Sarcopenia and Kampo Medicine: A Nutrition-Relevant Approach
Sarcopenia is sustained by age-related declines in muscle anabolism and reduced nutritional intake, among other factors. Interventions influencing appetite, nutrient handling, and physical function may be relevant in mul
BackgroundSarcopenia is sustained by age-related declines in muscle anabolism and reduced nutritional intake, among other factors. Interventions influencing appetite, nutrient handling, and physical function may be relevant in multimodal sarcopenia care. Kampo medicine, a traditional Japanese system of standardized multi-component herbal formulations, may be positioned as a nutrition-relevant multi-target intervention. However, its clinical evidence base for sarcopenia remains heterogeneous and largely indirect.
MethodsThis narrative review of published clinical, translational, and mechanistic literature addressed sarcopenia, frailty, cachexia, nutrition-related muscle wasting, the gut–muscle axis, systems pharmacology, and representative pharmaceutical-grade Kampo formulations. Searches were performed in PubMed, Scopus, and Web of Science from database inception to May 2026 using prespecified combinations of disease-, mechanism-, and formula-specific terms, supplemented by an additional search for Juzentaihoto/Juzen-taiho-to and related transliterations in response to peer review.
ResultsSarcopenia shares important pathophysiological features with frailty and cachexia, including chronic inflammation, impaired mitochondrial function, anabolic resistance, reduced food intake, fatigue, and neuromuscular dysfunction. Several Kampo formulations, including Ninjin'yoeito, Rikkunshito, Hochuekkito, Juzentaihoto, Hachimijiogan, and Goshajinkigan, have been associated with biological or clinical domains potentially relevant to appetite regulation, oral intake, inflammatory balance, gut microbiota-related pathways, metabolic resilience, and functional support.
ConclusionKampo medicine is best regarded as a hypothesis-generating, nutrition-relevant complementary approach within multimodal sarcopenia care rather than as an established stand-alone therapy for muscle loss. Future studies should use standardized diagnostic criteria, prespecified sarcopenia endpoints, rigorous safety monitoring, and transparent reporting to determine whether selected Kampo formulations can improve clinically meaningful nutrition-related and muscle-related outcomes.