Does urolithin A improve muscle health with age?
Short answer
Unclear: small trials, mixed results.
In a few small trials, urolithin A improved some strength and endurance tests. But the two trials in middle-aged and older adults missed their main goals, and pooled walking results showed no clear gain.
This page says what the research shows. It does not say whether you should take urolithin A.
Where the evidence stands
Each dot is one on-topic paper. Steps near the top answer the question more directly. Select a dot to see the study.
↑ Stronger evidence
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Trials in people: muscle strength and endurance
Trials that measured muscle strength, endurance and mitochondrial health directly.
0Not done yet. This is the step that would answer the question.
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Trials in people: other measures
Trials that measured other health or performance measures.
4 -
Trials in people: lab tests or safety
Trials that measured lab tests, side effects or safety.
0None among the papers we read.
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Population studies
Studies that followed or surveyed groups of people. They show links, not causes.
0None among the papers we read.
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Blood levels and genes
Studies that link blood levels or genes to health.
0None among the papers we read.
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Animals
Studies in mice, rats, worms or flies.
2 -
Cells in a dish
Studies of cells grown in a lab.
1
↓ Weaker evidence
- Points to benefit
- Mixed
- No difference
- No direction
- Points to harm
Not on the ladder: 2 reviews of many studies (shown below). Counts are papers, not people. Some studies appear in more than one paper.
See every studyWhat we found
- Four placebo-controlled trials in people tested urolithin A on muscle: two in middle-aged or older adults (one with 66 people) and two in trained male athletes (20 and 42). Singh 2022, Liu 2022, Zhao 2024, Whitfield 2025
- Three trials gave 1000 mg (1 g) a day; one compared two doses with placebo. Trials lasted from 4 weeks to 4 months. Liu 2022, Zhao 2024, Whitfield 2025, Singh 2022
- Three of the four trials had employees of Amazentis SA, maker of Mitopure, among their authors. Amazentis sponsored two of them. Singh 2022, Liu 2022, Whitfield 2025
- A 2024 review said urolithin A raised strength and endurance; a 2026 pooled analysis called those results exploratory and found no clear walking gain. Kuerec 2024, Dao 2026
What the research says
Strength rose in some tests, not others
In middle-aged adults, muscle strength rose ∼12% with urolithin A over 4 months. In 20 weight-trained men, holding strength and reps to failure improved more than with placebo after 8 weeks, but bench press and squat maximums did not clearly differ.
Studies: Singh 2022, Zhao 2024
Trials in aging adults missed their main goals
In 66 adults aged 65 to 90, walk distance rose 60.8 m with urolithin A and 42.5 m with placebo, a gap the trial could not tell apart from chance. Energy (ATP) production in muscle also did not differ.
Hand and leg muscles did more contractions before tiring at 2 months, a secondary measure. In middle-aged adults, peak power output, the trial's main goal, did not improve.
Studies: Liu 2022, Singh 2022
No race gain in trained runners
In 42 highly trained male runners given 1000 mg a day for 4 weeks, 3000 m race times did not improve, and gains in aerobic capacity did not differ from placebo. A blood marker of muscle damage after running was lower, and runs felt easier.
Studies: Whitfield 2025
Markers moved, but energy output did not
Trials found lower blood markers of inflammation (CRP) and of poor mitochondrial efficiency (acylcarnitines), and more mitophagy proteins in muscle. These are stand-ins, not strength or endurance. Direct tests of mitochondrial function and maximal ATP production showed no change.
Studies: Singh 2022, Liu 2022, Whitfield 2025, Kuerec 2024
Animal and cell studies show possible ways it works
In 2016, urolithin A improved exercise capacity in two mouse models of age-related muscle decline and in young rats. In mice weakened by sepsis, it improved muscle force (215 vs. 244 mN/mm2) and mitochondrial oxygen use (81 vs. 106 pmol/s/mg).
In muscle cells from 9 donors aged 55 to 96, urolithin A changed 1918 genes, mainly in energy and inflammation pathways. Lab results like these do not show what happens in aging people.
