Hyaluronic Acid and Joint Health
I was chatting with a patient recently about joint supplements after noticing yet another “anti-ageing” skin product boasting hyaluronic acid (HA) on the label. It struck me how often we see HA promoted for plumping the skin, yet far less is said about its potential benefits as a joint supplement.
That conversation reminded me of something close to home. My 11-year-old whippet started struggling to get up last year — slow to rise, stiff, clearly in pain and that hesitant first few steps many of my patients describe in themselves. Anyone with a pet, dog or otherwise, knows the pang of empathy when you see them in pain. So I set about looking at joint supplements for dogs, turns out there are tons of them — all in tasty treats with a price tag to go with them. Well, they’re onto a winner sales wise, monthly subscriptions etc etc. Ultimately I was prepared to pay, in an attempt to help my pooch, as would many other animal owners. However, with a little research it seemed that the ingredient in these supplements which, had any evidence backing benefits for joint function in arthritis: Hyaluronic Acid. Within two weeks of starting an oral syringe fed HA, and without changing anything else, she was back to her usual self. Still looking silvery in her face, yes, but moving freely and without showing signs of pain.
Her improvement and this discussion with a patient nudged me to revisit the research in humans and ask the same question many patients do: does hyaluronic acid genuinely help our joints, or is it just clever marketing?
What is hyaluronic acid?
HA is a naturally occurring molecule found in synovial fluid — the thick, cushioning liquid that keeps our joints gliding smoothly. It attracts and holds water, reduces friction, and acts a bit like nature’s own shock absorber.
As we age, our natural HA levels decline. With that comes dryness, stiffness, inflammation, and the familiar early signs of osteoarthritis.
HA has been used as a direct injectable into joints, and more recently oral supplementation.
So what’s the evidence in humans?
The research is quietly growing, and while HA isn’t a cure for osteoarthritis, it does offer meaningful benefits for many people:
Oral HA (typically 80–240 mg daily) has been shown to reduce knee pain and stiffness within around eight weeks.
Injected HA, used in knee osteoarthritis, can provide relief for 6–12 months and may delay the need for joint replacement.
Several trials also report improvements in function — easier walking, less start-up pain, and reduced inflammatory markers.
Mechanistically, it makes sense: you’re adding back a molecule the joint is gradually losing, helping restore lubrication and calm irritation.
Why don’t we hear more about HA supplements?
This is a question I am now asking — especially when the evidence looks promising. There are a few reasons why HA supplements don’t enjoy the same spotlight as glucosamine, omega-3 or turmeric:
1. It arrived later to the supplement world
Glucosamine and chondroitin dominated the market for decades. HA only appeared more recently, so it hasn’t had the same marketing push.
2. Strict advertising rules
In the UK and EU, supplement companies can’t legally claim that HA “reduces knee pain” unless the evidence meets extremely high regulatory thresholds.
Even if early research is encouraging, they can’t say it — so public awareness stays low.
3. People associate HA with skincare, not joints
Because HA is everywhere in beauty products, most people file it under “skin” rather than “movement”. So even when capsules are on the shelf, they’re easily overlooked.
4. Oral HA is newer to healthcare
Doctors and therapists are familiar with injectable HA, but many haven’t kept pace with the evidence for oral supplementation.
5. It’s not a high-profit product
Injectable HA is lucrative for pharmaceutical companies. Over-the-counter HA capsules are not.
Less profit means less promotion and less public education.
In short: HA supplements do exist, and the research is growing — they’ve just never had the commercial push that propels certain supplements into the spotlight.
Not a high profit margin for Pharma?
Is it worth trying HA supplements for osteoarthritis?
For many people, yes. It’s a gentle, low-risk option that may improve comfort and mobility, particularly in early to moderate osteoarthritis. According to some studies, many notice a shift within 6–8 weeks.
It can be especially helpful for:
morning stiffness
“rusty” first steps after sitting
early knee or hip osteoarthritis
a sense of dryness or grittiness in the joint
those wanting support alongside osteopathic care and strength work
individuals not ready for injections or surgical options
Arthritis is a common diagnosis later in life.
Who shouldn’t take HA supplements?
Although HA has an excellent safety profile, there are a few situations where caution or advice is needed.
1. Bird or egg allergies
Some HA supplements come from rooster combs.
Anyone with avian or egg allergies should choose a bacterial-fermented (vegan) version instead.
2. Pregnancy and breastfeeding
Not because it’s known to be unsafe, but because research is limited. Best avoided unless advised otherwise by a GP or midwife.
3. Autoimmune rheumatic conditions
People with rheumatoid arthritis, lupus, ankylosing spondylitis or psoriatic arthritis can use HA, but they should check with their rheumatologist first as flare patterns can be unpredictable.
4. Severe kidney disease
Anyone under nephrology care should speak to their GP before starting new supplements, including HA.
5. Multiple medications
HA has no known major interactions, but extra caution is sensible if someone is taking:
immunosuppressants
long-term steroids
biologics
anticoagulants like warfarin
6. Very advanced osteoarthritis
HA won’t cause harm, but expectations need to be realistic. When cartilage is severely reduced (“bone-on-bone”), oral HA is unlikely to make a significant change.
In Summary
Hyaluronic acid is often thought of as a skincare ingredient, but there’s a growing body of evidence showing it can support joint comfort too. For people with early to moderate osteoarthritis, HA supplements offer a gentle, low-risk option that may ease stiffness, reduce “start-up” pain and improve day-to-day mobility within a couple of months. They won’t reverse arthritis, and they’re not a replacement for good movement, strength work or personalised care — but they can sit alongside these approaches as a useful extra layer of support.
With a solid safety profile, a clear biological rationale and positive findings from several clinical trials, HA is certainly worth considering if joint discomfort is beginning to affect your routine.
References
Oe M. et al. (2016). Oral hyaluronan relieves knee pain: a 12-week randomised, double-blind, placebo-controlled study. https://doi.org/10.1186/s12937-016-0135-0
Tashiro T. et al. (2020). Oral intake of high-molecular-weight hyaluronan improves symptoms of knee osteoarthritis. https://doi.org/10.1016/j.jos.2019.03.016
Hung S. et al. (2015). Systematic review of oral hyaluronic acid in osteoarthritis. https://doi.org/10.1111/jcpt.12264
Kawada C. et al. (2014). Effects of oral administration of hyaluronan on knee joint pain and function.https://apjcn.nhri.org.tw/server/APJCN/23/4/626.pdf
Ghosh P. (1994). Hyaluronic acid and osteoarthritis. https://pubmed.ncbi.nlm.nih.gov/7719930/
Balazs E. (2004). Viscoelastic properties of hyaluronan and joint lubrication. https://doi.org/10.3233/BIR-2004-41-3-4-371
Bannuru R. et al. (2015). Comparative effectiveness of pharmacologic interventions for knee osteoarthritis.https://doi.org/10.7326/M14-1231
Rutjes A. et al. (2012). Viscosupplementation for knee OA: systematic review and meta-analysis.https://doi.org/10.7326/0003-4819-157-3-201208070-00473
EFSA (2008). Safety of hyaluronic acid for use in foods. https://doi.org/10.2903/j.efsa.2008.741
Pavicic T. et al. (2011). Safety and tolerability of oral hyaluronic acid. Journal of Cosmetic Dermatology, 10(2), 105–112.