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The Guide to Collagen

Last publication: 05/09/2014

Collagen is a fibrous glycoprotein that makes up our tissue, is located in lots of parts of the body, and has interesting properties. 15-20% of our body is made of collagen.

This tissue is fibrous and forms a strong frame to strengthen our organs. For example, the tendons that connect our muscles to our bones are made of collagen.

The lungs also have high collagen levels. Our bones have a collagen structure that is then loaded with calcium phosphate. If the collagen structure is not big enough, the bone cannot mineralize, and we can then develop osteoporosis. Osteoporosis is not just caused by a calcium and phosphorus or vitamin D deficiency - it also often reflects a lack of collagen.

The walls of the arteries and veins that make up our vascular system have very high collagen levels. It gives them their elasticity.

In skin, dermal cells make collagen, which supports it, makes it supple and elastic, and insulates it from heat and cold.

The walls of our eyes and lenses are also made of collagen. Finally, our nails and hair contain a lot of collagen.

The big problem with collagen is that we do not know how to maintain it, and it degrades slowly over our lifetime.

This collagen degradation comes from the fact that we do not eat products that contain a lot of it any more, so we develop deficiencies in some of the proteins that make it. Foods with high collagen levels were stocks made with joints and bones and tripe and chitterlings, brawn and other things that we used to eat. We do not renew our collagen any more, and this causes serious deficiencies and degeneration in some of our organs, in particular those that work all the time: tendons and cartilage in our joints and vertebrae, for example.

Joint problems

This degeneration in tendons affects body processes at a number of joints: knees, hips and inter-vertebral cartilage in our spine, causing a problem that affects many people. For example, in France it affects 80% of people as back pain.

Joint disease (osteoarthritis) is the most common chronic problem above age 50. We use anti-inflammatories and analgesics to calm the pain, but this has no effect on the progressive nature of these problems.

Taking collagen long term will provide the constituent elements needed for the body to repair cartilage and tendons and to truly improve these problems.

Many clinical studies have been done on hundreds of patients all over the world, particularly in Germany and the USA, to show the value of consuming collagen hydrolysate to improve osteoarthritis problems and rheumatic pain that arise from degeneration in joint cartilage. They all showed it was highly effective:

  • pain reduction
  • decreased analgesic consumption
  • improved joint use
  • much better feeling of joint comfort.

Many clinical studies (more than 30 – see the list at end of this booklet), in particular those by Adam, Beuker, Rippe and Moskowitz, have shown that taking about 10 g collagen hydrolysate for at least 6 months improved symptoms of arthritis, greatly reduced pain and discomfort, and allowed damaged joints to rebuild.

As we explained above, it is a collagen deficiency in our diet that causes the poor renewal in tendon's structure. The loss of cartilage in tendons and joints causes the progressive destruction of all these joint shock absorbers and creates the conditions that favour pain and unpleasant side effects: loss of joint elasticity and inflammatory reactions with oedema and joint deformation.

What is more, using anti-inflammatory medications reduces the ability of proteoglycans to construct and affects the cells that reform cartilage, chondrocytes.

Using collagen hydrolysate for several months causes a clear improvement in joint problems, including joint suppleness and pain reduction.

Collagen hydrolysate is therefore remarkable in how it improves rheumatic pain. It favours the synthesis of all joint cartilage and tendons. It improves back pain, suppleness in general, and how our members move.

This action is remarkable and very effective in patients suffering from arthritis.

However, for athletes, who are less affected than seniors, improved movement is an appreciable gain that will have a preventive effect, which they always notice.

What is more, and this is very important for seniors, especially women, collagen hydrolysate also improves osteoporosis. This is a very common problem, especially in women over 50. It is prevented by taking calcium and vitamin D supplements. The collagen-based protein frame has to be abundant for the bone to recalcify. Collagen deficiencies, which favour arthritis, also exist in bone's protein frame. If the frame is not strong enough, calcification cannot occur. There to prevent osteoporosis it is important to take calcium, vitamin D and phosphate, but also collagen for the bone's protein frame.

