Collagen is so much bigger and more important than the skin anti-ager it’s best known to be: It plays a role in supporting your body head to toe, organs and all. And if you have a chronic illness like chronic Lyme disease, fibromyalgia, or chronic fatigue syndrome (CFS), there’s a good chance you’re losing your collagen at an accelerated rate. Find out why, and smart ways to both rebuild the collagen you’ve lost and protect what you have, below.

What is Collagen?

Before you worry about saving your collagen, it helps to understand exactly what it is and why it’s so worth your effort.

For starters, it’s the most abundant protein in your body. It’s what literally holds you together. Three strands of protein twist together to make a collagen fiber. And collagen fibers come together to form the tendons and ligaments that provide support for your entire skeleton.

Cartilage in joints is made of collagen. Collagen is also present in muscles and bones for added support. Without collagen, you would be a pile of bones on the floor. Collagen also provides support to skin, ligaments, blood vessels, heart muscle and valves, gums, eyes, intestines, and really anything in the body that needs to be supported.

In other words, collagen is really important. But not just to you: Many microbes that inhabit your body also use it as a nutrient resource. And that’s where things can get complicated.

Why Microbes Are After Your Collagen

Whether or not you’re struggling with a microbe-related chronic illness like Lyme or fibromyalgia, know that you are already in competition with microbes in your microbiome over your collagen.

We all have a microbiome, a vast ecological community of microbes that exists in our bodies. The microbiome was once thought to be isolated to your gut and on skin, but more recent research suggests that it’s quite a bit more complex.

Back in 2015, a study in PLOS One found that healthy mice have distinct populations of microbes as permanent residents in their muscle, liver, heart, and brain tissue. The researchers surmised that this was true of all creatures, and since then, human studies have confirmed that microbe populations exist in the brain tissue, joints, and other organs in healthy people. The evidence also strongly suggests that even healthy individuals harbor low concentrations of microbes in all tissues.

Some of these microbes have the ability to degrade collagen by producing enzymes for breaking down the protein. Many of them are potential pathogens that can exist within a person’s mouth, gut, and skin. Microbes that are typically associated with chronic illness, including borrelia (the prime suspect in Lyme), mycoplasma, and chlamydia, among many others, also have the ability to break down collagen.

In a scientific paper published in Infection and Immunity in 1996, researchers speculated why microbes might need to break down collagen, and proposed the following reasons:

• To release amino acids for their growth
• To break down natural tissue barriers to allow them to spread into deeper tissues
• To create a protective environment in deeper tissues for growth of anaerobic microbes (bacteria that don’t use oxygen — examples include borrelia and mycoplasma)

In healthy people, collagen breakdown by microbes is probably occurring at a very low level. Their immune systems are able to keep microbes in check such that significant damage doesn’t accumulate, and they’re able to constantly rebuild new collagen.

Net loss of collagen due to microbes doesn’t occur unless immune system functions are compromised and microbes are allowed to flourish, in which case things can get out of hand quickly. Chronic Lyme disease is possibly the best example of this.

The Link Between Chronic Illness and Loss of Collagen

Borrelia is possibly the most well known microbe with the ability to break down collagen. Not surprisingly, many of the symptoms of chronic Lyme disease occur at locations of high-density collagen: joints, ligaments, skin, eyes, gums, heart, and brain tissue. Inflammation and breakdown of collagen by microbes are likely the driving forces behind symptoms at these locations.

But borrelia isn’t the only microbe causing problems; a long list of possible coinfections are also typically present. Of the collagen-degrading microbes on the list, mycoplasma species are the most well studied.

Though mycoplasma commonly occurs as a Lyme coinfection, it has also been associated with a variety of other chronic illnesses, including rheumatoid arthritis and multiple sclerosis. And it’s been linked with damaged heart valves and arthritic joints (along with other microbes, including chlamydia and borrelia), both of which are associated with loss of collagen.

Interest in mycoplasma as a possible cause of rheumatoid arthritis (RA) dates back to the 1970s. In a flurry of research at the time, mycoplasma was found to be present in a high percentage of RA sufferers. However, interest in the connection seemed to die off when antibiotic therapy seemed effective in these patients. It is now known that mycoplasma is extremely resistant to antibiotic therapy.