Studies: Ryu 2016, Pierre 2025, Henrotin 2026
What reviews of many studies found
Reviews pool or sum up earlier studies. They are not on the ladder, because they repeat studies already counted there.
Pooled review (meta-analysis) · Dao 2026
Combined five randomized trials (236 people). Only the 6-minute walk could be pooled, from two trials: +17.03 m, with a likely range of -5.33 to 39.40 m, which includes no effect. Certainty was rated low.
Systematic review · Kuerec 2024
Reviewed five studies in 250 healthy people taking 10-1000 mg/day for 28 days to 4 months, without pooling. Urolithin A raised muscle strength and endurance but not physical function, and did not change maximal mitochondrial ATP production.
How the research grew
The papers we read span 2016 to 2026. 6 of the 9 on-topic papers came out in 2024 to 2026. The earliest trial in people here is from 2022.
- 2016
- 2022
- 2024
- 2025
- 2026
Each dot is one on-topic paper, colored by what it found. Rings mark key papers:
- 2016. Early study: urolithin A improved rodent exercise capacity. Ryu 2016
- 2022. Middle-aged trial: strength up, main goal missed. Singh 2022
- 2022. Trial in adults 65 to 90 missed main goals. Liu 2022
- 2025. Elite runner trial: no race time gain. Whitfield 2025
- 2026. Pooled analysis of five trials: walking gain unclear. Dao 2026
Doses tested
3 trial papers gave a set daily amount in g a day, from 1 to 1. Each dot shows the dose and what the trial found.
- g a day00.20.40.60.811.2
- Points to benefit
- Mixed
- No difference
- No direction
- Points to harm
One row per paper, so a trial reported in two papers appears twice.
Not shown: 1 trial paper with no single daily dose in the abstract, or a different unit.
Who funds this research
Three of four human trials had Amazentis SA employees among their authors; Amazentis, maker of Mitopure, sponsored two. The one trial without a stake also found some strength gains, so confidence was not lowered for stake. Both reviews declared no company ties.
- Company stake 3
- No stake declared 1
- Singh 2022Company stake
- Liu 2022Company stake
- Whitfield 2025Company stake
- Zhao 2024No stake declared
Funding rule. A stake is always shown. Confidence is lowered only when every supporting study comes from a party with a stake. "No disclosure in PubMed" means the PubMed record has no conflict-of-interest statement. It does not mean there is no conflict.
All 9 on-topic papers
Each paper shows what it tested, what it found, and who has a stake. Every paper also has its own page that explains how much it counts and how it fits. See every study as a list.
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Randomized trial · other health measuresWhitfield et al., 2025Sports medicine (Auckland, N.Z.) · PubMed
Evaluating the Impact of Urolithin A Supplementation on Running Performance, Recovery, and Mitochondrial Biomarkers in Highly Trained Male Distance Runners.
42 people · 42 young, highly trained male distance runners at an altitude camp
Tested1000 mg urolithin A a day for 4 weeks, vs placebo
The 3000 m time trial did not improve in either group (UA p = 0.116, placebo p = 0.771). Aerobic capacity gain did not differ between groups (p = 0.138). Muscle damage marker CK was lower with UA (p < 0.0001).
No differenceCompany stakeAbstract onlyAmazentis SA, maker of Mitopure (urolithin A), sponsored and funded the study; three authors are its employees and one got its travel support.
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Randomized trial · other health measuresZhao et al., 2024Journal of the International Society of Sports Nutrition · PubMed
Assessment of Urolithin A effects on muscle endurance, strength, inflammation, oxidative stress, and protein metabolism in male athletes with resistance training: an 8-week randomized, double-blind, placebo-controlled study.
20 people · 20 male athletes who do weight training
Tested1 g urolithin A a day for 8 weeks, vs placebo
Versus placebo, bench press and squat maximums rose but not clearly (p = 0.462; p = 0.710). Isometric strength (p = 0.048) and reps to failure (p = 0.011) improved more. CRP fell more (p = 0.032).
MixedNo stake declaredAbstract onlyNo potential conflict of interest was reported.
