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MSM - does sulfur therapy help with osteoarthritis?

What should I look out for when using MSM products?

In 2007, the US Food and Drug Administration (FDA) rated an MSM product with a daily dose of 4.8 g as "safe" (Generally Recognized As Safe = GRAS). However, it is not known whether long-term use of MSM products poses health risks. There are no references to this. Short-term side effects can include allergic reactions, gastrointestinal problems, and skin irritation.

What's behind the MSM advertisement?

The sulfur-containing methylsulfonylmethane or MSM for short is supposed to eliminate a lack of sulfur allegedly present in osteoarthritis patients and is presented as a "gentle alternative pain reliever". It should also be used for muscle cramps and pain, sports injuries, autoimmune diseases, carpal tunnel syndrome and even against snoring, hay fever, cancer or HIV.

However, dietary supplements are not yet there to prevent, alleviate or cure diseases. As a matter of principle, providers are therefore not allowed to advertise with corresponding statements about the effect on osteoarthritis and other diseases. Health-related advertising statements (so-called "health claims") such as "contributes to normal collagen formation" may also not be used.

MSM is not approved as a medicinal product. It is usually sold online as a dietary supplement, often in combination with other remedies for joint problems such as glucosamine or chondroitin. Vitamin C is also often added - certain health-related statements can be made here, for example "Vitamin C contributes to normal collagen formation for normal bone function".

The term "joint" in the product name, advertising with improved joint functions and the depiction of a movable joint are inadmissible in the opinion of the Working Group of Food Chemical Experts of the Federal States (ALS), as this suggests a causal relationship that the experts believe is not given.

Such a mapping would mean an inadmissible expansion of the approved health claims.

Overall, the study situation for MSM is described as “poor”. It is unclear whether it can noticeably relieve osteoarthritis pain, and it is also unclear what amount would be required over what period of time. MSM is also not mentioned in the guidelines for the treatment of knee osteoarthritis.

Nothing is known about possible side effects that can occur when taking it over a longer period of time.

What is MSM?

Methylsulfonylmethane as an organic sulfur compound occurs in many plants and animals, including food. As a component of chondroitin sulfate, sulfur plays a role in cartilage tissue. There is no specific recommended daily intake for sulfur. The body needs sulfur in the form of the sulfur-containing amino acids (protein building blocks) methionine and cysteine. Due to the very protein-rich diet in the western industrialized countries, a sufficient supply of these sulfur-containing amino acids and thus sulfur is guaranteed. An isolated sulfur deficiency is unknown, according to the German Nutrition Society.

MSM is a novel food ingredient and, according to the European Novel Food Catalog, may only be added to food supplements. This classification is not legally binding, but corresponds to the European public opinion. There are no requirements for maximum or minimum quantities for this substance, neither at national nor at European level.



Medicine transparent: does MSM help with osteoarthritis? As of December 15, 2016. Accessed March 5, 2020

National Center for Complementary and Integrative Health (NIH): Dimethyl Sulfoxide (DMSO) and Methylsulfonylmethane (MSM) for Osteoarthritis. As of: 24.09.2017, accessed on 05.03.2020 In: Gute Pillen Bad Pillen, issue 2/2013, accessed on 05.03.2020

EFSA (2010) Scientific Opinion on the substantiation of health claims related to Methylsulphonylmethane (MSM) (...); EFSA Journal 2010; 8 (10): 1746. Accessed March 5, 2020

Working group of food chemical experts: Opinion 2016/42: Joint preparations as food supplements with approved health-related information in relation to connective tissue, cartilage or bones. Accessed March 5, 2020

Novel Food Catalog of the European Commission, accessed on March 5th, 2020

Food and Drug Administration, GRAS Notice 000229, accessed October 12, 2018

Personal letters from the BfR and the DGE to the consumer advice center in North Rhine-Westphalia, 2013

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