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Oral Collagen Type II For Arthritis 


What is collagen type II and where is it found in the body?


Collagen is the protein building block found in skin, ligaments, tendons, bone, cartilage, blood vessels, and other connective tissue.  There are about nineteen different types of collagen, but collagen type II is the most abundant in the human body.  Collagen type II is specifically found in joints, such as the knees, elbows, hips, wrists and fingers.  These joints are the ones most affected by arthritis.


What is oral collagen type II?


There are many different companies selling oral collagen type II on the internet.  Some of the trade names of these products are Collagen Solution, Maxilife Chicken Collagen Type II, Bio-Cell Collagen II, and Collagen II.  Most of these products are derived from bovine and chicken bones and joints.  These products are sold in both liquid and tablet form. 


Which types of arthritis might it help?


Oral collagen type II has been shown to alleviate the pain and swelling associated with both rheumatoid arthritis and osteoarthritis.


Why it might help arthritis?

When people suffer from arthritis, there is a selective destruction of collagen type II in the joint cartilage.  This destruction of cartilage may activate the immune system to develop antibodies against collagen type II.  This sets up an autoimmune response to all of the cartilage degenerating in the body, which results in rheumatoid arthritis (RA).  In osteoarthritis there is a wear and tear destruction of cartilage with loss of collagen type II, but there is no immune response. 

Oral collagen type II is thought to help prevent an immune response through oral tolerance.  There is a part of the intestine called the GALT (gut-activated lymphoid tissue) which is part of our immune system.  In essence, white blood cells in the GALT allow us to eat a variety of different kinds of proteins without developing an allergy or sensitivity to them.  Consequently, repeated oral collagen intake will result in a state of absent or minimal immune response to the collagen found in the joints.  This will cause a reduction in the pain and swelling associated with rheumatoid arthritis.  The exact mechanism is still not fully understood. It is also unknown why this treatment would relieve the symptoms of osteoarthritis and other types of arthritis that are not associated with autoimmunity.  [1]


What dosage is recommended?


Some products are available in 500 mg tablets or capsules taken one to three times daily.   Others are available in liquid form taken one to three times daily (the actual dose in each drop cannot be determined).  Doses of collagen type II over 10 mg per day have not been tested.  Please be aware that a larger dose does not necessarily mean that the remedy will work better.


What are the side effects?


While most people will not have any adverse effects, there complete side effect profile of  oral collagen is unknown and so caution should be exercised.  Nausea is the only side effect documented in one study [6].  As with any oral preparation, nausea, vomiting, headache, diarrhea, and constipation may also be associated with oral collagen.


Is there any research to support or refute its efficacy?


Clinical trials have yielded mixed results.  Four studies reported positive effects and no side effects in response to therapy.  However, the studies were not extensive and all recommended further controlled studies [2] [3] [4] [5]. 


One study claimed that oral collagen only improved symptoms in a minority of patients and reported a side effect of nausea [6].  Another study reported no improvement in disease activity in patients with rheumatoid arthritis [7].  While another study claimed that this treatment may actually cause an exacerbation of RA symptoms [8]. 


The fact is that more research needs to be conducted in order to assess the safety and efficacy of this treatment.


Authors: Maria A. Boiano BA, New York College of Osteopathic Medicine, Old Westbury, NY

               Alex Visco, MD, New York-Presbyterian Hospital, The University Hospital of Columbia and Cornell, New York, NY





1.      Min S, Hwang S, Park K, Lee J, Lee K, Kim K, Jung Y, Koh H, Do J, Kim H, Kim HY: Induction of IL-10-producing CD4+ CD25+ T cells in animal model of collagen-induced arthritis by oral administration of type II collagen.  Arthritis Res Ther 2004, 6:R213-R219.

2.      Barnett ML, Kremer JM, St Clair EW, Clegg DO, Furst D, Weisman M, Fletcher MJ, Chasan-Taber S, Finger E, Morales A, Le CH, Trentham DE: Treatment of rheumatoid arthritis with oral type II collagen.  Results of a multicenter, double-blind, placebo-controlled trial.  Arthritis Rheum 1998 Feb;41(2):290-7.

3.      Ausar SF, Beltramo DM, Castagna LF, Quintana S, Silvera E, Kalayan G, Revigliono M, Landa CA, Bianco ID: Treatment of rheumatoid arthritis by oral administration of bovine tracheal type II collagen.  Rheumatol Int. 2001 May;20(4):138-44.

4.      Trentham DE, Dynesius-Trentham RA, Orav EJ, Combitchi D, Lorenzo C, Sewell KL, Hafler DA, Weiner HL: Effects of oral administration of type II collagen on rheumatoid arthritis.  Science 1993 Sep 24;261(5129):1727-30.

5.      Bagchi D, Misner B, Bagchi M, Kothari SC, Downs BW, Fafard RD, Preuss HG:  Effects of orally administered undenatured type II collagen against arthritic inflammatory disease: a mechanistic exploration.  Int J Clin Pharmacol Res. 2002;22(3-4):101-10.

6.      sieper J, Kary S, Sorensen H, Alten R, Eggens U, Huge W, Hiepe F, Kuhne A, Listing J, Ulbrich N, Braun J, Zink A, Mitchison NA: Oral type II collagen treatment in early rheumatoid arthritis.  A doube-blind, placebo-controlled, randomized trial.  Arthritis Rheum. 1996 Jan;39(1):41-51.

7.      McKown KM, Carbone LD, Kaplan SB, Aelion JA, Lohr KM, Cremer MA, Bustillo J, Gonzalez M, Kaeley G, Steere EL, Somes GW, Myers LK, Seyer JM, Kang AH, Postlethwaite AE: Lack of efficacy of oral bovine type II collagen added to existing therapy in rheumatoid arthritis.  Arthritis Rheum. 1999 Jun;42(6):1304-8

8.      Cazzola M, Antivalle M, Sarzi-Puttini P, Dell’Acqua D, Panni B, Caruso I: Oral type II collagen in the treatment of rheumatoid arthritis.  A six-month double blind placebo-controlled study.  Clin Exp Rheumatol. 2000 Sep-Oct; 18(5):571-7.





 Arthritis MD. © 2005