Kampo Medicine as a Nutrition-Relevant Approach for Sarcopenia
Sarcopenia involves age-related anabolism decline alongside reduced intake, inflammation, and metabolic dysfunction. This narrative review evaluates Kampo medicine's potential role in multimodal care.
Sarcopenia is sustained by multiple factors including age-related declines in muscle anabolism, reduced nutritional intake, anorexia, metabolic dysregulation, mitochondrial dysfunction, chronic inflammation, neuromuscular deterioration, and physical inactivity. Interventions targeting appetite, oral intake, nutrient handling, fatigue, metabolic resilience, and physical function may be relevant within multimodal sarcopenia care.
The authors conducted a narrative review of published clinical, translational, and mechanistic literature addressing 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.
Sarcopenia 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.
Nevertheless, direct evidence using standardized sarcopenia criteria and validated endpoints remains limited. Kampo 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.