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Connective Tissue Wellness and Healthy Aging

Why connective tissue and collagen are essential for vital aging, and how evidence-based supplements can keep your patients healthy and strong throughout the years.


Connective tissue health is a critical but underestimated aspect of aging, often taking a back seat to factors like diet and exercise. But connective tissue wellness is pivotal to vital aging and longevity, influencing how patients look, feel and function with advancing years. Emerging research now recognizes the primary role of collagen and supportive nutrients in protecting connective tissue health and mitigating age-related changes. What you need to know about connective tissue maintenance and how to choose a comprehensive collagen supplement.


How Connective Tissue Health Impacts Aging.

Throughout the body, connective tissue is responsible for support, structure and stability, forming the framework for organs, muscles and other tissues and providing the scaffold for cells to rebuild and repair damage. During the process of aging, connective tissues become weaker and less flexible, manifesting in joint pain and stiffness, loss of skin elasticity, reduced strength and function, and other issues associated with aging. Changes in connective tissue also impact organs, airways and blood vessels, and may contribute to an increased risk of age-related diseases.

“The health of our connective tissue dictates our overall vitality in the aging process,” says Dr. Arland Hill, DC, Biotics Research Director Of Clinical Education. “Addressing age-related changes and supporting connective tissue wellness is crucial, especially for integrative practitioners and functional medicine doctors.”

Collagen and silicon play central roles in connective tissue health. Collagen, the most abundant protein in the body and a major component of the extracellular matrix, is a foundational element of cartilage, bones, tendons, ligaments, muscles, skin and blood vessels. Silicon, also a key component of the extracellular matrix, facilitates collagen synthesis, serving as a crosslinking agent between collagen and proteoglycans of the extracellular matrix.

“While collagen provides the tensile strength in connective tissue health, a bioactive silicon enhances the structural integrity, and a combination of the two is critical in this process,” says Dr. Hill. “Incorporating a daily broad-spectrum collagen formula plays a key role in maintaining skin elasticity, joint mobility and tissue integrity as we age.”

Collagen synthesis is a complex and tightly regulated process involving various molecular and cellular mechanisms and requiring specific nutrients. But diet-related deficiencies in amino acids, vitamin C and other essential nutrients impair collagen production. High sugar intake, excessive sun exposure and lifestyle influences—including smoking, lack of exercise, inadequate sleep, poor hydration and chronic stress—inhibit collagen synthesis and accelerate its degradation. Hormonal fluctuations, especially during menopause, also affect collagen, as do some medications, autoimmune disorders and chronic inflammatory conditions.

And age has a significant effect, reducing collagen synthesis, disrupting its structure and organization and speeding degradation. Collagen production begins to decline as early as the mid-20s, and by the age of 80, may decrease by up to 75 percent—with pronounced impacts on connective tissue health. Diminished collagen production is a primary factor in signs of aging, including joint pain and stiffness, weakened muscle strength and function, loss of skin elasticity and tone, wrinkling and skin sagging, brittle nails and hair, gum problems, increased intestinal permeability, impaired bone remodeling and reduced bone density. Insufficient collagen also contributes to arterial stiffness, vascular fragility, the development and progression of atherosclerosis and a heightened risk of cardiovascular disease. Silicon concentrations in connective tissue likewise decline over time, further exacerbating age-related issues.1, 2, 3


Personalized Protocols: The Role of Collagen.

A personalized healthy aging protocol begins with protecting connective tissue. Along with dietary interventions and lifestyle changes, supplementing with collagen can offset decreased collagen production and mitigate the effects of time on connective tissue. Numerous studies validate the benefits of collagen for joints, muscles, skin, bones and other aspects of aging—but collagen supplements vary widely in composition and efficacy. The most important factors to consider in choosing a high-quality formulation:

