Sarcopenia
Supplements studied for sarcopenia.
Overview
Supplement evidence for sarcopenia is mixed and mostly inconclusive. Branched Chain Amino Acids (BCAAs) (5 studies) combined with exercise may improve muscle strength and size, though benefits appear similar to exercise alone in some trials. L-Carnitine (4 studies) may increase muscle mass in inactive adults over 75 but not in healthier older women.
Vitamin D (2 studies) with protein may modestly improve strength without increasing muscle size. L-Citrulline and Nattokinase have insufficient evidence. See the heatmap and evidence reviews below.
Effect graph
Relevant supplements
Relevant supplements sorted by DEX Score.
| Branched Chain Amino Acids (BCAAs) | ★★★★★ | Low |
| Vitamin D | ★★★★★ | Low |
| L-Carnitine | ★★★★★ | Low |
| Nattokinase | ★★★★★ | Low |
| Garlic | ★★★★★ | Low |
| Nicotinamide Riboside | ★★★★★ | Very Low / None |
| L-Citrulline | ★★★★★ | Very Low / None |
Studies
Find individual evidence reviews for supplements sorted by DEX Score.
7 supplements for and rated at least stars. All purchase bands. No minimum star filter.
Branched Chain Amino Acids (BCAAs)View supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is not clear whether taking branched-chain amino acid (BCAA) supplements helps older adults with muscle loss (sarcopenia), including those with liver disease.
- In some studies, older people who took BCAAs with resistance exercise saw improved muscle strength and size compared to before they started, but these benefits were similar to those seen with alone exercise.
Browse 5 studies·1 meta-analysis
RCTThe efficacy of Sarcomeal® oral supplementation plus vitamin D3 on muscle parameters, metabolic factors, and quality of life in diabetic sarcopenia: a randomized controlled clinical trial2025n=60
A 12-week RCT of 60 diabetic sarcopenia patients found Sarcomeal plus 1,000 IU vitamin D improved skeletal muscle mass index and preserved weight versus control advice alone.
- Effect
- Benefit
- Duration
- 12 weeks
- Dose
- 1000 IU/day
- Population
- RA patients
- Participants
- 60
- Ages
- 50–75
Systematic reviewEffects of branched-chain amino acids on parameters evaluating sarcopenia in liver cirrhosis: systematic review and meta-analysis2022n=1,225
A meta-analysis of 12 studies in 1,225 liver cirrhosis patients found BCAA supplementation improved skeletal muscle index and mid-arm muscle circumference but not handgrip strength.
- Effect
- Benefit
- Population
- Patients with liver cirrhosis
- Participants
- 1,225
RCTEffects of branched-chain amino acid supplementation and resistance training in postmenopausal women2021n=10
An 8-week RCT of 30 postmenopausal women found resistance training increased muscle mass and strength, but adding 9 g/day BCAA did not augment these gains.
- Effect
- No Benefit
- Duration
- 8 weeks
- Dose
- 9 g/day
- Population
- Postmenopausal women
- Participants
- 10
Open-labelImpact of branched-chain amino acid on muscle mass, muscle strength, physical performance, combined survival, and maintenance of liver function changes in laboratory and prognostic markers on sarcopenic patients with liver cirrhosis (BCAAS Study): a randomized clinical trial2021
A 6-month open-label RCT of 106 sarcopenic cirrhosis patients found 7.2 g/day BCAA improved muscle strength, function, and mass more than lactoalbumin and reduced complications.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 7.2 g/day
- Population
- Patients with cirrhosis
RCTEffects of branched-chain amino acids and vitamin D supplementation on physical function, muscle mass and strength, and nutritional status in sarcopenic older adults undergoing hospital-based rehabilitation: a multicenter randomized controlled trial2019n=68
An 8-week multicenter RCT of 68 sarcopenic older rehab patients found BCAA plus vitamin D with low-intensity training improved handgrip, calf circumference, and BMI more than control.
