Your cells produce collagen but, starting in our mid-to-late 20s, cellular aging along with environmental exposure causes collagen production to decline, at a rate of ~1% per year [1]. NAD+ is a critical coenzyme found in every cell in your body that helps keep cells youthful and functioning optimally. As we age, our NAD+ levels also naturally decline—NAD+ decline is a hallmark feature of cellular aging. In skin, NAD+ levels decline by almost 60% between young adulthood and middle age [2], impacting the health and function of the cells (called fibroblasts) that produce collagen and other components necessary for maintaining skin health and structure. 

Chart: NAD+ and collagen levels relative to their amount at age 20 (expressed as % values). Sources: Shuster, S. et al., Br J Dermatol. 1975;93(6):639-643, Massudi, H. et al., PLoS One. 2012;7(7):e42357.

There is growing evidence supporting the various health benefits of collagen peptide supplements for the skin, joint, and bone. Studies show that collagen peptides work by stimulating the production of procollagen (a precursor of collagen), elastin (another structural protein in the skin), and hyaluronic acid (a molecule in the skin that attracts and maintains moisture), and down-regulating collagen-degrading enzymes [3]—all of which require optimally functioning cells. Laboratory studies have shown that treating aged fibroblasts, which secrete less collagen than youthful fibroblasts, with NAD+ precursors can stimulate collagen production [4].

Cofactor by Elysium Health provides an advanced 4-in-1 collagen support system that combines: bioactive collagen peptides, which provide the stimulus and the building blocks for collagen; nicotinamide riboside, a clinically proven NAD+ booster, to help improve the health and function of the cells that use these building blocks to produce collagen; hyaluronic acid to improve skin hydration and elasticity; and vitamin C, an essential cofactor for collagen synthesis.

Skin benefits

Collagen is the most abundant protein in your skin, responsible for strength and structure. As collagen production declines, the skin loses volume and firmness and starts to thin and wrinkle. The reduction in collagen production also coincides with a loss of hyaluronic acid further impacting the hydration and suppleness of the skin. Human clinical studies demonstrate that supplementation with collagen peptides results in a significant increase in skin elasticity [3] and improvements in dermal density, wrinkles, and skin roughness [5]. One study even saw improvements in cellulite scores in normal weight patients after 6 months of supplementation [6]. Oral administration of hyaluronic acid has also been demonstrated in multiple clinical studies to increase skin moisture levels, boost skin elasticity, and improve skin barrier function [7]. There is also emerging evidence for collagen peptides in supporting healthy hair, with improvements in thickness and smoothness [8] and nail growth [9]. The hair and nail benefits are likely driven by improvements in skin health, as hair follicles and nails are extensions of the skin and highly dependent on skin health.

Chart: Reduction in the average wrinkle volume after 16 weeks of supplementation with collagen peptides (CP). Figure adapted from Zmitek, et al., 2024.

Bone and joint benefits

In addition to being the most abundant protein in the skin, collagen is the primary building block for the body’s connective tissues, such as bones, tendons, ligaments, and cartilage, playing a key role in supporting our strength, flexibility, and movement. Human clinical studies showed that oral supplementation with collagen peptides resulted in improvements in markers of bone health, including bone mineral density in postmenopausal women [10] and reduced joint pain and discomfort in individuals with knee conditions [11,12]. Preclinical studies suggest these benefits are mediated through the stimulation of chondrocytes and osteoblasts, cells in the cartilage and bone, responsible for collagen production [13,14]. 

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References:

1. Shuster, S. et al., Br J Dermatol. 1975;93(6):639-643.

2. Massudi, H. et al., PLoS One. 2012;7(7):e42357. 

3. Choi, F.D. et al., J Drugs Dermatol. 2019;18(1):9-16.

4. Oblong, J.E., et al., 59th Annual Meeting American Academy of Dermatology, Washington, 2001.

5. Žmitek, K. et al., Nutrients. 2024;16(12):1908. 

6. Schunck, M. et al., J Med Food. 2015;18(12):1340-1348. 

7. Kawada, C. et al., Nutr J. 2014;13:70. 

8. Reilly, D.M. et al., Dermatol Res Pract. 2024;2024:8752787. 

9. Hexsel, D. et al., J Cosmet Dermatol. 2017;16(4):520-526. 

10. König, D. et al., Nutrients. 2018;10(1):97. 

11. Kumar, S. et al., J Sci Food Agric. 2015;95(4):702-707. 

12. Martínez-Puig, D. et al., Nutrients. 2023;15(6):1332. 

13. Oesser, S. et al., Cell Tissue Res. 2003;311(3):393-399. 

14. Guillerminet, F. et al., Bone. 2010;46(3):827-834.