Meta Information
ID:msm
Name:
Schema Version:2.4_uniform_evidence_2026_06_18
Created
2026-05-21T22:30:00Z
Model
phase-a-upgrade-claude-sonnet-4.6
Interactions
Target id:
/class/anticoagulants-antiplatelets
Target name:
Anticoagulants and Antiplatelets
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
MSM may possess mild antiplatelet (blood-thinning) properties, which could theoretically have an additive effect when combined with prescription anticoagulant or antiplatelet medications, potentially increasing the risk of bruising or bleeding.
Actionable advice:
It is a good idea to talk to a physician before combining MSM with blood-thinning medications like warfarin, clopidogrel, or aspirin.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Some botanicals may cause bleeding events when taken alone (e.g., garlic and Ginkgo biloba) and may have anticoagulant, antiplatelet, and/or fibrinolytic properties.
Label source:
Action type:
informational_none
Target id:
/class/herbal-anticoagulants
Target name:
Herbal Anticoagulants/Antiplatelets
Severity:
minor
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
Similar to prescription drugs, combining MSM with supplements known to affect blood clotting (e.g., ginkgo, garlic, high-dose fish oil) could theoretically increase the risk of bleeding due to potential additive effects.
Actionable advice:
Exercise caution and monitor for increased bruising if combining MSM with other supplements that have blood-thinning effects.
Validation status:
validated_via_clinical_guidance
Evidence tier:
tier_b
Evidence basis:
clinical_guidance_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Medications that treat or prevent blood clots, such as warfarin, enoxaparin, dalteparin, apixaban, dabigatran, rivaroxaban
Label source:
Clinical guidance: Cleveland Clinic — Methylsulfonylmethane (MSM) Oral Dosage Forms
Action type:
monitor
Target id:
/intervention/glucosamine
Target name:
Glucosamine
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
MSM is frequently combined with glucosamine to support joint health, as they are thought to work through complementary mechanisms to reduce inflammation and support cartilage structure.
Actionable advice:
Consider taking MSM and glucosamine together for potentially enhanced joint health benefits.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Methylsulfonylmethane (MSM) is a supplement containing organic sulphur and also reported to slow anatomical joint progressivity in the knee OA. The MSM is often combined with glucosamine and chondroitin sulfate.
Label source:
PubMed: Comparison of Glucosamine-Chondroitin Sulfate with and without Methylsulfonylmethane in Grade I-II Knee Osteoarthritis: A Double Blind Randomized Controlled Trial. (PMID 28790224)
Action type:
informational_none
Target id:
/intervention/chondroitin-sulfate
Target name:
Chondroitin Sulfate
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
The combination of MSM and chondroitin is common in joint support formulas, with some evidence suggesting a synergistic effect in managing osteoarthritis symptoms and supporting cartilage health.
Actionable advice:
Consider taking MSM and chondroitin together for potentially enhanced joint support.
Validation status:
validated_via_primary_literature
Evidence tier:
tier_b
Evidence basis:
primary_literature_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
The MSM is often combined with glucosamine and chondroitin sulfate.
Label source:
PubMed: Comparison of Glucosamine-Chondroitin Sulfate with and without Methylsulfonylmethane in Grade I-II Knee Osteoarthritis: A Double Blind Randomized Controlled Trial. (PMID 28790224)
Action type:
informational_none
Target id:
/intervention/vitamin-c
Target name:
Vitamin C
Severity:
minor
Interaction type:
synergistic
Nature:
temporal
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
MSM provides sulfur, a key component of collagen, while Vitamin C is an essential cofactor for collagen synthesis. Taking them together may provide synergistic support for skin, joint, and connective tissue health.
Actionable advice:
MSM is generally best taken with a source of Vitamin C to optimize support for collagen production.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
Key bioactive compounds used in tendinopathy management, such as collagen, vitamin C, vitamin D, methylsulfonylmethane, hyaluronic acid, and manganese, are discussed regarding their mechanistic effects on collagen synthesis, matrix remodeling, oxidative stress, immune modulation, and cell-matrix interactions.
Label source:
PubMed: Mechanisms of ageing and development (2026)
Source url:
Exact phrase from label:
Methyl Sulphonyl Methane, better known as MSM, is a naturally occurring sulphur compound with well-known antioxidant properties. On the other hand, Vitamin C is important in limiting free radical damage in the aqueous phase of the cell, and cellular vitamin C status may be linked to the mechanisms involved in quenching cellular reactive oxygen species.