- Effect
- Benefit
- Duration
- 8 weeks
- Population
- Older adults
- Participants
- 68
- Ages
- 65+
L-CarnitineView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Inactive or weaker adults over 75 may gain 2–4 kg of muscle with L-carnitine supplements (2–4 g daily for 1–6 months).
- But in healthy, active women aged 60–70, smaller studies show that L-carnitine, even when combined with leucine and exercise, does not increase strength or muscle size.
- More research is needed.
Browse 4 studies
RCTL-Carnitine Combined with Leucine Supplementation Does Not Improve the Effectiveness of Progressive Resistance Training in Healthy Aged Women2022n=13
In 37 women aged 60–75 completing 24 weeks of resistance training, L-carnitine plus leucine did not improve muscle strength or hypertrophy beyond training alone.
- Effect
- No Benefit
- Duration
- 24 weeks
- Dose
- 1 g/day
- Population
- Women
- Participants
- 13
- Ages
- 60–75
RCTl-Carnitine Supplementation in Older Women. A Pilot Study on Aging Skeletal Muscle Mass and Function2018
In women aged 65–70, 24 weeks of L-carnitine-L-tartrate 1,500 mg/day raised plasma carnitine but did not change skeletal muscle strength, inflammatory markers, or IGF-1 versus placebo.
- Effect
- No Benefit
- Duration
- 24 weeks
- Dose
- 500 mg/day
- Population
- Women
- Ages
- 65–70
RCTL-Carnitine treatment reduces severity of physical and mental fatigue and increases cognitive functions in centenarians: a randomized and controlled clinical trial2007n=34
In 34 centenarians, L-carnitine 2 g/day reduced physical and mental fatigue and improved lipid profiles versus baseline over the treatment period.
- Effect
- Benefit
- Dose
- 2 g/day
- Participants
- 34
RCTLevocarnitine administration in elderly subjects with rapid muscle fatigue: effect on body composition, lipid profile and fatigue2003n=42
In 42 elderly subjects with muscle fatigue, levocarnitine 2 g twice daily for 30 days improved exercise tolerance versus baseline.
- Effect
- Benefit
- Duration
- 30 days
- Dose
- 2 g 2×/day
- Population
- Older adults
- Participants
- 42
Vitamin DView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- It is not clear if vitamin D helps older adults with muscle loss (sarcopenia).
- Studies show taking vitamin D with protein or amino acids for a few months can moderately improve muscle strength but does not increase muscle size or walking speed.
- Some research also suggests vitamin D with protein and exercise might help hand strength and getting up from a chair faster, but it’s uncertain if vitamin D alone is responsible.
- More research is needed.
Browse 2 studies·2 meta-analyses
MetaThe effect of vitamin D plus protein supplementation on sarcopenia: A systematic review and meta-analysis of randomized controlled trials2021n=776
A meta-analysis of 8 RCTs (776 patients) found vitamin D plus protein supplementation improved muscle strength and physical performance in sarcopenia versus control.
- Effect
- Benefit
- Dose
- 1600 IU/day
- Population
- Adults
- Participants
- 776
MetaThe Optimal Strategy of Vitamin D for Sarcopenia: A Network Meta-Analysis of Randomized Controlled Trials2021n=1,420
A network meta-analysis of RCTs (1,420 older adults) found vitamin D supplementation strategies did not consistently rank best for sarcopenia muscle outcomes.
- Effect
- No Benefit
- Population
- Older adults
- Participants
- 1,420
NattokinaseView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- There is not enough evidence to determine if nattokinase has any benefit for sarcopenia.
Browse 2 studies
RCTDaily Supplementation With Whey, Soy, or Whey-Soy Blended Protein for 6 Months Maintained Lean Muscle Mass and Physical Performance in Older Adults With Low Lean Mass2021n=123
In 123 older adults with low lean mass, 6 months of 16 g/day whey, soy, or blended protein maintained appendicular lean mass and physical performance vs habitual diet control.
