Sarcopenia: The Evidence-Based Supplement Protocol

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Sarcopenia — age-related muscle mass and function loss — accelerates after age 60 and predicts mortality, disability, and falls. Resistance training is the single most effective intervention. Among supplements, protein-leucine, vitamin D, creatine, and HMB have credible geriatric trial evidence.

Whey Protein + Leucine, 25–40 g per Serving × 3 Daily

The PROVIDE and other trials in older adults established that anabolic resistance — the diminished muscle protein synthesis response to dietary protein in aging — requires higher per-meal protein and a leucine threshold of ~3 g per serving. Effective protocols target 1.2–1.6 g protein/kg/day from whey protein, leucine-fortified, distributed across 3 meals. See our sarcopenia protein piece.

Vitamin D — Repletion to 30+ ng/mL

Vitamin D deficiency is associated with sarcopenia and falls. The 2018 STRIDE secondary analysis showed vitamin D repletion modestly improved muscle function in deficient adults. Treat the deficiency. See vitamin D piece.

Creatine Monohydrate, 5 g Daily

The 2018 meta-analysis of 22 trials in older adults showed creatine 5 g/day plus resistance training increased lean mass and strength significantly more than resistance training alone. Effect roughly doubles the strength gains from training. See our creatine and aging piece.

HMB (β-Hydroxy-β-Methylbutyrate), 3 g Daily

HMB has positive RCT evidence in sarcopenic populations, particularly in bedridden or hospitalized elderly where muscle loss accelerates. The 2018 meta-analysis showed HMB attenuates muscle loss in older adults. Effect smaller than protein + resistance training but additive. See HMB piece.

Omega-3, 2 g EPA + DHA Daily

Omega-3 augments muscle protein synthesis response to amino acids in older adults. Effect on independent muscle mass smaller, but adds to the anabolic stack.

What NOT to Take

Avoid testosterone-boosting supplements — they don't work and ashwagandha-thyroid interaction is real. Skip "longevity peptides" without prescription. Avoid SARMs entirely — illegal and dangerous. Don't replace resistance training with supplements — training is the dominant driver. Skip BCAA-only products in favor of complete protein.

How to Run the Protocol

Resistance training 2–3×/week is the foundation — it outperforms any supplement combination. Aim for 1.2–1.6 g protein/kg/day. Whey + leucine at 25–40 g per serving × 3 daily. Creatine 5 g daily ongoing. Add HMB 3 g daily for adults over 70 or hospitalized/cachectic. Vitamin D to repletion. Omega-3 2 g daily. Re-evaluate grip strength and gait speed at 12 weeks. See the recovery stack for the athletic parallel.