  • Collagen types: a comprehensive profile. Any collagen product you’re considering should contain a blend of several different varieties, with an emphasis on types I, II and III. Considered the major types, these account for 80 to 90 percent of the body’s collagen and are critical for providing mechanical resilience and support for cell growth. Along with these three, complementary types create a comprehensive collagen profile. Look for supplements that contain minor collagen types such as V and X, found in smaller quantities in the body, but equally important in supporting the extracellular matrix.
  • Bioavailability: hydrolyzed collagen peptides. Collagen is a large protein, and it’s unclear how effectively it’s absorbed intact through the digestive system to reach targeted tissues. The process of hydrolysis breaks long collagen protein chains into shorter peptides, resulting in collagen peptides with a lower molecular weight and better solubility, digestibility and absorption. Hydrolyzed collagen comprised of low molecular weight bioactive peptides is shown to be significantly more bioavailable than intact collagen protein, offering a wide range of benefits for joints, muscles, skin, bones and overall connective tissue health.4, 5
  • Sources: variety and proven efficacy. In addition to bovine sources, a comprehensive collagen supplement should feature evidence-based sources with proven benefits. Avian sternum collagen, rich in type II collagen, has been studied for its measurable impacts on cartilage repair and joint function. Sternal collagen extracts, shown to support cutaneous collagen production, reduce facial lines and wrinkles and enhance skin elasticity. Eggshell membrane contains type I collagen as well as other bioactive compounds, like hyaluronic acid, chondroitin sulfate and proteoglycans. In clinical trials, eggshell membrane decreased joint stiffness, potentially slowing joint degeneration by promoting immune tolerance and modulating the inflammatory process.6, 7, 8, 9, 10, 11
  • Silicon: bioavailable, stabilized forms. A complete supplement should include silicon to boost the benefits of collagen alone. Orthosilicic acid (OSA), a highly soluble form of silicon, is readily absorbed and significantly more bioavailable than other forms. However, OSA is reactive, prone to polymerization or precipitation, which limit its absorption and availability. Stabilized forms of OSA maintain orthosilicic acid in a soluble form, enhancing its absorption, bioavailability and positive effects on connective tissue. Stabilized OSA stimulates type I collagen synthesis, and in studies, is associated with reduced joint discomfort and markers of cartilage degeneration, accelerated bone formation, and improvements in skin texture, firmness and hydration.12, 13, 14, 15, 16, 17


Science-Backed Collagen Supplements: Research Highlights

A hydrolyzed collagen supplement enriched with stabilized OSA is a powerful tool in offsetting age-related declines in collagen, supporting connective tissue health and protecting your patients from the detrimental impacts of aging. What the science shows:

  • Joint mobility, comfort and function. Hydrolyzed collagen peptides have been shown to improve various joint parameters, including decreased discomfort and increased mobility and function, and provide relief for symptoms of osteoarthritis. Sternum cartilage in particular is associated with reduced knee and back stiffness and better joint flexibility and mobility, and in a number of clinical trials, eggshell membrane eased joint stiffness and minimized cartilage degeneration. Stabilized OSA also benefits joint health, increasing mobility, lessening discomfort and mitigating cartilage degeneration.18, 19, 20, 21, 22, 23, 24, 25
  • Bone strength and density. Hydrolyzed collagen supplements with silicon may also protect bones, improving bone density, strength and composition and lowering the risk of osteoporosis. One study of post-menopausal women found a positive shift in bone markers indicating a reduction in bone loss and an increase in bone formation, after collagen peptide supplementation. Other research links collagen peptide supplementation with greater bone mineral density and fewer fractures. Additionally, silicon plays a key role in bone strength, composition and mechanical properties, and a higher intake is associated with increased density and mineralization. In studies, bioavailable OSA has been shown to stimulate the synthesis of type I collagen, promote osteoblast function, accelerate bone formation, suppress bone breakdown and enhance mineralization.26, 27, 28, 29, 30, 31, 32
  • Skin: hydration and elasticity, reduced wrinkling. Multiple studies validate collagen’s effectiveness for repairing sun damage and lessening the signs of aging. In a double blind, placebo-controlled study, participants taking collagen supplements showed better skin hydration, elasticity and firmness, with reduced wrinkling. Sternal collagen extracts in particular support cutaneous collagen production and minimize facial lines and wrinkles, and in clinical trials, eggshell membrane improved skin tone and crow’s feet, as well as hair thickness, nail growth and nail strength. Stabilized forms of OSA are also associated with increased skin firmness and hydration.33, 34, 35, 36, 37, 38, 39
  • Muscle mass, strength and body composition. Collagen is rich in specific amino acids required for the synthesis and maintenance of muscle tissue, and some studies suggest collagen peptides stimulate anabolic signaling pathways in muscle cells, potentially boosting muscle protein synthesis and muscle growth. Other research suggests collagen peptides enhance contractile force transmission and may act as signal messengers in anabolic cellular processes in tendons, ligaments and cartilage, tendons. Collagen is thought to stimulate creatine synthesis and promote muscle growth after exercise, and in one study, collagen peptide supplementation increased muscle mass and muscle strength and favorably altered body composition when combined with resistance exercise.40, 41, 42, 43
  • Gut, heart and brain health. As a fundamental component of the gut lining, collagen is essential for the structural integrity of the intestinal barrier, and some research links collagen supplementation with improvements in tight junctions and reduced gut permeability. Collagen supplementation may also protect cardiovascular and brain health. In one study, adults who took collagen daily demonstrated a significant decrease in arterial stiffness and positive shifts in lipid profiles, and other research suggests collagen peptides may lower LDL and systolic blood pressure, modestly increase HDL and reduce arterial stiffness. Additionally, a few studies hint at a protective role of silicon and certain types of collagen against neurodegenerative disease.44, 45, 46, 47, 48, 49



