In brief: MSM (methylsulfonylmethane) is an organic sulfur compound marketed as a dietary supplement primarily for joint issues. The state of research is mixed: an older meta-analysis found no clinically relevant effect on pain, while more recent individual studies and a systematic review report small, statistically significant improvements. There is no authorized health claim for MSM in the EU – in fact, advertising with the term "joint" is considered legally sensitive by German food authorities.

What is MSM?

Methylsulfonylmethane, or MSM for short, is an organic sulfur compound that naturally occurs in small amounts in many foods – such as eggs, dairy products, fish, meat, and sulfur-containing vegetables like onions, garlic, and broccoli. For dietary supplements, MSM is produced industrially and is usually offered as a powder or in capsules, often in combination with glucosamine, chondroitin, or collagen.

Chemically, MSM is related to dimethyl sulfoxide (DMSO), a solvent that is also discussed for joint issues but is less well-tolerated and is not an approved dietary supplement in Germany. MSM itself is considered a novel food ingredient according to the European Commission's Novel Food Catalogue, meaning it may be used in dietary supplements without special authorization – although this classification is not legally binding, it reflects the European view on marketability.

Mechanism of action: What is plausible, what is proven?

Sulfur is a building block of the sulfur-containing amino acids methionine and cysteine, which are required for the formation of connective tissue proteins like collagen and keratin, among other things. In cell and animal studies, MSM has also shown anti-inflammatory and antioxidant properties, for instance through the reduction of certain inflammatory messengers.

Important context: These mechanisms are biochemically plausible but, in themselves, do not prove any noticeable effect in humans. According to the German Nutrition Society (DGE), there is no such thing as an isolated "sulfur deficiency" – a standard, protein-rich diet in Western industrialized countries provides sufficient sulfur in the form of methionine and cysteine. The theoretical mechanism of action is therefore no evidence that additional MSM intake corrects a deficiency in the context of a normal diet.

MSM for joint issues: What the research actually shows

Clinical research on MSM for knee osteoarthritis spans over a decade and a half and provides an inconsistent picture:

• Debbi et al. (2011, BMC Complementary and Alternative Medicine): In this randomized, double-blind study, 49 people with knee osteoarthritis (ages 45–90) received either 3.375 g of MSM daily (divided into three doses) or a placebo for 12 weeks. WOMAC pain, stiffness, and function scores as well as a quality-of-life questionnaire (SF-36) were recorded.
• Brien, Prescott & Lewith (2011, Evidence-Based Complementary and Alternative Medicine): This meta-analysis evaluated three methodologically high-quality, placebo-controlled studies on DMSO and MSM (totaling 326 patients). The authors' conclusion: The available evidence is insufficient to classify MSM as clinically effective for pain reduction in osteoarthritis – partly because many studies were of too short a duration.
• Systematic Review, British Journal of Sports Medicine (2018): In this broader review of dietary supplements for osteoarthritis, MSM showed statistically significant but clinically unclear improvements in pain scores – similar to glucosamine and chondroitin.
• Toguchi et al. (2023, Nutrients): In this double-blind, placebo-controlled study, 88 adults with mild knee pain took 2 g of MSM (as OptiMSM) or a placebo for 12 weeks. According to the JKOM questionnaire, the MSM group showed significant improvements in morning and nighttime pain as well as pain while standing. A limitation: The study was funded by the manufacturer of the MSM raw material used, and it involved mild knee pain not necessarily diagnosed by a doctor, rather than diagnosed osteoarthritis.

For further context: A current network meta-analysis from 2025 (Han et al., Nutrients), which directly compared seven common dietary supplements for knee osteoarthritis, did not even include MSM in its analysis – it examined eggshell membrane, vitamin D, frankincense (Boswellia), curcumin, ginger, krill oil, and collagen. Boswellia performed best across all endpoints. The fact that a current, extensive comparative study does not even consider MSM is an indication in itself of how inconsistent and limited the evidence base for MSM is currently estimated to be compared to other joint nutrients.

Conclusion on the state of research: In some studies, MSM shows small, sometimes statistically significant effects on pain and function scores for knee problems. Other evaluations conclude that these effects are not clinically meaningful. A confirmed, generally accepted efficacy for osteoarthritis cannot be derived from the available data.

Why MSM is not allowed to bear health claims

A point often downplayed in the advertising of MSM products: The European Food Safety Authority (EFSA) evaluated the submitted health claims regarding MSM in 2010 and recognized none of them as sufficiently scientifically proven – this includes the claim that MSM contributes to normal collagen formation. Consequently, providers may not use such statements for MSM products in the EU.

German consumer protection centers also point to another legal gray area: The Working Group of Food Chemistry Experts of the Federal States (ALS) classifies the term "joint" in product names, as well as depictions of a moving joint for dietary supplements like MSM, as inadmissible, as this suggests a scientifically unproven causal link. Furthermore, MSM is not approved as a medicine – according to EU law, it may not be advertised with claims regarding the prevention, alleviation, or cure of diseases such as osteoarthritis, as dietary supplements are not intended for this purpose.

