Sulphur tablets are most commonly used to reduce joint pain from osteoarthritis, though people also take them for skin health, stronger hair and nails, and general antioxidant support. The vast majority of sulphur tablets sold today contain a compound called MSM (methylsulfonylmethane), an organic form of sulfur that the body can absorb and use. Here’s what the evidence actually shows for each use.
Joint Pain and Osteoarthritis
Joint relief is the most popular and best-studied reason people reach for sulphur tablets. MSM may have anti-inflammatory properties distinct from those of common painkillers like ibuprofen, though the exact mechanism isn’t fully understood.
Several clinical trials have tested MSM specifically for knee osteoarthritis. In a 2011 Israeli study of 50 people, those who took MSM for 12 weeks saw a 21 percent decrease in pain, while the placebo group’s pain actually increased by 9 percent. Overall symptoms improved by 20 percent in the MSM group and worsened by 14 percent in the placebo group. A 2006 trial found a 25 percent reduction in pain with a higher dose, along with improved physical function in the knee, though stiffness only improved slightly compared to placebo.
One particularly useful finding came from a 2004 study in India that compared MSM, glucosamine, and a combination of both. All three groups saw meaningful reductions in pain and swelling after 12 weeks, but the combination of MSM and glucosamine together delivered an additive benefit. This is why you’ll often see the two sold together in joint-support formulas.
An interesting caveat from the research: one study found no change in inflammatory markers in the blood despite patients reporting less pain. This suggests MSM may work through pathways scientists haven’t fully mapped yet.
Hair and Nail Strength
Sulfur is a building block of keratin, the protein that makes up your hair and nails. The theory behind taking sulphur tablets for hair health is straightforward: MSM donates sulfur to keratin molecules, helping strengthen the bonds between them. Without adequate sulfur, keratin can’t form properly.
A 2019 study of 63 people found that oral MSM supplements improved the appearance of both hair and nails. Participants who took 3 grams per day saw quicker, more noticeable results than those taking 1 gram per day. Animal research has also shown that topical MSM promoted hair growth in mice when combined with other compounds, with results depending on how much MSM was applied. The human evidence is still limited, but what exists points in a positive direction.
Skin Conditions
Sulphur has a long history in skin care. In homeopathic medicine, sulphur pellets are specifically indicated for skin problems, and sulphur-based creams and ointments have been used for decades to treat conditions like acne, rosacea, and seborrheic dermatitis. Oral sulphur tablets are sometimes taken alongside topical treatments with the goal of supporting skin from the inside, though clinical evidence for this specific approach is thinner than for joint pain.
How Sulfur Works in Your Body
Sulfur isn’t just a supplement ingredient. It’s an essential element your body needs for several core functions. It gets incorporated into amino acids (the building blocks of protein), particularly two that are critical for tissue repair and antioxidant defense.
One of its most important roles is enabling your body to produce glutathione, often called the body’s “master antioxidant.” Glutathione protects cells from damage and supports detoxification. Your cells build glutathione in a two-step process, and they can’t complete it without cysteine, a sulfur-containing amino acid. The cysteine your cells use comes from the sulfur available in your diet or supplements, making sulfur intake a limiting factor in your antioxidant defenses.
Sulfur also contributes to collagen and connective tissue, which is part of why it shows up in joint and skin supplements. It helps maintain the structural integrity of cartilage, tendons, and skin.
Dosage and What to Expect
There’s no officially established dose for MSM, but clinical trials have used a wide range. For joint pain, most studies used between 1,500 milligrams and 6,000 milligrams per day, typically split into two or three doses. For hair and nails, 3 grams per day appeared more effective than 1 gram. For general supplementation, up to 4 grams daily is considered safe for most people.
If you’re new to sulphur tablets, starting with 500 to 1,000 milligrams three times a day is a reasonable approach. Results in clinical trials generally appeared after 12 weeks of consistent use, so this isn’t a supplement that works overnight. At higher doses, some participants experienced mild bloating and constipation.
Interactions With Medications
MSM can interact with several types of medication. The most important interaction is with blood thinners, including warfarin, apixaban, rivaroxaban, dabigatran, and injectable anticoagulants like enoxaparin. If you take any of these, adding MSM could alter how your blood clots.
MSM may also interact with common over-the-counter pain relievers like ibuprofen and naproxen, as well as other herbal supplements. This is worth keeping in mind since many people who take sulphur tablets for joint pain are also using anti-inflammatory painkillers for the same problem. Long-term safety data for MSM is still limited, which is another reason to pay attention to how your body responds over time.