Collagen, omega-3, ashwagandha and supplements that support hormones and healthy ageing — evidence-based guidance for South Africans, reviewed by HPCSA-registered dietitians with cited peer-reviewed sources.
Evidence-based content with peer-reviewed sources cited in each section.
Click any section below to expand the full content, including protocols, evidence and cited sources.
Healthy ageing and hormonal support is one of the fastest-growing supplement categories, driven by an ageing population and interest in longevity. The evidence varies dramatically by compound. Omega-3 (EPA/DHA) and vitamin D have the strongest evidence for healthy ageing. Collagen peptides have growing evidence for skin and joint health. Adaptogens (ashwagandha, rhodiola) have emerging but not conclusive evidence. Many “anti-ageing” supplements (resveratrol, NMN, NAD+ precursors) have promising animal data but limited human evidence.
The principle: no supplement reverses ageing. Exercise, sleep, nutrition and stress management are the proven anti-ageing interventions. Supplements may provide marginal additional benefit once the fundamentals are in place. Longo and Panda (2016) and the Harvard Study of Adult Development confirm lifestyle dominates supplement effects.
Strong evidence (ageing)
• Omega-3 (heart, brain, inflammation)
• Vitamin D (bone, immune, muscle)
• Protein (sarcopenia prevention)
• Creatine (muscle, brain in elderly)
• Calcium (bone, diet-first)
Emerging / weak evidence
• Collagen (skin, joints — moderate)
• Ashwagandha (stress, cortisol — moderate)
• Resveratrol (animal data, human weak)
• NMN/NR (NAD+ — early human trials)
• DHEA (banned in sport, weak evidence)
The fundamentals of healthy ageing
Exercise (aerobic + resistance) is the single most powerful anti-ageing intervention — maintaining muscle, bone, cardiovascular and cognitive health. Sleep (7-9 hours) drives cellular repair and hormone balance. A Mediterranean-style diet (omega-3, polyphenols, fibre) supports inflammation control. Stress management protects cortisol balance. Supplements add 5-10% on top of these fundamentals — they do not replace them.
1Longo VD, Panda S. Fasting, circadian rhythms, and time-restricted feeding in healthy lifespan. Cell Metab. 2016;23(6):1048-1059.
Collagen is the most abundant protein in the body — found in skin, tendons, ligaments, cartilage and bone. Proksch et al. (2014) and Clark et al. (2008) showed that hydrolysed collagen peptides (2.5-15g/day for 8+ weeks) improve skin elasticity, hydration and reduce joint pain in athletes. Khatri et al. (2016) and Laus et al. (2015) confirmed skin benefits. The mechanism: collagen peptides stimulate fibroblast and chondrocyte collagen production. However, collagen is low in tryptophan — it is not a complete protein and should not replace dietary protein.
For Skin
2.5-5g hydrolysed collagen daily for 8-12 weeks. Proksch et al. (2014) showed improved skin elasticity and hydration. Type I collagen is most relevant for skin. Combine with vitamin C (required for collagen synthesis). Results are modest — not dramatic.
For Joints
10-15g collagen peptides daily for 3+ months. Clark et al. (2008) showed reduced joint pain in athletes. May benefit those with osteoarthritis or joint stress from training. Type II collagen is most relevant for cartilage. Evidence is moderate — not conclusive.
For Tendon/Ligament
Emerging evidence (Shaw et al. 2017) that collagen peptides (15g with vitamin C, 1 hour before exercise) may support tendon repair and reduce injury risk. Relevant for athletes with chronic tendon issues. Evidence is early-stage.
Collagen is supplementary, not a replacement
Collagen peptides are low in tryptophan (an essential amino acid) — they are not a complete protein. Do not replace whey, meat or other complete proteins with collagen. Use collagen as an add-on for skin/joint health, alongside your regular protein intake. Combine with vitamin C for collagen synthesis.
1Proksch E, Segger D, Degwert J, Schunck M. Oral supplementation of specific collagen peptides improves skin texture. Skin Pharmacol Physiol. 2014;27(1):47-55.
2Clark KL, Sebastianelli W, Flechsenhar KR, et al. 24-Week study on the use of collagen hydrolysate. Int J Sports Med. 2008;29(9):759-766.
3Khatri M, Naughton DP, O'Kane M, et al. The evaluation of nutraceutical supplements for skin health. J Cosmet Dermatol. 2016;15(4):e437-e444.