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Urolithin A improves muscle strength, exercise performance, and biomarkers of mitochondrial health in a randomized trial in middle-aged adults.
Middle-aged adults
TestedUrolithin A (Mitopure) at two doses for 4 months, vs placebo
Muscle strength rose ∼12% with urolithin A. Peak power output, the main goal, did not clearly improve. Blood markers of poor mitochondrial efficiency and of inflammation fell, and muscle mitophagy proteins rose.
MixedCompany stakeAbstract onlyAuthors are employees, board members or advisers of Amazentis SA, which makes Mitopure and sponsored the trial.
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Effect of Urolithin A Supplementation on Muscle Endurance and Mitochondrial Health in Older Adults: A Randomized Clinical Trial.
66 people · Adults aged 65 to 90, mostly women
Tested1000 mg urolithin A a day for 4 months, vs placebo
Walk distance rose 60.8 (67.2) m with urolithin A and 42.5 (73.3) m with placebo, not a clear difference. Hand and leg muscle endurance was better at 2 months. Some blood markers, including CRP, fell.
MixedCompany stakeAbstract onlySeveral authors were employees, the CEO, board chair, shareholders or patent holders of Amazentis SA, maker of Mitopure (urolithin A).
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Sepsis Induces Long-Term Muscle and Mitochondrial Dysfunction due to Autophagy Disruption Amenable by Urolithin A.
Mice that survived a severe infection (sepsis), plus muscle data from human ICU survivors
TestedUrolithin A given to mice after sepsis, and to cells
In sepsis-surviving mice, urolithin A improved muscle force (215 vs 244 mN/mm2) and muscle weight, and raised energy-making in mitochondria (81 vs 106 pmol/s/mg).
Points to benefitNo stake declaredAbstract onlyThe authors declare no conflicts of interest.
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Urolithin A induces mitophagy and prolongs lifespan in C. elegans and increases muscle function in rodents.
Roundworms, plus young rats and mouse models of age-related muscle decline
TestedUrolithin A by mouth in worms and rodents
Urolithin A extended worm lifespan and kept worms moving. In two mouse models of age-related muscle decline and in young rats, it improved exercise capacity.
Points to benefitNo disclosure in PubMedAbstract onlyNo disclosure in PubMed.
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Exploring the Impact of Urolithins A and B on Muscle Health: A Transcriptomic Analysis in Human Myotubes.
Muscle cells grown in a dish from 9 donors aged 55 to 96
TestedUrolithin A or B at 5 μM for 24 hours on muscle cells; gene activity measured
UA and UB changed 1918 and 339 genes. UA mainly affected energy-making and inflammation pathways. No strength or endurance test in people.
No directionNo stake declaredAbstract onlyThe authors declare no conflicts of interest.
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Effects of Urolithin A supplementation on muscle health outcomes in humans from randomized controlled trials.
5 studies, 236 people · People in five small trials with different health backgrounds
TestedUrolithin A by mouth vs placebo, pooled for the 6-minute walk test
Pooling two trials for the 6-minute walk gave +17.03 m (95% CI -5.33 to 39.40 m; p = 0.135), low certainty. Strength, endurance and marker results were not pooled and called exploratory.
No differenceNo stake declaredAbstract onlyAuthors declared no commercial or financial relationships.
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Targeting aging with urolithin A in humans: A systematic review.
5 studies, 250 people · 250 healthy people in five studies
TestedUrolithin A at 10 to 1000 mg a day for 28 days to 4 months
Across 250 people, urolithin A increased muscle strength and endurance but not physical function, body measures or heart outcomes. It did not change maximal mitochondrial energy (ATP) production. Unrelated adverse events were mild or moderate.
MixedNo stake declaredAbstract onlyFunding disclosed from the Lien Foundation (not a company). No company tie stated.
