4 supplements for regenerating cartilage

Why might supplements be needed to help regenerate cartilage?

Cartilage: one of the few tissues with limited regeneration

Both flexible and tough, cartilage plays a crucial role in the body, covering the ends of bones at their joints to facilitate movement and absorb shocks.

Unlike other types of tissue (muscles, tendons, skin, etc.), cartilage has limited regenerative ability due to its low blood supply and cell density, and absence of lymphatic vessels and nerves.

In addition, chondrocytes - the cells that make up cartilage and produce the cartilaginous matrix (in particular collagen) - have a limited capacity for division and repair, especially in the adult body. Indeed, when damage occurs, healing is slow or virtually non-existent in adults.

Why does cartilage gradually wear out?

Over time, cartilage becomes damaged and less flexible.

Repetitive activities, the heavy loads placed on joints throughout life (compounded by excess weight), injuries, as well as the development of numerous conditions such as osteoarthritis, inflammatory disease and diabetes, and the cumulative effects of dietary deficiencies (espepcially vitamin D) all contribute to this progressive wear and tear.

Ways of slowing down cartilage degeneration

As it is difficult to regenerate damaged cartilage, it makes sense to do everything possible to slow down its deterioration and maintain it in an optimal state for as long as possible. For that, 3 measures are usually recommended (1):

• eat a sensible, balanced diet, both to provide the nutrients needed for healthy cartilage and to maintain an optimal weight and so reduce the pressure exerted on sensitive joints such as the knees and hips;
• take regular exercise, to stimulate blood flow to cartilage and strengthen the muscles around joints, though repetitive, high-intensity exercise should be avoided (heavy loads, road running, repeated jumps…);
• ensure any joint injury is treated promptly and carefully: untreated sprains, tears and fractures can cause irreversible damage to cartilage.

Research has, however, shown that cartilage regeneration can be stimulated to some degree, both through innovative surgical procedures and treatments (2), as well as the use of nutritional substances available in the form of dietary supplements.

4 dietary supplements good for cartilage regeneration

Key role of chondroitin in cartilage

Chondroitin is an essential component of cartilage, produced directly by the body. Many studies have suggested it is associated with cartilage reconstruction.

Three mechanisms of action are thought to be at play, though further research is needed: maintaining water in the cartilage matrix, inhibiting certain enzymes which destroy cartilage (primarily MMPs and aggrecanases) and stimulating chondrocytes to produce more material like collagen (3-5).

Its potential in terms of supplementation has long been played down because chondroitin is a very large molecule with relatively low absorption, but it seems this absorption rate (8%-20%) is still enough to produce clinical effects. It’s best to opt for marine chondroitin, recognised as offering high bioavailability (such as Chondroitin Sulfate 95%).

Glucosamine, natural support for the joints

Like chondroitin, glucosamine is produced by the body, under normal conditions, from glucose and glutamine. A number of studies have shown that cartilage degenerates when the glucosamine production process is disrupted.

Several mechanisms of action have been proposed for its potential restorative effect on the cartilaginous matrix: a key role in the natural production of several components of the matrix (glycosaminoglycans and proteoglycans), its contribution to joint lubrication, and its inhibition of destructive enzymes. Some synergistic joint supplements contain marine-source glucosamine sulfate (such as Joint Support Formula).

Type II collagen supplements

Returning to collagen, while the body is again theoretically able to produce this protein in sufficient quantities, it is absent in degenerative cartilage, yet to have any hope of repairing cartilage, optimal levels are essential.

Studies suggest that an exogenous intake of type II collagen may be able to stimulate the body’s own collagen production (6). It is found primarily in offal as well as in collagen supplements aimed specifically at cartilage (such as UC II®).

As a substitute, you can take glycine – one of the base materials of collagen production – combined with vitamin C, which supports collagen formation and normal cartilage function.

What effect do hyaluronic acid supplements have on cartilage?

While young people’s joints have a high level of hyaluronic acid the body’s production declines with age, resulting in the joints becoming painful and less flexible.

It is actually a key component of synovial fluid, which helps to absorb shocks and provide nutrients to cartilage chondrocytes. Without it, natural waste material and debris produced by wear and tear of the joints are not properly eliminated, impairing cartilage function and repair.

In an effort to regenerate seriously degenerated joint cartilage, visco-supplementation is often used, which involves injecting a hyaluronic acid-based gel directly into the joint, but there are also dietary supplements available that can provide high molecular weight hyaluronic acid absorbable by the body (such as Hyaluronic Acid).