Condition

Healthy Muscle Aging

Sarcopenia is the gradual loss of muscle mass and strength with age, which raises the risk of weakness, falls and frailty as muscles respond less to protein and activity. Creatine, protein and vitamin D have the strongest evidence behind them, and trials of whey in older women found body fat went down. That whey evidence was limited, from two small studies, and the remaining supplements have moderate support at best.

Sources: PMID 21798863; PMID 36235862

Supplements studied: 14
Graded outcomes: 13
Trials: 21
People studied: 8,442

Evidence by supplement

Strong
Moderate
Limited
Very limited

14 supplements

Chromium

Chromium: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People
	Blood glucose Small Improvement	Improves (the measure goes down)	Small effect	6 studies	35 people
Studies that measured blood glucose Effects of acute chromium supplementation on postprandial metabolism in healthy young menJ Am Coll Nutr · 2004 · PMID 15310739 Effect of Chromium Supplementation on Blood Glucose and Lipid Levels in Patients with Type 2 Diabetes Mellitus: a Systematic Review and Meta-analysisBiol Trace Elem Res · PMID 33783683 Beneficial effects of oral chromium picolinate supplementation on glycemic control in patients with type 2 diabetes: A randomized clinical studyJ Trace Elem Med Biol · PMID 26302914 and 3 more on the Chromium page
	Weight	Changes; see studies		12 studies	70 people
Studies that measured weight Chromium picolinate supplementation in women: effects on body weight, composition, and iron statusNutrition · PMID 17291720 Effect of resistance training with or without chromium picolinate supplementation on glucose metabolism in older men and womenMetabolism · PMID 10337851 Chromium supplementation shortens QTc interval duration in patients with type 2 diabetes mellitusAm Heart J · PMID 15990745 and 9 more on the Chromium page
	Muscle Mass	Improves (the measure goes up)		5 studies	70 people
Studies that measured muscle mass Effects of resistance training and chromium picolinate on body composition and skeletal muscle in older menJ Appl Physiol · 1985 · PMID 9887110 Effects of resistive training and chromium picolinate on body composition and skeletal muscle size in older womenInt J Sport Nutr Exerc Metab · PMID 12187613 The effect of chromium picolinate on muscular strength and body composition in women athletesJ Strength Cond Res · PMID 11710399 and 2 more on the Chromium page
	Insulin	Changes; see studies		1 study	35 people
Studies that measured insulin A pilot study of chromium picolinate for weight lossJ Altern Complement Med · PMID 20192914
	Body Fat	Improves (the measure goes down)			70 people
	Power Output	Improves (the measure goes up)			35 people

Nitrate

Nitrate: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People
	Blood Pressure Small Improvement	Improves (the measure goes down)	Small effect	6 studies	12 people
Studies that measured blood pressure Effect of inorganic nitrate supplementation on blood pressure in older adults: A systematic review and meta-analysisNitric Oxide · PMID 33905826 Effects of short-term dietary nitrate supplementation on blood pressure, O2 uptake kinetics, and muscle and cognitive function in older adultsAm J Physiol Regul Integr Comp Physiol · PMID 23174856 Nitrate Derived From Beetroot Juice Lowers Blood Pressure in Patients With Arterial Hypertension: A Systematic Review and Meta-Analysis.Front Nutr · PMID 35369064 and 3 more on the Nitrate page
	Oxygen Cost of Exercise	Improves (the measure goes up)		2 studies	12 people
Studies that measured oxygen cost of exercise Dietary nitrate supplementation reduces the O2 cost of walking and running: a placebo-controlled studyJ Appl Physiol · PMID 21071588 The effects of dietary nitrate supplementation on endurance exercise performance and cardiorespiratory measures in healthy adults: a systematic review and meta-analysis.J Int Soc Sports Nutr · PMID 34243756
	Cognitive Decline	Improves (the measure goes down)			12 people
	Functionality in Elderly or Injured	Improves (the measure goes up)			12 people

Caffeine

Adrenaline: improves
Blood Lactate (Exercise): changes; see studies
Glycemic Control: improves