26 papers we read and set aside as off topic
- Wang et al., 2024. Age-related sarcopenia and altered gut microbiota: A systematic review. (systematic review)
- Tow et al., 2022. The Therapeutic Relevance of Urolithins, Intestinal Metabolites of Ellagitannin-Rich Food: A Systematic Review of In Vivo Studies. (systematic review)
- Lippi et al., 2022. Impact of nutraceuticals and dietary supplements on mitochondria modifications in healthy aging: a systematic review of randomized controlled trials. (systematic review)
- Frye et al., 2026. Mechanistic pathways linking gut microbial metabolites, microbial structural products, and host-microbe co-metabolites to mitochondrial function. (systematic review)
- Denk et al., 2025. Effect of the mitophagy inducer urolithin A on age-related immune decline: a randomized, placebo-controlled trial. (randomized trial)
- Jamialahmadi et al., 2024. Evaluation of Urolithin A Efficacy in Heart Failure Patients with Reduced Ejection Fraction: A Randomized, Double-blind, Crossover, Placebo-controlled Clinical Trial. (randomized trial)
- Yaskolka Meir et al., 2023. The effect of polyphenols on DNA methylation-assessed biological age attenuation: the DIRECT PLUS randomized controlled trial. (randomized trial)
- Singh et al., 2022. Direct supplementation with Urolithin A overcomes limitations of dietary exposure and gut microbiome variability in healthy adults to achieve consistent levels across the population. (randomized trial)
- Meroño et al., 2022. The relevance of urolithins-based metabotyping for assessing the effects of a polyphenol-rich dietary intervention on intestinal permeability: A post-hoc analysis of the MaPLE trial. (randomized trial)
- Kaplan et al., 2022. The effect of a high-polyphenol Mediterranean diet (Green-MED) combined with physical activity on age-related brain atrophy: the Dietary Intervention Randomized Controlled Trial Polyphenols Unprocessed Study (DIRECT PLUS). (randomized trial)
- da Costa Pinaffi-Langley et al., 2026. Urolithin A and Endothelial and Cerebrovascular Function in Middle-Aged Adults With Obesity: A Randomized Clinical Trial. (randomized trial)
- Martínez-Sánchez et al., 2017. Consumption of Watermelon Juice Enriched in l-Citrulline and Pomegranate Ellagitannins Enhanced Metabolism during Physical Exercise. (randomized trial)
- Galkina et al., 2026. Microbiota-derived urolithins and cortical thickness in cognitively healthy older adults: a longitudinal MRI analysis of the WAHA trial. (randomized trial)
- Rodríguez-García et al., 2025. Microbiota-derived urolithin A in monoclonal gammopathies and multiple myeloma therapy. (population study: followed a group)
- Waltz et al., 2018. Sarcopenia, Aging and Prospective Interventional Strategies. (opinion or narrative review)
- Bae et al., 2025. Distinct classes of gut bacterial molybdenum-dependent enzymes produce urolithins. (cell study)
- An et al., 2023. Urolithins: A Prospective Alternative against Brain Aging. (opinion or narrative review)
- Cortés-Martín et al., 2018. The gut microbiota urolithin metabotypes revisited: the human metabolism of ellagic acid is mainly determined by aging. (population study: one-time survey)
- Tavartkiladze et al., 2026. A Dysbiosis-Urolithin A Depletion-Low 6-Sulfatoxymelatonin Triad as a Composite Biomarker Framework Across Age-Related Vascular and Malignant Disease States. (population study: one-time survey)
- Gao et al., 2026. Deoxycholic acid impairs mitochondrial fitness and suppresses mitophagy through Parkin ubiquitination driving CD8+ T cell Exhaustion in Colorectal Cancer. (animal study)
- Rzeski et al., 2026. Natural Bioactive Compounds Targeting Key Hallmarks of Aging: Functional Food Potential of Spermidine, Fisetin, Berberine, and Urolithin A. (opinion or narrative review)
- Fang et al., 2019. Mitophagy inhibits amyloid-β and tau pathology and reverses cognitive deficits in models of Alzheimer's disease. (animal study)
- Hou et al., 2024. Urolithin A improves Alzheimer's disease cognition and restores mitophagy and lysosomal functions. (animal study)
- Gao et al., 2022. Urolithin A protects against acetaminophen-induced liver injury in mice via sustained activation of Nrf2. (animal study)
- Denk et al., 2022. Expansion of T memory stem cells with superior anti-tumor immunity by Urolithin A-induced mitophagy. (animal study)
- Kang et al., 2024. Urolithin A's Role in Alleviating Severe Acute Pancreatitis via Endoplasmic Reticulum-Mitochondrial Calcium Channel Modulation. (animal study)
Words on this page
- 95% CI (confidence interval)
- The range where the true result likely lies. If the range includes no effect (1 for ratios, 0 for differences), the result is not clear.
