Clinical Insights

Beyond Beauty: The Protein Behind Healing, Movement and Resilience Collagen is usually associated with skin. Smoother texture, greater elasticity and fewer visible signs of ageing tend to dominate the conversation. But collagen does much more beneath the surface. It is the most abundant protein in the human body, making up around 30% of our total protein. It provides structure to our skin, bones, cartilage, tendons and ligaments—and plays an important role in how these tissues repair and renew themselves. When we are injured or undergo surgery, the body produces new collagen to help rebuild damaged tissue. When we move and exercise, collagen-rich cartilage, tendons and ligaments help our bodies absorb force, transfer movement and remain stable. Even our bones depend on a collagen framework for strength and resilience. These functions become increasingly important as we age. Because healthy ageing isn't only about how we look. It is also about how well we heal, move, recover and remain physically capable. So what role does collagen supplementation play—and can providing more of its building blocks help support these processes? To answer that, we need to look beyond the skin and understand what collagen is doing throughout the body. What Is Collagen—and Why Does the Body Need It? Collagen is the body's main structural protein. Rather than performing one specific job, it forms a framework that gives different tissues strength, flexibility and support. There are at least 28 known types of collagen, but three are particularly relevant to everyday health. Type I is the most abundant. It is found in skin, bones, tendons and ligaments, where strength and resistance to pulling forces are important. Type II is concentrated in cartilage, helping create the smooth, resilient tissue that cushions our joints. Type III often works alongside Type I and is found in skin, muscles, blood vessels and internal organs. Together, these collagen fibres form part of the extracellular matrix—the supportive structure surrounding our cells and holding tissues together. Collagen Is Constantly Being Rebuilt Collagen isn't a permanent structure. The body continually breaks down old collagen and produces new collagen, although the speed of this turnover varies considerably between tissues. This process becomes particularly important when tissue is damaged. Following an injury or surgery, collagen helps form the new extracellular matrix needed to rebuild damaged tissue. As healing progresses, newly formed collagen fibres are reorganised and remodelled, gradually giving the repaired tissue greater strength and structure. The same process of collagen synthesis and remodelling is also happening—at different rates—in our tendons, cartilage, bones and other connective tissues throughout life.   What Changes as We Age? Our relationship with collagen changes as we get older. Collagen formation and breakdown become altered with age, and existing collagen can undergo structural changes that affect the properties of our tissues. These changes vary by collagen type, tissue and sex rather than following one simple age-related decline. Lifestyle matters too. Factors such as UV exposure and smoking can accelerate collagen damage, while nutrition and physical activity influence the environment in which connective tissues are maintained and remodelled. The effects aren't limited to wrinkles. Age-related changes to collagen-rich tissues can influence how our joints, tendons, bones and skin perform and recover. So What Happens When We Take Collagen? Most collagen supplements contain hydrolysed collagen, or collagen peptides. Hydrolysis breaks the large collagen protein into smaller peptides that are easier to digest and absorb. Once consumed, collagen may support the body's own collagen production in two ways. First, it provides the building blocks. Collagen is particularly rich in glycine, proline and hydroxyproline—amino acids the body uses to make new collagen. Second, some small collagen-derived peptides can enter the bloodstream intact. Researchers believe these peptides may also act as biological signals, encouraging cells involved in connective tissue to produce more collagen. In other words, collagen supplementation doesn't simply replace old collagen with new collagen. It provides the raw materials—and potentially some of the signals—the body can use to support its own collagen production. Collagen Beyond Skin: Recovery, Movement and Resilience Collagen is constantly at work beneath the surface—helping tissues repair after injury, supporting our joints through everyday movement and giving connective tissues the strength to withstand physical stress. These roles make collagen much more than a beauty protein. It is an important part of how the body heals, moves and remains physically resilient. Healing & Recovery When tissue is damaged through injury or surgery, the body needs to rebuild the structural framework that has been disrupted. Collagen is central to this process. During healing, specialised cells called fibroblasts produce new collagen, creating a framework for repairing damaged tissue. Over time, those collagen fibres are reorganised and strengthened as the tissue remodels. This process doesn't happen overnight. Collagen formation and remodelling continue long after a wound appears to have healed on the surface. Nutrition matters during this period because the body needs adequate protein, amino acids and micronutrients to build new tissue. Collagen peptides provide particularly high concentrations of glycine, proline and hydroxyproline—the amino acids commonly found in collagen itself. For a deeper look at how nutrition supports healing after surgery, we explore this further in A Surgeon's Perspective: What Your Body Needs to Heal, Recover and Build Resilience. Protecting Joint Health & Mobility Everyday movement puts our joints to work. Cartilage cushions the bones where they meet, while collagen helps give that cartilage its strength and resilience. As we age, cartilage can gradually change and become less resilient. In conditions such as osteoarthritis, its breakdown can contribute to joint pain and stiffness. This is one of the areas where collagen supplementation has attracted the most clinical research. Studies suggest that oral collagen supplementation may help reduce joint pain and stiffness and improve physical function, particularly in people with osteoarthritis. Research has also explored its use in physically active adults experiencing activity-related joint discomfort. For active and ageing adults, supporting joint comfort and mobility can make an important difference to staying physically active.  Supporting Tendons & Ligaments Through Recovery Muscles tend to get most of the attention when we exercise or recover from injury. But movement depends just as much on the connective tissues supporting them. Tendons connect muscle to bone, while ligaments connect bones and help stabilise our joints. Both are dense, collagen-rich tissues designed to withstand considerable physical force. When injured, they can also be frustratingly slow to recover. Their relatively limited blood supply and slow rate of tissue remodelling mean that sprains, strains and overuse injuries can take considerable time to heal. Collagen is central to this repair process. As damaged connective tissue heals, new collagen is produced and gradually reorganised to restore strength and function. This has led researchers to investigate whether collagen supplementation can provide additional nutritional support during rehabilitation. Studies combining collagen peptides with resistance or loading exercise suggest that supplementation may support tendon structure, strength and adaptation.  Exercise stimulates connective tissues to adapt and strengthen, while collagen peptides provide the building blocks the body uses to produce new collagen. Together, they can support the ongoing repair and resilience of tendons and ligaments.  Supporting Recovery From Exercise Exercise doesn't challenge our muscles alone. Tendons, ligaments and other connective tissues are also placed under load and need to adapt and recover. Collagen is particularly rich in glycine, proline and hydroxyproline—the amino acids the body uses to build collagen in these tissues. This has led to growing interest in collagen supplementation as part of exercise recovery, particularly when combined with training. Vitamin C also plays an important role because it is essential for collagen synthesis. Some research has explored taking collagen or gelatin with vitamin C before exercise, with evidence that the combination can increase markers of collagen synthesis in response to physical loading. For active adults, collagen's role in recovery may therefore be less about building bigger muscles and more about supporting the connective tissues that keep those muscles moving. Bones Need Collagen Too When we think about strong bones, calcium usually comes to mind. But collagen is also an essential part of bone structure. Collagen forms a flexible framework within the bone, which is then strengthened by minerals such as calcium and phosphate. Together, they give bones the combination of strength and resilience needed to withstand everyday forces. As we age, changes in this collagen framework can affect bone quality. This has led researchers to investigate whether collagen supplementation can help support bone health, with some human studies reporting encouraging effects on bone formation and bone mineral density. So supporting bone health isn't only about minerals. Maintaining the collagen framework they are built around matters too. What About Gut Health? Collagen is increasingly promoted for “gut repair” and supporting the intestinal barrier. Part of this interest comes from its high glycine content, an amino acid involved in tissue repair and studied for its role in intestinal health. The theory is plausible: collagen provides amino acids that may support the tissues forming the gut barrier. But the human clinical evidence has not yet caught up with the claims. At present, there isn't enough high-quality research to conclude that taking collagen peptides can repair intestinal permeability or treat gastrointestinal conditions. Gut health remains an interesting area for collagen research, but for now, the evidence is much stronger for its role in connective tissues such as joints, tendons and bones. Collagen is far more than a beauty ingredient or another protein powder. Collagen supplementation provides targeted building blocks for the tissues that allow us to heal, move, recover and remain physically resilient throughout life.  