Supplement
MSM (Methylsulfonylmethane)
Longevity · methylsulfonylmethane, Methylsulfonylmethan, dimethyl sulfone, methyl sulfone, organic sulfur, OptiMSM
MSM, short for methylsulfonylmethane, is a small sulfur compound found in trace amounts in fruit, vegetables, coffee and milk. As a powder or capsule it is a classic for joints, skin and hair. The studies are favorable but small, and that is exactly what makes the assessment interesting.
In short
MSM has slightly improved knee pain and mobility in osteoarthritis in several small, placebo-controlled studies, mostly over 12 weeks. A review in the British Journal of Sports Medicine found a statistically significant effect on pain whose clinical relevance, however, is unclear, and an older meta-analysis saw no significant difference. Tolerability is good in all studies; in the US, MSM has been notified as a food ingredient without objections from the FDA. For skin, hair, allergies and sport there are only individual small, often manufacturer-linked studies. In the EU, MSM is permitted as a food supplement, but no health claims have been authorized.
What it is
MSM is an organic sulfur compound made of two methyl groups and a sulfone group. It arises in the natural sulfur cycle and is found in small amounts in fruit, vegetables, cereals, coffee, tea, beer and cow’s milk. Other names are dimethyl sulfone or organic sulfur.
Chemically, MSM is the oxidized form of DMSO, a solvent that has been studied for decades because of its anti-inflammatory properties. Unlike DMSO, MSM is odorless and is swallowed rather than applied to the skin. On the market there are mainly powders and capsules, often combined with glucosamine, chondroitin, collagen or boswellia. A large share of the studies use the product of a single US manufacturer.
How it is supposed to work
The main idea is inhibition of inflammation. In cell cultures, MSM slows the inflammatory switch NF-κB and influences other signaling pathways related to oxidative stress. In a study with trained men, resting levels of pro-inflammatory messengers were somewhat lower after 28 days with 3 g of MSM, and the immune system’s response to hard training changed.
The second idea is MSM as a source of sulfur. Sulfur is contained in the amino acids methionine and cysteine and thus in collagen, keratin and glutathione. In guinea pigs, labeled sulfur from MSM did end up in blood proteins, presumably via the gut bacteria. In humans this has not been shown: plasma sulfate and homocysteine did not change in a dose-dependent manner in one study. MSM is absorbed quickly, in humans within less than an hour.
What users are looking for
Most people take MSM for their joints, often from midlife onward or after years of running and strength training. Many report that their knees feel less stiff in the morning and that stairs are easier. Others use it for skin, hair and nails or after hard training sessions, some also during hay fever season. These are user reports without a control group, but they fit the study situation in osteoarthritis, where the effects are small and the direction is positive.
What is well supported
Knee osteoarthritis is the best-studied area. In a placebo-controlled study with 50 patients, 6 g of MSM per day over 12 weeks reduced pain and functional impairment in the WOMAC questionnaire, the standard in osteoarthritis research. A second study with 49 patients found significantly better function and a better total score over 12 weeks; for pain it narrowly fell short. In an Indian study with 118 patients, the pain index fell under MSM, and even more clearly together with glucosamine. And a Japanese study with 88 people with mild knee pain reached its primary endpoint after 12 weeks.
The 2018 review by Liu and colleagues, which analyzed 69 studies on 20 preparations, counts MSM among the agents with a statistically significant improvement in pain, but rates the clinical relevance as unclear. A network meta-analysis with 22 studies and 2,777 participants placed MSM among the 3 best preparations for joint stiffness. Tolerability is also well supported: in none of the studies mentioned were there relevant side effects.
What the studies show
The pilot study with 6 g per day
50 men and women between 40 and 76 years of age with knee osteoarthritis took 3 g of MSM or placebo twice daily for 12 weeks. Pain and limitations in daily life decreased significantly more under MSM; stiffness and the total score did not. The authors themselves call their work a pilot study from which long-term benefit and safety cannot be derived.
The Israeli osteoarthritis study
49 patients between 45 and 90 years of age with radiologically confirmed knee osteoarthritis received 1.125 g of MSM or placebo three times daily for 12 weeks. Function and the WOMAC total score improved significantly; pain, at p = 0.08, narrowly did not. The researchers write openly that the improvements are small and their clinical relevance remains to be clarified.
The study with 180 recruits
The largest single RCT tested MSM preventively: 180 US Army recruits between 18 and 40 years of age took 3 g per day or placebo for 8 weeks during basic training. Neither knee complaints nor mood differed after 30 or 60 days. MSM was safe, but prevented nothing in young, healthy knees under strain.
Where the data stop
The osteoarthritis studies are small and short, with 49 to 118 participants and mostly 12 weeks’ duration. Whether the effect lasts over months and years, nobody knows. The only meta-analysis that specifically pooled MSM and DMSO found, across 3 studies with 326 patients, only a non-significant reduction in pain of 6.34 mm on a 100 mm scale, and only one of them was an MSM study. Liu and colleagues found a clinically relevant long-term effect on pain for not a single preparation.
For the other areas of use the data are thin. In 22 half-marathon runners, 3 g per day produced no statistically significant differences in muscle damage, oxidative stress or pain, even though pain scores in the MSM group fell noticeably in clinical terms. The skin study with 20 and 63 participants has a co-author from the manufacturer; the hay fever study with 18 participants had no placebo group at all. In a study with 22 overweight adults, HDL cholesterol rose compared with baseline; a comparison with placebo is missing from the abstract. In addition, many studies work with the product of one manufacturer and are sponsored or co-authored by it. That does not make them wrong, but independent replications are lacking.
