11/12/24 Myostatin Inhibition: a Novel Way to Suppress Muscle Atrophy
By Chris D. Meletis, N.D.
("Educational Only" - This article written for medical professional healthcare providers.)
Muscle loss is inevitable with age. After age 30, people lose about 3% to 5% of their muscle mass each decade with the greatest losses occurring in inactive people.1 At around age 60, muscle loss accelerates, and after age 80, research indicates that 11% to 50% of people have sarcopenia,1 the significant loss of skeletal muscle mass, muscle strength, and/or function that occurs during advancing age.
Lean body mass is primarily made up of skeletal muscle. Reduced skeletal muscle mass and function in adults is associated with chronic diseases, poor quality of life, physical disability, increased risk of fractures, and risk for frailty.2 Muscle loss becomes a vicious cycle since it promotes injury, which in turn contributes to a more sedentary phase of life, which in turn leads to more muscle loss.
When you argue with the muscles, the muscles will always win. Hence, when performing a therapeutic realignment of the spine and distal joints, tight muscles and weak muscles dramatically impact the outcome of therapeutic interventional support. When patients have tight muscles it becomes difficult to fully address the subluxations/misalignment.3 They often come back reporting, “I don’t seem to hold my adjustment.” Therefore, it is critical to address muscle health in patients.
A Novel Way To Build Skeletal Muscle Mass
The two standard ways to increase or maintain skeletal muscle mass is through consuming protein and performing resistance exercise. In this article, we would like to propose an additional way to build and maintain muscle mass: inhibiting myostatin through the use of an all-natural molecule derived from fertilized chicken yolk. However, before we address this novel solution, let’s review the causes and symptoms of muscle loss.
Causes of Muscle Atrophy
The main cause of muscle atrophy (sarcopenia) is aging itself. During this time, there are a number of things happening in the body that can lead to muscle loss. These include:
• Reduced activity in nerve cells responsible for coordinating movement.
• Lower levels of growth hormones, testosterone, and insulin-like growth factor.
• A reduced ability to convert protein into energy.
• Elevated inflammation.
• Anabolic resistance, the age-related suppression of muscle protein synthesis after a dose of protein/amino acids.4
In addition to aging, muscle atrophy can also be caused by disuse, such as when patients are sedentary for long periods.
Diagnosing Muscle Atrophy
Muscle atrophy is usually diagnosed by measuring loss of muscle mass and a questionnaire to measure strength and other factors related to muscle loss. A hand grip test to measure grip strength is also an effective tool. In addition, symptoms are evaluated including:
• Muscle weakness
• Loss of stamina during activity
• Difficulty performing daily activities
• Walking slowly
• Difficulty climbing stairs
• Balance issues
• Increased incidence of falls
• Shrinking muscles
Muscle Loss Is a Risk of Weight Loss
Maintaining muscle while losing fat is critical to the success of weight loss efforts. This is one of the challenges of the popular GLP-1 agonist drugs, which lead to both fat loss and muscle loss during long-term treatment.5
Muscle is involved in weight loss in a number of ways, including:
• Regulating metabolism – As metabolically active tissue, muscle burns more calories at rest compared with fat tissue. The preservation of muscles leads to a higher basal metabolic rate, which is important for keeping the extra weight off during the long term.
• Preserving physical function and strength – Maintaining muscle mass helps patients stay active as they age.
• Maintaining insulin sensitivity and blood sugar – Muscle is involved in glucose metabolism and insulin sensitivity. Muscle loss, on the other hand, can lead to disrupted glycemic control even in patients who are losing fat.
• Maintaining weight over time – If muscle is lost while a person is on a weight-loss diet, keeping the pounds off over time is more difficult. The lower metabolic rate that accompanies reduced muscle mass leads to patients being more prone to regain the lost weight.
Therefore, sustaining muscle during weight loss is critical to maintain a healthy weight over time.
The Solution: Inhibiting Myostatin
A lot of research revolving around the therapeutic interventions to prevent, slow, or reverse sarcopenia spotlights myostatin, which is involved in suppressing muscle growth and is found primarily in skeletal muscle. It inhibits the Akt/mammalian target of rapamycin (mTOR) pathway and therefore, reduces protein synthesis.6
Evidence suggests that myostatin levels rise during aging. In a study of younger, middle-aged, and older men and women, serum myostatin levels increased with age.7 The study also indicated myostatin levels are the highest in physically frail older women and that the higher the skeletal muscle mass, the lower the myostatin levels.
In rodent models, animals with a mutated or deleted myostatin gene experience beneficial effects such as resistance to obesity, hepatic steatosis, and atherogenesis, as well as macrophage infiltration/activation in skeletal muscle and adipose tissue.1 Myostatin-null mice also experienced increased bone mineral density.1
According to researchers writing in the journal Gerontology, “Myostatin inhibition provides a promising means to attenuate or reverse skeletal muscle loss in the context of sarcopenia as well as cachexia (disease-associated muscle loss), and to enhance skeletal muscle regeneration in the context of congenital disease (i.e. muscular dystrophies) and injury.”1
Decrease Myostatin and Increase Protein Synthesis
An emerging new strategy for reducing muscle atrophy and inhibiting myostatin is a bioactive complex known as Fortetropin, derived from raw, fertile egg yolk. Supplementation with Fortetropin increases lean body mass, reduces markers of protein breakdown consistent with inhibition of myostatin, and increases mTOR signaling, which is associated with muscle growth. These results were evident in human, rat, and animal studies.