How to Support Collagen Production Our bodies make collagen naturally, but the process depends on having the right raw materials and nutrients available. Diet, lifestyle and supplementation can all play a role. Start With the Building Blocks Collagen is a protein, so producing it requires amino acids. Protein-rich foods such as meat, fish, poultry, eggs, dairy, legumes and soy provide amino acids the body can draw upon to build and repair tissues. Foods containing connective tissue—such as bone broth, chicken skin, fish skin and slow-cooked cuts of meat—also contain collagen or gelatin directly. But eating more collagen isn't the only consideration. The body also needs specific nutrients to turn those building blocks into new collagen. Vitamin C Is Essential Of all the nutrients involved in collagen production, vitamin C is one of the most important. The body needs vitamin C for key enzymatic steps that stabilise newly formed collagen. Without enough of it, normal collagen synthesis is impaired. This is why severe vitamin C deficiency causes symptoms such as poor wound healing and fragile connective tissue. Good sources include citrus fruits, berries, kiwi, capsicum, broccoli and leafy vegetables. This relationship has also prompted researchers to investigate collagen or gelatin together with vitamin C around exercise, when connective tissues are being mechanically stimulated. Early research suggests this combination may support collagen synthesis, although the optimal dose and timing are still being studied. Don't Forget Zinc and Copper Zinc and copper also contribute to normal connective-tissue formation and repair. Zinc is involved in protein synthesis, cell growth and wound healing, while copper is required by enzymes that help cross-link collagen fibres, giving connective tissues strength and stability. Rather than thinking of collagen production as dependent on one “hero” nutrient, it is better understood as a process requiring adequate protein alongside a range of vitamins and minerals. Where Collagen Peptides Fit In A balanced diet provides the nutrients needed to make collagen. Collagen peptide supplementation offers a more concentrated source of collagen-specific amino acids and peptides. As we discussed earlier, hydrolysed collagen provides high levels of glycine, proline and hydroxyproline. Some smaller peptides can also enter the circulation intact and may have signalling effects on cells involved in connective-tissue metabolism. This makes collagen peptides different from simply adding more general dietary protein—particularly when the goal is to support collagen-rich tissues such as joints, tendons, ligaments and bone. Not All Collagen Comes From Animals Traditionally, collagen supplements have been derived from animal tissues. Bovine collagen typically comes from cattle hides and bones, marine collagen from fish skin and scales, while porcine and poultry tissues can also provide different forms of collagen. But animal tissue is no longer the only way to produce collagen. Advances in biotechnology are making it possible to produce non-animal collagen and collagen-like proteins through fermentation. Instead of extracting collagen from hides, bones or skin, microorganisms are used as biological production systems to create specific proteins or peptides under controlled manufacturing conditions. Advances in biotechnology are making it possible to produce non-animal collagen and collagen-like proteins through fermentation. Instead of extracting collagen from hides, bones or skin, microorganisms are used as biological production systems to create specific proteins or peptides under controlled manufacturing conditions.   Fermentation-derived products can instead contain proteins designed to share structural characteristics with particular types of collagen. For example, PearlRx Collagen 99 uses COLLAWISE™, a non-animal, fermentation-derived collagen that shares structural features with human Type III collagen.   This emerging technology also raises an interesting question about where our supplements come from. Conventional animal-derived collagen makes use of valuable animal by-products, but it remains connected to livestock or seafood supply chains and requires multiple stages of extraction and processing. We explore that journey—and its environmental considerations—in Acid Washes and Carbon Footprints: The Processing of Animal-Derived Collagen. Fermentation technology now makes it possible to produce collagen without animal sources, reducing reliance on livestock and the associated environmental burden. It represents an important advancement in how collagen can be produced and offers consumers a new alternative with fewer ties to resource-intensive animal supply chains.  Built to Move Our bodies are designed to move. But movement depends on more than muscle. Every step, stretch and lift relies on a network of collagen-rich tissues working together—cartilage absorbing pressure, tendons transferring force, ligaments stabilising joints and bones providing the framework beneath it all. These structures also need to repair and renew themselves throughout life. As a surgeon, I view healthy ageing as the total package: looking great, feeling great, and keeping your body performing at its peak. It’s about maintaining the energy, strength, mobility, and recovery needed to stay active and independent—proactively doing what supports us physically, mentally, and emotionally. Dr Pearlie Tan, Founder of PPS Wellness Looking after collagen is therefore about more than skin. It is about supporting the physical framework that allows us to move, recover and remain resilient for longer.

Beyond the pastel tubs and wellness promises: a closer look at how animal-derived collagen is made, where it comes from, and the environmental and sourcing questions behind the daily scoop. From Animal Tissue to Wellness Powder Collagen has become one of the most familiar products in the wellness aisle. It is stirred into coffee, added to smoothies and promoted for skin, joints, hair and healthy ageing. In its finished form, hydrolysed collagen is a pale, virtually odourless powder that bears little resemblance to where it came from. But collagen is an animal protein. Most commercial collagen comes from collagen-rich tissues from cattle, pigs, chickens or fish. Common sources include cattle hides and bones, pig skin, poultry tissues, and fish skin, scales and bones. Many of these tissues are by-products of the meat, leather and seafood industries. Turning them into collagen makes use of materials that might otherwise have relatively little commercial value. However, this also means that animal-derived collagen is part of a much wider livestock and seafood supply chain. Its production is therefore connected to broader questions about how animals are raised or sourced, the resources these industries consume, and their environmental impact. Transforming these animal tissues into the fine, soluble powder found in a supplement tub also requires several stages of processing. Understanding that journey gives us a clearer picture of where collagen comes from, how it is made and what sits behind the daily scoop.   The first challenge in making a collagen supplement is getting collagen out of the animal tissue. Collagen is a structural protein. In skin, bone and connective tissue, its fibres form a strong biological framework designed to resist breaking down easily. That durability is extremely useful inside the body, but it also means extracting collagen requires several stages of processing. The exact method varies according to the animal source, tissue and manufacturer, but the basic journey follows a similar sequence.  Preparing the Raw Material Animal tissues are first cleaned and prepared to remove unwanted material. Hides and skins may need to be trimmed and washed, while bones require additional preparation to remove minerals and other components before their collagen can be efficiently extracted. At this point, the material is still recognisably animal tissue. The next stages begin separating the collagen from the biological structure surrounding it.   