A 2023 rodent study performed nearly a dozen experiments to investigate oral hyaluronic acid bioavailability:

“Hyaluronan (HA) is a simple repeating disaccharide polymer, consisting of glucuronic acid (GlcA) and N-acetylglucosamine (GlcNAc), which is found in all vertebrate tissues as an essential component of the extracellular matrix. In the human body, HA is most abundant in the knee joint, articular cartilage, and skin, where it acts as a lubricant, shock absorber, and moisturizer.

We used ¹³C-hyaluronan combined with LC–MS analysis to compare absorption and metabolism of oral hyaluronan in germ-free and conventional wild-type mice. The presence of Bacteroides spp. in the gut was crucial for hyaluronan absorption.

Specific microorganisms cleave hyaluronan into unsaturated oligosaccharides (<3 kDa) which are partially absorbed through the intestinal wall. The remaining hyaluronan fragments are metabolized into short-chain fatty acids. Unsaturated oligosaccharides and SCFAs are the only metabolites available to the host in vivo.

Our main finding is that depolymerization of orally-administered HA by gut microorganisms is essential for ensuring its bioavailability, and is fully dependent on gut microbiota, since in GF animals high-molecular HA is not absorbed at all. The in vivo fate of HA is not related to the molecular weight of the administered HA (15–1600 kDa), and orally-administered HA does not serve as a nutrition for joints and skin.

Poor bioavailability (~0.2 %) of oral hyaluronan indicates that the mechanism of action is the result of systematic regulatory function of hyaluronan or its metabolites rather than direct effects of hyaluronan at distal sites of action.”

https://www.sciencedirect.com/science/article/abs/pii/S0144861723003454 “Molecular weight and gut microbiota determine the bioavailability of orally administered hyaluronic acid” (not freely available) Thanks to Dr. Matěj Šimek for providing a copy.