In parallel with work on osteoarthritis, clinical work (for example by Professor Adam) has also shown that collagen hydrolysate improves osteoporosis, even without a calcium or vitamin D supplement. This is why collagen is also important in osteoporosis.

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The skin

It has been known for many years that taking collagen improves skin moisturisation and suppleness, i.e. it has anti-wrinkle action as it reduced their depth. Using collagen hydrolysate has been common for a long time in Japan and Asia, where collagen solutions are taken by millions of women. Clinical studies have shown that absorbing 10 g per day collagen hydrolysate affects the skin in a promising way. It is more hydrated, has fewer deep wrinkles and is suppler.

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Circulatory system

Collagen, which is abundant in our whole circulatory system (arteries and veins), will therefore be more abundant in people who take 10 g sachets of collagen hydrolysate.

Therefore, the handling your osteoarthritis and rheumatism may also improve artery suppleness and circulatory system function.

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Since collagen is abundant, toning the eyeball and reconstituting the lens, we might wonder whether collagen deficiencies might tend to increase cataracts, which are lens opacity. We might wonder whether taking collagen hydrolysate might improve cataracts.

To treat osteoarthritis, symptomatic medication (pain relievers and NSAID) is the first step in fighting inflammation and joint pain. In the long term, these medications cause non-negligible side effects and none of them halts the progressive cartilage destruction.

Several studies have already revealed the beneficial effects of a number of nutrients for joint health. These are mainly glucosamine, chondroitin and SAM. Among these nutrients, collagen found in food and especially in meat, is a major component of joint cartilage.

Its hydrolysed form is characterized by good bioavailability since it reaches maximum plasma concentration 6 hours after being eaten. Kinetic studies in animals have shown that fragments of radio-labelled hydrolysed collagen (HC) were found in cartilage 12 hours after oral administration [Oesser, 1999].

The specificity of HC is that it contains three times more proline and glycine than other proteins. It is precisely these two amino acids that, firstly, are responsible for the three-dimensional conformation of collagen, and secondly that influence the stability of collagen structures in cartilage. These intrinsic properties thereby contribute to maintaining joint structure. From a pharmacological point of view, in vitro studies have shown that supplying HC to the culture medium of chondrocytes caused a significant, dose-dependent increase in collagen type II synthesis [Figure 1].

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Collagen and rheumatism

Figure 2 also illustrates the synthesis of type II collagen by chondrocytes in contact with HC.

Similarly, it was observed that the quantity of proteoglycans was also significantly increased in the presence of HC [Bello, 2006]. These results have led the investigators to explore the use of HC as an agent involved in the regulation of cartilage metabolism and to evaluate its efficacy in patients suffering from osteoarthritis.

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Clinical studies

In a review of literature published in 2006, there were four uncontrolled (370 subjects in all) and three double blind experiments versus placebo (720 subjects) [Bello, 2006]. Generally speaking, the results were seen to be interesting and often significant compared to the placebo group, in particular for improving joint pain and mobility (Table 1).

Author No. of subjects Pain location Study protocol Results studied Results
Krug 56 Tibia, femur, knee or spine Open trial Pain and general condition 10 (24%) report very clear improvement, 18 (44%) note improvement, 13 (32%) do not note improvement.
Götz 60 Knees Open trial Pain reported by the patient 45% no longer feel pain, 30% report improvements symptoms, 25% have no improvement.
Oberschelp 154 Knees, hip or lower back Comparative study Pain intensity Better results have been obtained in the group combining physical exercise when taking collagen. 56% patients have observed an improvement versus 20% for the "exercise alone" group.
Flechsenhar 100 Pain in the hips, knees or shoulders due to sport Open trial Pain upon movement Pain reduction: improvement for 68 subjects, unchanged for 19. One did not give opinion.
Adam 81 knees or hips Double blind Pain, consumption of analgesics Pain reduction reported by: 81% of those who take collagen hydrolysate, 23% of those who take egg white (placebo); 69% consuming collagen (versus 35% of those taking a placebo) halved the amount of analgesic they were taking.
Zuckley 250 Knees (mean) Randomised, double blind versus placebo Leg isokinetic and isometric forces, pain, stiffness, mobility and flexibility No significant difference between groups for measurements of pain, stiffness, mobility or flexibility; improvements (p<0.05) in 3/6 measurements of leg isokinetic force
Moskowitz 389 Knees Prospective study, randomised, double blind versus placebo Pain score with the WOMAC test, function score and patient’s overall assessment No significant difference for the whole of the study group. The German patients show a statistically significant benefit with collagen use for pain reduction (p=0.016) and functional improvement (p = 0.007) but no overall change (p=0.074).

