Related Terms

• Articular cartilage, Bio-Cell Collagen II®, bovine collagen II, CII, cartilage, chicken collagen II, chondroitin, CII, Collagen II (Natrol®), Colloral®, C-telopeptide, CTX-II, gelatin, glucosamine, glycosaminoglycans (GAGs), hyaluronan, Kolla2® (Collagen Nutraceuticals, Inc.), Maxilife Chicken Collagen Type II (Twinlab®), Rheumatoid Tolerance Factor: Type II Collagen Caps (Pharmax Inc.), triple helical collagen type II, uCTX-II, unhydrolyzed chicken sternum cartilage collagen type II, urinary C-terminal crosslinking telopeptide.

• Note: This monograph is limited to type II collagen. This monograph does not include hydrolyzed collagen (also called HCP, hydrolysate, collagen peptide, gelatin, gelatin hydrolysate, and hydrolyzed gelatin), which is made predominantly from type I collagen.

Background

• Collagen is the most abundant protein in mammals. It is the main component of cartilage, skin, ligaments, tendons, bone, and teeth. More than 29 different types of collagen have been described. The most common forms in the human body are types I, II, III, and IV.

• Type II collagen is responsible for strength and toughness in the cartilage. This type of collagen is found in the joints, breastbone, and respiratory tract.

• Type II collagen accounts for over 50 percent of the dry weight of cartilage and is also found in small amounts in a number of tissues during early development.

• Preliminary evidence suggests that type II collagen may help relieve the pain of osteoarthritis (OA) and rheumatoid arthritis (RA). Some studies found that a product containing type II collagen may provide short-term pain relief for osteoarthritis patients. However, more evidence is needed before conclusions can be made regarding the use of type II collagen for any health condition.

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

• Athletic injuries, bone loss, breast cancer, brittle fingernails, hair tonic, joint problems, osteoporosis, weight loss.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

• Collagen type II from chickens has been taken in tablet and capsule form at 500-4,000 milligrams daily.

• For rheumatoid arthritis, 0.1 milligram of collagen type II in 200 milliliters of cold water has been taken daily for 24 weeks.

• To relieve joint pain and swelling, 20-2,500 micrograms of collagen type II in 4-6 ounces of cold orange juice has been taken daily for 24 weeks.

Children (under 18 years old)

• For rheumatoid arthritis, 100 micrograms of collagen type II has been taken daily for one month, followed by 500 micrograms for an unspecified amount of time.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

• Avoid in people with a known allergy or sensitivity to chicken or beef.

Side Effects and Warnings

• Collagen type II may be safe when taken by mouth in small doses for up to 24 weeks. Avoid taking high doses without the approval of a healthcare professional.

• Collage type II may cause anorexia, bloating, stomach upset, nausea, vomiting, mouth sores, gassiness, skin redness and flushing, headache, dizziness, sleep difficulties, and an unpleasant taste in the mouth.

• Because collagen type II contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered. Use cautiously in people receiving hormone replacement therapy.

• Use cautiously in people with skin sensitivities, stomach problems, or a history of headache, dizziness, or sleep difficulties; in people who have autoimmune disorders or who are taking medications that may affect the immune system; and in people who have liver disorders or who are taking medications that may prevent liver damage.

• Avoid in people with a known allergy or sensitivity to chicken or beef.

Pregnancy and Breastfeeding

• There is currently a lack of scientific evidence on the use of collagen type II during pregnancy or breastfeeding.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

• Because collagen type II contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

• Collagen type II may interact with agents for arthritis, agents for liver damage, and agents that affect the immune system.

Interactions with Herbs and Dietary Supplements

• Because collagen type II contains estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered.

• Collagen type II may interact with herbs and supplements for arthritis, herbs and supplements for liver damage, and herbs and supplements that affect the immune system.