Acid or Alkaline Treatment This is perhaps one of the least visible parts of collagen production. Depending on the raw material and manufacturing process, animal tissues may be treated with acidic or alkaline solutions. Alkaline processing has traditionally included substances such as lime or sodium hydroxide, while acidic processing uses controlled acid solutions. These treatments help loosen the dense structure surrounding collagen fibres and remove non-collagenous material, making the collagen easier to extract. Treatment conditions vary considerably between manufacturing methods. The concentration of the solution, temperature and duration all depend on the type of tissue being processed. The important point is that collagen powder is not simply animal tissue that has been dried and ground. The protein first has to be separated from the complex biological material in which it naturally exists.   Extraction and Hydrolysis Once the raw material has been prepared, the collagen can be extracted. Heat and water can disrupt collagen's tightly organised structure, converting it into gelatin. To produce the hydrolysed collagen commonly found in supplements, these larger proteins are then broken down further into much smaller chains of amino acids known as collagen peptides. Enzymes are commonly used during this stage to control the breakdown of the protein. This explains one of the most noticeable characteristics of hydrolysed collagen: its ability to dissolve. Native collagen is a large structural protein that is poorly soluble in water. Hydrolysis produces much smaller peptides that disperse considerably more easily, allowing the finished powder to disappear into a drink.   Purifying and Drying The extracted collagen solution still needs further refinement. Filtration and purification processes remove unwanted components and help improve the purity, colour, flavour and odour of the resulting collagen. The liquid is then concentrated before being dried. One commonly used technique is spray drying, where the collagen solution is dispersed into tiny droplets and exposed briefly to heated air. Moisture evaporates rapidly, leaving behind the fine powder familiar to consumers.     What began as hide, skin, bone or fish tissue has now become something almost unrecognisable from its original source. Animal tissue → preparation → acid/alkaline treatment → extraction → hydrolysis → purification → concentration → drying → collagen peptides None of these processes is inherently unusual within modern food manufacturing. What is noteworthy is simply the degree of transformation required to produce something marketed and consumed as a seemingly simple nutritional supplement. The Environmental Question The environmental footprint of collagen is more complicated than simply categorising it as an animal product. Because collagen is frequently produced from tissues generated by other industries, manufacturers can reasonably argue that converting these materials into useful products reduces waste and increases the value obtained from an animal already being processed for food or other purposes. But describing collagen simply as a “waste product” does not tell the entire story either. The Livestock Supply Chain Animal-derived collagen is connected to the livestock industries that provide its raw materials. Bovine collagen is commonly derived from cattle hides and bones, while porcine collagen is typically sourced from pig skin. Poultry, particularly chicken skin, cartilage and other connective tissues, can also provide sources of collagen. These different livestock systems have different environmental footprints. Cattle production, in particular, is associated with greenhouse-gas emissions, substantial land and water use and, in some regions, land conversion and deforestation. Pig and poultry production generally require less land than cattle farming, but still carry environmental impacts associated with feed production, water and energy use, manure management and greenhouse-gas emissions. The extent to which these environmental burdens should be allocated specifically to collagen is debated because the tissues used for collagen are generally co-products or by-products rather than the primary reason the animals are raised. This makes carbon-footprint comparisons surprisingly complicated. The more useful consumer question may therefore be: Where did the raw material come from, and can the manufacturer trace it? Country of origin, livestock practices, traceability and environmental standards can make meaningful differences between supply chains. Water and Processing Collagen production also requires water, energy and chemical processing. Acid and alkaline treatments generate wastewater that must be appropriately treated before discharge. Organic material removed from animal tissues can contribute to high biological and chemical oxygen demand in wastewater, while salts, acids, alkalis and other processing residues must be managed by the manufacturing facility. This does not mean that collagen production necessarily pollutes local waterways. Modern industrial facilities operate under wastewater-treatment and environmental regulations. But it does mean that the environmental performance of collagen depends partly on how and where it is manufactured. What About Contaminants? Animal tissues reflect, to some extent, the environments in which animals live and what they consume. This has led researchers and regulators to examine potential contaminants in animal-derived supplements, including heavy metals such as lead, cadmium, mercury and arsenic. Marine products raise their own sourcing questions because some environmental contaminants can accumulate in aquatic ecosystems. The presence of a potential contaminant in a raw material does not mean it will necessarily be present at an unsafe level in the finished collagen powder. Purification, quality control and testing all matter. This is why third-party testing and transparent manufacturing standards are more useful indicators of product quality than marketing language alone. Terms such as grass-fed, pasture-raised, wild-caught or marine collagen may tell consumers something about sourcing, but they do not replace laboratory testing for contaminants or provide a complete picture of the supply chain. Can We Support Collagen Without Animal-Derived Collagen? Interest in alternatives has grown alongside consumer awareness of animal sourcing, sustainability and ingredient transparency. But the term vegan collagen can be confusing because products marketed under this description may represent very different technologies. Collagen-Supporting Nutrients The human body already knows how to make collagen. To do so, it requires amino acids and micronutrients involved in collagen synthesis. Glycine and proline are important structural components, while vitamin C is essential for enzymes involved in stabilising newly formed collagen. Some products described as vegan or plant-based collagen therefore do not contain collagen at all. Instead, they provide nutrients intended to support the body's own collagen-production pathways. These are more accurately described as collagen builders or collagen-support supplements. They should not be confused with hydrolysed animal collagen because they are fundamentally different products. Precision Fermentation and Recombinant Collagen A very different approach is emerging from biotechnology. Scientists can introduce genetic instructions for producing specific collagen proteins into microorganisms such as yeast. Through fermentation, these microorganisms act as microscopic production systems, creating collagen proteins that can subsequently be isolated and purified. This is known as recombinant collagen. Rather than extracting collagen from hides, bones or fish tissues, the protein is produced within a controlled biological manufacturing system. The technology potentially offers several advantages, including greater control over the type and consistency of collagen produced and reduced reliance on animal-derived tissues. However, recombinant and fermentation-derived collagen technologies are still developing. Manufacturing scale, cost, regulatory approval and evidence for different applications will determine how widely they ultimately replace conventional animal-derived collagen. While scaling and regulatory pathways continue to advance, fermentation-derived collagen is rapidly moving from innovation to have a greater industry presence. With its unmatched purity, sustainability, and precision, yeast-derived collagen isn't just an alternative—it may represent the future of how high-performance collagen will be made. Looking Beyond the Scoop Collagen is often presented as a simple wellness ingredient, but its journey is considerably more complex. Animal-derived collagen begins as hide, bone, skin, scales or other collagen-rich tissue. Through a sequence of preparation, chemical or enzymatic treatment, extraction, hydrolysis, purification and drying, those tissues are transformed into the pale, soluble peptides found in supplement tubs. There is nothing inherently wrong with that transformation. Modern food production relies on sophisticated processing to make many ingredients safe, stable and useful. Understanding that journey empowers consumers to make choices that aligns with their health and wider ethical and environmental values and priorities.  Is the raw material traceable? How was it sourced? What manufacturing standards were followed? Has the finished supplement been tested for contaminants? What environmental considerations exist within its supply chain? Looking ahead, non-animal derived collagen offers a transformative alternative, and that the best results may no longer require relying on conventional animal sources. As biomedical science continues to advance, it offers the possibility of new and better ways to produce collagen—reducing our reliance on animal-derived sources and potentially the environmental footprint that comes with them.