Caffeine: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People
	Adrenaline Small Increase	Improves (the measure goes up)	Small effect	2 studies	30 people
Studies that measured adrenaline Effects of caffeine on the metabolic and catecholamine responses to exercise in 5 and 28 degrees CMed Sci Sports Exerc · PMID 8201901 Caffeine can decrease insulin sensitivity in humansDiabetes Care · PMID 11815511
	Blood Lactate (Exercise)	Changes; see studies		4 studies	30 people
Studies that measured blood lactate (exercise) Effect of Caffeine on LT, VT and HRVTInt J Sports Med · PMID 22499570 Metabolic effects of caffeine ingestion and physical work in 75-year old citizens. A randomized, double-blind, placebo-controlled, cross-over studyClin Endocrinol · PMID 16886964 Caffeine and sprinting performance: dose responses and efficacyJ Strength Cond Res · PMID 22388491 and 1 more on the Caffeine page
	Glycemic Control	Improves (the measure goes up)		1 study	30 people
Studies that measured glycemic control Caffeine ingestion decreases glucose disposal during a hyperinsulinemic-euglycemic clamp in sedentary humansDiabetes · PMID 11574419
	Fat Oxidation	Improves (the measure goes up)			30 people

Whey Protein

Body Fat: improves
Muscle Mass: improves
Weight: changes; see studies

Whey Protein: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People
	Body Fat Small Decrease	Improves (the measure goes down)	Small effect	2 studies	807 people
Studies that measured body fat The effects of a higher protein intake during energy restriction on changes in body composition and physical function in older womenJ Gerontol A Biol Sci Med Sci · PMID 21798863 Effect of Whey Protein Supplementation in Postmenopausal Women: A Systematic Review and Meta-Analysis.Nutrients · PMID 36235862
	Muscle Mass	Improves (the measure goes up)		5 studies	776 people
Studies that measured muscle mass The effects of protein and amino acid supplementation on performance and training adaptations during ten weeks of resistance trainingJ Strength Cond Res · PMID 16937979 Effect of protein-supplement timing on strength, power, and body-composition changes in resistance-trained menInt J Sport Nutr Exerc Metab · PMID 19478342 Whey Protein Before and During Resistance Exercise Has No Effect on Muscle Mass and Strength in Untrained Young AdultsInt J Sport Nutr Exerc Metab · PMID 22806076 and 2 more on the Whey Protein page
	Weight	Changes; see studies		4 studies	807 people
Studies that measured weight Effect of whey protein supplementation on weight and body composition indicators: A meta-analysis of randomized clinical trials.Clin Nutr ESPEN · PMID 35871954 Changes in antioxidant status and cardiovascular risk factors of overweight young men after six weeks supplementation of whey protein isolate and resistance trainingAppetite · PMID 22889987 Efficacy and Safety of Whey Protein Supplements on Vital Sign and Physical Performance Among Athletes: A Network Meta-Analysis.Front Pharmacol · PMID 31068804 and 1 more on the Whey Protein page
	Muscle protein synthesis (MPS)	Improves (the measure goes up)		2 studies	33 people
Studies that measured muscle protein synthesis (mps) Ingestion of casein and whey proteins result in muscle anabolism after resistance exerciseMed Sci Sports Exerc · PMID 15570142 Amino acid absorption and subsequent muscle protein accretion following graded intakes of whey protein in elderly menAm J Physiol Endocrinol Metab · PMID 22338070
	Strength	Improves (the measure goes up)		2 studies	776 people
Studies that measured strength Effect of Whey Protein Supplementation on Perioperative Outcomes in Patients with Cancer-A Systematic Review and Meta-Analysis (PROSPERO 2020: CRD42020188666).Nutr Cancer · PMID 34961401 Whey Protein Supplementation with or without Vitamin D on Sarcopenia-Related Measures: A Systematic Review and Meta-Analysis.Adv Nutr · PMID 37196876

