Urolithin A is a compound some gut bacteria make from pomegranates, walnuts and berries, sold as a purified dietary supplement for its proposed role in helping cells replace worn-out energy-producing parts. Small, short, mostly company-funded trials show modest signals for muscle endurance and strength. Short-term safety looks reassuring; long-term effects are unknown. For active adults, a plausible but unproven add-on, most relevant for those who cannot make it from food. (Full Review)
| Marker | Target | Why |
|---|---|---|
| hs-CRP | Below 1.0 mg/L (functional target below 0.5 mg/L) | Inflammation marker that fell in trials |
| ALT and AST | ALT below 25 U/L; AST below 25 U/L | Liver safety |
| Creatinine and eGFR | eGFR above 90 mL/min/1.73 m² | Kidney safety |
| Lipid panel with HDL | HDL above 60 mg/dL; triglycerides below 100 mg/dL | Cardiovascular context; HDL rose in one trial |
| Plasma ceramides | Low-risk CERT-2 score category (0–2); otherwise track change from own baseline | Marker that fell with urolithin A |
| Urolithin A producer status | No established target; record producer versus non-producer | Shows whether food alone yields urolithin A |
| Handgrip strength | Men above 40 kg; women above 27 kg | Tracks muscle strength response |
| Six-minute walk distance | No universal target; track change from own baseline | Tracks physical performance |
| VO2 max | Above the 75th percentile for age and sex | Tracks aerobic fitness |
Cadence: Baseline, 3 months, then every 6–12 months, repeating safety labs and function tests under identical conditions