In recent years, I've noticed a shift in the questions patients ask about their skincare. Increasingly, they are looking beyond claims such as anti-ageing, hydrating or brightening and asking something much more fundamental: what exactly is in the products I use every day? These conversations are especially common among women planning a pregnancy, those undergoing IVF and fertility treatment, patients receiving chemotherapy, and individuals recovering from surgery. Others simply want to make more informed choices about the products they use, seeking greater ingredient transparency and a better understanding of what is often described as clean skincare. One topic that frequently arises is endocrine disruptors in skincare. While many cosmetic ingredients remain approved for use and scientific research continues to evolve, certain ingredients have attracted attention for their potential to interact with the body's hormonal systems. It is understandable that this has led many people to ask whether these ingredients deserve closer consideration, particularly during periods when their health or wellbeing may be a greater priority. Understanding the Endocrine System and Endocrine Disrupting Chemicals The endocrine system is one of the body's most important communication networks. Made up of glands such as the thyroid, adrenal glands, ovaries, testes and pancreas, it produces hormones—chemical messengers that travel through the bloodstream to regulate countless biological processes. Hormones influence far more than reproduction. They help regulate growth and development, metabolism, sleep, mood, stress responses, immune function and tissue repair. Every day, your body relies on these finely balanced chemical signals to keep its systems functioning as they should. As a plastic surgeon, I've always found the endocrine system remarkable because of how precisely it coordinates the body's response to change. Whether healing after surgery, adapting during pregnancy or responding to physical stress, hormones work continuously behind the scenes to maintain that delicate balance. What Are Endocrine Disrupting Chemicals? Endocrine disrupting chemicals (EDCs) are substances that have been shown, or are suspected, to interfere with the body's hormonal signalling. Rather than acting like toxins in the traditional sense, they may influence the way hormones are produced, transported, recognised or broken down within the body. Scientists have identified several ways in which certain endocrine disrupting chemicals may affect the endocrine system. Some may mimic naturally occurring hormones such as oestrogen, causing cells to respond as though the body's own hormones were present. Others may block hormone receptors, preventing natural hormones from carrying out their normal functions. Some may also alter hormone production, metabolism or elimination, potentially affecting the body's normal hormonal balance. It is important to recognise that endocrine disruption is an active and evolving field of scientific research. Not every chemical has the same biological activity, and any potential effects depend on many factors, including the specific ingredient, the amount of exposure, the duration of exposure, the route of absorption and an individual's own physiology. Many ingredients discussed in relation to endocrine disruption continue to be approved for cosmetic use by regulatory authorities around the world within established safety limits. Why Are Endocrine Disruptors in Skincare Receiving So Much Attention? Skincare products are unique because they are often used every day, sometimes several times a day, over many years. Although the amount of any single ingredient absorbed through the skin is typically low, researchers have increasingly explored the concept of cumulative exposure—the idea that we may encounter the same or similar chemicals from multiple sources throughout our daily lives, including cosmetics, personal care products, food packaging and the environment. This does not mean that using a skincare product containing one of these ingredients will cause harm. Rather, it has prompted scientists to better understand how repeated, long-term exposure to certain chemicals may contribute to overall exposure throughout a person's lifetime. As research continues to evolve, many individuals choose to take a precautionary approach by becoming more familiar with the ingredients in the products they use every day. "Patients often ask me whether an ingredient is "safe" or "unsafe", but the answer is rarely that simple. A more useful question is whether an ingredient serves an essential purpose, what the current evidence tells us about it, and whether equally effective alternatives exist. " — Dr Pearlie Tan, Founder of PPS Wellness Every ingredient should justify its place in a formulation. When equally effective alternatives are available, I believe it is reasonable to favour ingredients that offer the strongest safety profile and the fewest unanswered questions. When Ingredient Choices Matter Most -  - Women Trying to Conceive and Undergoing IVF - During Pregnancy - During Cancer Treatment - Recovery After Surgery - Health-Conscious Consumers   While research into endocrine disrupting chemicals continues to evolve, there are certain stages of life and medical situations where people naturally become more mindful of the products they use. During these times, many individuals begin looking beyond marketing claims and pay closer attention to ingredient labels, seeking greater transparency and reassurance about what they apply to their skin. Women Trying to Conceive and Undergoing IVF For many women, preparing for pregnancy is a time of heightened awareness about health and wellbeing. Nutrition, exercise and lifestyle habits often come under closer scrutiny, and skincare is no exception. It is increasingly common for women trying to conceive or undergoing fertility treatment to seek information about fertility-safe skincare and to better understand the ingredients in the products they use every day. During Pregnancy Pregnancy brings profound hormonal and physiological changes, making many expectant mothers more conscious of the products they use. Questions about pregnancy-safe skincare are among the most common concerns raised during this period, particularly as women become more aware of ingredient labels and the concept of cumulative exposure. During Cancer Treatment Cancer treatments such as chemotherapy and radiotherapy can significantly affect the skin, often leaving it drier, more sensitive and more easily irritated. During this time, many patients seek gentle skincare with fewer unnecessary ingredients, focusing on products that support the skin barrier and maintain comfort. Recovery After Surgery Following surgery or aesthetic procedures, the skin enters a complex healing process involving inflammation, tissue repair and remodelling. During recovery, patients often become more selective about the products they apply to healing skin, choosing formulations that are gentle, well tolerated and free from ingredients they consider unnecessary. Health-Conscious Consumers Interest in ingredient transparency is no longer limited to those facing a specific medical condition or life event. Increasingly, people are taking a more proactive approach to their health, seeking to understand the products they use just as they do the food they eat or the environments they live in. The growing interest in endocrine disrupting chemicals reflects a broader shift towards evidence-based, informed decision-making, with many people seeking to reduce unnecessary chemical exposure in their daily lives. Understanding Commonly Encountered Endocrine Disrupting Chemicals  Not all skincare ingredients have the same function, nor do they carry the same level of scientific interest. Among the thousands of ingredients used in cosmetic formulations, a relatively small number have been studied for their potential endocrine activity. It is important to remember that the presence of an ingredient does not automatically mean a product is unsafe. Many of these ingredients remain approved for cosmetic use within established concentration limits set by regulatory authorities. However, because scientific understanding continues to evolve, they remain the subject of ongoing research and discussion. The following endocrine disrupting chemicals are among the most commonly encountered in skincare products. Ingredient Group Why It's Used Why It's Being Studied What to Look for on Labels Parabens Preservatives that prevent microbial growth and extend shelf life. Certain parabens have demonstrated weak oestrogen-like activity in laboratory studies. Methylparaben, Propylparaben, Butylparaben, Ethylparaben Phthalates Used in some fragrance formulations and as solvents or fixatives. Certain phthalates have been studied for potential effects on reproductive and hormonal signalling. Diethyl Phthalate (DEP), Dibutyl Phthalate (DBP)*, or potentially within Fragrance / Parfum formulations Benzophenones / Oxybenzone UV filters used in sunscreens and some cosmetics. Some have demonstrated potential endocrine activity in laboratory and animal studies. Oxybenzone / Benzophenone-3 (BP-3) BHA & BHT Antioxidants that help prevent oils and formulations from oxidising. Studied for potential endocrine effects, primarily based on laboratory and animal evidence. Butylated Hydroxyanisole (BHA), Butylated Hydroxytoluene (BHT) Important: The presence of one of these ingredients does not mean that a cosmetic product has been proven to cause endocrine disruption in humans. The strength of evidence varies considerably between chemicals, and many remain permitted for cosmetic use within regulatory limits. They are included here because of scientific research into their potential endocrine activity.  Parabens Parabens are preservatives that help prevent the growth of bacteria, mould and yeast in cosmetic products. They have been used for decades because they are highly effective at extending shelf life and maintaining product safety. Common examples include: Methylparaben Ethylparaben Propylparaben Butylparaben Why are they being studied? Certain parabens have demonstrated weak oestrogen-like activity in laboratory studies, meaning they may bind to oestrogen receptors under experimental conditions. This has prompted researchers to investigate whether long-term exposure could have biological effects, particularly when combined with exposure from multiple sources.