Mineral

    Sulfur

    MSM / elemental sulfur

    TL;DR

    Dietary sulfur deficiency is essentially unheard of; what people actually buy is MSM, which has small randomized trials showing modest joint-pain relief and little else.

    Ideal For

    • People with mild osteoarthritis pain wanting a low-risk adjunct

    Avoid If

    • You expect hair, skin or nail benefits — that evidence does not exist

    Frequently Asked Questions

    Overview

    Sulfur is the third most abundant mineral in the body, built into cysteine and methionine, the disulfide bridges that hold keratin and collagen together, glutathione, chondroitin sulfate and the sulfation pathways of phase II detoxification. None of that means supplementing it is useful, because sulfur is supplied abundantly by protein intake and true deficiency does not occur outside severe malnutrition. In practice "sulfur supplements" means methylsulfonylmethane, a small oxidized sulfur compound that crosses membranes easily and shows up in trials for osteoarthritis and exercise recovery. Those trials are small, short and often industry-funded, but they lean in the same direction: modest WOMAC pain improvement at 3-6 g/day. Claims about hair, nails and skin trace back to sulfur being present in keratin rather than to any controlled outcome data. Elemental sulfur itself is used topically for acne and scabies, an entirely separate and better-established use.

    How It Works

    • Supplies sulfur for glutathione synthesis and phase II sulfation
    • Contributes to disulfide crosslinks in keratin and connective tissue
    • MSM suppresses NF-kB signalling and IL-6/TNF-alpha release in vitro

    Quick Facts

    • Dietary deficiency does not occur with adequate protein intake
    • MSM joint trials use 3-6 g/day, far above any dietary amount
    • Topical sulfur for acne is a different, better-supported use

    Benefits & Outcomes

    No linked outcomes yet. Research is ongoing.

    Health Concerns Addressed

    Joint Pain

    symptom
    Mixed evidence
    Effectiveness 3/5

    Consistent direction of effect at 3-6 g/day, but trials are small, brief and often industry-linked, so the true effect size is uncertain.

    Supporting Research
    12 studies

    Does glucosamine, chondroitin sulfate, and methylsulfonylmethane supplementation improve the outcome of temporomandibular joint osteoarthritis management with arthrocentesis plus intraarticular hyaluronic acid injection. A randomized clinical trial.

    Score: 7/10
    2021
    rct
    n=26

    Comert Kilic S

    Three months of glucosamine, chondroitin and MSM after arthrocentesis plus intra-articular hyaluronic acid gave no additional improvement in pain, maximum mouth opening or joint sounds at 12 months compared with the procedure alone.

    View source

    Comparison of Glucosamine-Chondroitin Sulfate with and without Methylsulfonylmethane in Grade I-II Knee Osteoarthritis: A Double Blind Randomized Controlled Trial

    Score: 6/10
    2017
    rct
    n=147

    Lubis AMT, et al

    In 147 patients with grade I-II knee osteoarthritis, adding methylsulfonylmethane to glucosamine-chondroitin sulfate for 12 weeks produced greater improvement in WOMAC pain and function scores than glucosamine-chondroitin alone, though the between-group difference was modest and both arms improved substantially.

    View source

    Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study

    Score: 6/10
    2011
    rct
    n=50

    Debbi EM, Agar G, Fichman G

    MSM 3.4 g/day for 12 weeks produced small but statistically significant improvements in WOMAC pain and function versus placebo, of uncertain clinical importance.

    View source

    Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial

    Score: 5/10
    2006
    rct
    n=50

    Kim LS, Axelrod LJ, Howard P

    MSM 3 g twice daily improved WOMAC pain and physical function versus placebo without notable adverse events.

    View source

    Methylsulfonylmethane: applications and safety of a novel dietary supplement

    Score: 6/10
    2017
    systematic_review

    Butawan M, Benjamin RL, Bloomer RJ

    MSM shows anti-inflammatory and antioxidant activity with a good safety profile across doses up to 4 g/day, but clinical trials remain small.

    View source

    Effect of methylsulfonylmethane supplementation on exercise-induced muscle damage and oxidative stress

    Score: 4/10
    2012
    rct
    n=18

    Barmaki S, Bohlooli S, Khoshkhahesh F

    MSM reduced markers of exercise-induced muscle damage and oxidative stress after eccentric exercise.

    View source

    Methylsulfonylmethane for seasonal allergic rhinitis: a pilot multicenter open-label study

    Score: 2/10
    2002
    observational
    n=50

    Barrager E, Veltmann JR, Schauss AG +1 more

    Respiratory and total symptom scores fell over 30 days of MSM 2600 mg/day, with no change in inflammatory biomarkers.

    View source

    Effects of sulfur bath on hip osteoarthritis: a randomized, controlled, single-blind, follow-up trial

    Score: 5/10
    2016
    rct
    n=48

    Kovacs C, Pecze M, Tihanyi A +3 more

    Sulfurous balneotherapy provided additional symptomatic benefit in hip osteoarthritis.

    View source

    Balneotherapy (or spa therapy) for rheumatoid arthritis and osteoarthritis

    Score: 8/10
    2007
    systematic_review

    Verhagen AP, Bierma-Zeinstra SMA, Boers M +4 more

    Evidence for sulfur and mineral balneotherapy in arthritis is positive but of insufficient quality to be conclusive.

    View source

    Balneotherapy for rheumatoid arthritis

    Score: 8/10
    2015
    systematic_review

    Verhagen AP, Bierma-Zeinstra SMA, Boers M +4 more

    There is insufficient evidence that sulfur balneotherapy improves rheumatoid arthritis outcomes.

    View source

    Sulfur and its derivatives in dermatology: insights into therapeutic applications - a narrative review

    Score: 5/10
    2025
    systematic_review

    Chen YJ, Tang J, Wang L +1 more

    Sulfur remains a useful low-cost dermatologic agent, chiefly topically rather than as an oral supplement.

    View source

    The use of methylsulfonylmethane-containing products in dermatology: an evidence-based systematic review of safety and efficacy

    Score: 5/10
    2026
    systematic_review

    Dermatologic Therapy Review Group

    Organosulfur supplementation shows preliminary dermatologic benefit but needs larger trials.

    View source

    Safety Information

    Potential Side Effects

    Bloating, gas, loose stools, occasional headache or insomnia at higher doses.

    Contraindications

    No absolute contraindications established; safety data beyond 12 weeks is thin.

    Pregnancy & Breastfeeding

    Pregnancy: insufficient_data

    Breastfeeding: insufficient_data

    Dosage Guidelines

    Dosage Used in Studies

    Consult healthcare provider

    Best Time to Take

    Split morning and evening

    Best Form

    MSM powder or capsules, distilled grade

    Bioavailability

    MSM is well absorbed and crosses the blood-brain barrier; elemental sulfur is poorly absorbed

    Forms Compared

    The form used in nearly all human trials

    Dermatological use for acne and rosacea

    No clinical evidence; laxative and gas effects likely

    Food & Timing

    With meals to reduce gastrointestinal upset

    Medical Disclaimer

    The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or before starting any supplement regimen.

    Individual results may vary. The statements on this website have not been evaluated by the Food and Drug Administration. Products and information are not intended to diagnose, treat, cure, or prevent any disease.