Collagen for Osteoporosis? Facts and Fraud

Dr Doug Lucas here retired orthopedic surgeon now focusing my practice on health span and bone health are you taking collagen for your bones and you're hoping that by supplementing with collagen that your bones are going to get stronger well you're not alone a lot of people take collagen for their bone health in addition to other things like skin hair and nails there are some websites that really sell these very specific types of collagens for people that are concerned about their bone health and I really wanted to look into this because they seemed a little fishy to me so stick around because we're going to go through really the only research that's out there that I could find on collagen for bone health and talk a little bit about why maybe it's not as important as you think so stick around we'll figure out more together foreign so first of all why do people take collagen for bones well collagen is actually part of the bone matrix in fact collagen makes up 90 of the bone matrix you have to have collagen specifically a certain type of collagen called type 1 collagen in order to mineralize your bones so if you didn't have collagen you could never improve your bone mineral density in addition we are of course mostly worried about bone strength not just bone mineral density and without collagen you're really not going to have any bone strength so collagen is critically important and that's probably why a lot of people take collagen for bone health but here's the thing collagen is not what's called essential meaning that your body can make it on its own you don't have to consume collagen in order to have collagen in your body your body can make it just fine as long as it has all the building blocks but just like several other things that decrease predictably with age collagen production decreases with age as well which which might be a part of the predictable decline of bone health over time now before we jump on the bandwagon of just supplementing collagen I think it would help us to understand a little bit about what the building blocks are because when you're supplementing collagen the hope is that you're taking this big protein you're putting it in your stomach your body absorbs it and then it goes to your bones there are a lot of assumptions in there and I think the biggest part of that is that it's a big protein to begin with and it's most assuredly being broken down into very specific amino acids that then get reassimilated and made into bone assuming that that's what happens so you could also argue that if you just consume the building blocks of collagen that you would be doing just as much good for your body as if you're consuming collagen so what are those building blocks well they're kind of divided in my head into two different categories some are non-essential and some are essential and again the non-essential ones are the ones that your body can make and the essential ones are the ones that your body cannot so the non-essential amino acids are things like glycine Proline hydroxyproline you need these in large quantities when you're making collagen for your bones the essential ones are things like methionine and lysine these are two specific types of amino acids in vitamin C which we know we can get pretty readily through fruits and vegetables so where can you get methionine and lysine these are found predominantly in animal products so starting with meat and fish and then eggs and then Dairy and then you start to cease a little bit in nuts and seeds in a very little bit in whole grains now with Lysine for example you actually will see a little bit more in things like quinoa and things like beans rather than whole grains but again the primary source is going to be meat fish Dairy and eggs so despite all the hype around collagen I could not find a lot of evidence to support its use there was one step study I found that was not funded by the supplement industry and then one big study that was we'll go through them both so the first one is relatively old it's from 1996 and it was a prospective study now the reason why this study went forward is because it was actually a drug study so they used a calcitonin arm so calcitonin is a drug that can be given either either through injection or through a nasal spray and it can help improve bone mineral density and reduce fracture risk so calcitonin works as a drug and this is one of the studies that helped show that they also had calcitonin plus a collagen arm and the collagen arm used 10 grams of collagen hydrosylate which is not a collagen peptide which is really commonly sold in the industry now but collagen hydrosylate is the the full collagen molecule and they did see some slight benefit in the collagen group over the calcitonin alone group but not significantly and again we don't really know you know was this a part of working with calcitonin was this part of the the process of the drug just working better because it had the building blocks and would this stand on its own and we can't get that out of this study so it maybe shows us a little bit of signal but it doesn't really support the idea of using it by itself all right now this is the second study which is from 2018. so this is a well-designed study but like I said earlier this was funded by the supplement industry so there's a particular company that sells a very specific type of Bio active collagen and so they funded this study and the authors of the study who said that they had no conflicts of interest as it stated in the study but they chose to use this particular type of collagen which is proprietary to this company and I think one other company has it but it's not globally available so they use this specific type of collagen and I'll talk about the results but the problem is is that that then makes it difficult to say that this these results are true for all collagens and then it really kind of drives you towards that one specific type of collagen but let's just go through this study so this like I said it was a 2018 randomized control trial double-blinded trial so a well-designed study on 131 patients there were two groups one group got these what they call specific collagen peptides and the other group was a control group now the study went for 12 months and in the end they looked at bone mineral density of the spine of the femoral neck and they got bone turnover markers they used P1 and P for bone growth and they used CTX for bone breakdown I think this is a really really well designed study I love this design I love these endpoints I think this is exactly what we should be looking at if only we could also add reduction in fracture risk but I'll take it for what it is I think overall this is a really well designed study let's look at the results so when you look at the results in bone mineral density the spine improved by about four percent and the hit by about six percent which looks pretty good but when you look at the absolute change what that's saying is that's actually a change in t score from a negative 2.4 on average to a negative 2.3 in the spine and that changes even smaller in the hip and so even though four and six percent sound pretty good and you'd be happy with that if this was your process really you're talking about a negligible change clinically and a t-score and so this is why if you look at the drug trials you start seeing changes like 10 15 that's really what is even questionably clinically significant then but that's what happens with t-score and it just has to do with the statistics around standard deviation and