Author Information

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

1. Bagchi, D. Undenatured type II collagen for arthritis. Natural Pharmacy (USA) 2003;7(2)

2. Barnett, M. L., Kremer, J. M., St Clair, E. W., Clegg, D. O., Furst, D., Weisman, M., Fletcher, M. J., Chasan-Taber, S., Finger, E., Morales, A., Le, C. H., and Trentham, D. E. Treatment of rheumatoid arthritis with oral type II collagen. Results of a multicenter, double-blind, placebo-controlled trial. Arthritis Rheum 1998;41(2):290-297. View Abstract

3. Buckman K and Gutierrez J, et al. Effects of collagen type II for subjective pain relief. Applied health solutions 1999;

4. Cathcart, E. S., Hayes, K. C., Gonnerman, W. A., Lazzari, A. A., and Franzblau, C. Experimental arthritis in a nonhuman primate. I. Induction by bovine type II collagen. Lab Invest 1986;54(1):26-31. View Abstract

5. Forsblad, d'Elia H., Christgau, S., Mattsson, L. A., Saxne, T., Ohlsson, C., Nordborg, E., and Carlsten, H. Hormone replacement therapy, calcium and vitamin D3 versus calcium and vitamin D3 alone decreases markers of cartilage and bone metabolism in rheumatoid arthritis: a randomized controlled trial [ISRCTN46523456]. Arthritis Res Ther 2004;6(5):R457-R468. View Abstract

6. Funayama, A., Niki, Y., Matsumoto, H., Maeno, S., Yatabe, T., Morioka, H., Yanagimoto, S., Taguchi, T., Tanaka, J., and Toyama, Y. Repair of full-thickness articular cartilage defects using injectable type II collagen gel embedded with cultured chondrocytes in a rabbit model. J Orthop.Sci 2008;13(3):225-232. View Abstract

7. Garnero, P., Landewe, R., Boers, M., Verhoeven, A., Van Der Linden, S., Christgau, S., Van Der Heijde, D., Boonen, A., and Geusens, P. Association of baseline levels of markers of bone and cartilage degradation with long-term progression of joint damage in patients with early rheumatoid arthritis: the COBRA study. Arthritis Rheum 2002;46(11):2847-2856. View Abstract

8. Moskowitz, R. W. Role of collagen hydrolysate in bone and joint disease. Semin.Arthritis Rheum 2000;30(2):87-99. View Abstract

9. Nissim, A., Winyard, P. G., Corrigall, V., Fatah, R., Perrett, D., Panayi, G., and Chernajovsky, Y. Generation of neoantigenic epitopes after posttranslational modification of type II collagen by factors present within the inflamed joint. Arthritis Rheum 2005;52(12):3829-3838. View Abstract

10. Pucci-Minafra, I, Albanese, NN, Di Cara, G, Minafra, L, Marabeti, MR, and Cancemi, P. Breast cancer cells exhibit selective modulation induced by different collagen substrates. Connective Tissue Research 2008;49(3-4):252-256.

11. Ravn, P., Warming, L., Christgau, S., and Christiansen, C. The effect on cartilage of different forms of application of postmenopausal estrogen therapy: comparison of oral and transdermal therapy. Bone 2004;35(5):1216-1221. View Abstract

12. Rubin, MG. Significant cosmetic benefits found with the combination of TCA peeling and injectable collagen implants. Cosmetic Dermatology (USA) 1994;7:21-22.

13. Trentham DE, Halpner AD, Trentham RA, Bagchi M, Kothari S, Preuss HG, and Bagchi D. Use of undenatured type II collagen in the treatment of rheumatoid arthritis. Clinical Practice of Alternative Medicine 2001;2(4):254-9.

14. Trentham, DE., Townes, AS., and Kang, AH. Autoimmunity to type II collagen an experimental model of arthritis. J Exp Med 9-1-1977;146(3):857-868. View Abstract

15. Zhang, L. L., Wei, W., Xiao, F., Xu, J. H., Bao, C. D., Ni, L. Q., and Li, X. F. A randomized, double-blind, multicenter, controlled clinical trial of chicken type II collagen in patients with rheumatoid arthritis. Arthritis Rheum 7-15-2008;59(7):905-910. View Abstract