More recently, interest in the mycoplasma-arthritis link seems to be rekindling. In 2000, a group of researchers published their findings in the Journal of Clinical Microbiology after examining samples of synovial fluid from the knees of 44 arthritis patients. They were able to detect Mycoplasma fermentans in 88% of cases of rheumatoid arthritis and other forms of arthritis, including ankylosing spondylitis, juvenile chronic arthritis, gout, and psoriatic arthritis (arthritis associated with psoriasis).

Later, in a 2006 study, the same lead researcher found Mycoplasma pneumoniae, a common cause of childhood bronchitis and chronic low grade pneumonia, in 79% of rheumatoid arthritis patients enrolled in the study, 80% of osteoarthritis patients, and 100% of those with other types of chronic arthritis.

Mycoplasma is a remarkably common microbe in human populations, with 40-60% of healthy people testing positive for some species of it. Though different species of mycoplasma are commonly spread by respiratory and genital infections, once the microbes are in the body, they can show up most anywhere. Sites of collagen are common final residences of the microbe.

When you add mycoplasma to the list of possible microbes that degrade collagen, and consider that symptoms of many chronic illnesses share collagen-located symptoms, the possibility of microbes being the driving force behind many types of chronic misery is highly likely.

The bottom line is that everyone harbors microbes with the potential to break down collagen — they’re just waiting for an opportunity. Some microbes are more threatening than others. Whether you will end up being ill or suffering from symptoms associated with collagen degradation depends on three factors:

• Genetics: Some people are more inherently susceptible to rheumatoid illnesses than others.
• Microbes: The type of microbes you pick up during your lifetime and harbor in your tissues can increase your risk.
• Immune system function: How factors come together during your lifetime to disrupt your immune system impact the strength of your defenses against collagen-degrading microbes.

While you can’t change your DNA, there’s a lot you can do to keep stealth microbes under containment and your immune system running efficiently so you can prevent collagen loss and rebuild healthy levels.

How to Protect Your Collagen

Whether you’re struggling with a chronic illness associated with symptoms of collagen loss, or having aging-related mild arthritis and skin changes, you want to protect the collagen in your body. There are four specific categories of actions you can take.

1. Suppress Collagen-Degrading Microbes with Herbal Therapy

Though mycoplasma and borrelia were my primary examples above, there are many microbes known to break down collagen — which means you can’t target just one. What’s more, most all of these microbes fit into the category of stealth microbes, which live inside cells (intracellular), grow very slowly, and are widely distributed in low concentrations throughout tissues in the body. Most notably, they are all notoriously resistant to conventional antibiotic therapy.

A better approach is taking certain herbs with known antimicrobial properties, which work differently than conventional antibiotics. Instead of one potent chemical, herbs contain hundreds of chemical compounds known to suppress microbes — they hit the microbes from a variety of different directions at once.

Many of the chemical compounds found in herbs are fat-soluble, and therefore can penetrate cell membranes to affect stealth microbes where they live. Antimicrobial herbs typically don’t disrupt normal flora and are extremely well tolerated, so they can be used for months or even years without concern. That’s key, because long-term suppression appears to be the only effective solution for these microbes.

When multiple antimicrobial herbs are combined, the benefits are synergistic. They also support optimal immune functions and provide protective antioxidants. Some of the best antimicrobial herbs include andrographis, cat’s claw, Japanese knotweed, sarsaparilla, garlic, berberine.

2. Support Your Immune System

Your immune system’s most important job is managing the wide spectrum of microbes that inhabit your body. A healthy immune system is essential for staying well and protecting collagen. However, the modern world is saturated with factors that disrupt immune system functions — especially our highly processed diet, exposure to high concentrations of man-made environmental toxins, chronic stress, and tendency to lead a sedentary life.

The most obvious solution is to take steps to counter the modern-life system-disruptors that ding your immune system every day. That means doing things like eating a healthful diet full of fresh, whole foods (more on that below); filtering your water; opting for organic foods and natural, non-toxic cleansers whenever possible; and making time each day for yourself to find a little stress relief and move your body.

