Enhancing Muscle Health: Lactobacillus and Sarcopenia

The Role of Lactobacillus in Muscle Health and Function

Sarcopenia, characterized by the decline in skeletal muscle mass and strength, poses significant health risks, especially among the aging population. The clinical importance of sarcopenia is becoming increasingly prominent due to its association with increased mortality rates and severe disabilities (Cruz-Jentoft et al., 2019). Recent research has highlighted the critical role of gut microbiota, particularly Lactobacillus species, in muscle health through mechanisms involving the gut-muscle axis. Lactobacillus, a genus of beneficial bacteria, plays a vital role in maintaining gut health and has been shown to influence muscle mass and function positively.

Lactobacillus probiotics are commonly used for gut health and immune support, but their specific mechanisms in combating sarcopenia remain to be fully elucidated. Studies have suggested that these probiotics may help preserve muscle mass and function through various mechanisms, including reducing inflammation, enhancing metabolic processes, and improving gut barrier function (Zhu et al., 2025). By restoring a healthy gut microbiome, Lactobacillus can potentially alleviate symptoms of sarcopenia and improve overall muscle health.

Mechanisms of Lactobacillus Impacting Sarcopenia

Lactobacillus may alleviate sarcopenia symptoms through several mechanisms that interplay with muscle function and metabolism. These include:

1. Regulation of Inflammation: Lactobacillus can modulate the immune response by promoting a higher ratio of anti-inflammatory to pro-inflammatory markers. For instance, L. rhamnosus has been shown to enhance the Treg/Th17 ratio, which can mitigate chronic inflammation that contributes to muscle atrophy (Bindels et al., 2016).

2. Oxidative Stress Reduction: Reactive oxygen species (ROS) are implicated in muscle degeneration. Lactobacillus species like L. plantarum can enhance antioxidant enzyme levels and reduce oxidative stress markers, thereby protecting muscle cells from damage (Hor et al., 2021).

3. Improvement of Skeletal Muscle Metabolism: Probiotics can influence muscle metabolism by regulating glucose uptake and utilization. For example, L. acidophilus has been reported to enhance glycogen synthesis in muscle cells by modulating key metabolic pathways (Yan et al., 2019).

4. Enhancement of Gut Barrier Function: Lactobacillus strengthens the intestinal barrier, reducing permeability to harmful substances that can exacerbate inflammation and muscle degradation. This protective function is crucial in maintaining muscle health, particularly in older adults (Guo et al., 2023).

5. Modulation of Gut Microbiota Composition: Lactobacillus can restore gut microbiota balance, promoting the growth of beneficial bacteria while inhibiting pathogenic strains. This restoration is essential for optimal nutrient absorption and overall health, which directly impacts muscle function (Kang et al., 2021).

These mechanisms collectively contribute to preserving muscle mass and function, making Lactobacillus a promising adjunct therapy for sarcopenia.

The Gut-Muscle Axis: How Gut Microbiota Influences Muscle

The gut-muscle axis refers to the complex interactions between the gut microbiome and skeletal muscle health. Emerging evidence indicates that gut microbiota composition significantly influences muscle mass and function. Germ-free mice, for instance, exhibit more severe muscle atrophy compared to their conventionally raised counterparts, underscoring the importance of a balanced gut microbiome for maintaining muscle integrity (Lahiri et al., 2019).

Moreover, gut dysbiosis—a condition characterized by an imbalance in gut microbiota—has been implicated in muscle deterioration. Studies show that older adults with sarcopenia often have reduced levels of beneficial bacteria such as Lactobacillus and increased levels of inflammatory bacterial species (Lou et al., 2024). This dysbiosis may lead to elevated levels of inflammatory markers, contributing to muscle wasting and functional decline.

Probiotics, particularly Lactobacillus, can restore a healthy gut environment, promoting muscle health through the gut-muscle axis. For instance, supplementation with L. casei has been shown to enhance muscle mass and strength in aged mice, demonstrating the potential of probiotics in mitigating sarcopenia (Ni et al., 2019).

Probiotics as a Treatment Strategy for Sarcopenia

The use of probiotics, especially Lactobacillus, presents a novel strategy for preventing and treating sarcopenia. Several studies have documented the efficacy of Lactobacillus strains in improving muscle health and function:

• L. rhamnosus: This strain has been observed to enhance muscle mass and strength in aged rodents by reducing inflammatory cytokines and promoting muscle protein synthesis (Lee et al., 2023).