Status, approval and legal
MSM is legally sold in Germany and the EU as a food supplement. In the European Commission’s Novel Food Catalogue it is listed as not novel in food supplements, so it needs no separate authorization there; this status does not apply to other foods. Health claims are not permitted: the EU rejected all submitted claims on joints, collagen formation, hair, nails, the immune system and digestion after review by EFSA. In the US, MSM has been notified as a food ingredient since 2008, and the FDA had no objections. I found no official maximum amounts from EFSA, BfR or DGE; MSM is also not an essential nutrient. MSM is not on the 2026 WADA Prohibited List.
Safety
MSM is among the well-tolerated food supplements. In the studies of up to 16 weeks, no or only mild side effects occurred; a review reports good tolerability up to 4 g daily. In 90-day animal studies, no harmful effects were found at 1.5 g per kg of body weight per day. A single case of skin rash has been described. In the laboratory, MSM did not inhibit the most important liver enzymes for drug metabolism, but there are no clinical interaction studies. Forums report greater sensitivity to alcohol; this has not been studied. Human data are lacking for pregnancy, breastfeeding and children, so restraint makes sense here. Anyone taking long-term medication should discuss its use with a doctor.
BK-Score Thin human evidence
| Human evidence | 5 | |
|---|---|---|
| Mechanism | 4 | |
| Safety data | 5 | |
| Hype gap | 4 | |
| Track record of use | 7 |
Evidence 5, because several small RCTs over 12 weeks show positive effects in knee osteoarthritis (Kim 2006: 50 patients; Debbi 2011: 49 patients, function significant, pain at p = 0.08 not; Usha 2004: 118 patients; Toguchi 2023: 88 participants), but the meta-analysis by Brien 2011 across 3 RCTs with 326 patients was not significant, the largest single RCT with 180 recruits found no effect (Tennent 2017), and Liu 2018 rates the clinical relevance as unclear. Mechanism 4, because inhibition of inflammation via NF-κB and the role as a sulfur donor come from cell culture and animals, and in humans plasma sulfate and homocysteine did not rise in a dose-dependent manner (Butawan 2017); in humans there are only small cytokine studies (van der Merwe 2016). Safety 5, because RCTs of up to 16 weeks without relevant side effects, 90-day animal studies (NOAEL 1.5 g/kg/day) and an FDA GRAS notice without objections (GRN 229) are available, but long-term data and data on pregnancy are lacking. Hype 4, because MSM is marketed for joints, skin, hair, nails, the immune system and allergies, but the EU has rejected all submitted health claims and outside osteoarthritis only individual small, often manufacturer-linked studies exist. Use 7, because MSM has been widely used as a food supplement for many years, is considered not novel in food supplements in the EU and is notified as a food ingredient in the US. Direction mixed: small positive osteoarthritis studies stand against a non-significant meta-analysis and a negative prevention RCT.
The score rates the state of knowledge, not the substance. “Safety data 9” means well studied – not harmless.
Subjective assessment by Biohacking Kompakt based on published scoring rules – not a scientific rating and not a medical recommendation. Rules and all ratings (German)
Frequently asked questions about MSM (methylsulfonylmethane)
Does MSM help with knee osteoarthritis?
In several small studies over 12 weeks, pain or function improved slightly compared with placebo. A large review considers the effect statistically significant but clinically unclear. An older meta-analysis found no significant difference.
How much MSM was taken in studies?
The osteoarthritis studies used between 500 mg three times daily and 3 g twice daily, mostly over 12 weeks. In sport and skin studies it was 1 to 3 g per day. There is no official maximum amount in Germany.
Does MSM have side effects?
In the studies, MSM was very well tolerated; side effects were rare and mild. A single case of skin rash has been described. There are no data for pregnant women, breastfeeding women and children.
Does MSM help skin, hair and nails?
There is only one small skin study for this, in which an employee of the manufacturer was involved. It found fewer wrinkles and better skin elasticity. Reliable studies for hair and nails are lacking, and the EU has rejected corresponding health claims.
Is MSM the same as DMSO?
No. MSM is a breakdown product of DMSO and is formed when the body converts DMSO. DMSO is a solvent; MSM is an odorless powder sold as a food supplement.
Can I combine MSM with glucosamine?
Yes, that is a common combination. In an Indian study with 118 patients, the pain index fell more with both together than with either agent alone. Independent confirmation of this combination is lacking so far.
Related
- Same goal: joints & mobilityCollagen peptides
- Same goal: joints & mobilityFrankincense (Boswellia)
- Same goal: joints & mobilityHyaluronic acid
- Same goal: joints & mobilityEvening primrose oil
- Same goal: joints & mobilityTurmeric (curcumin)
- Same goal: skin, hair, nailsBiotin (vitamin B7)
Sources
- Kim LS et al., Osteoarthritis Cartilage 2006 – MSM in knee osteoarthritis, pilot RCT
- Debbi EM et al., BMC Complement Altern Med 2011 – MSM in knee osteoarthritis, RCT
- Usha PR, Naidu MU, Clin Drug Investig 2004 – glucosamine, MSM and combination
- Tennent DJ et al., US Army Med Dep J 2017 – MSM for the prevention of knee pain
- Brien S et al., Evid Based Complement Alternat Med 2011 – meta-analysis of DMSO and MSM
- Liu X et al., Br J Sports Med 2018 – dietary supplements in osteoarthritis
- Withee ED et al., J Int Soc Sports Nutr 2017 – MSM and the half marathon
- Butawan M et al., Nutrients 2017 – MSM: applications and safety
- FDA GRAS Notice GRN 229 – Methylsulfonylmethane
- EFSA NDA Panel, EFSA J 2010 – health claims on MSM
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Information only, not medical advice and not a usage or dosage recommendation. Prescription-only and unapproved substances belong in the hands of a physician. Last updated: 2026-09-30.