For consumers, this means in concrete terms: MSM is a dietary supplement, not a medicine. Anyone seeking a cause or treatment for joint issues should have this clarified by a doctor and should view MSM at most as a possible supplement, not a replacement for medical treatment.

MSM dosage: What quantities were used in studies?

For MSM, there is no officially established recommended daily allowance or legal maximum limit, either at the EU level or in Germany. The following information is based on the dosages used in clinical studies as well as common practical recommendations for a gradual start:

Higher doses should be introduced slowly and divided into several portions throughout the day to improve tolerability. In 2007, the US FDA evaluated a single MSM product at 4.8 g per day as "Generally Recognized as Safe" (GRAS) – this classification refers to its use as a food ingredient in the US, not as a medically recommended therapeutic dose.

Side effects and who should be cautious with MSM

At the dosages typical in studies, MSM is considered well-tolerated by most healthy adults. Possible, usually mild and temporary, side effects include:

• Flatulence, loose stools, or other minor gastrointestinal complaints
• Headaches
• Skin reactions or allergic reactions in case of individual sensitivity
• Occasionally restlessness or lighter sleep if taken late in the day

There is currently insufficient data on the long-term safety of MSM with continuous use over several years. Particular caution is advised for:

• Pregnancy and breastfeeding (insufficient data, only after medical consultation)
• Children and adolescents (no sufficiently verified recommendation)
• Kidney or liver diseases (medical clearance recommended before use)
• Use of long-term medication (potential interactions should be checked by a doctor or pharmacist)

If complaints persist or are severe after intake, use should be paused and medical advice sought.

For whom might an MSM supplement be of interest?

MSM is not a proven miracle cure for osteoarthritis or other joint diseases – the research is too inconsistent for that, and no authorized health claim exists. Nevertheless, supplementation may be of interest for individuals who wish to try a well-tolerated, sulfur-based option as part of a more comprehensive approach to joint health – such as in combination with exercise, weight management, and potentially other nutrients like glucosamine and chondroitin or collagen. Those interested in a combination of several of these well-researched joint nutrients can find the Veyt Joint Protection Package, which combines MSM, glucosamine, chondroitin, collagen, vitamin D3/K2, magnesium, and vitamin C. Those who specifically want to test only MSM will find a high-purity, vegan, and sugar-free version without unnecessary additives with the Pure MSM Sulfur Complex powder from Veyt.

As with most dietary supplements with a thin evidence base, the following applies: set realistic expectations, do not consider MSM as a replacement for a medical diagnosis or treatment, and observe your own tolerability over a few weeks. If joint pain occurs for the first time around menopause, the article Joint pain during menopause: A study check explains what can be hormonally triggered and when a doctor's visit is advisable.

Frequently asked questions about MSM

Is there proven evidence that MSM helps with osteoarthritis?

Not definitively. Individual studies show small, sometimes statistically significant improvements in pain and function scores; other evaluations – including a 2011 meta-analysis – conclude that the effects are not clinically significant. There is no authorized health claim for MSM in the EU.

How much MSM per day is sensible?

Studies typically used 2 to 3.4 g daily, sometimes up to 6 g. A common starting dose is 0.5 to 1 g daily, with a slow, weekly increase. There is no official recommended daily allowance for MSM.

Is MSM safe?

At standard dosages, MSM is considered well-tolerated by healthy adults. Possible side effects are primarily minor gastrointestinal issues and headaches. There is currently no sufficient data on safety for continuous use over many years.

Why is MSM not allowed to be advertised as "helps the joints"?

Because the EFSA did not classify the health claims submitted for MSM in 2010 as sufficiently scientifically proven. Additionally, German food authorities evaluate the term "joint" in product names or illustrations as potentially misleading, as it suggests a causal relationship that is not sufficiently proven.

Can I combine MSM with glucosamine or collagen?

Yes, this combination is common in practice and is investigated together in several studies. A scientifically clear additional benefit of the combination compared to individual intake has not yet been definitively proven.

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Sources:

• Debbi E. M. et al. (2011): Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study. BMC Complementary and Alternative Medicine, 11:50.
• Brien S., Prescott P., Lewith G. (2011): Meta-Analysis of the Related Nutritional Supplements Dimethyl Sulfoxide and Methylsulfonylmethane in the Treatment of Osteoarthritis of the Knee. Evidence-Based Complementary and Alternative Medicine.
• Liu X. et al. (2018): Dietary supplements for treating osteoarthritis: a systematic review and meta-analysis. British Journal of Sports Medicine.
• Toguchi A. et al. (2023): Methylsulfonylmethane Improves Knee Quality of Life in Participants with Mild Knee Pain: A Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients, 15(13), 2995.
• Han J. et al. (2025): Comparative Effectiveness of Nutritional Supplements in the Treatment of Knee Osteoarthritis: A Network Meta-Analysis. Nutrients, 17(15), 2547.
• EFSA (2010): Scientific Opinion on the substantiation of health claims related to Methylsulphonylmethane (MSM). EFSA Journal, 8(10):1746.
• Verbraucherzentrale / Arbeitskreis Lebensmittelchemischer Sachverständiger der Länder (ALS): Position paper 2016/42 on joint preparations as dietary supplements.
• German Nutrition Society (DGE): Reference values for nutrient intake.