Omega-3 fatty acids (EPA and DHA) from fish oil or algal oil have the broadest evidence base of any supplement — cardiovascular health, brain function, inflammation, joint health and muscle preservation. Kris-Etherton et al. (2002) AHA scientific statement confirmed cardiovascular benefits. Mozaffarian and Wu (2011) reviewed the mechanisms. For healthy ageing, omega-3 supports brain health (DHA is a major brain structural component), reduces inflammation, and may preserve muscle mass. Philpott et al. (2018) showed omega-3 enhances the muscle protein synthesis response.
Cardiovascular Health
Reduces triglycerides (20-30%), slightly increases HDL, reduces blood pressure modestly, and lowers cardiovascular event risk. Kris-Etherton et al. (2002). AHA recommends 1g EPA+DHA/day for cardiovascular health. The REDUCE-IT trial (2018) showed high-due EPA (4g) reduces cardiovascular events in high-risk patients.
Brain and Cognitive Health
DHA is a major structural component of the brain. Low omega-3 is associated with cognitive decline and depression. supplementation (1-2g EPA+DHA) may support cognitive function in older adults — evidence is moderate, not conclusive. Useful for healthy ageing of the brain.
Muscle and Recovery
Philpott et al. (2018) showed omega-3 supplementation (2-4g EPA+DHA) enhances the anabolic response to protein in older adults — relevant for sarcopenia prevention. Also reduces exercise-induced inflammation and DOMS. 2-4g/day for athletes and older adults.
Sources and Dose
Fish oil (sardines, salmon, mackerel) or algal oil (vegan). Aim for 1-4g EPA+DHA daily. Check the label — many cheap fish oils have low EPA+DHA despite high total oil. Look for at least 500mg EPA+DHA per capsule. Take with fat-containing meals for absorption.
Omega-3 is the one supplement most adults should consider
Omega-3 has the strongest evidence of any supplement for broad health benefits — cardiovascular, brain, inflammation and muscle. SA diets are often low in oily fish (sardines, mackerel, salmon). If you eat oily fish 2-3 times per week, supplementation is less critical. If not, 1-2g EPA+DHA daily from fish or algal oil is well-supported.
2Mozaffarian D, Wu JHY. Omega-3 fatty acids and cardiovascular disease. J Am Coll Cardiol. 2011;58(20):2047-2067.
3Philpott JD, Donnelly C, Walshe IH, et al. Metabolic insights and the effect on MPS. Front Nutr. 2018;5:67.
4Bhatt DL, Steg PG, Miller M, et al. REDUCE-IT trial. N Engl J Med. 2019;380(1):11-22.
Adaptogens are herbs and roots claimed to help the body adapt to stress. Ashwagandha (Withania somnifera) is the most researched, with Chandrasekhar et al. (2012) showing cortisol reduction and stress symptom improvement. Salve et al. (2019) and Wankhede et al. (2015) showed potential benefits for sleep, anxiety and testosterone (in men). However, the evidence is moderate — not conclusive — and many studies are small and industry-funded. Rhodiola rosea and panax ginseng have weaker evidence.
Ashwagandha (KSM-66 or Sensoril)
300-600mg of standardised extract daily. Chandrasekhar et al. (2012) showed 22% cortisol reduction and improved stress scores over 60 days. May improve sleep quality and mild anxiety. Some studies show modest testosterone increase in men (Wankhede et al. 2015). Avoid in autoimmune conditions and pregnancy. Evidence is moderate.
Rhodiola Rosea
200-400mg standardised extract. Some evidence for reducing fatigue and improving stress adaptation (Ishaque et al. 2012). Evidence is weaker than ashwagandha. AIS Group C (not enough evidence for recommendation).
Panax Ginseng
200-400mg. Traditional use for energy and vitality. Evidence is mixed — some studies show mild fatigue reduction, others show no effect. Can interact with blood thinners and blood sugar medications. AIS Group C.
Adaptogens are not a substitute for stress management
Ashwagandha and other adaptogens may provide modest stress support, but they do not replace the fundamentals: adequate sleep, regular exercise, mindfulness/meditation, social connection, and addressing the root causes of stress. If you have chronic stress, anxiety or depression, consult a mental health professional — not just a supplement.
1Chandrasekhar K, Kapoor J, Anishetty S. A prospective, randomized double-blind, placebo-controlled study of ashwagandha on stress. Indian J Psychol Med. 2012;34(3):255-262.
2Wankhede S, Langade D, Joshi K, et al. Examining the effect of Withania somnifera supplementation on muscle strength and recovery. J Int Soc Sports Nutr. 2015;12:43.
