Methylsulfonylmethan
Also known as: MSM, dimethyl sulfone, Methylsulfonylmethane
Overview
Methylsulfonylmethane (MSM) is a naturally occurring organosulfur compound found in various plants, fruits, vegetables, and beverages. It is widely used as a dietary supplement, primarily for its potential to alleviate symptoms of osteoarthritis (OA), such as pain and inflammation, and to mitigate exercise-induced muscle damage and oxidative stress. MSM is characterized by its sulfur content and its ability to penetrate tissues, which is thought to enable its modulation of inflammatory and oxidative pathways. While research on MSM is moderate, with several randomized controlled trials and meta-analyses available, the quality of evidence is mixed, with some studies showing small but statistically significant effects, particularly for OA, while others report non-significant clinical outcomes. Its overall safety profile is considered good.
Benefits
MSM offers several evidence-based benefits, primarily in the areas of joint health and exercise recovery. For osteoarthritis, a meta-analysis indicated a small but statistically significant reduction in pain (SMD = -0.23) and improvement in physical function, with greater effects observed with longer supplementation durations (over 10 months). However, another meta-analysis reported no clinically significant pain reduction, highlighting mixed results and potential issues with dosing or study duration. Beyond joint health, MSM exhibits antioxidant effects by reducing markers of oxidative stress like malondialdehyde (MDA) and nitric oxide (NO), while increasing levels of glutathione (GSH) and antioxidant enzymes in both animal and human studies. It has also been shown to attenuate exercise-induced oxidative damage and muscle soreness in endurance athletes when used as a pre-treatment. These benefits are mainly observed in adults with osteoarthritis and physically active individuals. The effect sizes are generally small to moderate, and clinical relevance can be uncertain due to variability in study designs.
How it works
MSM is believed to exert its therapeutic effects by modulating inflammatory pathways and reducing oxidative stress at a cellular level. It achieves this by suppressing the mitochondrial generation of reactive oxygen species (ROS), such as superoxide and hydrogen peroxide, thereby helping to restore cellular redox balance, exemplified by the normalization of the GSH/GSSG ratio. Furthermore, MSM may enhance the body's natural antioxidant defenses by increasing the activity of key antioxidant enzymes like catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx). Its sulfur content is also thought to contribute to the synthesis of sulfur-containing amino acids and components essential for connective tissue, potentially supporting joint health. MSM's good tissue penetrability allows it to effectively reach target sites and potentially act as a carrier for other therapeutic agents.
Side effects
MSM is generally considered safe and well-tolerated, with a low incidence of adverse effects reported in clinical trials. The most commonly reported side effects, occurring in less than 5% of users, are mild gastrointestinal discomfort, headache, and occasional skin reactions. No consistently reported uncommon side effects (1-5%) have been identified. Serious adverse events are rare, with no such occurrences documented in high-quality studies. While no significant drug interactions have been definitively established, caution is advised when combining MSM with anti-inflammatory or anticoagulant medications due to a theoretical potential for additive effects. There are no well-established contraindications for MSM use. However, due to limited research, caution is recommended for pregnant and lactating women, and safety in children has not been thoroughly studied. Overall, MSM has a favorable safety profile for most adults within recommended dosages.
Dosage
For the symptomatic relief of osteoarthritis, studies typically utilize MSM dosages ranging from 1.5 to 3 grams per day. The optimal dosage range commonly observed in clinical trials is between 2 to 6 grams per day, often administered in divided doses. Short-term studies indicate that dosages up to 6 grams daily are generally well-tolerated, though long-term safety data at this higher end is limited. MSM is typically taken orally on a daily basis, and for benefits related to osteoarthritis, consistent supplementation over several weeks to months is often required. It is available in various forms, including powder, capsules, or as part of combination supplements (e.g., with glucosamine). MSM exhibits good oral bioavailability, and its absorption may be enhanced when taken with meals. No specific cofactors are required for its efficacy, but it is sometimes combined with other antioxidants for potential synergistic effects.
FAQs
Is MSM effective for osteoarthritis?
Evidence suggests MSM can provide small to moderate pain relief for osteoarthritis, but clinical significance varies. Longer supplementation (over 10 months) may improve outcomes.
Is MSM safe?
Yes, MSM is generally well-tolerated with a low incidence of mild side effects like GI discomfort or headache reported in clinical trials.
How long before effects appear?
For osteoarthritis, effects may take several weeks to months to become noticeable. Antioxidant benefits, especially for exercise recovery, can be observed more acutely.
Can MSM be combined with other supplements?
MSM is often combined with supplements like glucosamine and chondroitin, and no major safety concerns have been reported with such combinations.
Research Sources
- https://pmc.ncbi.nlm.nih.gov/articles/PMC3135791/ – This meta-analysis of three randomized controlled trials on osteoarthritis patients found no clinically significant pain reduction with MSM supplementation. The study highlighted limitations such as a small number of trials, heterogeneity among studies, and short dosing periods, suggesting that the observed small effect size was not statistically significant.
- https://www.nature.com/articles/s41598-020-78075-x – This systematic review and meta-analysis, encompassing multiple RCTs with over 500 OA patients, reported a small but statistically significant reduction in pain (SMD = -0.23) with MSM. The review noted that larger effects were observed with longer supplementation durations (over 20 months), despite moderate heterogeneity and variable dosing across included studies, indicating moderate to high quality research.
- https://pmc.ncbi.nlm.nih.gov/articles/PMC5372953/ – This narrative review, incorporating both human and animal data, provides mechanistic insights into MSM's actions. It concludes that MSM reduces oxidative stress markers, improves antioxidant status, and attenuates exercise-induced damage. The review acknowledges that much of the clinical evidence comes from small RCTs and animal studies, limiting large-scale trial data but providing a good understanding of its biological effects.