Table 1: Clinical studies performed with hydrolysed collagen

Very recently, Benito-Ruiz et al. [2009] did a randomised double blind clinical study versus placebo on 250 patients suffering from osteoarthritis of the knee (gonosteoarthritis). The patients, who had an average age of 59, received 10 grams of HC daily or a placebo for 6 months. Efficacy was evaluated using scales evaluating patients' improvement in joint comfort and quality of life. The severity of the pathology and consumption of animal protein were also analysed statistically.

The symptomatic change has been estimated using three different scales. The means were compared at inclusion and after 6 months: the visual analogue pain scale, the WOMAC osteoarthritis index and the SF-36 questionnaire assessing quality of life.

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1- Visual analogue pain scale (VAS):

The difference observed before and after 6 months of treatment between the HC group and the placebo is statistically significant (p=0.024) and clearly indicates that administering HC improves joint comfort.

This efficacy was even higher for patients whose osteoarthritis was severe to start with (p=0.015) and in patients who ate little meat, and had lower dietary collagen intake (p=0.01).

Figure 3 represents the percentage of patients in each of the groups who had a reduction of at least 300 mm VAS pain. These values corresponded to the calculation of the lowest clinically relevant change. 75% of the patients taking HC reach this criterion for efficacy, versus 53% in the placebo group (p<0.001).

2- WOMAC (Western Ontario and McMaster Universities): index of symptomatic severity in osteoarthritis of the lower limbs and health questionnaire (SF-36):

A significant improvement of +19% (p=0.044) in the WOMAC index (pain) between inclusion and after 6 months of treatment was higher in the HC group than for the placebo group. Much higher efficacy (+ 41%) in the two groups for the most severely affected patients.

A positive change of SF-36 was observed in both groups after 6 months treatment but no statistically significant difference was shown.

The value of collagen in other populations


Flechsenhar et al. [2005] evaluated the efficacy of HC in athletes with joint pain linked to the practice of intense physical activity. 100 athletes with knee, hip or elbow pain received 10 g HC for 12 weeks. A clinical trial was carried out with a score scale including pain at rest, pain with movement, functional limitation and inflammation. The intensity of each parameters was evaluated on a scale of 1 (no pain) to 10 (intense pain, movement limited).

The patients and physicians evaluated the intensity of the pain in various situations: walking, climbing stairs, when still and during the night. The results indicate that 78% of patients had noted a clear reduction in pain after the 12 weeks of treatment [cited in Schrieber, 2007].

In another clinical trial published by Clark et al. in 2008, 97 university athletes with joint pain linked to physical exertion consumed 25 ml of a drink containing 10 g collagen hydrolysate or a placebo for six months. Several parameters were evaluated, such as pain, inflammation and joint mobility. The collagen hydrolysate based drink was statistically more effective than the placebo in reducing joint pain in athletes.

The HC had a positive influence on joint health and may also slow down long term cartilage deterioration, which is particularly stressed in athletes.

Menopausal women with osteoporosis:

Osteoporosis is a disease characterized by an excessively fragile skeleton, due to reduced bone mass and changing bone microarchitecture. This is a frequent disease in post-menopausal women because bone mass reduces with age and with female hormone (oestrogen) deficiencies. Normally, up to one third of the adult skeleton is remodelled each year by two types of cells whose opposing actions are balanced by a complex mixture of hormones and chemical factors. Osteoblasts begin the bone formation process, secreting collagen and mineralising it with calcium and phosphorus. The osteoclasts reabsorb proteins and calcium before releasing them into the circulatory system.

Osteoporosis results from either insufficient bone capital being acquired at the end of growth, or excessive bone loss during adult life. Genetic, nutritional and environmental factors determine how much bone is acquired during growth, and lost later.