3Salve J, Pate S, Debnath K, Langade D. Adaptogenic and anxiolytic effects of ashwagandha. Cureus. 2019;11(12):e6418.
Hormonal health — testosterone, thyroid, cortisol, insulin — is central to healthy ageing and wellbeing. No legal supplement dramatically boosts hormones in healthy individuals. Zinc and vitamin D support testosterone production when deficient. Ashwagandha may modestly reduce cortisol. DHEA is a prohormone with weak evidence and is banned in sport. The most effective hormonal support is lifestyle: adequate sleep, healthy body fat, resistance training, stress management and avoiding extreme diets.
Zinc (8-15mg/day)
Zinc deficiency reduces testosterone. Prasad et al. (1996) showed zinc supplementation in deficient men restores testosterone. If you are zinc-replete, additional zinc does not further boost testosterone. Vegetarians, vegans and heavy sweaters are at higher risk of deficiency. Food sources: oysters, beef, pumpkin seeds.
Vitamin D and Hormones
Vitamin D deficiency is associated with low testosterone in men. Correcting deficiency may restore normal testosterone. If you are replete, more vitamin D does not further boost hormones. Test and supplement to optimal levels (75-125nmol/L).
DHEA (Avoid)
Dehydroepiandrosterone is a prohormone marketed for anti-ageing and testosterone support. Evidence is weak for benefit in healthy adults, and it is banned by WADA. Can cause hormonal imbalances, acne and hair loss. Avoid unless prescribed by an endocrinologist for a specific condition.
The natural hormone optimisers
For testosterone and hormonal health: sleep 7-9 hours (most testosterone is produced during sleep), maintain healthy body fat (both excess and very low fat impair hormones), do resistance training (boosts testosterone acutely), manage stress (chronic cortisol suppresses testosterone), eat adequate dietary fat and zinc, and avoid crash diets. These produce far more hormonal benefit than any supplement.
1Prasad AS, Mantzoros CS, Beck FW, et al. Zinc status and serum testosterone levels of healthy adults. Nutrition. 1996;12(5):344-348.
2Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357(3):266-281.
The anti-ageing supplement market is booming with compounds like resveratrol, NMN (nicotinamide mononucleotide), NR (nicotinamide riboside) and curcumin. Longo and Panda (2016) note that while animal studies are promising, human evidence is limited. The concern with high-dose antioxidant supplementation: it may blunt the beneficial adaptations from exercise (the hormesis principle — some oxidative stress is a signal for adaptation). Peternelj and Coombes (2011) documented that antioxidant supplements can reduce training adaptations.
Resveratrol
Found in red wine and grapes. Animal studies show lifespan extension, but human trials are disappointing — poor bioavailability and no clear benefit. Not recommended based on current evidence.
NMN and NR (NAD+ Precursors)
NAD+ is essential for cellular energy and repair. Levels decline with age. NMN and NR are being studied as NAD+ boosters. Early human trials (Irie et al. 2019) show safety and modest NAD+ elevation, but clinical benefits are not yet demonstrated. Promising but experimental — not ready for routine use.
Curcumin (Turmeric)
Anti-inflammatory compound from turmeric. Needs piperine (black pepper extract) or lipid formulation for absorption. Modest evidence for reducing inflammation and joint pain. Daily et al. (2016). Not a longevity cure — a mild anti-inflammatory.
The Antioxidant Paradox
High-dose antioxidant supplements (vitamin C, vitamin E) may blunt exercise adaptations by neutralising the oxidative stress signals that trigger mitochondrial biogenesis and muscle adaptation. Peternelj and Coombes (2011). Get antioxidants from food (fruit, vegetables, tea) rather than high-dose supplements if you train hard.
The anti-ageing supplement reality
No supplement has been proven to extend human lifespan. The "blue zones" (longest-living populations) achieve longevity through diet, movement, social connection, purpose and moderate calorie intake — not pills. If you are interested in longevity, invest in exercise, sleep, Mediterranean-style eating, stress management and social connection before spending on resveratrol, NMN or other experimental compounds.
1Longo VD, Panda S. Fasting, circadian rhythms, and time-restricted feeding in healthy lifespan. Cell Metab. 2016;23(6):1048-1059.
3Irie J, Inagaki E, Fujita M, et al. Effects of oral administration of nicotinamide mononucleotide. Endocr J. 2019;67(6):653-660.
4Daily JW, Yang M, Park S. Efficacy of turmeric extracts and curcumin. J Med Food. 2016;19(8):717-729.