- p-value (p =)
- How likely a result this large would be by chance if there were no real effect. Below 0.05 is usually called a clear result.
- Placebo
- A dummy pill or fake treatment, so people do not know which group they are in.
- Pooled review (meta-analysis)
- A study that combines the results of many earlier studies to get one overall answer.
- Marker
- A lab or scan result that stands in for a health outcome. A better marker does not always mean better health.
How the short answer is set
Fixed rules turn the studies into the short answer, so the same studies always give the same answer. The rules start from GRADE, a standard system for rating evidence, in plain language.
| Confidence | What it means |
|---|---|
| High | We are confident the answer is right. |
| Moderate | The answer is probably right, but it could change. |
| Low | The answer may well change. |
| Very low (this page) | Any answer is very uncertain. |
| Not tested in people | Only cell or animal studies exist. |
Why very low here
- Trials were small, 20 to 66 people, and one gave no size.
- Both trials in middle-aged and older adults missed their main goals.
- The only pooled result, from two trials, includes no effect.
- Two of four trials studied trained athletes, not aging adults.
How this page was made
Label
- Search
- PubMed, Nov 14, 2026. Searches written by Claude Opus 5.5; papers ranked by PubMed
- First read of all 35 papers
- Claude Sonnet
- Independent second read
- Claude Haiku
- Disagreements settled by
- Claude Opus 5.5
- Page text written by
- Claude Opus 5.5
- Charts
- Drawn by code from the study records
- Source check by a person
- Not yet. Required before search engines may list this page.
- Expert review
- No
- Papers read in full
- 0 of 35; all from PubMed abstracts
- Method
- v0.2, created Nov 14, 2026
Search. We ran four PubMed searches for urolithin A and muscle strength, endurance and mitochondrial health: pooled and systematic reviews since 2012 (6 of 6), trials in people (13 of 13), population studies (10 of 10), animal studies (6 of 100). The first number is how many papers we read; the second is how many PubMed found. We took the ones PubMed ranks as most relevant. See the full PubMed search. Of the 35 papers read, 9 were on topic.
Limits. Digestery reads at most about 60 papers per question, so large fields are sampled, not covered in full. Abstracts can leave out key details, such as side effects and funding.
Review queue
These items wait for a person. Search engines are asked not to list the page until the first one is done.
- OpenThe short answer is new. It waits for a source check by a person.
- OpenDenk 2025 (immune trial, 1000 mg/day, Amazentis-funded) measured mitochondrial markers in immune cells only; left off-topic. Confirm mitochondrial health means muscle only.
- OpenReviews Kuerec 2024 and Dao 2026 likely include trials Singh 2022 and Liu 2022; avoid counting the same trials twice.
- OpenSingh 2022 abstract gives no sample size or doses; Dao 2026 mentions 500 mg and 1,000 mg arms of Singh et al.
- OpenZhao 2024: CRP rose from baseline in the urolithin A group yet fell versus placebo; check the full text.
- OpenSingh 2022 and Liu 2022 missed primary goals but both reads set direction mixed; by the primary-outcome rule it may be none.
- OpenRyu 2016 has no conflict statement in PubMed; check the full paper for company ties.
- OpenWhitfield 2025 (young runners) and Pierre 2025 (sepsis mice) are indirect for aging; kept relevant because they test urolithin A on muscle.
Page history
| Date | Change | Reason |
|---|---|---|
| Nov 14, 2026 | Page created from 35 papers. | First version of the page. |
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