As we age it is common for individuals to experience joint issues due to wear and tear over a lifetime as well as an increase in inflammation. Musculoskeletal pain, arthralgia and arthritis are all more common in women, and their frequency increases with age. In some, a decline in women's joint health appears to be associated with the onset of menopause.¹

As menopause is a time when activity and mental health is essential to wellbeing, it is an important time to support joint health and reduce pain in order to both ameliorate symptoms and maintain movement. This blog looks at collagen as a therapeutic support for joints which may be considered during menopause to support joint health, wellness and exercise.

Women's joint health - pain and oestrogen

The effect oestrogen has on joint health is not fully understood and is certainly multifactorial. One study that looked at the administration of oestrogen alone to women in the climacteric stage of menopause found a reduction in joint pain².

This demonstrates that decreasing levels of oestrogen during menopause may be a trigger, or at least a contributor, to joint pain.

Potential influences of oestrogen on joint health are:

• Reduction in inflammation, oestrogen has been shown to suppress inflammation mainly through regulation of the NF-kB pathway.^3,4
• Oestrogen levels regulate changes in osteoarthritis (OA) by inhibiting degradation of the extracellular matrix and reducing cartilage turnover⁵
• Oestrogen is responsible for regulating fluid levels in the body; therefore, if levels of this hormone are low, the body becomes less able to hold water, which can affect the hydration and lubrication of the joint tissues, including the cartilage, ligaments and tendons⁶
• Catabolism and anabolism – oestrogen is an anabolic (tissue building) hormone - promoting growth and therefore repair and regeneration of tissue. Osteoarthritis is a catabolic (breaking down tissue) condition and therefore a drop in oestrogen can have a significant impact on cartilage degradation and the subsequent onset of osteoarthritis

Therefore, it is important to support joint health, particularly by protecting cartilage, as menopause approaches in order to maintain mobility into old age. Collagen supplementation can be effective at maintaining and repairing cartilage. This blog looks at the mechanisms and research as to how collagen supports joint health and functionality.

Repair of collagen matrix and regeneration of connective tissue cells

Cartilage is made up of specialised cells known as chondrocytes, which produce an extracellular matrix made up of collagen, proteoglycans, and elastin. This matrix acts as shock absorber in the joint, to take strain off the end of the bone and help prevent wear and tear on the cartilage itself. Therefore, supporting this matrix and regenerating chondrocytes is essential for supporting joint health.

Collagen - Collagen type II is a major component of the extracellular matrix of hyaline cartilage and its synthesis and catabolism is regulated by chondrocytes (cells found in cartilage connective tissue).⁷

Collagen type II fibres: the main structural component of cartilage, providing structure, firmness, and resistance to compression – account for 60% of cartilage. Studies have demonstrated that the supplementation of specific collagen peptides in young adults with functional knee problems led to a statistically significant improvement of activity-related joint pain. It is also important to note that the body’s ability to synthesise collagen declines with age.⁸

Specialised cells called fibroblasts play a key role in collagen synthesis in the body. They work by incorporating amino acids such as proline, lysine and glycine into complex strands in order to create the basic collagen molecule. This basic molecule then undergoes further binding, cross-linking and folding depending on the final type of collagen being produced. Vitamin A, vitamin C and copper are important for collagen production.⁹

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Colartix^®   (formerly Peptan II collagen)

A form of hydrolysed collagen type II which has been specifically formulated with joint health in mind. It has been matrixed with chondroitin sulphate and hyaluronic acid, making it identical to the composition of cartilage in humans. As a natural source of collagen, it can stimulate the synthesis of collagen within the body, while also providing the building blocks necessary for joint support. The recommended dose for Colartix® (formlerly Peptan II collagen) is 1-3g/daily.

Colartix^® (formerly Peptan II collagen) and women's joint health – what does the research say?

Maintaining sufficient levels of collagen is essential for the maintenance of healthy and flexible joints. Studies have shown the following effects of collagen type II consumption on joint health:

• Improved overall joint health: Colartix® (formerly Peptan II collagen) treatment resulted in a 32% decrease in joint pain and a 44% improvement in stiffness among women with osteoarthritis.⁶ A statistically significant reduction in the WOMAC score (international standard method for assessing joint health) was also observed
• Improved knee-joint function: Colartix® (formerly Peptan II collagen) treatment resulted in a 7% increase in the Lysholm score; a scale linked to improved knee movement in everyday activities.⁸ In a 24-week clinical trial, improved joint health and a reduced risk of joint deterioration in athletes was observed following supplementation with hydrolysed collagen.¹⁰ Furthermore, statistically significant improvements in activity related joint pain versus control were also observed¹¹
• Chondrocyte (cartilage cell) stimulation: Hydrolysed collagen type II treatment stimulated chondrocyte excretion of type II collagen¹²
• Protection from degeneration: In a model for post-traumatic osteoarthritis, Colartix® (formerly Peptan II collagen) supplementation provided protection to cartilage from degeneration, as well as promotion of lubrication through the stimulation of proteoglycan synthesis in chrondrocytes.¹⁰ Similar findings were found in a model for obesity-associated osteoarthritis¹³
• Anti-inflammatory effect: Colartix® (formerly Peptan II collagen) supplementation showed an anti-inflammatory effect in the knee joint¹³
• Improved recovery: Following supplementation with hydrolysed type II collagen and glycosaminoglycans, blood markers associated with muscular stress, including creatine kinase, lactate dehydrogenase and c-reactive protein all showed improvements compared with control¹⁴

Collagen absorption

Collagen itself is a complex protein molecule with a quaternary structure, therefore it needs to go through several stages of digestion to be broken down into amino acids to be absorbed and this is why there have been conflicting opinions as to whether collagen supplements are effective.