  1. Shin JW et al. Molecular Mechanisms of Dermal Aging and Antiaging Approaches. Int J Mol Sci. 2019 Apr 29;20(9):2126.
  2. Jugdaohsingh R et al. The decrease in silicon concentration of the connective tissues with age in rats is a marker of connective tissue turnover. Bone. 2015 Jun;75:40-8.
  3. Sorushanova A et al. The Collagen Suprafamily: From Biosynthesis to Advanced Biomaterial Development. Adv Mater. 2019 Jan;31(1):e1801651.
  4. Skov K et al. Enzymatic Hydrolysis of a Collagen Hydrolysate Enhances Postprandial Absorption Rate-A Randomized Controlled Trial. Nutrients. 2019; 11(5), 1064.
  5. León-López A et al. Hydrolyzed Collagen-Sources and Applications. Molecules. 2019 Nov 7;24(22):4031.
  6. Schwartz SR et al. Novel Hydrolyzed Chicken Sternal Cartilage Extract Improves Facial Epidermis and Connective Tissue in Healthy Adult Females: A Randomized, Double-Blind, Placebo-Controlled Trial. Altern Ther Health Med. 2019 Sep;25(5):12-29.
  7. Ruff KJ et al. Eggshell membrane in the treatment of pain and stiffness from osteoarthritis of the knee: a randomized, multicenter, double-blind, placebo-controlled clinical study. Clin Rheumatol. 2009 Aug;28(8):907-14.
  8. Ruff KJ et al. Beneficial effects of natural eggshell membrane versus placebo in exercise-induced joint pain, stiffness, and cartilage turnover in healthy, postmenopausal women. Clin Interv Aging. 2018 Feb 19;13:285-295.
  9. Cánovas F et al. Randomised Clinical Trial to Analyse the Efficacy of Eggshell Membrane to Improve Joint Functionality in Knee Osteoarthritis. Nutrients. 2022; 14(11), 2340.
  10. Kiers JL, Bult JHF. Mildly Processed Natural Eggshell Membrane Alleviates Joint Pain Associated with Osteoarthritis of the Knee: A Randomized Double-Blind Placebo-Controlled Study. J Med Food. 2021 Mar;24(3):292-298.
  11. Kalman DS, Hewlings S. The effect of oral hydrolyzed eggshell membrane on the appearance of hair, skin, and nails in healthy middle-aged adults: A randomized double-blind placebo-controlled clinical trial. J Cosmet Dermatol. 2020 Jun;19(6):1463-1472.
  12. Sergent T et al. In vitro investigation of intestinal transport mechanism of silicon, supplied as orthosilicic acid-vanillin complex. Mol Nutr Food Res. 2017 Feb;61(2).
  13. Marcowycz A et al. Digestive absorption of silicon, supplemented as orthosilicic acid-vanillin complex. Mol Nutr Food Res. 2015; 59(8), 1584–1589.
  14. Geusens P et al. A 12-week randomized, double-blind, placebo-controlled multicenter study of choline-stabilized orthosilicic acid in patients with symptomatic knee osteoarthritis. BMC Musculoskelet Disord. 2017 Jan 5;18(1):2.
  15. Petersen Vitello Kalil CL et al. Evaluation of cutaneous rejuvenation associated with the use of ortho-silicic acid stabilized by hydrolyzed marine collagen. J Cosmet Dermatol. 2018 Oct;17(5):814-820.
  16. Zhou H et al. Orthosilicic Acid Accelerates Bone Formation in Human Osteoblast-Like Cells Through the PI3K-Akt-mTOR Pathway. Biol Trace Elem Res. 2019 Aug;190(2):327-335.
  17. Ma W et al. Ortho-silicic Acid Inhibits RANKL-Induced Osteoclastogenesis and Reverses Ovariectomy-Induced Bone Loss In Vivo. Biol Trace Elem Res. 2021 May;199(5):1864-1876.
  18. Clark KL 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 May;24(5):1485-96.
  19. Woo T et al. Efficacy of Oral Collagen in Joint Pain – Osteoarthritis and Rheumatoid Arthritis. J Arthritis. 2017, 6:2.
  20. García-Coronado JM et al. Effect of collagen supplementation on osteoarthritis symptoms: a meta-analysis of randomized placebo-controlled trials. Int Orthop. 2019 Mar;43(3):531-538.
  21. Bagi CM et al. Oral administration of undenatured native chicken type II collagen (UC-II) diminished deterioration of articular cartilage in a rat model of osteoarthritis (OA). Osteoarthritis Cartilage. 2017 Dec;25(12):2080-2090.
  22. Kviatkovsky SA et al. Collagen peptides supplementation improves function, pain, and physical and mental outcomes in active adults. J Int Soc Sports Nutr. 2023 Dec;20(1):2243252.
  23. Kumar P et al. Efficacy of undenatured collagen in knee osteoarthritis: review of the literature with limited meta-analysis. Am J Transl Res. 2023 Sep 15;15(9):5545-5555
  24. Martínez-Puig D et al. P. Collagen Supplementation for Joint Health: The Link between Composition and Scientific Knowledge. Nutrients. 2023 Mar 8;15(6):1332.
