Do hyaluronic acid pills work?

The effectiveness of hyaluronic acid pills is always in question, but what exactly is hyaluronic acid? How do your benefits from taking hyaluronic acid pills? 

These are the question that many people are wondering, especially since this type of pill has become so popular in recent years.

While there is no definitive answer, there is some evidence to suggest that these pills may provide certain benefits.

In a few minutes, you will know more about hyaluronic acid pills and whether they might be right for you.


What is hyaluronic acid?


Hyaluronic acid is a glycosaminoglycan, a molecule naturally produced by our cells and formed by repeating disaccharides (two sugars) in large chains (3-4 MDa). They have a high viscosity and polarity, which gives them a high ability to bind and retain water molecules. Therefore, it is widely used in cosmetics as a moisturizer in creams and a volume filler in injectable fillers.


It is mainly present in the skin and appears in other tissues, such as joint cartilage.

In humans, about half of the hyaluronic acid is found in the skin, both in the dermis (deep layers) and epidermis (superficial layers). It is also present in other tissues and body fluids, such as articular cartilage, the vitreous body of the eye, and synovial fluid.


What type of hyaluronic acid is produced by humans?


Human cells cannot produce "very high" molecular weight (6-12MDa) and large amounts of hyaluronic acid like mole rats. Our cells, however, produce similar high molecular weight hyaluronic acid (HMW-HA 1-3 MDa), which also holds cells together stably without dividing and has anti-inflammatory properties.

In certain signs, for example, in a wound, high molecular weighed hyaluronic acid (HMW) breaks down into low molecular weight hyaluronic acid (LMW-HA, less than 0.2 MDa), which promotes cell release, cell proliferation and migration. This process is required, for example, for wound healing or skin regeneration. In addition, the degradation of hyaluronic acid appears to have a pro-inflammatory effect. It activates inflammatory cells, such as macrophages, which play an important role in tissue repair and protection.

Thus, in healthy people, there is a balance between the production and degradation of high molecular weight hyaluronic acid when it is needed, for example, for wound healing.


What is natural hyaluronic acid used for?

It is a very important molecule in the body with various structural and signaling functions:

  • Hyaluronic acid occupies the space between cells in skin and cartilage, acting as a viscous filler or glue that holds cells together. It also plays an important role in hydration due to its high water retention capacity.
  • It provides cushioning to joints as it is part of synovial fluid and lubricates the eyes.
  • It protects against ultraviolet radiation from the sun.
  • In turn, it regulates tissue and wound repair by influencing the proliferation and differentiation of immune cells, fibroblasts and epithelial cells.

    The amount of hyaluronic acid decreases with age.


    The hyaluronic acid content in the skin decreases by 70% between the ages of 19 and 70, leading to a loss of hydration and volume. This, accompanied by a decrease in collagen and elastin, explains the dehydration, atrophy and loss of elasticity of aging skin. A similar decrease is observed in other tissues.

    Therefore, it makes sense to try to compensate for the loss.


    If I take oral hyaluronic acid supplements in pill form, can it be absorbed by the body and get into my skin and joints?


    Hyaluronic acid is a very large molecule that is difficult to absorb. The question arises whether ingested hyaluronic acid can be absorbed by the body, reach the skin or other tissues, or whether it is eliminated from the body. Several studies have attempted to clarify this unknown.

    Studies on the absorption of ingested hyaluronic acid

    Studies in animal models have used radioactively labelled hyaluronic acid to monitor its passage through the body (Hyaluronic Acid Absorption Studies 3 and 4). High-weight oral hyaluronic acid (1 MDa) was detected in the skin after 8 hours of administration. It was also detected in other tissues, including joints. Up to 91.3% was excreted, within seven days, and 8.7% remained in the body.


    In these studies, it has been suggested that high molecular weight hyaluronic acid (1 MDa) may enter tissues via the lymphatic system, as it occurs in some tissues before a peak in the blood occurs. However, the extent of its deposition in tissues has not been analyzed. 


    In rats (study 5), it was subsequently observed that medium-weight hyaluronic acid (0,3 MDa) administered orally can be broken down in the digestive tract by intestinal bacteria. Hyaluronic acid fragments or oligosaccharides are absorbed in the intestine and distributed in the blood to various tissues, including the skin.


