Role of nutritional supplements in the management of tendinopathies: focus on combination of type 1 collagen, vitamin C and mucopolysaccharides

Abstract

<p class="abstract">Tendinopathy is a common disease that is difficult to manage due to its recurrent nature. It is associated with increased healthcare costs and significantly impacts quality of life of patients. Also, according to recent studies patients with high cholesterol and diabetes are at a higher risk of developing tendinopathy. There has been rise in the incidence of tendinopathies due to increase in sport activities, life expectancy and some other factors (environment, diet and some drug therapies). Approximately 30% of visits for musculoskeletal pain in general practice are related to tendon injury. Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids remain the mainstay of treatment. Despite the use of current therapies, there is need of a supportive therapy that can help in the healing process towards development of physiologically normal tendons. Nutraceuticals have been used as supportive therapy for management of tendinopathies. This review focuses on the management of tendinopathy with special attention on role of nutraceuticals such as type I collagen, mucopolysaccharides and vitamin C in the management of tendinopathy. Clinical data suggests that this combination (type I collagen, mucopolysaccharides and vitamin C) promotes the endogenous synthesis of collagen type I, avoiding the accumulation of collagen type III and aggrecan, thus interfering with the degeneration of tendon tissue. Based on the available clinical data, combination of type I collagen, mucopolysaccharides and vitamin C not only reduce the clinical symptoms but also improve structural evolution of different types of tendinopathies as well as plantar fascitis.</p>

Comparing Effectiveness of Combination of Collagen Peptide Type-1, Low Molecular Weight Chondroitin Sulphate, Sodium Hyaluronate, and Vitamin-C Versus Oral Diclofenac Sodium in Achilles Tendinopathy: A Prospective Randomized Control Trial

“…Most have limited evidence and suboptimal effectiveness. Oral supplements of glucosamine and chondroitin sulphate [ 6 ], vitamin C [ 7 ], hydrolyzed type 1 collagen [ 8 ] have been used to achieve a cost-effective and non-invasive solution with promising results. A clinical study comparing the effects of injectable glucosamine and indomethacin in the management of Achilles peri-tendinitis showed that glucosamine had a better overall therapeutic effect on two-thirds of the patients, especially in those patients who endured persistent pain [ 13 ].…”

“…In the past several years, oral nutritional supplements have been used to streamline the turnover of tendon connective tissue to prevent ineffective healing. Oral supplements of glucosamine and chondroitin sulphate [ 6 ], vitamin C [ 7 ], hydrolyzed type 1 collagen [ 8 ], and sodium hyaluronate [ 9 , 10 ] increase the concentration of these building blocks of tendon and might facilitate to conserve, or even repair, the degenerated tendon connective tissues. This study hypothesized that the nutraceutical combination (collagen peptide type-1, low molecular chondroitin sulphate, sodium hyaluronate, and vitamin C) would fare better than diclofenac sodium concerning pain and ultrasound findings.…”