Singapore Thong Chai Medical Institution

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What is Sarcopenia?

Sarcopenia is the progressive loss of skeletal muscle mass, strength, and quality that occurs gradually with ageing. It typically begins around age 40 and accelerates after the ages of 65 to 75. Sarcopenia can reduce one’s ability to perform daily tasks and increase risk of frailty, falls and fractures, which may lead to hospitalisations or even more serious complications.


Common risk factors of sarcopenia
  • Ageing
  • Hormonal imbalance
  • Undernutrition
  • Physical inactivity
  • Obesity
  • Chronic diseases such as rheumatoid arthritis, osteoarthritis, diabetes etc.


Symptoms of sarcopenia

The most common symptoms of sarcopenia is muscle weakness. Other signs and symptoms may include:
  • Unexplained weight loss
  • Decrease in muscle mass
  • Poor balance and frequent falls
  • Reduced strength (e.g. inability to wring a towel dry or lift a water jug)
  • Reduced mobility (e.g. walking slowly, difficulty in standing up from sitting position, or difficulty in climbing stairs)
If you notice you or your loved ones displaying the above signs and symptoms, it is important to consider the possibility of sarcopenia in its early stages.


Treatment for arcopenia

The primary treatment of sarcopenia involves lifestyle intervention such as:
  • Physical activity: Resistance training such as using dumbbells, resistance bands, or weight-bearing exercises is the most effective way to build muscle mass and strength.
  • Sufficient protein intake: High quality protein intake is crucial, often aiming for an intake of approximately 1.2 grams per kg of body weight daily.
  • Sufficient vitamin intake: Other nutrients that support muscle health include zinc and vitamins A, C, D and E. Vitamin D, in particular, plays an important role in the normal functioning and strength of muscles.
  • Physical Therapy & Mobility: Doing targeted exercises with a physiotherapist to improve balance, gait, and strength, reducing fall risks.


Traditional Chinese Medicine (TCM) Perspective and Remedies for sarcopenia

In TCM, sarcopenia falls under the category of “痿证” (Wěi Zhèng） — a term for a disorder characterized by muscle weakness, limpness, and atrophy of the limbs, often leading to restricted movement. According to TCM theory, the root cause of sarcopenia is the deficiency of the spleen and kidneys. These deficiencies often lead to the loss of essence, qi, and blood which results in the malnutrition of tendons and muscles, hence weakness in muscles and reduced mobility.  Therefore, remedies focus on:
  • Nourishing the spleen and kidney
  • Improving production of essence, qi, and blood


Commonly used herbal formulas include:

  • 八珍汤（Bā Zhēn Tāng）
  • 补中益气汤 （Bǔ Zhōng Yì Qì Tāng）
  • 参苓白术散 （Shēn Líng Bái Zhú Sǎn）
Other forms of TCM treatment include:

  1. Acupoint massage
    2. Acupoint massage can help reduce inflammation, increase blood flow to muscle tissues, and improve muscle functionality. Some key acupoints used to treat sarcopenia include:
    • 足三里 Zusanli (ST36): On the outside of the lower leg, four fingers width down from the bottom of your knee cap, along the outer boundary of your shin bone.
    • 阳陵泉 Yanglingquan (GB34):  The depression anterior and inferior to the head of the fibula on the lateral aspect of the lower leg.
    • 曲池 Quchi (LI11): On the outer aspect of the elbow, in the depression found at the lateral end of the crease when the elbow is bent at 90 degrees.
    • 手三里 Shousanli (LI10): On the forearm, three fingers below the lateral end of the elbow crease on the outer surface of the forearm.
    It is advisable to massage the acupoints 3 times a day for about 5-10 minutes each time.

  2. Herbal tea
    3. Herbal tea that nourishes the spleen and tonifies qi can help maintain muscle strength and functionality. The ingredients used are:
    • 党参 Dǎng Shēn (Codonopsis pilosula) - 10g
    • 茯苓 Fú Líng (Wolfiporia extensa) - 10g
    • 陈皮 Chén pí (Dried tangerine peel) - 5g
    • 白术 Bái Zhú (Glycyrrhiza uralensis) - 5g
    • 甘草Gān Cǎo (Atractylodes macrocephala) - 5g
Add the ingredients to a teapot, pour in 500 ml of hot water, and let it steep for about 10 minutes.


Conclusion

Losing muscle strength as you age is common, but it doesn’t have to compromise your independence. Regular physical activity and getting enough protein can go a long way in helping you stay strong and steady. If you’ve started to notice weakness or slower movements, taking action early can help you remain mobile, confident, and in control of your health.


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