits and vegetables, nuts and seeds, that's not just good for your overall health, but they also contain things our bodies need to support collagen production, things like vitamin C and zinc and copper. And you also want to make sure you get plenty of protein from things like fish, poultry, meat, dairy, eggs, soy, legumes. Basically, you want to eat foods that contain the amino acids you need for collagen production.

Marielle Segarra (15:05)

Yeah.

Maria Godoy (15:06)

And the last thing I'm going to evangelize is to get plenty of sleep and exercise. Again, part of my Regular spiel. So research has shown that poor sleep and stress can take a toll on skin. And exercise can not only improve your mood, but it can improve blood flow to the skin. And it may help counteract the loss of elasticity and dermal thickness that comes with aging. So, you know, if you don't want to do it for your health, do it for your vanity.

Marielle Segarra (15:35)

Totally. That's what, that's what I say to people about sunscreen, too.

Maria Godoy (15:39)

Me too. All the time. Also, I tell my daughter, good skin in your 40s begins in your tens with sunscreen in your tens.

Marielle Segarra (15:46)

Oh, no. All right, Maria, thank you so much for this.

Maria Godoy (15:54)

Oh, it's my pleasure.

Marielle Segarra (15:59)

Okay, time for a recap. There are randomized controlled trials showing that collagen supplements can make your skin look and feel better, specifically making your wrinkles less prominent and your skin thicker and more elastic. But a meta analysis of 23 of these studies found a big caveat. When you remove the lower quality studies and the ones that were funded by the industry, you don't see those results. Kind of the same deal with joint health. Some studies show benefits, but many of them are industry funded and low quality. There is basically no evidence that collagen supplements can make your hair healthier. But some things we know can improve collagen production. Eating a Mediterranean diet, using topical retinoids, avoiding alcohol, not smoking, wearing sunscreen, and getting plenty of sleep and exercise. Yeah, all the boring stuff we're always telling you to do. That's our show. Have you subscribed to the Life Kit newsletter yet? Every Friday you'll get even more expert advice on health, money and more, all curated by the Life Kit team. Think of it as a weekly check in from your friends at Life kit. Subscribe@npr.org LifeKitnewsletter this episode of Life Kit was produced by Margaret Serino. Our visuals editor is Beck Harlan and our digital editor is Malika Gharib. Megan Kane is our senior supervising editor and Beth Donovan is our executive producer.

Announcer (17:25)

Producer.

Marielle Segarra (17:26)

Our production team also includes Andy Taegle, Claire Marie Schneider and Sylvie Douglas. Engineering support comes from Stacey Abbott with fact checking by Tyler Jones. I'm Mariel Segarra.

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