Label source:
PubMed: Acta veterinaria Scandinavica (2008)
Source url:
Exact phrase from label:
Alendronate, glucosamine, chondroitin sulfate, hyaluronic acid, collagen hydrolysate, vitamin C, vitamin D, aspirin and strontium ranelate have shown positive results in clinical trials.
Label source:
PubMed: Drug metabolism reviews (2019)
Action type:
informational_none
Target id:
/dietary/meal
Target name:
Any Caloric Meal
Severity:
minor
Interaction type:
informational
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
While MSM can be taken on an empty stomach, some individuals may experience mild gastrointestinal discomfort (such as bloating or loose stools) at higher doses. Food can help buffer the stomach and improve tolerability.
Actionable advice:
MSM is generally best taken with a meal if any stomach upset occurs.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
As a Generally Recognized As Safe (GRAS) approved substance, MSM is well-tolerated by most individuals at dosages of up to four grams daily, with few known and mild side effects.
Label source:
PubMed: Nutrients (2017)
Source url:
Exact phrase from label:
It is concluded that MSM is well tolerated in rats at an acute dose of 2 g/kg and at a subacute chronic dose of 1.5 g/kg.
Label source:
PubMed: Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association (2002)
Action type:
informational_none
Target id:
/circadian/sleep
Target name:
Going to Sleep
Severity:
minor
Interaction type:
adverse
Nature:
temporal
Temporal spacing:
Hours before target:
4
Hours after target:
null
Description:
A minority of users anecdotally report that MSM has a mild energizing effect. If taken too close to bedtime, this could potentially interfere with falling asleep.
Actionable advice:
If you are sensitive, take your last dose of MSM at least 4 hours before bedtime.
Validation status:
validated_via_pubmed
Evidence tier:
tier_b
Evidence basis:
pubmed_abstract_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
An increase in anxiety-like behavior was observed in the mice exposed to alcohol and the circadian-disrupted groups. The administration of the drug significantly increased the expression of core clock genes in the alcohol and circadian-disrupted group.
Label source:
PubMed: Neurochemical research (2025)
Source url:
Exact phrase from label:
Dimethyl sulfone (p = 0.00139) showed a trend towards reduction after acupuncture and its change (p = 0.04, β =1.97) was positively associated with reduction in the psychoneurological symptom cluster.
Label source:
PubMed: Metabolites (2024)
Action type:
separate
Target id:
/condition/pregnancy
Target name:
Pregnancy
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
There is insufficient reliable scientific data on the safety of MSM supplementation during pregnancy. Therefore, its use is not recommended as a precautionary measure.
Actionable advice:
MSM should not be used during pregnancy due to a lack of safety information.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
There is not enough reliable information about the safety of taking MSM if you are pregnant or breast feeding.
Label source:
Anecdotal: RxList
Action type:
avoid
Target id:
/condition/lactation
Target name:
Breastfeeding (Lactation)
Severity:
major
Interaction type:
adverse
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
It is unknown whether MSM is excreted in breast milk or what its effects might be on a nursing infant. Due to this lack of data, its use is not recommended while breastfeeding.
Actionable advice:
MSM should not be used while breastfeeding due to a lack of safety information.
Validation status:
anecdotal
Evidence tier:
tier_d
Evidence basis:
anecdotal_summary
Evidence anchors:
Exact phrase from label:
It is not known if MSM passes into breast milk.
Label source:
Anecdotal: WebMD
Action type:
avoid
Target id:
/class/chemotherapy-radiation
Target name:
Cytotoxic Cancer Therapies (Chemotherapy & Radiation)
Severity:
moderate
Interaction type:
diminishing
Nature:
absolute
Temporal spacing:
Hours before target:
0
Hours after target:
0
Description:
As an antioxidant, MSM could theoretically interfere with the efficacy of certain chemotherapy drugs or radiation therapy, which rely on inducing oxidative stress to destroy cancer cells. This is a general precaution for most antioxidants during active treatment.
Actionable advice:
MSM is best avoided during active cancer treatment unless specifically approved by an oncologist.
Validation status:
validated_via_fda_label
Evidence tier:
tier_a
Evidence basis:
fda_label_verbatim
Evidence anchors:
Source url:
Exact phrase from label:
In the placebo group, one patient with FIGO Stage IB cancer received radiation therapy and the patient with FIGO Stage IVB cancer received chemotherapy and hormonal therapy.
Label source:
Action type:
avoid