Q: Are hyaluronic acid supplements effective against joint pain?
A: Hyaluronic acid (HA), also called hyaluronan, is produced in the body, particularly in the skin, eyes and joints. But that doesn't mean swallowing it will do anything or is safe.
HA acts as an antioxidant and modifies inflammation. In joints, it cushions and lubricates. Levels of HA in joint fluid can be significantly reduced in people with osteoarthritis. So the substance (extracted from rooster combs or made by bacteria in a lab) is sometimes injected into joints to reduce arthritis pain and improve function.
The Natural Medicines Comprehensive Database says that HA is "possibly effective" for osteoarthritis when injected, though results have been mixed. It's also injected as a facial filler.
More dubious is the use of oral HA, available in gel caps and liquid forms. The supplements are touted to treat arthritis and delay aging (the "key to the fountain of youth"). They are said to promote healthy skin, stabilize vertebrae in the spine, promote recovery from sports and so on.
There are different sources and types of HA, with different biological effects. It's unknown which, if any, supplement might work. The only published human research we could find was a 2008 study that gave an HA supplement to people with knee osteoarthritis. It was very small and had questionable findings. And aside from some animal research, it's uncertain whether the substance is even well absorbed, much less that it makes it to the intended part of the body.
In 2010, the FDA warned one company that it was illegally marketing HA products as drugs and making unsubstantiated health claims. Be aware that some HA supplements also contain other questionable and potentially harmful ingredients.
Until there are larger, well-designed, published clinical trials showing safety and effectiveness, skip hyaluronic acid supplements.
Source: Originally published in The University of California, Berkeley Wellness Letter (August 2011)