• L. plantarum: Known for its antioxidant properties, L. plantarum supplementation has been linked to improved muscle function and reduced oxidative stress in elderly populations (Chen L. et al., 2022).

• L. casei: Studies demonstrate that L. casei can improve muscle strength and function in older adults by regulating muscle metabolism and enhancing gut health (Rondanelli et al., 2022).

These findings indicate that probiotics can serve as a safe and effective adjunct treatment for patients at risk of sarcopenia, especially the elderly.

Clinical Evidence Supporting Lactobacillus for Muscle Preservation

Numerous clinical trials have explored the effects of Lactobacillus supplementation on muscle health. A systematic review found that Lactobacillus supplementation resulted in significant improvements in muscle mass and strength among elderly participants (Huang et al., 2019). Additionally, a double-blind randomized controlled trial showed that L. plantarum supplementation significantly enhanced muscle performance and recovery in older adults engaged in physical activity (Fu et al., 2021).

Moreover, Lactobacillus strains have been shown to improve markers of muscle metabolism, such as increased levels of insulin sensitivity and muscle protein synthesis (Bagarolli et al., 2017). These studies collectively support the notion that Lactobacillus can play a crucial role in preserving muscle health and combating sarcopenia.

Table 1: Summary of Clinical Trials on Lactobacillus and Muscle Health

FAQ

How do Lactobacillus probiotics help with sarcopenia?

Lactobacillus probiotics help by reducing inflammation, enhancing muscle metabolism, and improving gut barrier function, which collectively support muscle health.

Are there any side effects of using Lactobacillus?

Generally, Lactobacillus is considered safe, but mild gastrointestinal symptoms like bloating may occur. In immunocompromised individuals, there is a risk of bacterial overgrowth.

How long does it take to see results from Lactobacillus supplementation?

Results can vary, but clinical studies have shown significant improvements in muscle health within 6 to 12 weeks of consistent supplementation.

Can Lactobacillus be used alone to treat sarcopenia?

While Lactobacillus can be beneficial, it is recommended to use it as an adjunct therapy alongside exercise and nutritional interventions for optimal results.

Is there ongoing research on Lactobacillus and muscle health?

Yes, ongoing research is focusing on understanding the mechanisms of Lactobacillus in muscle health and its potential applications in preventing sarcopeni

References

1. Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., … & Morley, J. (2019). Sarcopenia: Revised European consensus on definition and diagnosis

2. Bindels, L. B., Beck, R., Schakman, O., Martin, J., De Backer, F., Sohet, F., … & Delzenne, N. M. (2012). Restoring specific lactobacilli levels decreases inflammation and muscle atrophy markers in an acute leukemia mouse model. PLoS One, 7(2), e37971. https://doi.org/10.1371/journal.pone.0037971

3. Guo, M., Liu, H., Yu, Y., Zhu, X., Xie, H., & Wei, C. (2023). Lactobacillus rhamnosus GG ameliorates osteoporosis in ovariectomized rats by regulating the Th17/treg balance and gut microbiota structure

4. Lee, M. C., Hsu, Y., Chen, M., Kuo, Y., Lin, J., & Tsai, T. (2021). Lactobacillus plantarum TWK10 improves muscle mass and functional performance in frail older adults: A randomized, double-blind clinical trial. Microorganisms, 9(7), 1466. https://doi.org/10.3390/microorganisms9071466

5. Fu, S., Tseng, W., Tseng, K., Lai, C., Tsai, Y., & Tai, H. (2021). Effect of daily oral lactobacillus plantarum PS128 on exercise capacity recovery after a half-marathon. Nutrients, 13(11), 4023. https://doi.org/10.3390/nu13114023

6. Yan, F., Li, N., Shi, J., Li, H., & Yue, Y. (2019). Lactobacillus acidophilus alleviates type 2 diabetes by regulating hepatic glucose, lipid metabolism and gut microbiota in mice. Food Funct

7. Zhu, J., Peng, F., Yang, H., Luo, J., Zhang, L., Chen, X., … & Zhao, H. (2025). Probiotics and muscle health: The impact of Lactobacillus on sarcopenia through the gut-muscle axis. Frontiers in Microbiology, 14, 1559119. https://doi.org/10.3389/fmicb.2025.1559119