My chiropractor has noticed my hip mobility has declined and suggested I take collagen supplements. Would this be beneficial? I’m 82 and in good health for my age. I am still able to play golf a couple of times a week.
William Nelson, Co. Antrim.
Dr Martin Scurr replies: I am glad you’ve asked about this, as it’s something that comes up regularly in my practice – patients convinced that taking collagen supplements has eased their arthritis.
In fact, I’m extremely sceptical that these could possibly help with long-term gradual degeneration of tissue, such as cartilage in the joints.
Collagen is a form of protein and protein is digested in the digestive tract, where it is broken down into peptides and amino acids.
Peptides act like messengers in the body, telling cells what to do, including repair and grow, while amino acids are the building blocks for the proteins needed for healthy tissues.
So how can it be that taking collagen orally can effectively repair damaged tissues – when it, too, is broken down? Against that healthy scepticism has to be set the fact that there is research – mainly industry- funded – that does show modest benefits from collagen supplements, in terms of easing pain for osteoarthritis and tendon damage, and improving skin elasticity and strength of tissues, such as tendons.
Some of the peptide fragments from the collagen supplements have been detected in the bloodstream after ingestion and it is possible that they are able to stimulate fibroblasts – cells that form connective tissue – and other repair mechanisms to increase the production of collagen and other components needed for tissue repair.
My feeling, however, is that any reduction in joint pain is an example of the placebo effect – I would not expect too much, despite the encouragement of your chiropractor.
I’m extremely sceptical that collagen supplements could possibly help with long-term gradual degeneration of tissue, such as cartilage in the joints, writes Dr Scurr
After going through the menopause at 51, I was diagnosed with atrophic vaginitis and prescribed the oestrogen pessary, Vagifem. But my GP advised only taking it for short periods due to a possible increased risk of womb cancer. I’ve recently read that this advice has changed. Is this correct?
Name and address supplied.
Dr Martin Scurr replies: Taking oral oestrogen hormone replacement therapy after the menopause has been linked to a raised risk of womb cancer, which is why women should also take the hormone progesterone at the same time.
Oral oestrogen causes the womb lining to thicken, a possible forerunner to cancer – progesterone helps prevent the womb lining thickening.
However, since your diagnosis (you say in your longer letter that this was ten years ago), multiple reviews have confirmed that low-dose vaginal oestrogen – such as that used in Vagifem –does not increase the risk of the tissue thickening or womb cancer and its use does not require the addition of progesterone.
NHS treatment guidelines now state it can be continued long-term (though, of course, any post-menopausal bleeding – a potential sign of cancer – must be fully investigated).
The advice is to use 10mcg pessaries twice a week. I suggest you discuss this with your GP.
Separately, recent research has also suggested that, just like the gut, the bladder and vagina also have their own identifiable microbiomes – communities of microbes that are essential to the health of these tissues – and that applying oestrogen in the form of vaginal pessaries helps maintain a healthy balance of bacteria. This, in turn, helps to reduce infections and tissue inflammation.
In my view… Proof that prostate screening works
GPs have worried for years about prostate cancer screening – using a blood test to identify men at risk of the disease (through raised levels of prostate-specific antigen, or PSA) before they have symptoms. The problem is that PSA tests (first introduced in the 1990s) can throw up both false positive and false negative results, which is why there’s not been a national screening programme.
But the results of a 23-year study of PSA screening in 55 to 69-year-olds may change this view: the research, published last week in the prestigious New England Journal of Medicine, shows that screening reduced the risk of dying from prostate cancer by 13 per cent: screening 456 men prevents one death.
Some prostate cancers are not aggressive, yet the treatment itself can do harm. So while screening is now the right thing to do, as the Mail has campaigned for, the way for ward is for selective screening, focusing on men most at risk: men from black ethnic groups and men with a family history of the disease – and lowering the age range for screening down to 40