¹³ Current evidence suggests that the oestrogenic activity of parabens is significantly weaker than that of the body's naturally occurring oestrogen. However, questions remain regarding cumulative exposure and the potential effects of prolonged use, particularly for ingredients such as propylparaben and butylparaben.¹³ What should consumers know? Many regulatory authorities continue to permit parabens in cosmetic products within specified concentration limits, while some manufacturers have chosen to formulate products without them in response to evolving consumer preferences and ongoing scientific research.⁴ Phthalates Phthalates are a family of chemicals commonly used to improve flexibility in plastics and to help fragrances last longer in some personal care products. Why are they being studied? Certain phthalates have been associated with endocrine and reproductive effects in laboratory and epidemiological studies, leading many jurisdictions to restrict or prohibit their use in cosmetics.¹³⁴ What should consumers know? Not all phthalates are used in cosmetics, and regulations differ around the world. Increasingly, manufacturers offer phthalate-free products for consumers who prefer to minimise exposure.⁴ Benzophenones (Including Oxybenzone) Benzophenones are ultraviolet (UV) filters used to protect products and the skin from damage caused by sunlight. Oxybenzone is one of the best-known members of this group. Why are they being studied? Laboratory and animal studies have suggested that oxybenzone may demonstrate endocrine activity, and researchers have confirmed that it can be absorbed through the skin. However, there is currently no conclusive evidence that normal use of approved sunscreen products causes endocrine disorders in humans.¹³⁴ Beyond human health, researchers have been closely studying oxybenzone's impact on ocean life. When swimmers wear sunscreen in the ocean or wash it off in the shower, the chemical flows into marine habitats. Laboratory studies show that even low concentrations of oxybenzone can exacerbate coral bleaching by lowering corals' tolerance to warm temperatures. It has also been shown to damage coral DNA, cause severe deformities in young coral larvae, and act as an endocrine disruptor in marine life—impairing reproduction in fish, sea urchins, and algae.  What should consumers know? Sun protection remains one of the most effective ways to reduce premature skin ageing and lower the risk of skin cancer. Individuals who prefer to avoid oxybenzone may choose sunscreens formulated with alternative UV filters, including mineral filters such as zinc oxide or titanium dioxide. BHA and BHT BHA (butylated hydroxyanisole) and BHT (butylated hydroxytoluene) are antioxidants that help prevent oils and other ingredients from oxidising, improving product stability and shelf life. Why are they being studied? Questions about BHA and BHT arise largely from high-dose animal studies investigating their potential endocrine activity. Evidence relating to cosmetic use in humans remains limited, and both ingredients continue to be permitted within regulated concentration limits in many countries.¹³⁴ What should consumers know? For many consumers, avoiding BHA or BHT is a personal preference rather than a medical necessity. Those wishing to minimise exposure can choose formulations that use alternative stabilising ingredients. A Balanced Perspective   As a surgeon, I encourage patients to approach ingredient information with curiosity rather than fear. Cosmetic safety is rarely determined by a single ingredient in isolation. Instead, it depends on the formulation as a whole, the concentration of each ingredient, how the product is used and the quality of the scientific evidence supporting its safety. Dr Pearlie Tan, Founder of PPS Wellness   Ultimately, informed consumers are empowered consumers. By understanding why certain ingredients attract scientific attention, you can make choices that reflect your own health priorities, values and stage of life. Choosing Skincare with Confidence Navigating skincare ingredients can feel overwhelming, particularly when scientific studies, social media and marketing messages often appear to contradict one another. While ingredient awareness is valuable, it is equally important to view each ingredient within the context of the product as a whole rather than in isolation. One term that has gained significant popularity is clean skincare. Although widely used by brands and consumers alike, there is currently no universally accepted scientific or regulatory definition of what constitutes "clean" skincare. One company's definition may differ considerably from another's, making it important to look beyond marketing claims and understand the ingredients themselves. Rather than relying solely on labels such as natural, organic or clean, I encourage patients to develop the habit of reading ingredient lists. Becoming familiar with commonly discussed ingredient groups—such as parabens, phthalates, benzophenones and BHA or BHT—allows you to make decisions that are based on knowledge rather than assumptions. It is also worth remembering that skincare is only one source of potential exposure to environmental chemicals. The products we use every day, the food we eat, food packaging, household items and our surroundings all contribute to our overall exposure. For this reason, many researchers now consider the concept of cumulative exposure, rather than focusing on a single product or ingredient in isolation. Conclusion The science surrounding endocrine disrupting chemicals continues to evolve, and researchers are constantly improving our understanding of how different substances interact with the human body. While many cosmetic ingredients remain approved for use within established safety limits, ongoing research helps us make better-informed decisions about the products we choose every day. My hope is not that every reader reaches the same conclusion, but that every reader feels empowered to ask thoughtful questions, understand the available evidence and make skincare choices that reflect their own health priorities. Informed decisions, guided by evidence and personal circumstances, are ultimately the foundation of confident and responsible skincare. Medical Disclaimer This article is intended for educational purposes only and reflects current scientific understanding at the time of writing. Research into endocrine disrupting chemicals continues to evolve, and scientific recommendations may change as new evidence emerges. The information provided should not be considered a substitute for personalised medical advice. Individuals who are pregnant, undergoing fertility treatment, receiving cancer therapy or managing other medical conditions should consult their healthcare professional regarding products that are appropriate for their individual circumstances. References Endocrine Society. Endocrine-Disrupting Chemicals: Position Statement. Diamanti-Kandarakis E, et al. Endocrine-Disrupting Chemicals: An Endocrine Society Scientific Statement. Endocrine Reviews. Tomar C, et al. Endocrine-disrupting chemicals in cosmetics: mechanistic insights and their impact on human and skin health. Scientific Committee on Consumer Safety (SCCS). Scientific opinions on parabens, benzophenone-3 (oxybenzone), BHA and related cosmetic ingredients.

Discover the key factors that support healing, recovery and resilience, from nutrition and hydration to sleep, skin health and lifestyle habits. A science-based look at what the body needs to recover effectively.

After a procedure, I spend a great deal of time talking to my patients about what happens next—how to care for their wound, when they can return to normal activities, what medication they may need and what to expect as their body heals. But there is another question I hear surprisingly often: “Is there anything I can take to help myself recover better?” It is a reasonable question. Recovery places considerable demands on the body. Damaged tissue needs to be rebuilt. New collagen is produced. Blood vessels repair and regenerate. The immune system is active. All of this requires energy, protein, amino acids, vitamins and minerals. Yet this is often happening at precisely the time when eating well becomes more difficult. Appetite may be reduced. Normal routines are disrupted. Pain, medication or fatigue can make food less appealing. So supplements can certainly have a place. But I don't believe the best approach is to assemble a long list of products labelled for “recovery” and take them all. More supplements do not necessarily mean better healing. Instead, I prefer to start with a different question: What is your body trying to do right now—and are you giving it what it needs to do it well? That distinction matters. Some nutrients are fundamental to tissue repair. Others may only be useful when your diet isn't providing enough or when a deficiency exists. And some supplements that sound beneficial may be unnecessary—or even inappropriate around a procedure. So let's look at what actually matters during recovery, where supplementation can be useful, and what I would look for when choosing a product. Recovery Is an Active Process We tend to think of recovery as a period of rest. Biologically, however, the body is anything but inactive. From the moment tissue is injured, a highly coordinated repair process begins. The body manages inflammation, clears damaged tissue, forms new blood vessels, produces collagen and gradually rebuilds and remodels the injured area. These processes require both energy and raw materials. This is why nutrition matters. Your body cannot manufacture new tissue out of nothing. It needs protein and amino acids to provide building blocks, along with vitamins and minerals that enable the many biological reactions involved in repair. Supplements can help provide some of these nutrients when needed, but they should sit on top of a good nutritional foundation—not replace it. And that is why, when patients ask me about recovery supplements, I usually start somewhere much simpler. Start With Protein Before looking at specialised recovery ingredients, I would first ask: are you getting enough protein? Protein provides the amino acids your body uses to build and repair tissue, and the body's demand for protein can increase during healing. Ideally, much of this comes from food. Fish, poultry, eggs, dairy, soy, legumes and nuts can all contribute protein as part of a balanced diet. The difficulty is that recovery doesn't always happen under ideal circumstances. After a procedure, some patients simply don't feel like eating very much. Appetite can fall, meals become smaller and normal eating patterns can be disrupted. That creates an unfortunate mismatch: your body may need more nutritional support at the very time you're giving it less. This is where a protein supplement can be genuinely useful. Not because protein powder has some special ability to accelerate recovery, but because it can be a practical way of increasing protein intake when eating enough through food is difficult. If you do choose one, look beyond the claims on the front of the pack. I would pay attention to how much protein you are actually getting per serving, whether it provides a good amino-acid profile, how well you tolerate it and whether it contains a long list of additives you don't need. Before reaching for a specialised recovery supplement, make sure the basics are covered.   