Ask the doctors 12/27

Dear Doctors: I have been reading about how collagen peptides can be helpful to prevent menopausal bone loss. My own doctor has only recommended calcium, vitamin D and exercise. I would like to know more about what collagen peptides are and what they do. Do they really work?

Dear Reader: It’s not surprising that collagen peptides have appeared on your radar. These nutritional supplements, which have grown into a multibillion-dollar business, are having a media moment. As often happens with products that get elevated to superfood status, some of the health claims include a bit of exaggeration.

That said, recent research suggests that collagen peptides may play a role in supporting bone health. In order to understand why, we should start with collagen. It’s a structural protein made of long chains of amino acids. These are woven into a triple helix, a configuration that gives collagen both strength and flexibility. Collagen’s unique structure lends support to muscle, skin, bone, tendons, ligaments and other connective tissues. It’s also found in blood vessels, internal organs and intestinal lining, and it plays an important role in healing and in cellular signaling.

With so many jobs to do, it’s not surprising that collagen represents up to 30% of total proteins in the body. Another notable thing about collagen is that, as we reach our mid-20s and beyond, the body’s production of it begins to decrease. This contributes to the hallmarks of aging, including thinning skin and wrinkles. It also brings us to collagen peptides.

The term “collagen peptides” refers to a nutritional supplement made by extracting collagen from an animal source and processing it into a form that can be absorbed by the body. Depending on the manufacturer, collagen peptides are derived from cows, chickens, fish and even eggshell membranes. They are offered in various forms, such as powders, pills and beverages. Several studies have looked into their potential effect on age-related bone loss. This includes osteoporosis and its precursor, osteopenia.

Throughout our lives, our bones undergo a perpetual process of being broken down and rebuilt. When we’re younger, that equation stays balanced, and bone density is preserved. But as we age, rebuilding slows, which can lead to a net loss of bone mass.

Initial rodent studies into collagen peptides’ effect on bone density yielded promising results. These were followed with studies conducted in post-menopausal women. Researchers found that a year of daily collagen peptides supplementation measurably increased bone mineral density in the lumbar spine and in the upper femur. The women also had higher levels of a blood biomarker that indicates bone formation. In a follow-up study four years later, the researchers reported continued benefits. It’s important to note this is a small sample size, and that more research is needed for a definitive outcome.

If you want to try a collagen supplement, first check with your doctor. These products are not regulated, so choosing the right one takes research. Your doctor can guide you to the appropriate dosage based on your specific needs.

Send your questions to askthedoctors@mednet.ucla.edu.