From a nutritional point of view, collagen, calcium and vitamin D deficiencies are risk factors for developing osteoporosis. Given the structural role of collagen in bone constitution, calcium and collagen loss both imply a bone loss, consequently reducing skeletal rigidity and solidity.

In a study led by Adam et al. [1996], the efficacy of HC supplementation on bone metabolism in people with osteoporosis was evaluated.

This trial on 108 menopausal women lasted 24 weeks with osteoporosis and treated with calcitonin tea. This hormone is commonly prescribed to treat post-menopausal osteoporosis to fight bone loss as it participates in bone and calcium metabolism. Specifically, it reduces calcaemia (the calcium level in blood) by inhibiting mainly osteoclasts, which reduces bone resorption and therefore increases calcium storage in bone.

One group of patients received calcitonin alone, whereas the other group received a 10 g collagen hydrolysate sup­plement per day. Several exams were performed before treatment and afterwards. These included urine assays for specific markers for bone collagen resorption: pyridinoline (PYR) and deoxypyridinoline (DPD), which are released during degradation of the bone matrix by osteoclasts.

After six months of treatment, calcitonin caused a drop in these urinary markers. This drop was higher in the group that also received HC.

Therefore the researchers saw that taking collagen hydrolysate increased and prolonged the beneficial effects of calcitonin on bone loss.

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The results of the clinical studies suggest that long-term oral collagen hydrolysate administration improves joint pain linked mainly with osteoarthritis, and beyond this symptomatic effect, can contribute to slowing joint tissue degeneration, and also slow osteoporosis progression.

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Conjunctive issue

Conjunctive tissue

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Joint problems

Using collagen hydrolysate for several months causes a clear improvement in joint problems

Collagen type II synthesis

Figure 1: Collagen type II synthesis as a function of time in chondrocyte cultures with or without the presence of hydrolysed collagen (HC) (p<0.01).


Chondrocytes in contact

Figure 2: Chondrocyte cultures – On the right: collagen aggregates (brown colour) around chondrocytes indicate stimulation in HC collagen synthesis. On the left: chondrocyte culture in the absence of HC.

The results were seen to be interesting

The results were seen to be interesting and often significant compared to the placebo group, in particular for improving joint pain and mobility.

improvement in knee pain on the visual analogue scale

Figure 3: Proportion of patients having seen an improvement in knee pain on the visual analogue scale (VAS).


The HC had a positive influence on joint health and may also slow down long term cartilage deterioration



Adam M, Spacek P.

[Postmenopausal osteoporosis. Treatment with calcitonin and a diet rich in collagen proteins].

Cas Lek Cesk. 1996 Jan 31;135(3):74-8.

Bello 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. Review.

Benito-Ruiz P, Camacho-Zambrano MM, Carrillo-Arcentales JN, Mestanza-Peralta MA, Vallejo-Flores CA , Vargas-López SV, Villacís-Tamayo RA, Zurita-Gavilanes LA.

A randomized controlled trial on the efficacy and safety of a food ingredient, collagen hydrolysate, for improving joint comfort.

Int J Food Sci Nutr. 2009;60 Suppl 2:99-113.

Clark KL, Sebastianelli W, Flechsenhar

KR, Aukermann DF, Meza F, Millard RL,

Deitch JR, Sherbondy PS, Albert A.

24-Week study on the use of collagen hydrolysate as a dietary supplement in athletes with activity-related joint pain.

Curr Med Res Opin. 2008 May;24(5):1485-96.

Moskowitz RW.

Role of collagen hydrolysate in bone and joint disease.

Semin Arthritis Rheum. 2000 Oct;30(2):87-99.

Oesser S, Adam M, Babel W, Seifert J.

Oral administration of (14) C labeled gelatin hydrolysate leads to an accumulation of radioactivity in cartilage of mice (C57/BL).

J Nutr. 1999 Oct;129(10):1891-5.

Schrieber R., Gareis H.

The role of collagen hydrolysate in the prophylaxis of osteoarthritis and osteoporosis

In Gelatine Handbook : Theory and Industrial Practice, 1ere ed, Vch Verlagsgesellschaft

Mbh, 2007