Where Does Collagen Fit? This is where protein and collagen are sometimes confused. Collagen is a protein, but a collagen supplement and a conventional protein powder don't serve exactly the same nutritional purpose. Collagen is a major structural protein in skin and connective tissue. When tissue is damaged, the body produces new collagen as part of the repair process. That process continues beneath the surface long after a wound may appear to have healed. Collagen peptides are particularly rich in glycine, proline and hydroxyproline, amino acids commonly found in collagen itself. This makes them an interesting source of targeted nutritional support when the body is rebuilding collagen-rich tissues. But I think it is important to be precise about what that means. Taking collagen doesn't guarantee faster healing. It provides nutritional building blocks that the body can use as part of its normal collagen production and tissue-remodelling processes. When choosing a collagen supplement, I would look for a clearly identified source, transparent ingredient quantities, appropriate quality and contaminant testing and good traceability. Depending on the formulation, useful cofactors such as vitamin C must also be included. There are now also choices beyond conventional animal-derived collagen, including newer fermentation-derived options. For anyone interested in understanding those differences, I discuss them in more detail in Acid Washes and Carbon Footprints: The Processing of Animal-Derived Collagen Vitamin C, Zinc & Copper: The Supporting Players If protein and collagen provide some of the building blocks for repair, the body still needs the right micronutrients to put those materials to work. Three are particularly relevant: vitamin C, zinc and copper. Each plays a different role in the biological processes involved in tissue repair. Vitamin C: Essential for Collagen Formation Vitamin C deserves particular attention because the body needs it to make collagen. It is involved in key enzymatic reactions that help newly formed collagen develop a stable structure. Without adequate vitamin C, normal collagen synthesis is impaired—which is one reason severe vitamin C deficiency is associated with poor wound healing. For most people, vitamin C is readily available through food. Citrus fruits, berries, kiwi, capsicum, broccoli and leafy vegetables are all good sources. If dietary intake is limited during recovery, supplementation may be useful.  The goal is to make sure the body has enough vitamin C to carry out the work it needs to do. Zinc: Supporting Repair and Immune Function Zinc is involved in several processes that become important when the body is healing, including protein synthesis, cell division, immune function and normal wound healing. Again, context matters. Someone who is getting adequate zinc from their diet may not necessarily benefit from adding a high-dose supplement simply because they have undergone a procedure. But where intake is inadequate or deficiency is present, ensuring sufficient zinc becomes much more relevant. This is a distinction I make often when thinking about supplementation during recovery: a nutrient can be essential without everyone needing to supplement it. Copper: Small Amounts, Important Work Copper tends to receive much less attention, but it has an important structural role. The body uses copper-dependent enzymes to help cross-link collagen and elastin fibres. This cross-linking contributes to the strength and stability of connective tissues as they form and remodel. We only need copper in relatively small amounts, and it can be obtained from foods including shellfish, nuts, seeds, legumes and whole grains. So when I look at a recovery supplement containing vitamin C, zinc and copper, the biggest numbers on the label don't necessarily impress me. I'm more interested in whether each nutrient is there in an appropriate amount for the job it needs to do. Recovery isn't a competition to consume the highest dose. It is about making sure the body has the materials and micronutrients it needs to carry out repair effectively. Iron, B12 & Other Nutrients: When Deficiency Matters This brings us to an important point: not every useful recovery nutrient belongs in everyone's recovery plan. Iron is a good example. Some procedures involve blood loss, which can make iron particularly relevant. Iron is needed to produce haemoglobin, the protein in red blood cells that carries oxygen around the body. Vitamin B12 is also important for healthy red blood cell production. When either is deficient, tiredness and reduced physical capacity can become part of the recovery picture. But that doesn't mean everyone recovering from a procedure should automatically take iron or B12. This is where I would rather test than guess. If a patient is unusually fatigued, has experienced significant blood loss, has dietary risk factors or there is another reason to suspect a deficiency, blood tests and appropriate medical advice can tell us far more than the front of a supplement bottle. And sometimes the answer turns out to be surprisingly simple. The supplement that makes the greatest difference may not be the newest recovery ingredient. It may simply be the nutrient your body was actually lacking. What About Supplements for Inflammation? “Inflammation” has become something of a wellness villain. We see foods, supplements and entire diets marketed as anti-inflammatory, which can make it seem as though inflammation is something we should always try to eliminate. Inflammation is part of healing. After tissue is injured, the inflammatory response helps initiate the repair process. The objective is therefore not necessarily to suppress inflammation altogether, but to allow an appropriate response without it becoming abnormally prolonged or excessive. This is worth remembering when looking at supplements such as omega-3 fatty acids, curcumin and antioxidants, which are frequently promoted for their effects on inflammatory pathways. These ingredients may have interesting roles, but whether they are appropriate around a procedure depends on the ingredient, the dose, the type of procedure, the medications being used and the individual patient. Some supplements can also affect bleeding or interact with medication—so this is not an area where I would recommend adding products indiscriminately. The aim during recovery isn't to switch inflammation off. It is to support the body as it moves through a normal, controlled healing response. Hydration & Electrolytes: Keep It Simple Hydration can be easy to overlook when we're thinking about recovery nutrition, but water is fundamental to almost every process taking place in the body. Adequate fluid intake supports normal circulation and physiological function, helping nutrients move around the body and allowing cells and tissues to function normally. After a procedure, fluid needs may also change depending on factors such as reduced food and fluid intake, medications or illness. This doesn't mean everyone needs an electrolyte drink. For many people recovering normally and eating a balanced diet, water and food may be perfectly adequate. Electrolyte drinks can become useful when fluid or electrolyte losses are greater—for example, when someone has been eating and drinking poorly or has experienced vomiting or diarrhoea. If you do choose one, look beyond the word “electrolytes” on the front of the bottle. Some products are designed primarily for prolonged or intense exercise and can contain considerable amounts of sugar or ingredients that may not be necessary for everyday recovery. As with supplements, I prefer to ask what problem are we trying to solve? If you're adequately hydrated and eating normally, adding an electrolyte product simply because it sounds more restorative may not offer much additional value. Sleep: The Recovery Tool We Often Overlook We tend to focus on what we can take to support recovery. But one of the most important things we can give the body is something much simpler: enough good-quality sleep. Recovery doesn't stop when we go to bed. Sleep supports many of the physiological processes involved in restoration, immune function and tissue repair. Unfortunately, sleeping well after a procedure isn't always easy. Pain and physical discomfort can keep you awake. Anxiety can make it difficult to switch off. Medication can alter normal sleep patterns. Even something as simple as having to sleep in an unfamiliar position can disrupt a routine that normally works well. So before reaching for a sleep supplement, I would first try to understand why sleep has become difficult. Is pain waking you? Is the room uncomfortable? Has your normal sleep schedule changed? Are you struggling to fall asleep, or are you waking repeatedly through the night? These aren't necessarily problems that the same supplement will solve. Getting the basics right—a consistent sleep schedule, a comfortable environment and appropriate management of post-procedure pain or discomfort—is a sensible place to begin. When additional support is appropriate, ingredients such as magnesium, melatonin, glycine and L-theanine are