L-Carnitine

Blood Carnitine: improves
Muscle Mass: improves
Interleukin 6: improves

L-Carnitine: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People
	Blood Carnitine Large Increase	Improves (the measure goes up)	Large effect	2 studies	20 people
Studies that measured blood carnitine The effects of L-carnitine supplementation on performance during interval swimmingInt J Sports Med · PMID 8063466 L-carnitine supplementation in patients with cystic acne on isotretinoin therapyJ Eur Acad Dermatol Venereol · PMID 10642057
	Muscle Mass	Improves (the measure goes up)		3 studies	20 people
Studies that measured muscle mass Levocarnitine administration in elderly subjects with rapid muscle fatigue: effect on body composition, lipid profile and fatigueDrugs Aging · PMID 12875611 The effect of l-carnitine on fat oxidation, protein turnover, and body composition in slightly overweight subjectsMetabolism · PMID 15281008 L-Carnitine treatment reduces severity of physical and mental fatigue and increases cognitive functions in centenarians: a randomized and controlled clinical trialAm J Clin Nutr · PMID 18065594
	Interleukin 6	Improves (the measure goes down)		2 studies	20 people
Studies that measured interleukin 6 The effect of L-carnitine on inflammatory mediators: a systematic review and meta-analysis of randomized clinical trialsEur J Clin Pharmacol · PMID 30915521 Antiinflammatory effects of L-carnitine supplementation (1000 mg/d) in coronary artery disease patientsNutrition · PMID 25701337
	TNF-Alpha	Improves (the measure goes down)		2 studies	20 people
Studies that measured tnf-alpha L-carnitine supplementation to diet: a new tool in treatment of nonalcoholic steatohepatitis--a randomized and controlled clinical trialAm J Gastroenterol · PMID 20068559 Effects of carnitine supplementation on flow-mediated dilation and vascular inflammatory responses to a high-fat meal in healthy young adultsAm J Cardiol · PMID 18993165
	C-Reactive Protein (CRP)	Improves (the measure goes down)		1 study	20 people
Studies that measured c-reactive protein (crp) L-carnitine ameliorated fasting-induced fatigue, hunger, and metabolic abnormalities in patients with metabolic syndrome: a randomized controlled studyNutr J · PMID 25424121
	Weight	Changes; see studies		1 study	20 people
	IGF-1	Improves (the measure goes up)			20 people
	Strength	Improves (the measure goes up)			20 people

Tongkat Ali

Cortisol: improves
Testosterone: improves
Strength: improves

Tongkat Ali: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People
	Cortisol Small Decrease	Improves (the measure goes down)	Small effect		105 people
	Testosterone	Improves (the measure goes up)		4 studies	105 people
Studies that measured testosterone Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism?Andrologia · PMID 21671978 The effect of Eurycoma Longifolia on the regulation of reproductive hormones in young males.Andrologia · PMID 33559971 Effect of Eurycoma longifolia standardised aqueous root extract-Physta ® on testosterone levels and quality of life in ageing male subjects: a randomised, double-blind, placebo-controlled multicentre studyFood Nutr Res · PMID 34262417 and 1 more on the Tongkat Ali page
	Strength	Improves (the measure goes up)		2 studies	105 people
Studies that measured strength Exercise associated or not to the intake of Eurycoma longifolia improves strength and cardiorespiratory fitness in men with androgen deficiencyComplement Ther Clin Pract · PMID 33445146 Effects of Jack Supplementation Combined with Resistance Training on Isokinetic Muscular Strength and Power, Anaerobic Power, and Urinary Testosterone: Epitestosterone Ratio in Young Males.Int J Prev Med · PMID 31367282
	DHEAS	Improves (the measure goes up)			105 people
	Fatigue Symptoms	Changes; see studies			105 people
	Free Testosterone	Improves (the measure goes up)			105 people
	HbA1c	Changes; see studies			105 people
	IGF-1	Improves (the measure goes up)			105 people
	Sex Hormone Binding Globulin	Improves (the measure goes up)			105 people
	Thyroid-Stimulating Hormone	Improves (the measure goes up)			105 people

