Muscle Mass and MS: Preventing Sarcopenia with Diet, Exercise, and Hormone Support

We’ll examine the critical role of exercise and muscle mass for people with multiple sclerosis (MS). You’ll learn why sarcopenia (loss of muscle mass) can be so harmful to your health, why it occurs, and how to prevent it. I will also review a few ways to meet your body’s protein needs and support your hormonal system—both huge factors in maintaining your muscle mass.

Muscles as Endocrine Organs 

You may not realize this, but your muscles are endocrine organs. In addition to moving and supporting your skeletal frame, they send out important chemical signals that affect nearly every system in your body and brain.

When muscles contract during exercise, they release special messenger molecules called myokines into your bloodstream. These myokines help regulate inflammation, blood sugar levels, metabolism, and even brain health.

In other words, maintaining strong, healthy muscles can directly support your heart, brain, immune system, and overall health.

What Happens When You Lose Muscle Mass (Sarcopenia)

I’m sure you’ve heard a lot about the importance of exercise for people with MS. But while building muscle is so important for your health, losing muscle mass can have serious consequences. Sarcopenia (the medical term for loss of muscle mass) is linked to lower levels of BDNF, higher rates of brain shrinkage, cognitive decline, and an increased risk of dementia.⁽⁵⁾

If BDNF levels fall, the brain and spinal cord are more likely to shrink. This could lead to brain fog, trouble walking, emotional difficulties, and faster progression of disability. As you age, losing muscle mass increases your risk of frailty and could potentially hasten the need for assisted living or nursing home care.⁽⁶⁾

The key drivers of sarcopenia are lack of exercise or strength training; inadequate protein intake; and low testosterone levels. We can address the first two with movement and dietary changes, but how can we support our body’s ability to make more testosterone?

Why We ALL Need Testosterone

Although women naturally have lower testosterone levels than men, it’s still a crucial factor in our overall health—the female body produces testosterone in both the ovaries and the adrenal glands. Low testosterone levels in women are associated with an increased risk of osteoporosis; loss of muscle mass; decreased sexual responsiveness; and low libido.^{(7, 8)} Sex hormones, including testosterone, are also critical for brain health in women.

Loss of testosterone is especially detrimental for men. Low testosterone levels can lead to a decline in libido; erectile dysfunction; reduced strength and energy; loss of muscle mass; decreased bone mineral density; irritability; and a decline in mental clarity.^(9-12)

The aging process typically begins around age 40 for both men and women. For people with MS, declining testosterone can increase the risk of disability progression (and eventual job loss), ⁽¹³⁾ yet it’s often overlooked by the treating medical team.

Monitoring and improving your testosterone levels can be an important intervention to help you achieve healthier muscle mass and bone density. It can also contribute to better brain health, improved sexual functioning, and healthier aging.

Natural Support for Healthy Testosterone Levels

Shilajit for Hormonal and Physical Resilience

Shilajit is a naturally occurring, mineral-rich phytocomplex found in the Himalayan mountains. Made up of rock humus, marine microorganisms, and microbial metabolites, shilajit has been used for centuries in Ayurvedic medicine to combat chronic fatigue and support vitality. Modern research shows that shilajit may help modulate the hypothalamic-pituitary-adrenal (HPA) axis—the central system that manages your body’s response to stress and regulates sex hormone production.

Shilajit is often used by weightlifters to support muscle mass, enhance strength, and improve recovery times.⁽¹⁵⁾ Additionally, shilajit appears to support healthy testosterone levels, improving spermatogenesis (the production of sperm) and contributing to better sexual health in men.⁽¹⁶⁾ Beyond its hormonal benefits, shilajit also helps lower inflammatory cytokines, reduce oxidative stress, and support healthier blood lipid profiles—factors that are critical for protecting brain and cardiovascular health over time.⁽¹⁶⁾

Fulvic acid, a key component of shilajit, has been shown to block the formation of tau proteins, abnormal structures that are a contributing factor in cognitive decline and dementia.⁽¹⁷⁾ In a trial study of men with infertility and poor sperm quality, supplemental shilajit was associated with improved sperm production, semen quality, and testosterone and pituitary hormone levels.⁽¹⁸⁾

Beyond reproductive health, shilajit shows promise for supporting muscle repair and growth.
In a clinical study of obese men and women, participants who took shilajit tolerated it well and experienced greater evidence of muscle recovery and development compared to those who did not. ⁽¹⁸⁾

Eurycoma longifolia (Malaysian Ginseng) for Hormone Balance

Eurycoma longifolia root, often called Malaysian ginseng, is a traditional herb used in Southeast Asia as a tonic to enhance libido, energy, and athletic performance. It works by activating the CYP-17 enzyme, a key driver of cholesterol-based hormone production including testosterone and adrenal hormones.

In a prospective study of men and women aged 57-72, participants took Eurycoma longifolia root for five weeks. By the end of the study, both groups showed significant improvements in hand grip strength (a key indicator of muscle function) and testosterone levels. ⁽¹⁹⁾

Both shilajit and Eurycoma longifolia have been shown to support brain health, muscle mass, and hormonal balance as we age.

Other Ways to Maintain Your Muscle Mass 

Movement & Strength Training

Physical fitness and muscle mass are so important for your metabolism, bone health, and brain function. For all these reasons I want you to care deeply about the size of your muscles! Stay as physically active as you can. Try to find movement you enjoy, like walking with friends or playing soccer with your kids or grandkids. I also recommend including strength training in your exercise plan.

I have a grandson now, which is how I got into strength training. I try to lift three days a week—and I can carry more weight now than I could last year. My goal is to be able to carry 70% of my body weight for at least two minutes, and I know it might take me a year or two to get there. Setting long-term goals that directly impact my quality of life has really helped me stay focused and committed.

