Muscle, Strength & Healthy Aging

Written by Dr. Ryan Kneessi, ND

The mechanisms this protocol supports

Muscle is maintained by muscle protein synthesis, and the amino acid leucine helps switch it on through a nutrient sensing pathway called mTOR. With age, muscles respond less strongly to protein and exercise, which researchers call anabolic resistance.

Muscle cells also rely on healthy mitochondria, and mitophagy is the process that recycles worn-out mitochondria so new ones can take their place. Chronic low-grade inflammation and low vitamin D status both make it harder to hold on to muscle.

Meta-analyses have linked creatine combined with resistance training with greater gains in lean mass and strength in older adults than training alone, and randomized trials have linked urolithin A with better muscle endurance. Research has also linked low muscle mass and strength with falls and fractures in older adults, which is why this matters so much.

What is in the protocol

The exact products and directions are listed in the Fullscript plan, and here is what each one is commonly used to support.

• Creatine from Thorne supports the rapid recycling of ATP, the energy currency of muscle and brain cells. It is one of the most researched supplements for strength and lean mass.
• Whey Protein Isolate from Thorne is rich in leucine, which helps trigger muscle protein synthesis, and it makes it easier to reach daily protein goals.
• Mitopure from Timeline provides urolithin A, which supports mitophagy, the recycling of worn-out mitochondria.
• ProOmega-D from Nordic Naturals provides the omega-3 fats EPA and DHA along with vitamin D. Research has linked omega-3 fats with a stronger muscle-building response to protein in older adults.
• Vitamin D + K2 Liquid from Thorne provides vitamin D, which immune, muscle and bone cells all rely on, together with vitamin K2, which helps direct calcium into bone.

Related protocols you may find helpful include GLP-1 Agonist Side Effect Support and Cellular Energy & Recovery.

How to use it thoughtfully

Please talk with your provider before starting, especially if you take medications, are pregnant or nursing, or have a health condition. This page does not list amounts, so follow the label or the specific guidance your provider gives you. When you can, add one product at a time so it is easier to notice how you feel. Sleep, nourishing food, daily movement and stress care are the foundation, and supplements are meant to build on them.

If you have kidney disease, please talk with your provider before using creatine or protein supplements. Whey protein contains dairy. Vitamin K2 can interact with warfarin, so please check with your prescriber before starting if you take a blood thinner.

What the research shows

This protocol has not been tested as a whole in a clinical trial, so the studies below cover its main ingredients.

Creatine works best alongside strength training. A 2014 meta-analysis by Devries and Phillips pooled trials with 357 older adults, average age about 64, who did resistance training for about 12 weeks. Adding creatine increased lean mass and chest and leg press strength more than training alone, and improved a chair-stand test. The trials were short.

Protein supports training gains. A 2018 meta-analysis by Morton and colleagues of 49 trials with 1,863 adults found that protein supplements during resistance training modestly increased strength (about 2.5 kg on a one-rep max) and lean mass (about 0.3 kg). Benefits leveled off above about 1.6 g/kg of daily protein and were smaller in older adults.

Frequently asked questions

Sources

• Breen L, Phillips SM. Skeletal muscle protein metabolism in the elderly: Interventions to counteract the ‘anabolic resistance’ of ageing. Nutr Metab (Lond) 2011. PMID: 21975196. https://pmc.ncbi.nlm.nih.gov/articles/PMC3201893/
• Chilibeck PD, et al. Effect of creatine supplementation during resistance training on lean tissue mass and muscular strength in older adults: a meta-analysis. Open Access J Sports Med 2017. PMID: 29138605. https://pmc.ncbi.nlm.nih.gov/articles/PMC5679696/
• Liu S, et al. Effect of Urolithin A Supplementation on Muscle Endurance and Mitochondrial Health in Older Adults: A Randomized Clinical Trial. JAMA Netw Open 2022. PMID: 35050355. https://pmc.ncbi.nlm.nih.gov/articles/PMC8777576/
• Smith GI, et al. Dietary omega-3 fatty acid supplementation increases the rate of muscle protein synthesis in older adults: a randomized controlled trial. Am J Clin Nutr 2011. PMID: 21159787. https://pmc.ncbi.nlm.nih.gov/articles/PMC3021432/
• Yeung SSY, et al. Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle 2019. PMID: 30993881. https://pmc.ncbi.nlm.nih.gov/articles/PMC6596401/

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