Wild Yam

Blood Pressure: improves
Body Mass Index (BMI): improves
HbA1c: improves

Wild Yam: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People
	Blood Pressure Small Improvement	Improves (the measure goes down)	Small effect		66 people
	Body Mass Index (BMI)	Improves (the measure goes down)		1 study	66 people
Studies that measured body mass index (bmi) Dioscorea esculenta Intake with Resistance Training Improves Muscle Quantity and Quality in Healthy Middle-Aged and Older Adults: A Randomized Controlled Trial.Nutrients · PMID 37299401
	HbA1c	Improves (the measure goes down)			66 people
	Heart Rate	Improves (the measure goes down)			66 people
	High-density lipoprotein (HDL)	Improves (the measure goes up)			66 people
	Muscle Mass	Improves (the measure goes up)			66 people
	Muscular Endurance	Improves (the measure goes up)			66 people
	Strength	Improves (the measure goes up)			66 people
	Total cholesterol	Improves (the measure goes down)			66 people

Branched-Chain Amino Acids

Fatigue Symptoms: improves
Muscle Soreness: changes; see studies

Branched-Chain Amino Acids: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People
	Fatigue Symptoms Small Improvement	Improves (the measure goes down)	Small effect		21 people
	Muscle Soreness	Changes; see studies		2 studies	21 people
Studies that measured muscle soreness Does Branched-Chain Amino Acids (BCAAs) Supplementation Attenuate Muscle Damage Markers and Soreness after Resistance Exercise in Trained Males? A Meta-Analysis of Randomized Controlled TrialsNutrients · PMID 34072718 Energy expenditure during 2-day trail walking in the mountains (2,857 m) and the effects of amino acid supplementation in older men and womenEur J Appl Physiol · PMID 21744005

Black Ginger

Anti-Oxidant Enzyme Profile: improves
Functionality in Elderly or Injured: improves
Oxidative Stress Biomarkers: changes; see studies

Black Ginger: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People
	Anti-Oxidant Enzyme Profile Moderate Increase	Improves (the measure goes up)	Moderate effect		45 people
	Functionality in Elderly or Injured	Improves (the measure goes up)		1 study	45 people
Studies that measured functionality in elderly or injured Positive Modulation Effect of 8-Week Consumption of Kaempferia parviflora on Health-Related Physical Fitness and Oxidative Status in Healthy Elderly VolunteersEvid Based Complement Alternat Med · PMID 22899957
	Oxidative Stress Biomarkers	Changes; see studies			45 people

Nicotinamide Mononucleotide

Insulin Resistance
Walking Ability

Nicotinamide Mononucleotide: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Size	Studies	People
	Insulin Resistance No effect	NoneNo effect	2 studies	81 people
Studies that measured insulin resistance A Multicentre, Randomised, Double Blind, Parallel Design, Placebo Controlled Study to Evaluate the Efficacy and Safety of Uthever (NMN Supplement), an Orally Administered Supplementation in Middle Aged and Older Adults.Front Aging · PMID 35821806 Nicotinamide mononucleotide increases muscle insulin sensitivity in prediabetic womenScience · PMID 33888596
	Walking Ability No effect	NoneNo effect	1 study	80 people
Studies that measured walking ability The efficacy and safety of β-nicotinamide mononucleotide (NMN) supplementation in healthy middle-aged adults: a randomized, multicenter, double-blind, placebo-controlled, parallel-group, dose-dependent clinical trial.Geroscience · PMID 36482258