    In short, animal studies show that hyaluronic acid is broken down in the digestive tract and reaches the skin. However, it has not been shown to reach the skin in 'intact' form. The effect of ingested hyaluronic acid will be transient as it is gradually eliminated or destroyed. This means that the supplement must be taken continuously. 


    What effect would hyaluronic acid have on my body?


    Hyaluronic acid taken in tablets or pills could have a direct benefit in terms of hydration, lubrication and anti-inflammation if it were to reach tissues intact, but this seems unlikely. Studies suggest it is more likely to arrive in a fragmented form. So what is the benefit of taking hyaluronic acid if it comes in fragments? Laboratory studies have observed that hyaluronic acid is fragments or oligosaccharides (1-2 KDa):

    Stimulate fibroblasts' producing cells ( Study 6 ), to synthesize high molecular weight hyaluronic acid and other skin rejuvenating molecules such as collagen and elastin.

    They may also stimulate the proliferation of fibroblasts ( study 7 ) and prevent their decline with age.

    An increase in the number of cells and hyaluronic acid production may prevent dehydration, loss of elasticity, and tissue sagging associated with ageing.

    However, these are laboratory studies. Is there any benefit in humans? I'll talk about that below.

    Are there benefits to my skin if I take hyaluronic acid?


    Clinical trials have been conducted to determine the benefits of hyaluronic acid for humans. Below we will talk about the studies that have been done in this area. These small studies show the benefits of taking hyaluronic acid for the skin.

    Human studies on oral hyaluronic acid and its effects on the skin

    Several small studies (22 to 107 subjects) show that a daily dose of 120 to 240 mg of hyaluronic acid can rehydrate chronically rough and dry skin. In one of the first trials, conducted in 2001, randomly selected patients received 240 mg of hyaluronic acid (80 KDa) per day, and the rest received a placebo. After six weeks, a microscopic evaluation by a dermatologist showed that the group who took hyaluronic acid had a significant improvement in dry skin on the face and all over the body. 

    In another recent study (2017), 70 people with wrinkles around their eyes or crow's feet were randomized to take 120 mg of 2 KDa or 300 KDa hyaluronic acid or a placebo daily. Repeated analysis of wrinkles after 12 weeks showed a reduction in those taking hyaluronic acid.

    In addition, a skin hydration meter (Corneometer CM 825) was used to determine the effectiveness of 1000 KDa of oral hyaluronic acid in 20 women between the ages of 45 and 60. Skin hydration improved by 13.25%, and skin roughness was reduced by 16.9% after six weeks of treatment.


    Empyri Hemp Face Cream with Hyaluronic Acid

    Conclusions: benefits of hyaluronic acid applied to the skin.


    In conclusion, several clinical studies show that taking hyaluronic acid is beneficial for the skin, although these are small studies with no more than 107 participants. Even larger studies, both in terms of the number of subjects and time, as well as using various analytical methods that conclusively prove the benefits of taking hyaluronic acid in the long term, are lacking.


    The benefits that have been seen so far, which would be good to verify in a serious study, are as follows:

    • Increased skin hydration
    • Reduced wrinkles
    • Improvement of dry and rough skin
    • Increased hydration of the eyes.
    • Reduced inflammation with high molecular weight hyaluronic acid.
    • Promotes wound healing

      Since the skin is renewed every 28 days (though less frequently in older age), the moisturizing effect of taking hyaluronic acid can be noticed after two weeks, however, hyaluronic acid must be taken continuously to maintain the effect.

      The importance of hyaluronic acid in longevity

      This is another very interesting area of research. Longevity is determined by how healthy we are and what diseases we develop during our lifetime. In this sense, it has been observed that hyaluronic acid plays an important role in preventing diseases in old age, at least in some animals. The following are the data known so far.

      High molecular weighted hyaluronic acid has a protective effect that promotes longevity in some animals.

      In addition to its role in hydration, several studies have shown that hyaluronic acid plays a very important role in cell signaling, influencing cell division and migration. Signals differ depending on the size of the hyaluronic acid.