- Effect
- Benefit
- Duration
- 6 months
- Dose
- 16 g/day
- Population
- Older adults
- Participants
- 123
- Ages
- 65–79
RCTSoy isoflavones, body composition, and physical performance2005
In 202 postmenopausal women, 99 mg/day soy isoflavones for 12 months did not change BMI, waist-to-hip ratio, body composition, or handgrip strength vs milk protein placebo.
- Effect
- No Benefit
- Dose
- 99 mg/day
- Population
- Postmenopausal women
- Ages
- 60–75
GarlicView supplement →
Reconsider purchase·★★★★★
How we scored this▸
- Early research on garlic for sarcopenia is limited.
- A cohort study from the TCLSIH project investigating the association between consumption of Alliaceae vegetables (such as garlic and onions) and the risk of sarcopenia in adults.
- More studies are needed before any benefit can be considered reliable.
Browse 1 study
ObservationalAlliaceae vegetable consumption and sarcopenia: findings from the TCLSIH cohort study2025n=3,623
In 3,623 older adults, higher Alliaceae vegetable consumption was associated with lower sarcopenia prevalence in the TCLSIH cohort study after multivariate adjustment.
- Effect
- Benefit
- Population
- Older adults
- Participants
- 3,623
Nicotinamide RibosideView supplement →
Do not purchase·★★★★★
How we scored this▸
- Research shows that nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR) supplements do not improve muscle size or strength in older adults.
- Studies found no benefits of NMN for muscle strength, walking speed, or other muscle tests.
- While NR helped people with blood flow problems walk longer distances, it did not help, and may have made movement slower, in people with mild memory issues.
- Overall, these supplements do not seem to help maintain muscle health in older adults based on current evidence.
Browse 1 study·1 meta-analysis
MetaThe Effect of Nicotinamide Mononucleotide and Riboside on Skeletal Muscle Mass and Function: A Systematic Review and Meta-Analysis2025n=5
A meta-analysis of NAD+ precursor trials in older adults found NMN/NR did not significantly improve skeletal muscle index, handgrip strength, or gait speed vs placebo.
- Effect
- No Benefit
- Population
- Older adults
- Participants
- 5
- Ages
- 60+
L-CitrullineView supplement →
Do not purchase·★★★★★
How we scored this▸
- There is not enough evidence to determine if L-citrulline has any benefit for sarcopenia.
Browse 2 studies
RCTImpact of high-intensity interval training with or without l-citrulline on physical performance, skeletal muscle, and adipose tissue in obese older adults2022n=25
In 25 older adults, HIIT with or without L-citrulline did not show clear additive benefits on physical performance or skeletal muscle versus HIIT alone.
- Effect
- No Benefit
- Duration
- 12 weeks
- Population
- Older adults
- Participants
- 25
- Avg age
- ~67.2±5.0
RCTL-Citrulline Supplementation and Exercise in the Management of Sarcopenia2021n=22
In 44 adults aged 60–73 in an exercise program, 3 g/day L-citrulline did not clearly improve sarcopenia outcomes beyond physical activity alone.
- Effect
- No Benefit
- Dose
- 3 g/day
- Population
- Older adults
- Participants
- 22
- Ages
- 60–73
Evidence visualised
Same ratings as above, aggregated so you can see coverage and imbalance.
| Supplement | DEX | Studies | Meta-analyses | Share |
|---|---|---|---|---|
| Branched Chain Amino Acids (BCAAs) | ★★★★★52% | 5 | 1 | 29% |
| L-Carnitine | ★★★★★48% | 4 | 0 | 24% |
| L-Citrulline | ★★★★★32% | 2 | 0 | 12% |
| Nattokinase | ★★★★★44% | 2 | 0 | 12% |
| Vitamin D | ★★★★★48% | 2 | 2 | 12% |
| Garlic | ★★★★★40% | 1 | 0 | 6% |
| Nicotinamide Riboside | ★★★★★36% | 1 | 1 | 6% |