commonly used, but they aren't interchangeable. Melatonin primarily helps regulate the body's sleep-wake rhythm. Magnesium is involved in normal nervous-system function, while glycine and L-theanine are being studied for their potential effects on sleep quality and relaxation. The useful question, again, is not simply “What's the best sleep supplement?” It is “Why am I not sleeping well?” Matching the intervention to the problem makes far more sense than choosing a generic blend containing several ingredients simply because they're associated with sleep. And after a procedure, there is another consideration. Sleep supplements can interact with prescription painkillers, sedatives and other medications, so I would always discuss them with the treating healthcare professional before adding one during recovery. Be Discerning About Supplements for Recovery By this point, it would be easy to come away with quite a shopping list: protein, collagen, vitamin C, zinc, copper, perhaps iron or B12, electrolytes and something for sleep. That is not the message I want you to take from this article. A good recovery plan isn't measured by the number of supplements you're taking. Every supplement should have a reason for being there. This is particularly important around a procedure because supplements are biologically active. Some can affect bleeding, blood pressure, glucose levels or sedation. Herbal extracts deserve particular attention, and “natural” should never be assumed to mean harmless simply because something can be bought without a prescription. I encourage my patients to tell their healthcare team everything they are taking, including vitamins, herbal products and supplements they may use only occasionally. Some products support your immunity and healing, but some supplements may need to be stopped before a procedure. - Dr Pearlie Tan, Founder of PPS Wellness Higher doses don't automatically produce better outcomes either. This brings us back to the principle running through this entire article: Supplement with purpose. Ask what the body needs, identify where there is a genuine gap, and choose the simplest appropriate way to fill it. A thoughtful recovery plan is not about taking more. It is about making every intervention count. How to Choose a Recovery Supplement Walk into a pharmacy or search for recovery supplements online and it doesn't take long to become overwhelmed. Long ingredient lists, impressive-sounding blends and very high doses can make a product appear more comprehensive. But more ingredients don't necessarily make a better supplement. When I assess a product, I prefer to start with a much simpler question: What is this supplement actually trying to do? A good formulation should have a clear purpose. If it is designed to support tissue repair, for example, the ingredients and their doses should make sense in that context. If you can't work out why half the ingredients are there, a longer list isn't necessarily an advantage. Look Beyond the Ingredient List Seeing a familiar ingredient on the label tells you very little about how useful the product might actually be. The amount matters. Look for products that clearly disclose how much of each active ingredient they contain rather than hiding multiple ingredients inside a proprietary blend. This allows you to judge whether an ingredient is present in a meaningful quantity rather than simply included so that its name can appear on the packaging. I would also ask where the evidence comes from. Has the ingredient itself been studied for the purpose being claimed, or is the marketing making a much bigger leap than the research supports? These are simple questions, but they help separate thoughtful formulation from an impressive-looking label. Quality Matters Too What's inside a supplement matters, but so does how it was made and where its ingredients came from. I look for reputable manufacturing, appropriate quality and purity testing, clear ingredient information and good traceability. Traceability becomes particularly relevant with ingredients such as collagen, where the source and processing methods can differ considerably. And complexity shouldn't be confused with quality. Twenty ingredients aren't automatically better than five well-chosen ones. A focused formulation, where every ingredient has a clear reason for being there, is often much easier to understand—and makes it easier to know what you're actually taking. The Most Important Variable Is You Even a well-formulated supplement isn't automatically the right supplement for everyone. Your diet matters. So do existing deficiencies, medications, medical conditions and the type of procedure you've undergone. One person may simply need to eat more protein. Another may benefit from additional nutritional support because their appetite is poor. Someone with iron deficiency may need that corrected. Another person may already be meeting their nutritional needs perfectly well through food. And around any procedure, there is one final question I consider essential: Does your surgeon or healthcare professional know you're taking it? That question may be less exciting than anything written on the front of a supplement bottle—but it is one of the most important. Why I Began Formulating for Recovery In my practice, I saw this uncertainty repeatedly. Patients would invest considerable thought and preparation into their procedure, then afterwards ask me what they should eat, what supplements they should take and what they could do themselves to support their recovery. When I looked at what was available to them, I saw plenty of products designed for general wellness, beauty or sports performance. What I found less often were formulations developed specifically around the biological demands I was seeing in patients during recovery. That became one of the starting points for PearlRx. I wanted to start with the same questions we've been asking throughout this article: What is the body trying to do? What nutrients does that process require? And how can we support it intelligently? Those questions eventually helped shape the development of PearlRx's recovery-focused formulations. As I often tell my patients: “I wanted to approach formulation in the same way I approach recovery clinically—start with what the body actually needs to optimise results, and build from there.” - Dr Pearlie Tan, Founder of PPS Wellness Supplement With Purpose Recovery cannot be reduced to a single capsule, powder or ingredient. The body needs protein and good nutrition to provide the building blocks for repair. It needs vitamins and minerals to help put those building blocks to work. It needs adequate hydration, appropriate movement and, importantly, enough quality sleep. Supplements can play a useful role within that bigger picture. They can help when appetite is poor, when diet isn't providing enough of a particular nutrient, when a deficiency has been identified or when there is a clear reason for more targeted nutritional support.  Throughout my practice, I have come back to the same principle: understand what the body is trying to do, then give it the support it needs to do it well.  So rather than asking: “What supplements should I take?” I think the more useful question is: “What does my body need to heal and recover well right now—and what will genuinely help me provide it?” That is what I mean by supplementing with purpose.

From Lifespan to Healthspan For decades, the goal of healthy ageing was largely about lifespan—how long we live. Today, the conversation is increasingly about healthspan—how long we can remain healthy, active and functioning well as we age. This shift has encouraged scientists to look more closely at what happens inside our cells over time. One molecule attracting particular attention is NAD+ (nicotinamide adenine dinucleotide). NAD+ is essential for cellular energy production. It also supports DNA repair, cellular maintenance and the body's response to physiological stress. As we age, NAD+ metabolism changes and its availability may decline in some tissues, raising an intriguing question: could supporting NAD+ help our cells function better for longer? This is where NMN (nicotinamide mononucleotide) comes in. If we think of our cells as engines, NAD+ helps provide the fuel that keeps them running. NMN is one of the building blocks the body uses to replenish that supply. This relationship has made NMN one of the most closely studied molecules in healthy ageing research. Animal studies have produced promising results, while a growing number of human trials are beginning to explore its effects on NAD+ levels, metabolism, physical function and other markers associated with ageing. The science is still evolving, and NMN is not a proven way to reverse ageing. But its close relationship with NAD+ provides a compelling biological reason to investigate its potential. Understanding what NAD+ does—and how NMN helps the body make it—is a useful starting point for understanding where the science of healthy ageing may be heading. What Are NAD+ and NMN? NAD+: Powering Our Cells NAD+ (nicotinamide adenine dinucleotide) is a coenzyme found in every living cell. It plays an essential role in converting the food we eat into ATP—the energy our cells use to function. NAD+ is also required by enzymes involved in DNA repair, cellular maintenance and the body's response to physiological stress. Without enough NAD+, many of these processes cannot operate normally. Research suggests that NAD+ availability changes as we age and may decline in some tissues. This has led scientists to investigate whether maintaining NAD+ metabolism could help support healthier cellular function later in life. NMN: A Direct Precursor to NAD+ NMN (nicotinamide mononucleotide) is a naturally occurring compound and a direct precursor to NAD+. In simple terms, it is one of the molecules our bodies use to make NAD+. NMN sits close to the end of the body's NAD+ production pathway. Once available for NAD+ synthesis, it requires just one enzymatic step—through enzymes called NMNATs—to be converted into NAD+. This direct relationship is what makes NMN particularly interesting in longevity research. Why Not Simply Take NAD+? It seems logical: if we want more NAD+, why not supplement NAD+ itself? Three main biological barriers explain why: Molecule Size & Transport NAD+ is a large, bulky molecule (around 663 g/mol) that cannot easily cross cell membranes intact. Cells lack direct, efficient transporters to take up full NAD+ molecules from the bloodstream. NMN, by contrast, is half the size (around 334 g/mol) and utilizes dedicated cellular transporters (such as Slc12a8) to pass directly into cells. Digestive Breakdown When consumed orally, intact NAD+ is rapidly degraded by stomach acid and digestive enzymes in the gut long before it can reach your bloodstream or target tissues. It breaks down into smaller subunits like nicotinamide (NAM), forcing your body to reassemble it from scratch through lengthy metabolic pathways. Cellular Conversion Speed NMN acts as the immediate structural precursor to NAD+ in the body's internal "salvage pathway". Once NMN enters a cell, it requires only a single enzymatic step (catalyzed by NMNAT) to convert directly into active NAD+.   