Welcome to Paging Dr. Gupta. You know, I really do look forward to this part of the week. It's my chance to connect with you, hear what's on your mind, and dig into the health topics that matter the most to you. As a bonus, you get to hear what's on other people's minds as well. And you've been sending in some great questions lately. Jesse's back with us. Who do we have first?

All right, our first question today is coming from Michelle in New York.

Hi Sanjay. I've been seeing a lot of ads for collagen supplements and I know several women my age who take collagen in various forms. Are there any benefits to adding collagen along with my other supplements?

'Alright, Michelle, thank you for this question. No doubt supplements of all kinds are extremely popular. In fact, according to the FDA, more than three-quarters of Americans take at least one. And collagen is one of the buzzier supplements, if you will. It's important that we understand the potential, though, of what collagen can do and the limits of what it can do as well. So I'll break down the theory and the reality of collagen right after the break. Alright, Michelle wants to know if there are any benefits to taking collagen supplements. And I think I'm going to start by answering this part of the question. What is collagen? So collagen is a protein. Okay, and it's one of the most abundant proteins in your body. Roughly 30% of your body's protein is collagen. There are many different types of collagen, at least 28, but the most common is type 1. And that's the collagen that provides structure to your skin, your bones, your tendons, your ligaments. It does this by building strong, flexible fibrous networks. Think of that almost like scaffolding. Your body makes collagen naturally, but production does decline as you age. And that's probably the most popular reason people take collagen supplements in hopes of sort of preserving skin elasticity as they age. So now that you know what collagen is, here's the basic thinking behind taking collagen. The idea is that the supplements they make up the difference in the collagen that we lose naturally. The thinking goes that after your gut absorbs the collagen from a supplement, some of that might travel the tissues like your skin, and then help boost production of new collagen there. Beyond your skin, theoretically, collagen supplements could also potentially increase bone mineral density, cartilage volume overall in your body, and those things are helpful as we age because stronger bones mean better mobility and smoother cartilage means less joint pain. But now the important question are collagen supplements going to really address all that? Are they the real deal? And truth is, there's not enough scientific proof to be certain of that. There have been a couple of promising studies in recent years. In 2021, the International Journal of Dermatology published a review, an analysis of 19 studies that had more than 1,100 participants. Findings in that study suggested that people who use collagen supplements did see an improvement in firmness, suppleness, and moisture content of their skin, and also their wrinkles appeared less noticeable. But, as often happens with these studies, it was unclear if these skin improvements were actually caused by the collagen. Because most trials used commercially available supplements that had more than just collagen in them. They had vitamins and minerals and antioxidants, so it was hard to parse out exactly what was providing the benefit. There was a meta-analysis out of Taiwan in 2023 looking at 26 studies which found similar findings, which were improvements in skin hydration and elasticity. But again, that analysis also noted that large-scale randomized trials are required to truly understand whether or not there are clinical benefits of oral collagen supplements. So in one case, the studies weren't powered enough to really make a conclusion, and in the other study, it wasn't just the collagen being studied, so we don't know if the collagen alone was providing benefit. Some studies have had some promising results that suggest collagen might reduce pain and stiffness in people with osteoarthritis, but again, these are small studies and not conclusive. So what do you do with all that? Let me make a couple of points. First, I always think about harm first. I want to make sure that whatever is being recommended by someone to you, it's not going to cause you harm. And these collagen supplements are not typically associated with adverse side effects. However, manufacturers often combine collagen with other ingredients like herbal extracts, and that could potentially interact with some commonly prescribed medications. Or might be unsafe, for example, in women who are pregnant or nursing. The other thing to keep in mind, if your main concern is healthy skin, is that dermatologists say the best thing you can do to protect the collagen you do have is to wear sunscreen every day and take good care of your skin. Keep in mind things like smoking and consuming too much sugar. They're both known to weaken collagen production. So next time you reach for that candy, think about your skin. One last thing that I always mention about supplements in general. You should know that the FDA does not regulate these supplements the same way they approve drugs. This means they don't approve supplements before supplements are sold to the public. They can only really come off the market if they're proven to cause harm. So, you know, when you're talking about supplements, you do have to do your homework. And I think really importantly, buy from reputable brands. These are brands that have been around for a long time and have withstood the test of time. If you want to learn more about that, check out our episode called Did You Take Your Vitamins Today? And it's going to teach you a lot about supplement safety. Okay, up next, we're going to dig into something known as transcranial magnetic stimulation, TMS. Figuring out what it is and who it might help, stay with us. Alright, I know that sounds. Another question has landed. Jesse, what's up next?