For example, in one human study of 37 resistance-trained college-age males, lean body mass significantly increased in patients given Fortetropin compared with placebo.8 Subjects given 19.8 grams experienced greater improvements in lean body mass compared to those given 6.6 grams. Both of those groups experienced significant increases in muscle thickness and Fortetropin decreased markers of protein breakdown.
Another human study investigated the effects of 21 days of Fortetropin supplementation on muscle protein synthesis in older adults.9 The randomized, placebo-controlled, double-blind study of 20 participants found that average muscle protein synthesis rate in the Fortetropin group was 18% higher compared with the placebo group. The study indicated that Fortetropin has potential for managing age-related muscle loss (sarcopenia) in older adults. According to the lead researcher, “Stimulating muscle protein synthesis in elderly patients could potentially result in increased muscle mass and better outcomes for those with sarcopenia.”
In a study of dogs suffering from disuse muscle atrophy after having undergone tibial plateau leveling osteotomy (TPLO) surgery, the dogs given Fortetropin experienced no change in myostatin levels while the placebo-treated dogs experienced an increase in myostatin over eight weeks.10 The dogs given Fortetropin also experienced no change in thigh circumference while the placebo-treated dogs had a reduction in thigh circumference over eight weeks.
Conclusion
A number of strategies can be used to prevent muscle atrophy in our patients. Here is the clinical approach I take to support muscle health:
• Breaking through anabolic resistance by inhibiting myostatin and supporting healthy mTOR levels within skeletal muscle through the use of Fortetropin.
• Testing for diabetes, altered cortisol levels, DHEA, and testosterone for both males and females.
• Ensuring patients are eating sufficient protein and diverse phytonutrients.
• Recommending adequate and appropriate exercise, by meeting the patient where they are in their exercise journey.
• Ensuring patients have good sleep hygiene (quality and quantity) to help the body heal itself.
For more information, readers can e-mail me about my approach—NaturalMedMan@hotmail.com
References
1. White TA, LeBrasseur NK. Myostatin and sarcopenia: opportunities and challenges - a mini-review. Gerontology. 2014;60(4):289-293.
2. Nunes EA, Colenso-Semple L, McKellar SR, et al. Systematic review and meta-analysis of protein intake to support muscle mass and function in healthy adults. J Cachexia Sarcopenia Muscle. 2022;13(2):795-810.
3. Miyagi M, Inoue G, Hori Y, et al. Decreased muscle mass and strength affected spinal sagittal malalignment. Eur Spine J. 2022;31(6):1431-1437.
4. Aragon AA, Tipton KD, Schoenfeld BJ. Age-related muscle anabolic resistance: inevitable or preventable? Nutr Rev. 2023;81(4):441-454.
5. Sargeant JA, Henson J, King JA, Yates T, Khunti K, Davies MJ. A Review of the Effects of Glucagon-Like Peptide-1 Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors on Lean Body Mass in Humans. Endocrinol Metab (Seoul). 2019;34(3):247-262.
6. Trendelenburg AU, Meyer A, Rohner D, Boyle J, Hatakeyama S, Glass DJ. Myostatin reduces Akt/TORC1/p70S6K signaling, inhibiting myoblast differentiation and myotube size. Am J Physiol Cell Physiol. 2009;296(6):C1258-1270.
7. Yarasheski KE, Bhasin S, Sinha-Hikim I, Pak-Loduca J, Gonzalez-Cadavid NF. Serum myostatin-immunoreactive protein is increased in 60-92 year old women and men with muscle wasting. J Nutr Health Aging. 2002;6(5):343-348.
8. Sharp MH, Lowery RP, Mobley CB, et al. The Effects of Fortetropin Supplementation on Body Composition, Strength, and Power in Humans and Mechanism of Action in a Rodent Model. J Am Coll Nutr. 2016;35(8):679-691.
9. Evans W, Shankaran M, Nyangau E, et al. Effects of Fortetropin on the Rate of Muscle Protein Synthesis in Older Men and Women: A Randomized, Double-Blinded, Placebo-Controlled Study. J Gerontol A Biol Sci Med Sci. 2021;76(1):108-114.
10. White DA, Harkin KR, Roush JK, Renberg WC, Biller D. Fortetropin inhibits disuse muscle atrophy in dogs after tibial plateau leveling osteotomy. PLoS One. 2020;15(4):e0231306.
(The information shared here is "Educational Only." These articles are written for medical professional healthcare providers. Always consult with your medical provider before taking any supplement. The content of the articles is not intended as diagnosis or treatment.)