Urolithin A.
A muscle-health question.
Not a settled answer.

Who and how

Sixty-six adults aged 65 to 90 were randomized, 33 per group, to urolithin A 1,000 mg/day or placebo for four months. The sponsor-supplied preparation used four softgels daily. Participants were predominantly women and all White. Thirty per group contributed the reported four-month walking changes.

What changed

Six-minute walking distance increased 60.8 ± 67.2 m with urolithin A and 42.5 ± 73.3 m with placebo (mean ± SD). The difference was not statistically significant. Hand and leg muscle endurance favored urolithin A at two months, but not significantly at four months as placebo performance also improved.

What it means

The positive fatigue-test result is not proof of broad everyday energy, more muscle mass or increased lifespan. Many endpoints were tested without correction for multiple comparisons. Maximal ATP production, another primary outcome, did not significantly improve. Short-term adverse-event rates did not differ statistically. This sponsor-linked formulation was not a Neurogan capsule.

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Who and how

Eighty-eight overweight, untrained, middle-aged adults were randomized: 29 placebo, 29 at 500 mg/day and 30 at 1,000 mg/day of Mitopure urolithin A, for four months. Seventy-nine completed. The main analysis used the randomized population.

What changed

Hamstring strength improved significantly compared with placebo. The study did not establish a significant primary cycling peak-power benefit. Walking distance at 1,000 mg improved from the group’s own baseline, but the comparison with placebo was not significant (p = 0.098).

What it means

Within-group improvement does not establish a treatment effect. The study was exploratory and funded by Amazentis, with author commercial ties. Biomarker changes are consistent with effects on mitochondrial biology but do not prove a patient-important anti-aging benefit. Matching the milligram dose does not establish equivalence between Mitopure softgels and a different micronized capsule.

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Who and how

Twenty resistance-trained male athletes took 1 g/day of urolithin A or placebo for eight weeks. Investigators measured lifting performance, muscle endurance and blood and urine biomarkers.

What changed

The abstract reports no significant between-group difference in bench-press one-repetition maximum (p = 0.462) or squat maximum (p = 0.710). Selected endurance measures were more favorable.

What it means

The small sample, several outcomes and trained male population limit generalization. Biomarker differences are not proof of reduced inflammation throughout the body. The accessed abstract does not establish that this preparation was the current Neurogan product or clinically interchangeable with Mitopure.

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Who and how

Five randomized trials included 236 participants overall. Doses ranged from 500 to 1,000 mg/day and durations from four weeks to four months. The search covered studies through December 2025. Only two trials were sufficiently comparable to pool six-minute walking distance.

What changed

Pooled difference in walking-distance change: +17.03 m versus placebo, 95% CI −5.33 to +39.40 m; p = 0.135; I² = 0%. The confidence interval includes zero. Strength and endurance results were summarized narratively because methods and populations differed.

What it means

The review combined the two active ATLAS arms to avoid counting the shared placebo twice. Low statistical heterogeneity across two studies does not eliminate clinical uncertainty. Small, short trials and varied populations, including athletes, do not establish reliable benefit in people with sarcopenia. The review includes the trials above and must not be counted as an independent intervention.

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