the numbers that you're dealing with so I would say yes it did get better and yes that statistically significant as far as P1 and P the bone turnover marker for bone growth in CTX the bone turnover marker bone loss they showed a statistically improved P1 and P in the collagen group and a reduction in CTX in the control group so again this is exactly what you want to see from the effect of any intervention and this one specifically on collagen so some of the challenges of this study is that it had a relatively High dropout rate meaning that about a quarter of the people that started the trial didn't complete the trial and so they run the statistics as if they all had finished the trial but we don't know what happened to that other 20 22 is exactly what it was so we're missing some data and we're going to have to assume that those data would be consistent if we're going to carry this forward but ultimately the larger the dropout rate The More We can question what the results actually are but another thing to consider here is the absolute change and the bone turnover markers so P1 and P went on average from 33 to 37 and that's in micrograms per liter and that's not a huge change for me you know I like to see when we're working on a patient I want to see a P1 and P go from 30 to 100. you know I want to see big changes in bone turnover so yes it's better is it significantly better statistically yeah but clinically I don't I don't think so same thing with CTX now they use different units than we do but they went from 0.68 to 0.8 in the control group and so again that's a you know that is a statistically significant change but clinically I don't think that that's as big of a change as I would want to see with an intervention and lastly again this study was funded by a supplement Company the company jelita out of Germany and they make the product affordabone so if you go on their website they'll talk about research that supports the use of Florida bone and they're talking about this study my challenge with this is that they're using a proprietary form of collagen I don't know that we should really consider this to be the once and done study on collagen I would love to see this repeated by a third party somebody that doesn't have financial interest in the product and then I would also love to see it repeated in something like a collagen peptide or a collagen tripeptide that you can get commercially because ultimately we don't really know what those products are doing because this study isn't on those products all right sorry to interrupt this conversation on collagen but if you like this content please like subscribe and sign up for notifications most importantly subscribe because as long as you're subscribed we can send you notifications and you'll get more content about bone health if you know anybody that would be interested in this please share this with them and lastly if you want to learn more about how we manage bone health and other tips and tricks that you can do on your own or work with your own care team to implement then look for our free master class in the description below all right so here's the conclusion about collagen I think the collagen has benefits as a supplement I take it I put it in my protein smoothie I think there is likely benefit for skin hair and nails you can probably see and feel the difference if you're if you're taking a good quality product the challenge for bones is we don't really know what's happening on the inside I wouldn't say that we have enough evidence to say that it's a slam dunk I would say there's signal there seems like it's probably good but if you're getting enough amino acids through your diet and your body can build the collagen on its own I don't know that we necessarily need to spend the money on this now that said it comes as a powder typically it's easy to put into a smoothie there's probably not a lot of downside other than it's just layered cost after cost when you start adding these things up so this is not something that we incorporate on a regular basis for our patients however a lot of our patients take it anyway because they like how it makes other things feel so I think there's not a lot of risk there may not be a lot of benefit but there may be some benefit I would spend your time and money focusing on a good diet I think that's probably going to get you in a better place for a lot of other reasons and then continuing to add supplement after supplement and lastly I'm not opposed to Industry funded research I think industry-funded research is an important part of the model that helps gets us products it helps us to learn what really is good because we can't rely on government funded or other types of funding grant funding for research on on everything that we want to learn about so industry funded research is okay I just think that we need to take it for what it is this is a a potentially biased piece of research and I would love to see it repeated in a third-party study outside of an industry-funded model somebody that could take this information and say hey this is great let's prove it and this is really true for research in general if we find findings in a study then really the scientific model says hey that's great but let's prove it again and different Center let's prove it again in another location let's change the variables a little bit and let's prove it again really that is the scientific theory where we really need to have proven an intervention works the way that we think it's going to work in multiple settings with multiple variables crossed off before we should really be sure that it's doing what we think it's doing so again I'm not opposed to Industry industry funded research I just think we need to understand what it is and take it for what it is and then make our decisions based off of that accordingly all right thanks for making it to the end of this video on collagen if you found this helpful Please Subscribe like and sign up for notifications so we can let you know when we get new content out if you know anybody that would benefit from this material please share this with them so that they can continue to learn on their own bone health journey and lastly if you want to learn more about how we do bone health about how we manage patients other tips and tricks that you can do on your own or with your own team look for our free master class in the description below and also don't forget to leave comments below I love the interaction the back and forth I love answering questions helping to build and reinforce great topics and Concepts within the boat Health Community so leave me comments leave us questions we'll get to them as quickly as we can our team is working hard to create new materials so if you have ideas that you want us to do and you want us to to make videos on then please leave those below as well thanks so much foreign [Music]

Channel: The Dr Doug Show | Bones, Hormones and HealthSpan

Views: 26,479

Keywords: osteoporosis, fracture, fractureprevention, bonehealth, optimalbonehealth, longevity, hormones, vitamind, nutrients, macronutrients, micronutrients, deficiencies, nutrition, stress, movement, exercise, sleep, lifestyle, cortisol, guthealth, microbiome, supplements, hormoneoptimization, testosterone, estrogen, menopause, agingwithgrace, antiaging, fallprevention, osteopenia, bonebuilding, resistancetraining, gutdysfunction, strongbones, causes, symptoms, treatment, genetics, testing, dexascan, musclemass, bonedensity, bones, collagen

Id: 9-7qnPerpS4

Length: 14min 32sec (872 seconds)

Published: Thu Jun 22 2023