Supplement
Evidence
Best For
Recommend
Omega-3 (EPA/DHA)
Strong
Heart, brain, muscle
Yes (1-4g)
Vitamin D
Strong
Bone, immune, hormones
Yes (if deficient)
Collagen peptides
Moderate
Skin, joints
Maybe (2.5-15g)
Ashwagandha
Moderate
Stress, cortisol
Maybe (300-600mg)
Curcumin
Moderate
Inflammation
Maybe
Zinc
Moderate
Testosterone (if deficient)
If deficient
Resveratrol
Weak (human)
Nothing proven
No
NMN/NR
Early/experimental
NAD+ (trial stage)
No (yet)
DHEA
Weak/banned
Nothing (risky)
No
South Africa’s life expectancy has improved significantly (now ~65 years), and the population is ageing. Healthy ageing — maintaining function, independence and quality of life — is increasingly important. SA dietary patterns often lack omega-3-rich fish and adequate vegetables. Local sources: sardines and mackerel (affordable oily fish), biltong (protein, zinc), pumpkin seeds (magnesium, zinc), morogo (folate, magnesium), rooibos (antioxidants, caffeine-free), and citrus (vitamin C). The SA Department of Health promotes active ageing through community programmes.
Sardines and mackerel — affordable SA oily fish, omega-3, protein, calcium (bones)
Biltong and game — protein, zinc, iron for sarcopenia prevention
Maas (amasi) — protein, calcium, probiotics for gut and bone
The SA ageing priority: protein and movement
For South Africans focused on healthy ageing, the priorities are: adequate protein (1.0-1.2g/kg to prevent sarcopenia), resistance training (maintains muscle and bone), omega-3 (1-2g from sardines or supplements), and vitamin D (if indoor). These fundamentals far outweigh any exotic anti-ageing supplement.
1Bloom DE, et al. Global Ageing and Health. Lancet. 2015;385(9967):e1-e3.
The anti-ageing supplement market is full of exaggerated claims. No legal supplement reverses ageing. “Longevity” supplements (resveratrol, NMN, NAD+) have promising animal data but limited human evidence. Be sceptical of products promising dramatic results. Invest in proven interventions: exercise, sleep, nutrition, stress management.
Adaptogen Interactions
Ashwagandha, rhodiola and ginseng can interact with medications (thyroid, blood sugar, blood pressure, immunosuppressants). Avoid adaptogens in autoimmune conditions, pregnancy and breastfeeding without medical advice. Start with low doses and monitor effects.
Antioxidant-Exercise Blunting
High-dose antioxidant supplements (vitamin C 1g+, vitamin E 400IU+) may blunt exercise adaptations by neutralising the oxidative stress signals that trigger mitochondrial biogenesis and muscle adaptation. Peternelj and Coombes (2011). If you train hard, get antioxidants from food rather than high-dose supplements.
Fish Oil Quality
Many cheap fish oil products are oxidised (rancid) or have low EPA+DHA. Choose products with third-party testing (IFOS), check the EPA+DHA content per capsule, and store in a cool, dark place. Algal oil is a quality vegan alternative.
When to see a professional
If you are experiencing hormonal symptoms (low testosterone, thyroid issues, menopause), chronic stress, or are interested in healthy ageing supplements — consult an HPCSA-registered dietitian or doctor. They can test for deficiencies, check hormone levels, review medication interactions and recommend evidence-based supplements. Hormonal symptoms deserve medical investigation, not self-supplementation.
Connect with HPCSA-registered dietitians, GPs, endocrinologists and pharmacists across South Africa for evidence-based ageing and hormonal supplement guidance.
Healthy Ageing and Hormonal Support for South Africans
Healthy ageing and hormonal support is one of the fastest-growing supplement categories. HealthLab’s guide brings together the strongest evidence — from the Kris-Etherton omega-3 AHA statement and the Proksch collagen research to the Chandrasekhar ashwagandha trials and the Longgo and Panda longevity science. We cover collagen peptides (skin and joints), omega-3 (the most evidence-backed supplement for ageing), ashwagandha and adaptogens (stress and cortisol), hormonal support supplements (zinc, vitamin D), and antioxidants and anti-ageing compounds (resveratrol, NMN, NAD+). The principle is clear: no supplement reverses ageing. Exercise, sleep, Mediterranean-style eating and stress management are the proven anti-ageing interventions — supplements provide marginal additional benefit. Our evidence-based content, reviewed by HPCSA-registered dietitians, provides honest, balanced and locally relevant guidance for South Africans navigating the ageing supplement market.
