There is a piece of many of the most common health complaints that connects them. Back pain, knee pain, skin issues, gut issues, hair loss, osteoporosis… all of these have something in common. They all can be caused by weakening structural support in the body, known as connective tissue. This connective tissue is the cartilage in our joints. It is the tendons of our muscles. The strong base layer of our skin. The gums around our teeth. The lining of our stomach and intestines. The framework of our hair. The structure of our bone. All of these things are made up of the protein called collagen. In fact it is collagen, not muscle, that is the most abundant protein in our body. Yet it is a protein that most people rarely eat in modern times.

Collagen is one of those substances that researchers in their lab coats have been screaming and yelling about for decades, trying to get someone to pay attention. There have been over a hundred studies on it. Most of the research has centered on benefits to joint pain. But it wasn’t until the research showed benefits to skin health and hair health that the media started paying attention. Now, collagen is almost thought of as a fad supplement, with lots of chatter about it. But this is simply an example of culture catching up with research. And the research is profound.

In one study, collagen was compared to placebo (a sugar pill) and compared to a popular joint supplement glucosamine+chondroitin. The participants were tracked for 6 months and their knee pain was measured. The collagen group did the best of the three groups. What is most surprising about this particular study, is the dose of collagen was only 40mg a day. 40mg of collagen is basically a speck of dust, not even a pinch. And studies that use higher doses of collagen (such as 1,000mg to 10,000mg a day), have even more powerful results.

I call collagen a missing piece, rather than calling is something like a “miracle pill,” because it is a fundamental building block that used to be simply a part of our diet. Back before modern times, when someone would eat meat, they would keep the bones and boil them down to make bone broth and eat that too. Many people have stories of how their grandmother would break open chicken bones and eat the marrow inside. Animal tendons would be boiled overnight and eaten as soft tendon. Now you only see soft tendon as that odd thing sometimes in pho soup. Humans used to have collagen, from the connective tissue of animals, as part of our regular diet. Our bodies really rely on use getting this protein from our diet, and things start to fall apart without it.

Now just eating or supplementing collagen is not always enough, as our bodies still need to build it into the connective tissue. To build collagen into the structures of our joints, bone, gut, gums, skin, hair, etc. we need vitamin B12, folate (also called vitamin B9), and vitamin C. Vitamin C deficiency is known as scurvy, the thing old time sailors would get. Scurvy is when the body can’t use collagen due to lack of vitamin C, and everything starts falling apart.

For people who are vegetarian, collagen can be found in egg shell membrane based supplements. For vegans, there is no real source, though cabbage has lots of the precursor molecules for collagen building blocks. For everyone else, bone broth (made or bought) or powdered supplements are the easiest ways to get it, aiming for 5 to 10 grams a day. Most supplements are beef or chicken based, though there are fish options too.

Now the benefits of collagen should be expected to be gradual. Most of the studies are looking at 3 to 6 month time periods. Many of my patients have felt benefit within days, but if you don’t feel anything you shouldn’t be discouraged. It may take recording how you feel, and checking in with yourself months later, to realize the slow and steady benefits. This is because connective tissue takes a long time to build. So even though you are providing the building blocks, your body still needs time to do the work. Exercises are very important to stimulate this building if joints, bone, or skin are the aim to improve. And even if you have no health issues yet, preventing the inevitable march of old age requires regular collagen intake.