However, good quality collagen supplements are in hydrolysed collagen or collagen peptide form. These are already partially broken down and as they go through the digestive tract they are modified into di and tri peptides (molecules with 2 or 3 amino acids respectively). Collagen-specific amino acid hydroxyproline forms hydrolysis-resistant peptide bonds that lead to the appearance of di- and tripeptides. Those peptides are absorbed across the wall of the intestine into the bloodstream and exert a messenger function directly on the target cell.

The di- and tripeptides that are formed during the digestion process carry the inherent bioactivity of collagen peptides. Those peptides are effectively absorbed from the intestine into the bloodstream, meaning that they are highly bioavailable. Reaching the target tissue of their bioactivity, e.g., skin, bone or cartilage, they deliver a messaging signal to the local cells positively influencing its function. Therefore their mechanism of action appears to be more by influencing the activity of local cells as opposed to forming new collagen within the body, although hydrolysed collagen provides the building blocks to support collagen production.

Women's joint health summary:

It may be prudent to begin supporting cartilage maintenance prior to onset of degradation or osteoarthritis. As menopause can be a trigger for osteoarthritis, it is a good time to consider using a Colartix® (formerly Peptan II collagen) to protect joint health. It is known that using type 2 collagen such as Colartix® (formerly Peptan II collagen) can improve joint mobility and reduce pain. These factors are essential for maintaining functional movement and therefore fitness and movement as well as supporting mental wellbeing.

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Related products

CytoProtect® Joint Health is formulated using Colartix® (formerly Peptan® II collagen) powder, a hydrolysed matrix of type II collagen and glycoaminoglycans (chondroitin sulphate and hyaluronic acid).

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Women's joint health references

1. Watt FE. Musculoskeletal pain and menopause. Post Reprod Health. 2018;24(1):34-43. doi:10.1177/2053369118757537
2. Chlebowski RT, Cirillo DJ, Eaton CB, et al. Estrogen Alone and Joint Symptoms in the Women’s Health Initiative Randomized Trial. Menopause. 2013;20(6):1313-1320. doi:10.1097/GME.0B013E31828392C4
3. Duckles SP, Krause DN. Mechanisms of cerebrovascular protection: oestrogen, inflammation and mitochondria. Acta Physiol (Oxf). 2011;203(1):149-154. doi:10.1111/J.1748-1716.2010.02184.X
4. Duckles SP, Krause DN. Mechanisms of cerebrovascular protection: oestrogen, inflammation and mitochondria. Acta Physiol (Oxf). 2011;203(1):149-154. doi:10.1111/J.1748-1716.2010.02184.X
5. Xu X, Li X, Liang Y, et al. Estrogen Modulates Cartilage and Subchondral Bone Remodeling in an Ovariectomized Rat Model of Postmenopausal Osteoarthritis. Med Sci Monit. 2019;25:3146-3153. doi:10.12659/MSM.916254
6. Rodriguez-Giustiniani P, Rodriguez-Sanchez N, Galloway SDR. Fluid and electrolyte balance considerations for female athletes. Eur J Sport Sci. 2022;22(5):697-708. doi:10.1080/17461391.2021.1939428
7. Varani J, Dame MK, Rittie L, et al. Decreased collagen production in chronologically aged skin: roles of age-dependent alteration in fibroblast function and defective mechanical stimulation. Am J Pathol. 2006;168(6):1861-1868. doi:10.2353/AJPATH.2006.051302
8. (PDF) Collagen peptides improve knee osteoarthritis in elderly women: A 6-month randomized, double-blind, placebo-controlled study. Accessed March 6, 2023.
9. Alberts B, Johnson A, Lewis J, Raff M, Roberts K, Walter P. Fibroblasts and Their Transformations: The Connective-Tissue Cell Family. Published online 2002. Accessed March 6, 2023.
10. Clark KL, Sebastianelli W, Flechsenhar KR, et al. 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;24(5):1485-1496. doi:10.1185/030079908X291967
11. Zdzieblik D, Oesser S, Gollhofer A, König D. Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides. Appl Physiol Nutr Metab. 2017;42(6):588-595. doi:10.1139/APNM-2016-0390
12. Oesser S, Seifert J. Stimulation of type II collagen biosynthesis and secretion in bovine chondrocytes cultured with degraded collagen. Cell Tissue Res. 2003;311(3):393-399. doi:10.1007/S00441-003-0702-8
13. Rousselot (2011) Rousselot Unpublished Data, retrieved from: https://www.peptan.com/about-peptan/downloads/peptan-joint-health-in-vitro-study-whitepaper/.
14. Varlas S, Maitland GL, Derry MJ. Protein-, (Poly)peptide-, and Amino Acid-Based Nanostructures Prepared via Polymerization-Induced Self-Assembly. Polymers (Basel). 2021;13(16). doi:10.3390/POLYM13162603

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If you have questions regarding the topics that have been raised, or any other health matters, please do contact our team of Nutritional Therapists.

nutrition@cytoplan.co.uk
01684 310099