  25. Benito-Ruiz P et al. A randomized controlled trial on the efficacy and safety of a food ingredient, collagen hydrolysate, for improving joint comfort. Int J Food Sci Nutr. 2009;60 Suppl 2:99-113.
  26. Föger-Samwald U et al. Osteoporosis: Pathophysiology and therapeutic options. EXCLI J. 2020 Jul 20;19:1017-1037.
  27. Mobasheri A, et al. A White Paper on Collagen Hydrolyzates and Ultrahydrolyzates: Potential Supplements to Support Joint Health in Osteoarthritis? Curr Rheumatol Rep. 2021 Oct 30;23(11):78.
  28. König D et al. Specific Collagen Peptides Improve Bone Mineral Density and Bone Markers in Postmenopausal Women-A Randomized Controlled Study. Nutrients. 2018 Jan 16;10(1):97.
  29. Elam ML et al. A calcium-collagen chelate dietary supplement attenuates bone loss in postmenopausal women with osteopenia: a randomized controlled trial. J Med Food. 2015 Mar;18(3):324-31.
  30. Rondanelli M et al. Silicon: A neglected micronutrient essential for bone health. Exp Biol Med (Maywood). 2021 Jul;246(13):1500-1511.
  31. Jugdaohsingh R et al. Dietary silicon intake is positively associated with bone mineral density in men and premenopausal women of the Framingham Offspring cohort. J Bone Miner Res. 2004 Feb;19(2):297-307.
  32. Jugdaohsingh R. Silicon and bone health. J Nutr Health Aging. 2007 Mar-Apr; 11(2): 99–110.
  33. Barati M et al. Collagen supplementation for skin health: A mechanistic systematic review. J Cosmet Dermatol. 2020 Nov;19(11):2820-2829.
  34. Asserin J et al. The effect of oral collagen peptide supplementation on skin moisture and the dermal collagen network: evidence from an ex vivo model and randomized, placebo-controlled clinical trials. J Cosmet Dermatol. 2015 Dec;14(4):291-301.
  35. Proksch E et al. Oral supplementation of specific collagen peptides has beneficial effects on human skin physiology: a double-blind, placebo-controlled study. Skin Pharmacal Physio 2014;27(1):47-55.
  36. Pu SY et al. Effects of Oral Collagen for Skin Anti-Aging: A Systematic Review and Meta-Analysis. Nutrients. 2023 Apr 26;15(9):2080.
  37. Choi FD et al. Oral Collagen Supplementation: A Systematic Review of Dermatological Applications. J Drugs Dermatol. 2019 Jan 1;18(1):9-16.
  38. Kim DU et al. Oral Intake of Low-Molecular-Weight Collagen Peptide Improves Hydration, Elasticity, and Wrinkling in Human Skin: A Randomized, Double-Blind, Placebo-Controlled Study. Nutrients. 2018 Jun 26;10(7):826.
  39. Hexsel D et al. Oral supplementation with specific bioactive collagen peptides improves nail growth and reduces symptoms of brittle nails. J Cosmet Dermatol. 2017 Dec;16(4):520-526.
  40. Centner C et al. Supplementation of Specific Collagen Peptides Following High-Load Resistance Exercise Upregulates Gene Expression in Pathways Involved in Skeletal Muscle Signal Transduction. Front Physiol. 2022 Apr 5;13:838004.
  41. Oertzen-Hagemann V et al. Effects of 12 Weeks of Hypertrophy Resistance Exercise Training Combined with Collagen Peptide Supplementation on the Skeletal Muscle Proteome in Recreationally Active Men. Nutrients. 2019 May 14;11(5):1072.
  42. Zdzieblik D et al. Specific Bioactive Collagen Peptides in Osteopenia and Osteoporosis: Long-Term Observation in Postmenopausal Women. J Bone Metab. 2021 Aug;28(3):207-213.
  43. Zdzieblik D et al. Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: a randomised controlled trial. Br J Nutr. 2015 Oct 28;114(8):1237-45.
  44. Tomosugi N et al. Effect of Collagen Tripeptide on Atherosclerosis in Healthy Humans. J Atheroscler Thromb. 2017 May 1;24(5):530-538.
  45. Taylor G et al. The effects of collagen peptides on exercise-induced gastrointestinal stress: a randomized, controlled trial. Eur J Nutr. 2023 Mar;62(2):1027-1039.
  46. Chen Q et al. Collagen peptides derived from Alaska pollock skin protect against TNFα-induced dysfunction of tight junctions in Caco-2 cells. FASEB J. 2016.
  47. Jalili Z et al. Effects of collagen peptide supplementation on cardiovascular markers: a systematic review and meta-analysis of randomised, placebo-controlled trials. Br J Nutr. 2023 Mar 14;129(5):779-794.
  48. Cescon M et al. Lack of collagen VI promotes neurodegeneration by impairing autophagy and inducing apoptosis during aging. Aging (Albany NY). 2016 May;8(5):1083-101.
  49. Dudek Ł et al. Silicon in prevention of atherosclerosis and other age-related diseases. Front Cardiovasc Med. 2024 Mar 1;11:1370536.



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