Hyaluronic Acid 60 Capsules

Two very different people reach for this, one for skin and one for joints, and the evidence treats them differently. These are the questions our naturopaths ask in store to make sure you choose the right thing.

A good fit if

• Skin hydration and elasticity are what you're after. That's where the trial evidence is.
• You'll choose on the milligrams rather than the marketing, because dose made the difference between a good result and a modest one
• You'll take it as a three-month course and then reassess, which is what the label requires anyway
• You're an adult who isn't pregnant or breastfeeding

Check with us first if

• You take any prescription medicine. We found no interaction data and no side effect information beyond the label warnings, so we can't tell you there's nothing to find.
• Joint comfort is your main reason for buying. We haven't found a trial that tests oral hyaluronic acid on its own for joints.
• You want to keep taking it past three months, which is longer than the label recommends.
• You avoid poultry or animal-derived ingredients. Some raw material comes from rooster or chicken comb rather than a microbial ferment.
• If you take prescription medicines, check with your doctor, pharmacist or our naturopaths before starting.

• Sodium hyaluronate, oral. Best known for: The salt, and the only form Australian rules allow as an active ingredient taken by mouth. Absorption: Not established. It isn't obvious how a molecule this large is absorbed by mouth, and we haven't found a reliable explanation, so we don't offer one. Typical use: Skin hydration and elasticity, where the trial evidence is. For active use, the molecular weight has to be between 600 and 1600 kilodaltons.
• Hyaluronic acid, the free acid. Best known for: Texture and moisture in skin products, where it's allowed only as a non-active ingredient. Absorption: Not applicable. It's there to help make the product, not as the active. Typical use: It can't legally be the ingredient an Australian listed medicine says is doing the work, which is why labels for products you swallow say sodium hyaluronate.
• Topical sodium hyaluronate. Best known for: Serums and creams, capped at 2.0 per cent in a listed medicine used on the skin. Absorption: Not established in the research we reviewed. Typical use: Surface hydration. It's a different route from the oral trials above, so don't treat one as evidence for the other.
• Low versus high molecular weight. Best known for: A formula detail that gets promoted as a selling point more often than the evidence supports. Absorption: Not established for either size range. Typical use: Worth knowing: the strongest skin trial used 1.8 megadalton material, above the range Australian rules allow for an active, so it doesn't back up a product within the range.
• Animal-derived versus fermented. Best known for: Where the raw material came from: rooster or chicken comb, or microbial fermentation. Absorption: We found no comparison. Typical use: A sourcing and vegan question rather than a regulatory one. Check the product if poultry matters to you.

Reference values. There aren't any. Hyaluronic acid isn't an essential nutrient, so the NHMRC Nutrient Reference Values don't include it. Your body makes its own.

Typical supplemental range. We haven't surveyed doses on Australian labels, so we can't give you a typical shelf range. From the trials: 120 mg a day of sodium hyaluronate for 12 weeks worked best on skin, while 60 mg a day did much less. A small joint study used 80 mg a day of a chicken comb extract for eight weeks and didn't reach its main goal of reducing pain.

Upper level. There's no NHMRC upper level, because there's no reference intake to set one against. The limit that matters is the regulatory one: a listed medicine's maximum recommended daily dose can't provide more than 200 milligrams of sodium hyaluronate, and use is limited to three months.

Worth knowing. The 120 mg that worked best is under the 200 mg limit, so an Australian product can be dosed at the level that worked, as long as it actually contains that much. Check the milligrams, not the front of the pack. What you need depends on your age, diet and health, so talk to one of our naturopaths.

If any of these sound like you, talk to one of our naturopaths or your doctor before you start.

• You're pregnant. A mandatory label warning says it isn't recommended for pregnant women.
• You're breastfeeding. The same mandatory label warning covers breastfeeding women.
• Children and under-18s. Products with it as an active taken by mouth must carry an adults-only warning.
• You take prescription medicine. We found no interaction data, which isn't the same as there being none.
• You'd take it continuously. Recommended use is capped at three months.
• Dose. A listed medicine can't provide more than 200 mg of sodium hyaluronate a day.
• Skin products. In a listed medicine, sodium hyaluronate must not go over 2.0 per cent.
• You avoid poultry or animal-derived ingredients. Some hyaluronic acid is extracted from rooster comb.
• If you take prescription medicines, check with your doctor, pharmacist or our naturopaths before starting.