Common Collagen Claims (taken from actual websites selling collagen supplements):
Collagen as a supplement is not regulated by the Drug division of The Food and Drug Administration
If you look at the bottom of the websites, or on the bottles, you will see a disclaimer that the claims “have not been evaluated by the U.S. Food and Drug Administration. ” More telling is “these products are not intended to treat, diagnose, cure, or prevent any disease.” Such a disclaimer is provided by the lawyers because if one claims to cure, treat, or diagnose an actual medical condition then it must have passed a rigorous FDA approval. To be clear, there have been no FDA studies that show collagen as a supplement treats any disease.
Supplements commonly will use “support xyz health” – where you can fill in the blank with hair, nails, joints, skin – in the case of collagen.
One of the main issues with supplements is “If the composition and quality of ingredients cannot be reliably ensured, the validity of research on dietary supplements is questionable. Moreover, the health of the US public is put at risk.”
Starr RR. Too little, too late: ineffective regulation of dietary supplements in the United States. Am J Public Health. 2015;105(3):478-485. doi:10.2105/AJPH.2014.302348
As such, even when you look at the studies which promote collagen, or collagen byproducts, they do not meet the most basic of studies which are done to evaluate pharmaceuticals. In order to have an evaluation of a pharmaceutical you must have three phases in the trial:
Thalidomide, for example, was released in Europe and even had two drug trials in the United States but was NEVER approved in the United States by the FDA because of insufficient data.
Vioxx was a drug used worldwide and was taken off the market in 2004 because of the risk of a fatal heart attack, but was taken off after it had passed multiple drug tests previously.
FDA testing is rigorous and specific, with the highest standards in the world. Collagen has NEVER had such rigorous testing performed. These tests have not risen to the level and in 2022 one report noted “More research is needed to establish knowledge of the effects and physiologic mechanism of collagen supplementation. Dermatologists should be aware of the unsubstantiated proclamations of collagen made by companies and in social media, as well as what evidence is established thus far, to be equipped to discuss collagen supplementation with patients.”
Rustad AM, Nickles MA, McKenney JE, Bilimoria SN, Lio PA. Myths and media in oral collagen supplementation for the skin, nails, and hair: A review. J Cosmet Dermatol. 2022 Feb;21(2):438-443. doi: 10.1111/jocd.14567. Epub 2021 Oct 25. PMID: 34694676.
One of the most quoted meta-analysis looked at 19 studies with 1125 participants – which is barely enough in any given study to make bold statements about safety, efficacy, toxicity, and side effects of hydrolyzed collagen supplementation.
de Miranda RB, Weimer P, Rossi RC. Effects of hydrolyzed collagen supplementation on skin aging: a systematic review and meta-analysis. Int J Dermatol. 2021 Dec;60(12):1449-1461. doi: 10.1111/ijd.15518. Epub 2021 Mar 20. PMID: 33742704.
So when someone states that study as the basis for use of the product, one has to have caution that there is not enough data, not enough rigorous data, and when studies do not include toxicity, this should be a major red flag.
Collagen is regulated by the Center for Food Safety and Applied Nutrition
Meaning, collagen, like most supplements, is regulated as a food, not as a drug. This is not the celebrated division that worked hard to get a COVID vaccine or anti-viral medications, this is the division that is responsible for food safety. This is the division of the FDA that is slow-moving, filled with bureaucracy, and has not even responded in a timely manner to any of the recent bacterial contaminations of our food. Take the spinach contamination, where people across ten states became ill, by the time the FDA came out with a recall the shelf life for that spinach was long overdue.
The same division tasked with reducing salt in our diets, but fears industry so much that no regulations have been put into place.
This is the same division that does not have leadership, budget, or inspectors to police our food supply.
The only time the FDA has become involved in any supplements is when a proven threat to the public has been discovered, or if someone complains that a claim made by the company alleges to “treat a disease.” Which is why collagen manufacturers make the claims above.
The undisputed science of collagen
Collagen is the main protein that forms the connective tissue of our body: skin, muscles, tendons, bones, blood vessels, even our heart valves. There have been 28 different types of collagen identified in humans, but over 90% of the collagen is called “Type 1.” Type 1 collagen is a huge molecule with thousands of amino acids, and coded for by over 40 genes. Two chains are formed from the translation and these polypeptide chains are assembled, cut, arranged, glycosylated, and packaged in different parts of a cell called a fibroblast and then transported out of the cell where it is further trimmed, combined with other molecules of collagen and begins to form and reform and cross-link with other collagen molecules.
Gauza-Włodarczyk M, Kubisz L, Włodarczyk D. Amino acid composition in determination of collagen origin and assessment of physical factors effects. Int J Biol Macromol. 2017 Nov;104(Pt A):987-991. doi: 10.1016/j.ijbiomac.2017.07.013. Epub 2017 Jul 4. PMID: 28687386.
Brodsky B, Persikov AV. Molecular structure of the collagen triple helix. Adv Protein Chem. 2005;70:301-39. doi: 10.1016/S0065-3233(05)70009-7. PMID: 15837519.
Hulmes DJ. Building collagen molecules, fibrils, and suprafibrillar structures. J Struct Biol. 2002 Jan-Feb;137(1-2):2-10. doi: 10.1006/jsbi.2002.4450. PMID: 12064927.
In order to form in an orderly manner and to be strong, it must link with other collagen molecules in an organized manner and needing the help of Vitamin C to do this. Without vitamin C, the collagen doesn’t have strength and everywhere you have collagen you will suffer. Scurvy, the old name for Vitamin C deficiency, leads to loss of teach, wounds that come open again, blood vessels that break under the skin.
Peterkofsky B. Ascorbate requirement for hydroxylation and secretion of procollagen: relationship to inhibition of collagen synthesis in scurvy. Am J Clin Nutr. 1991 Dec;54(6 Suppl):1135S-1140S. doi: 10.1093/ajcn/54.6.1135s. PMID: 1720597.
Orgel JP, Irving TC, Miller A, Wess TJ. Microfibrillar structure of type I collagen in situ. Proc Natl Acad Sci U S A. 2006 Jun 13;103(24):9001-5. doi: 10.1073/pnas.0502718103. Epub 2006 Jun 2. PMID: 16751282; PMCID: PMC1473175.
While collagen contains 19 amino acids, 17% of the amino acids are proline, and glycine is found usually in every third amino acid. Some of the amino acids are modified to others after the collagen has been formed, for example, hydroxyproline is derived from proline and hydroxylysine from lysine – and both of these require Vitamin C to assist in that modification.
What happens when you eat, drink, or otherwise consume collagen
Let’s say you eat some chicken skin that is rich in collagen, or you buy liquid collagen, or collagen peptides (short chains of amino acids bonded together).
The large molecule of collagen is broken down starting with the teeth, the enzymes in the mouth, the acid in the stomach as well as the enzymes in the stomach. Once these byproducts reach the small bowel they are further broken down by the pancreatic and bile from the liver into small chains of 2-3 amino acids. The small bowel can transport simple amino acids, as well as dipeptides (two amino acids bonded together) or tri-peptides (three amino acids bonded together) into the portal circulation. Through the portal system, even some five peptide units have been found. These amino acids are not passively absorbed, but rather actively transported by membrane proteins found on the brush borders of the small intestine designed just to transport amino acids.
Kleinnijenhuis AJ, van Holthoon FL, Maathuis AJH, Vanhoecke B, Prawitt J, Wauquier F, Wittrant Y. Non-targeted and...
