I’ve just started training with a coach, a rugby coach nonetheless. It’s not because I want to be a rugby player or get huge muscles but I do want to get strong. It is common knowledge that as we get older we lose muscle mass, so called sarcopenia, so it is important to undertake in regular exercise, resistance or weight training and maintain an adequate protein intake to prevent this.
One thing my coach recommends, especially in women, is taking creatine supplements. This is because women have lower baseline intramuscular creatine levels than men and may also eat less creatine-rich animal products in their diet.
[Smith-Ryan AE, Cabre HE, Eckerson JM et al. Creatine Supplementation in Women’s Health: A Lifespan Perspective. Nutrients 2021;13:877]
What is creatine?
Creatine monohydrate is a widely used dietary supplement used by sportsmen and athletes to improve performance. Creatine is required for the production of adenosine triphosphate (ATP), the essential energy source for muscle cells. There is now a large body of evidence confirming the benefits of creatine supplementation on boosting strength, speed, power, any form of exercise requiring explosive bursts of energy, improve recovery and muscle growth.
It has also been shown to improve brain health also. This is because brain cells also use a lot of ATP. This can manifest as improved cognitive function and reduced mental fatigue, two things that could contribute to the brain fog of menopause. Creatine could also be neuroprotective too and promote recovery after traumatic brain injury.
[Gutiérrez-Hellín J, Del Coso J, Franco-Andrés A et al. Creatine Supplementation Beyond Athletics : Benefits of Different Types of Creatine for Women, Vegans, and Clinical Populations – A Narrative Review. Nutrients 2024;17:95.]
So should you take collagen supplements also?
This , however, has been of much debate. Collagen is required for our joints, bones, connective tissues, skin, hair and nails and again, collagen synthesis decreases as we get older.
Does collagen supplementation help with arthritis?
There are increasing studies looking at this with many showing benefits. However, all studies vary in their experimental protocol with differences in the type of collagen used, the dose and the optimal time for consumption. The European Food Safety Authority (EFSA) felt that there was not an established relationship between the consumption of collagen hydrolysate as a supplement and joint maintenance.
[Martínez-Puig D, Costa-Larríon E, Rubio-Rodríguez N et al. Collagen Supplementation for Joint Health: The Link between Composition and Scientific Knowledge. Nutrients 2023;15:1332.]
[EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Scientific Opinion on the substantiation of a health claim related to collagen hydrolysate and maintenance of joints pursuant to Article 13(5) of Regulation (EC) No 1924/2006. https://doi.org/10.2903/j.efsa.2011.2291]
What about collagen supplements and the skin then?
Again, the story is the same.
There are plenty of studies out there showing a benefit in skin elasticity, collagen density, improved wound healing and reduction in facial wrinkles.
[Hwa Seong S, In Lee Y, Lee J et al. Low-molecular-weight collagen peptides supplement promotes a healthy skin: A randomize, double-blinded, placebo-controlled study. J Cosmetic Dermatol 2024;23:554-562.]
[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;60:1449-1461.]
But is it all true?
Well the trouble is that a lot of the studies are small, funded by collagen-producing industry, look mostly at women, use different types of collagen in variable doses, and don’t consider changes in lifestyle (smoking, UV exposure, alcohol) and environment that may influence skin changes.
[Rustad AM, Nickles MA, McKenney JE et al. Myths and media in oral collagen supplementation for the skin, nails, and hair: A review. J Cosmet Dermatol 2022;21:438-443.]
[Dias Campos L, de Almeida Santos Junior V, Demuner Pimentel J et al. Collagen supplementation in skin and orthopedic diseases : A review of the literature. Heliyon 2023;9:e14961.]
Again, the EFSA concluded that ‘a cause and effect relationship has not been established between the consumption of L-cysteine and L-methionine alone or in combination and maintenance of normal skin.’ (L-cysteine and L-methionine are both amino acids that make up protein).
[EFSA Panel on Dietetic Products, Nutrition and Allergies. Scientific Opinion on the substantiation of health claims related to L cysteine and L methionine alone or in combination and maintenance of normal hair, normal nails, normal skin, contribution to normal collagen formation and contribution to normal glutathione formation pursuant to Article 13(1) of Regulation (EC) No 1924/2006. https://doi.org/10.2903/j.efsa.2010.1795]
And also…
Think where this collagen comes from. It comes from the chemically processed skin, and ground up bones and connective tissue of fish, chickens, pigs and cows. Think of the gelatine that goes into gummy sweets and jellies.
And though they have not been shown to be harmful, they are also expensive.
So should I take them or not?
Well that is up to you. It could be that the money spent on collagen supplements could be spent instead on a balanced, more varied diet or on more or higher quality proteins in your diet.
Also, you might find that the boring things in life such as getting the right amount of sleep and exercise, moderating UV exposure and regular sunscreen use will yield far better results than popping a tablet of collagen every day.
Kind regards,
Sandy
Dr Sandy Flann, Consultant Dermatologist