      In this context, Vera Gorbunova's laboratory has made some very interesting observations in the mole rat, the rodent that lives the longest and does not develop typical diseases of old age, such as cancer or arthritis. A study into the reasons for its vitality found that its fibroblasts are "extremely long (6-12MDa)" and produce "large amounts" of hyaluronic acid. This contributes to skin elasticity, essential for life underground, and appears to protect them from certain diseases (see study). This hyaluronic acid is 6-10 times longer than that produced by humans.

      In laboratory studies, this powerful "high molecular weight (HMM-HA)" hyaluronic acid has been shown to inhibit normal and cancer cell division, inhibit their motility or metastasis and have anti-inflammatory effects. It acts both as an adhesive that holds cells together and activates signals (CD44) that inhibit cell division. This protection helps the mole rat live healthier for more years than other rodents.

      However, the "powerful hyaluronic acid" is not the only factor contributing to the mole rat's resistance to disease and cancer; other genetic factors contribute to longevity.

      Although humans live longer than any rodent, and we probably don't need the protection we see in mole rats, it would be interesting to investigate the effects of the large increase in hyaluronic acid on our health.

      Excessive breakdown of hyaluronic acid in cancer

      The balance between high and low molecular weight hyaluronic acid production is upset when a cell becomes cancerous. Cancer cells generate signals that uncontrollably increase the degradation of hyaluronic acid, which promotes their proliferation and migration. In cancer patients, it has been observed that the metastasis or spread of cancer correlates with very high levels of low molecular weight hyaluronic acid in tissues and blood, which signals its degradation. 

      Effect of N-acetylglucosamine on lifespan

      Recently, it has been suggested that hyaluronic acid, particularly N-acetylglucosamine, may have protective effects on cells.

      Scientific studies have found that N-acetylglucosamine can prolong the life of various organisms under laboratory conditions. This is because it activates protein quality control, helps to remove poor quality proteins and thus prevents cell damage. The accumulation of damaged proteins is one of the causes of ageing.

      Therefore, it is thought that when consumed, hyaluronic acid can degrade into monosaccharides such as N-acetylglucosamine, which are protective and promote longevity.

      Hyaluronic acid appears to protect against disease and ageing in some animals. However, there is still no research to support the benefits of hyaluronic acid in prevention.

      In general, what should be considered before taking hyaluronic acid pills or capsules?

      Studies show that using hyaluronic acid is good for the skin and osteoarthritis (osteoarthritis research). There are still no human trials that show a protective effect against diseases such as cancer or increased longevity.

      All evidence suggests that hyaluronic acid enters tissues fragmented forms, as oligosaccharides and monosaccharides. It is suggested that the fragments can activate protein checkpoint mechanisms, promote fibroblast growth and stimulate them to produce high-molecular-weight hyaluronic acid. It has also been observed that these fragments can transiently activate inflammatory and epithelial cells involved in tissue regeneration, which is beneficial for wound healing.

      In any case, it seems to have had no side effects, at least during the one-year study period. Always speak with a healthcare professional before starting a new supplement.

      Conclusions: does it make sense to take hyaluronic acid?

      Several human clinical studies show that high or low hyaluronic acid improves skin hydration and eliminates wrinkles. In our opinion, more research is needed.

      Moles produce high molecular weight hyaluronic acid, which protects against cancer and may promote healthy ageing and prolong life. However, no human studies are yet available.

      Fragmented hyaluronic acid in N-acetylglucosamine has been shown to extend lifespan in cell models. There are as yet no human studies to confirm this.


      Are there any side effects or risks associated with taking hyaluronic acid pills?

      Talk to your doctor before taking any supplements, especially if you have any medical concerns.

      Studies have shown that it is safe to take hyaluronic acid. The safety of taking hyaluronic acid has been extensively studied in toxicity and mutagenesis studies in animal and cellular models, which have shown no adverse effects regardless of hyaluronic acid's source or molecular weight. In human clinical studies, no adverse effects were found in at least 13 studies using hyaluronic acid for one year. This indicates that it is safe for humans.

      It rarely causes allergies because it is a naturally occurring molecule.

      Its effects on children and pregnant women are not known.