Direct NAD+ delivery is only effective when given via IV or subcutaneous injection to bypass the digestive tract, whereas NMN has high oral bioavailability and easily elevates tissue NAD+ levels when taken as a pill. Why NAD+ Matters for Healthy Ageing NAD+ is involved in some of the most fundamental processes that keep our cells functioning. This is why changes in NAD+ metabolism have attracted so much interest in ageing research.   Cellular Energy & Mitochondrial Function Every cell needs energy to function. Much of this energy is produced by the mitochondria—the tiny powerhouses inside our cells. NAD+ plays a central role in this process, helping convert nutrients from food into ATP, the usable energy that powers cellular activity. As we age, mitochondrial function can become less efficient. Researchers are therefore studying whether supporting NAD+ metabolism could help maintain cellular energy and mitochondrial function as we get older. DNA Repair & Cellular Defence Our DNA is constantly exposed to damage from normal metabolism, UV radiation and environmental stress. NAD+ is used by enzymes called PARPs, which help detect and repair damaged DNA. It is also closely linked to sirtuins, a family of proteins involved in cellular stress responses, metabolism and healthy ageing. Both processes consume NAD+, creating an important connection between our NAD+ supply and the cell's ability to maintain and repair itself. Metabolic & Cardiovascular Health NAD+ is also involved in how the body regulates glucose, insulin sensitivity and vascular function. This has led researchers to investigate NMN in areas such as metabolic health and cardiovascular ageing. Some human studies have reported encouraging findings—including improvements in muscle insulin sensitivity in a trial involving women with prediabetes—but results across studies remain mixed. Brain Health & Cognitive Function The brain has exceptionally high energy demands, making healthy mitochondrial function particularly important. NAD+ is involved in neuronal energy metabolism, DNA repair and cellular responses to oxidative stress. Animal research has generated considerable interest in whether NAD+ precursors could help protect brain function during ageing. Human evidence, however, is still limited. It is too early to say that NMN supplementation improves memory or prevents cognitive decline. Muscle Function & Physical Performance Muscle health is an important part of healthspan. Maintaining strength, mobility and endurance helps us remain independent and active as we age. Because skeletal muscle depends heavily on mitochondrial energy production, researchers have also investigated whether NMN supplementation can influence physical performance. Early human trials have produced some encouraging results in measures such as walking performance and aerobic capacity, but the evidence is not yet consistent enough to consider NMN an established intervention for physical performance. The Bigger Picture These different areas share a common thread: NAD+ sits at the intersection of energy production, cellular maintenance and the body's response to stress. That does not mean increasing NAD+ will automatically improve every process associated with ageing. But it explains why NAD+—and precursors such as NMN—have become such an important focus of longevity research.   How to Support NAD+ Levels NAD+ is continuously produced, used and recycled by the body. While supplementation has attracted attention, our everyday habits also influence the metabolic pathways that regulate NAD+. Exercise Regular exercise is one of the most established ways to support healthy mitochondrial function and NAD+ metabolism. Both aerobic and higher-intensity exercise increase the energy demands placed on our cells, triggering adaptations that help mitochondria produce energy more efficiently. Exercise can also influence enzymes involved in maintaining and recycling NAD+. It is another reason physical activity remains one of the most powerful tools we have for healthy ageing. Nutrition The body can make NAD+ from several forms of vitamin B3 and related precursors obtained through food. NMN itself occurs naturally in small amounts in foods including edamame, avocado, broccoli, cucumber, cabbage and tomatoes. However, the quantities are far lower than those typically used in NMN supplements. A balanced diet therefore supports the body's normal NAD+ metabolism, but food and NMN supplementation are not directly equivalent. Sleep and Circadian Rhythm NAD+ metabolism is closely connected with the body's circadian clock, the internal system that coordinates sleep, metabolism and cellular activity across the 24-hour day. Maintaining regular sleep and wake patterns supports this broader metabolic rhythm. Rather than thinking of sleep as a direct “NAD+ booster,” it is better understood as part of the healthy cellular environment in which NAD+ metabolism operates. NMN and NR: What the Research Shows NMN is not the only NAD+ precursor being studied. Nicotinamide riboside (NR) is another naturally occurring molecule that can ultimately be converted into NAD+. Both NMN and NR have been shown to raise NAD-related biomarkers in humans, although they follow somewhat different metabolic routes. Researchers are still working to understand whether one offers meaningful advantages over the other in different tissues or individuals. Supporting the System, Not Just the Molecule NMN is an interesting way of supporting the NAD+ pathway, but it should not be viewed in isolation. Exercise, good nutrition, restorative sleep and metabolic health remain the foundations of healthy ageing. Supplementation is best considered alongside these habits, rather than as a substitute for them. Safety, Dosage and What We Know So Far Human research into NMN is still relatively young, but its short-term safety profile has so far been reassuring. A 2026 review of 15 randomized controlled trials found that doses ranging from 250 to 2,000 mg per day, taken for between two weeks and six months, did not significantly increase adverse events or markers of liver injury. Individual studies have also tested doses as high as 1,250 mg daily for four weeks in healthy adults without serious adverse effects.   How Much NMN Should You Take? There is currently no established optimal dose for healthy ageing. Clinical studies have investigated a wide range of doses, often from a few hundred milligrams upwards. More is not necessarily better, and the amount required to raise NAD+ biomarkers may not be the same as the amount needed to produce a meaningful health benefit. This is one of the questions ongoing research still needs to answer. What Does the Human Evidence Show? The clearest finding is that NMN can influence NAD+ metabolism in humans. Some individual trials have also reported encouraging results in areas such as insulin sensitivity, aerobic capacity and physical function. But the overall picture remains mixed. The latest meta-analysis found good short-term tolerability but no consistent improvement across common measures such as body weight, fasting glucose, HbA1c, cholesterol or systolic blood pressure. So while NMN has a compelling biological rationale, raising NAD+ and proving a long-term improvement in healthspan are not the same thing. Quality Matters As with any supplement, the contents of the bottle matter as much as the ingredient on the label. Look for products that clearly state the amount of β-NMN, provide information about manufacturing standards and use independent testing to verify purity and contaminants. Long-term safety data are still developing, so NMN should not be treated as a substitute for established approaches to healthy ageing. People who are pregnant or breastfeeding, taking medication or managing a medical condition should seek medical advice before supplementation. A Surgeon’s Perspective on Healthy Ageing and Longevity    As a surgeon, I view healthy ageing as the total package: looking great, feeling great, and keeping your body performing at its peak. It’s about maintaining the energy, strength, mobility, and recovery needed to stay active and independent—proactively doing what supports us physically, mentally, and emotionally. This is why I find the research into NAD+ and NMN particularly interesting. NAD+ sits at the centre of cellular energy production and is involved in processes such as DNA repair and cellular maintenance. NMN offers a way of supporting the body's own pathway for producing NAD+, which makes it a compelling area of healthy ageing research. — Dr Pearlie Tan, Founder of PPS Wellness     The human evidence is still developing. We know that NMN can influence NAD+ metabolism, but we do not yet know whether this will translate into longer-term improvements in healthspan. Current reviews similarly find clear biological activity but mixed clinical outcomes, which is why larger and longer human studies remain important. For me, healthy ageing has never been about finding a single molecule that promises to turn back time. It is about supporting the biological systems that allow us to function well for as long as possible. Exercise, good nutrition, quality sleep and maintaining muscle and metabolic health remain fundamental. But as our understanding of ageing biology advances, compounds such as NMN give us another interesting avenue to explore. We cannot stop ageing, but science is giving us a better understanding of how we age—and potentially, more tools to help us age well.