MSM (methylsulfonylmethane)
Bioavailable sulphur source with modest RCT signal for knee osteoarthritis pain at 3–6 g/day.
Why
Methylsulfonylmethane (MSM) is a small organosulphur molecule that delivers bioavailable sulphur to tissues. Multiple RCTs in knee osteoarthritis report modest reductions in WOMAC pain and stiffness scores at 1.5–6 g/day over 12 weeks, with the Kim 2006 and Debbi 2011 trials carrying the cleanest design. Effect size is smaller than NSAIDs but the safety profile is very favourable.
How it works
Provides sulphur substrate for glycosaminoglycan synthesis (chondroitin sulfate, dermatan sulfate) and for glutathione synthesis. Anti-inflammatory effects via NF-κB inhibition and reduced IL-6 and TNF-α. Mild antioxidant effect at high tissue concentrations.
Expected onset · Pain reduction over 4–8 weeks
How to take
Dosage
1.5–3 g twice daily (3–6 g/day total). Trials use up to 6 g/day without dose-limiting effects.
Timing
Divided 2–3 times daily with food
On the label
OptiMSM (purified, distilled methylsulfonylmethane) is the trial-grade form. Stated grams per serving.
Ideal for
Adults with mild-to-moderate knee osteoarthritis pain seeking an additional low-risk option; people exploring NSAID-sparing approaches.
Safety
Evidence
Brien 2008 Osteoarthr Cartil systematic review (2 RCTs at the time): MSM produced significant improvements in WOMAC pain and function vs placebo over 12 weeks, with effect size modest but consistent. Kim 2006 and Debbi 2011 confirmed the signal in independent trials. Favourable safety profile is the practical advantage.
- Kim et al., Osteoarthritis Cartilage 2006, efficacy of methylsulfonylmethane for osteoarthritis pain of the knee: pilot RCT (n=50)
- Debbi et al., BMC Complement Altern Med 2011, effect of MSM on osteoarthritis of the knee (RCT, n=49)
- Brien et al., Osteoarthritis Cartilage 2008, systematic review of MSM for osteoarthritis
Where to get it
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