All right, our next question today is from Maria in California, and it's right up your alley. It's about neuroscience. Check it out.

Hi, Dr. Sanjay Gupta. My son was recommended TMS therapy transcranial magnetic stimulation. And I'm wondering what your thoughts on that for helping with depression.

'Alright, Maria, let me give you the quick bottom line first. TMS is a well-supported non-invasive treatment option for major depressive disorder. It's FDA approved, it's generally considered safe, may have some mild to moderate side effects like scalp discomfort or headaches. TMS is often recommended when standard treatments for depression, like medications and psychotherapy, have not worked. So it's not always a first-line therapy, but again, it does have this FDA approval and it does have this evidence behind it. Now, I know you hear the term transcranial magnetic stimulation, and that might sound pretty intense, but it's a common treatment. So let me break it down. First of all, what is TMS? TMS uses focused magnetic pulses to stimulate specific brain regions with the goal of changing brain activity patterns that are linked to a person's mood. So you're stimulating specific regions because you know they're linked to mood. Basically, an insulated electromagnetic coil is placed against the scalp and that delivers the magnetic pulses. Treatments are typically five days a week for six weeks, and sessions last between three and thirty minutes. So, you know, it's a commitment, certainly to do this. If you're curious about the specific areas of the brain that we're talking about, there's an area that's called the left dorsolateral prefrontal cortex. That has been shown to be underactive in people with depression. So, as part of TMS therapy, your practitioner could target that area. Now, I want to be clear here. I don't think we fully understand the exact biology or mechanism of how TMS works, but we do know from outcome studies that it can be effective. How effective? About 60% of people who didn't respond to other treatments for depression did respond well to TMS. And in fact, more than half of those patients stayed in remission at their six-month follow-up appointment after stopping TMS. That's pretty good data. I do want to be clear, it may not be for everyone. People who've had a history of seizures or head injuries or substance abuse, they may be at higher risk for side effects. One thing I'll also point out because of the FDA approval and the accumulating evidence, at this point, most insurance companies will cover TMS therapy. So that's something to be mindful of as well. You know, TMS to me, especially as a neuroscientist, is a great example of how technology can provide hope to those who might feel stuck or out of good options after trying traditional treatments. So Maria, look, your son's doctor recommended TMS. It's worth seriously considering it. But I think I'd also encourage you to have a detailed conversation with your son and the doctor about what exactly the treatment plan would look like, how long it's going to be, what the commitment is like, what the side effects might be. Also, does TMS fit alongside current medications or therapy? Or is this replacing that entirely? That's a good question to ask up front as well. And you know, keep in mind, it's not a cure all. Even though there is good data, it's not going to work for everyone. And I think you have to have that in the back of your mind going in just to set your expectations. Look, I know conversations like this can feel overwhelming. So one thing that can help is take a little time beforehand to jot down a list of questions so you feel prepared and make sure you cover everything you want to ask at the next appointment. Maria, I hope this helps. You certainly are not alone. So thank you for reaching out to us today. That's all the time we have for today's episode. Thank you to everyone who sent in questions, your curiosity, your stories, your voices. That's what brings this show to life. Keep the questions coming. If there's something health-related you've been wondering about, send it to us and we might answer it even next week. Record a voice memo, email it to AskSanjay@CNN.com, or give us a call 470-396-0832 and leave a message. Thanks so much for listening.