Eating Enough Protein

You can’t grow muscles without protein, and you need a lot more protein than you might think. I recommend a daily protein intake of 0.7 grams per kilogram of your ideal body weight—so, if your ideal body weight is 165 pounds (75kg), you would aim for 53 grams of protein per day. If you’re over 60, you should increase that to 1.2 grams per kilogram.

To ensure you’re getting enough protein from your diet, meat and fish are excellent sources that also contain all the amino acids needed to grow muscles. Vegetarians need to combine beans and rice in order to get a complete amino acid profile.

Summary

As we age, hormone production declines for both men and women—typically beginning around age 40. A loss of testosterone can have many negative effects: for men, it impacts strength, muscle mass, sexual performance, mood, thinking, metabolism, and bone health. For women, low testosterone contributes to bone loss, slower metabolism, changes in mood, reduced libido, and lower sexual responsiveness.

Both men and women may benefit from natural support to maintain healthier testosterone levels. Two key compounds, shilajit and Eurycoma longifolia root, have been shown to promote hormone balance, muscle health, and vitality. I’ve combined these powerful ingredients into one convenient supplement: AndroTesto Boost.

I plan to thrive well into my 90s—and hopefully beyond—chasing after my great-grandchildren. Maintaining my muscle mass and supporting my hormone health are essential parts of that plan. I hope they will be part of your plan too.

Citations

1. Yu QY, Chen YZ, Xu YX, Yu Q. Which intervention is optimal to control blood glucose and improve physical performance in the elderly living with type 2 diabetes mellitus? A network meta-analysis. Asia Pac J Clin Nutr. 2024;33(3):319-47.
2. Cobianchi S, Arbat-Plana A, Lopez-Alvarez VM, Navarro X. Neuroprotective Effects of Exercise Treatments After Injury: The Dual Role of Neurotrophic Factors. Curr Neuropharmacol. 2017;15(4):495-518.
3. Haunhorst S, Bloch W, Ringleb M, Fennen L, Wagner H, Gabriel HHW, et al. Acute effects of heavy resistance exercise on biomarkers of neuroendocrine-immune regulation in healthy adults: a systematic review. Exerc Immunol Rev. 2022;28:36-52.
4. Pahlavani HA. Exercise therapy to prevent and treat Alzheimer's disease. Front Aging Neurosci. 2023;15:1243869.
5. Arosio B, Calvani R, Ferri E, Coelho-Junior HJ, Carandina A, Campanelli F, et al. Sarcopenia and Cognitive Decline in Older Adults: Targeting the Muscle-Brain Axis. Nutrients. 2023;15(8).
6. Sanford AM, Morley JE, Berg-Weger M, Lundy J, Little MO, Leonard K, et al. High prevalence of geriatric syndromes in older adults. PLoS One. 2020;15(6):e0233857.
7. Davis SR, Wahlin-Jacobsen S. Testosterone in women--the clinical significance. Lancet Diabetes Endocrinol. 2015;3(12):980-92.
8. Yasui T, Matsui S, Tani A, Kunimi K, Yamamoto S, Irahara M. Androgen in postmenopausal women. J Med Invest. 2012;59(1-2):12-27.
9. Beauchet O. Testosterone and cognitive function: current clinical evidence of a relationship. Eur J Endocrinol. 2006;155(6):773-81.
10. Korenman SG, Morley JE, Mooradian AD, Davis SS, Kaiser FE, Silver AJ, et al. Secondary hypogonadism in older men: its relation to impotence. J Clin Endocrinol Metab. 1990;71(4):963-9.
11. Vermeulen A, Kaufman JM. Diagnosis of hypogonadism in the aging male. Aging Male. 2002;5(3):170-6.
12. Wahjoepramono EJ, Asih PR, Aniwiyanti V, Taddei K, Dhaliwal SS, Fuller SJ, et al. The Effects of Testosterone Supplementation on Cognitive Functioning in Older Men. CNS Neurol Disord Drug Targets. 2016;15(3):337-43.
13. Hammad MAM, Rush A, Loeb CA, Banton J, Abou Chawareb E, Khanmammadova N, et al. Multiple sclerosis and hypogonadism: is there a relationship? Sex Med Rev. 2024;12(2):178-82.
14. Surapaneni DK, Adapa SR, Preeti K, Teja GR, Veeraragavan M, Krishnamurthy S. Shilajit attenuates behavioral symptoms of chronic fatigue syndrome by modulating the hypothalamic-pituitary-adrenal axis and mitochondrial bioenergetics in rats. J Ethnopharmacol. 2012;143(1):91-9.
15. Bucci LR. Selected herbals and human exercise performance. Am J Clin Nutr. 2000;72(2 Suppl):624S-36S.
16. Stohs SJ. Safety and efficacy of shilajit (mumie, moomiyo). Phytother Res. 2014;28(4):475-9.
17. Carrasco-Gallardo C, Guzman L, Maccioni RB. Shilajit: a natural phytocomplex with potential procognitive activity. Int J Alzheimers Dis. 2012;2012:674142.
18. Biswas TK, Pandit S, Mondal S, Biswas SK, Jana U, Ghosh T, et al. Clinical evaluation of spermatogenic activity of processed Shilajit in oligospermia. Andrologia. 2010;42(1):48-56.
19. Henkel RR, Wang R, Bassett SH, Chen T, Liu N, Zhu Y, et al. Tongkat Ali as a potential herbal supplement for physically active male and female seniors--a pilot study. Phytother Res. 2014;28(4):544-50.