Creatine

Aerobic Exercise Metrics
Power Output: improves
Muscle Mass: improves

Creatine: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People
	Aerobic Exercise Metrics No effect		NoneNo effect	2 studies	16 people
Studies that measured aerobic exercise metrics Creatine supplementation does not enhance submaximal aerobic training adaptations in healthy young men and womenEur J Appl Physiol · PMID 16896727 A randomized, controlled trial of creatine monohydrate in patients with mitochondrial cytopathiesMuscle Nerve · PMID 9390662
	Power Output	Improves (the measure goes up)		44 studies	72 people
Studies that measured power output Comparison of creatine ingestion and resistance training on energy expenditure and limb blood flowMetabolism · PMID 11735088 Creatine, arginine alpha-ketoglutarate, amino acids, and medium-chain triglycerides and endurance and performanceInt J Sport Nutr Exerc Metab · PMID 19033611 The effects of creatine ethyl ester supplementation combined with heavy resistance training on body composition, muscle performance, and serum and muscle creatine levelsJ Int Soc Sports Nutr · PMID 19228401 and 41 more on the Creatine page
	Muscle Mass	Improves (the measure goes up)		5 studies	30 people
Studies that measured muscle mass The Effects of Creatine Supplementation Combined with Resistance Training on Regional Measures of Muscle Hypertrophy: A Systematic Review with Meta-Analysis.Nutrients · PMID 37432300 The Effect of Creatine Supplementation on Resistance Training-Based Changes to Body Composition: A Systematic Review and Meta-analysis.J Strength Cond Res · PMID 39074168 Effects of creatine supplementation on nutritional status, muscle function and quality of life in patients with colorectal cancer--a double blind randomised controlled trialClin Nutr · PMID 16701923 and 2 more on the Creatine page
	Strength	Improves (the measure goes up)		5 studies	1,093 people
Studies that measured strength Efficacy of Creatine Supplementation Combined with Resistance Training on Muscle Strength and Muscle Mass in Older Females: A Systematic Review and Meta-Analysis.Nutrients · PMID 34836013 Creatine Supplementation and Lower Limb Strength Performance: A Systematic Review and Meta-AnalysesSports Med · PMID 25946994 Creatine Supplementation and Upper Limb Strength Performance: A Systematic Review and Meta-Analysis.Sports Med · PMID 27328852 and 2 more on the Creatine page
	Bone Mineral Density	Improves (the measure goes up)		2 studies	1,093 people
Studies that measured bone mineral density Impact of creatine supplementation and exercise training in older adults: a systematic review and meta-analysis.Eur Rev Aging Phys Act · PMID 41062952 Creatine monohydrate and resistance training increase bone mineral content and density in older menJ Nutr Health Aging · PMID 16222402
	Functionality in Elderly or Injured	Improves (the measure goes up)		1 study	16 people
	Body Fat	Improves (the measure goes down)			1,093 people
	Fatigue Resistance	Improves (the measure goes down)			15 people

DHEA

Body Fat
Muscle Mass: improves
Power Output: improves

DHEA: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People
	Body Fat No effect		NoneNo effect		280 people
	Muscle Mass	Improves (the measure goes up)		2 studies	280 people
Studies that measured muscle mass Oral dehydroepiandrosterone replacement in older adults: effects on central adiposity, glucose metabolism and blood lipidsClin Endocrinol · PMID 21521341 Dehydroepiandrosterone (DHEA) effects on HIV replication and host immunity: a randomized placebo-controlled studyAIDS Res Hum Retroviruses · PMID 17263636
	Power Output	Improves (the measure goes up)		1 study	280 people
Studies that measured power output Effect of 1-year oral administration of dehydroepiandrosterone to 60- to 80-year-old individuals on muscle function and cross-sectional area: a double-blind placebo-controlled trialArch Intern Med · PMID 12639206

Arginine

Growth Hormone: improves

Arginine: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Growth Hormone	Improves (the measure goes up)		3 studies	28 people

Beta-Alanine

Fatigue Symptoms: changes; see studies

Beta-Alanine: outcomes studied for Healthy Muscle Aging
Grade	Outcome	Effect	Size	Studies	People	Studies list
	Fatigue Symptoms	Changes; see studies			26 people

Key findings

Blood glucoseChromiumImproves (the measure goes down)
Blood PressureNitrateImproves (the measure goes down)
AdrenalineCaffeineImproves (the measure goes up)

The Healthy Muscle Aging (Sarcopenia Prevention) protocol

2 primary supplements · 5 supporting supplements

Creatine Monohydrate3–5 g daily
Protein (Whey/Leucine-enriched)1.2–1.6 g/kg daily (25–40 g per meal with 2.5–3 g leucine)

See the full protocol

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Studies cited

2 studies from PubMed

The effect of dose, frequency, and timing of protein supplementation on muscle mass in older adults: A systematic review and meta-analysis.Ageing Res Rev · PMID 38830547
Systematic review and meta-analysis of antioxidants with or without exercise training improving muscle condition in older adults.Sci Rep · PMID 41038909

Evidence by supplement

Key findings

The Healthy Muscle Aging (Sarcopenia Prevention) protocol

Shop the evidence-backed picks

Studies cited

Related conditions

Supplement stack for Healthy Muscle Aging