Herbal therapy is also an excellent choice for supporting optimal immune system functions. Antimicrobial herbs do some of that, but herbal adaptogens do even more. Not only do adaptogens help reduce damaging inflammation, but they also enhance the immune system’s ability to do its job by balancing hormones and increasing your resistance to stress. Common herbal adaptogens with immune-balancing properties include reishi, cordyceps, ashwagandha, rhodiola, and eleuthero.

3. Support Collagen Turnover

Collagen in your body is constantly being degraded and being rebuilt. A healthful diet is key for providing new raw materials for building new collagen. At the top of that list are kale and other deep-green leafy vegetables, cucumbers, salmon, sardines, eggs, celery, and olives.

Bone broth is the latest health fad for supporting collagen, and it’s one I can get behind. That’s because bone broth provides all the necessary ingredients for rebuilding cartilage, which is made up of collagen. You can make your own (many recipes are available on the web), or buy it in most grocery stores.

Eating gelatin is an easy way to add an extra supply of collagen to your diet. You can also get collagen in supplement form; the recommended dose is about 6000 mg daily of collagen powder mixed in a smoothie or shake.

Another supplement to consider is silicon, which is a necessary component of collagen generation, plus it’s important for repairing myelin nerve sheaths. Natural silicon can be obtained from the herb, horsetail, or as stabilized orthosilicic acid, a liquid that’s dosed at about 20 drops a day (this also can be added to smoothies).

Out of all supplements for supporting collagen and joint function, glucosamine has the most scientific evidence to back it up. Glucosamine is a precursor for proteoglycans, the chemicals necessary for smooth and slick joint linings. It also stimulates synthesis of collagen. With age, normal glucosamine synthesis decreases, which may be a contributing factor to arthritis. The suggested dose of glucosamine is 500-750 mg, twice daily.

4. Minimize Other Collagen Disruptors

Microbes aren’t the only forces that degrade collagen in the body. There are variety of additional factors that are continually wearing it down. Check out five more top offenders below, plus simple advice for navigating around them.

• Sugar and starch. Glucose and fructose — sugars from processed food products, table sugar, high fructose corn syrup, and concentrated fruit sugar — are notorious collagen crunchers. Sugar and starch (another type of carbohydrate) bind to collagen in a process called glycation and target it for destruction. Plus the processed foods they’re found in generate inflammation in the body. Try to minimize the amount of added sugars you consume, and reach for whole, fresh foods over packaged stuff with processed ingredients whenever possible.
• Poor sleep. Your body repairs damaged collagen while you sleep, so you need at least 8 hours of quality sleep every night for optimal health. The secret of a good night’s sleep is finding moments of calm throughout the day and allowing plenty of time for adequate sleep at night — which may mean tacking on an extra hour to allow for the time it takes you to drift off.
• Toxins. Toxins of any variety damage collagen, but smoking saturates the body with them. If you smoke, it’s time to quit. And look for other ways to prevent toxins from entering your body by ingesting them, breathing them in, or through skin absorption.
• Physical stress. Extreme physical activity causes excessive wear and tear on joints and ligaments. Look for low-impact exercise that’s easier on your body. For instance, the gentle stretching of yoga helps maintain healthy ligaments, good posture, and skeletal support, and it’s also been found to reduce risk of osteoporosis.
• Sunlight. UV, infrared, and visible light from the sun are potent collagen crunchers in skin. Sunblock protects against UV, but not infrared and visible light. You also gain significant protection from specific types of antioxidants that build up in skin layers and also the retina of the eye. Lutein and zeaxanthin (carrots, yellow vegetables, kale) and anthocyanins (blueberries and other blue produce) should be dietary staples. These antioxidants also protect collagen in blood vessels and other parts of the body.

Everyone should be thinking about protecting and rebuilding their collagen, but especially those who are staring down a chronic illness. The good news is, the tactics that work best to help support healthy collagen levels are the same ones that are most effective for overcoming Lyme, fibromyalgia, and CFS. Follow the tips outlined above, and you’ll be doing double duty for your health and well-being.

Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.

You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.