Kampo medicine may support appetite and metabolic resilience in patients with sarcopeniaKampo medicines may support appetite and metabolism in muscle loss
Frontiers in MedicinePublished August 23, 2026DOI ↗Editorial oversight: Dr. Amelia Tan, PhD · Internal Medicine & Chronic Disease
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Key Takeaway
Note that Kampo medicine is a hypothesis-generating complementary approach rather than a stand-alone therapy for sarcopenia.
This narrative review explores the clinical evidence for using specific Kampo medicines—including Ninjin’yoeito, Rikkunshito, Hochuekkito, Juzentaihoto, Hachimijiogan, and Goshajinkigan—in the management of sarcopenia and cachexia. The authors synthesize findings regarding these formulations' potential impacts on biological and clinical domains such as appetite regulation, oral intake, inflammatory balance, gut microbiota-related pathways, metabolic resilience, and functional support.
The review highlights that the current evidence base is heterogeneous and largely indirect. Specifically, there is limited direct evidence utilizing standardized sarcopenia criteria and validated endpoints to confirm efficacy for muscle loss. The authors note that these formulations are associated with domains relevant to nutritional status, but the data do not currently support a definitive clinical conclusion.
Due to the low certainty of current evidence, Kampo medicine should be viewed as a hypothesis-generating, nutrition-relevant complementary approach rather than an established stand-alone therapy. It may have a role within multimodal sarcopenia care programs, but its specific impact on muscle loss remains unconfirmed by standardized metrics.
How this fits prior evidence
This narrative review addresses a gap in the management of sarcopenia by exploring Kampo medicine as a potential complementary approach. While previous evidence highlights that sarcopenia is associated with higher odds of cognitive impairment and increased risk from circadian misalignment, this review focuses on nutritional and metabolic support. It does not confirm or contradict findings regarding exercise modalities for inflammation or digital tools for monitoring, but it provides a different perspective on non-pharmacological interventions.
Losing muscle mass, a condition known as sarcopenia, can make daily life difficult. Researchers looked into whether Kampo medicine—a traditional Japanese herbal system—could help manage this issue by supporting things like appetite, metabolism, and gut health.
The review looked at several specific formulas, including Ninjin’yoeito and Rikkunshito. These medicines are linked to factors that might help with eating more and maintaining a healthy balance in the body. However, it is important to note that much of this evidence is indirect and varies significantly across different studies.
Because the current evidence is not uniform, these treatments are not considered a standalone cure for muscle loss. Instead, they are best used as a complementary approach alongside nutrition and other medical care. Because the data is still limited, talk to your doctor about how these options might fit into your specific treatment plan.
What this means for you:
Kampo medicine may help with appetite and metabolism in muscle loss but is not yet a standalone treatment.
Common questions
What is Kampo medicine?
Kampo is a traditional Japanese herbal medicine. This review looked at specific formulas like Ninjin’yoeito, Rikkunshito, Hochuekkito, Juzentaihoto, Hachimijiogan, and Goshajinkigan. These may help with appetite, metabolism, and gut health in people experiencing muscle loss.
Is Kampo medicine a proven treatment for muscle loss?
Not yet as a standalone therapy. The current evidence is indirect and varies a lot. It is currently best used as a complementary approach alongside nutrition and other medical care rather than a primary treatment for sarcopenia.
How does it help with muscle loss?
The specific Kampo formulas are associated with several areas that could support someone with muscle loss. These include appetite regulation, oral intake, inflammatory balance, gut microbiota-related pathways, metabolic resilience, and functional support.
Study Details
Study typeSystematic review
EvidenceLevel 1
PublishedAug 2026
View Original Abstract ↓
BackgroundSarcopenia is sustained not only by age-related declines in muscle anabolism but also by reduced nutritional intake, anorexia, metabolic dysregulation, mitochondrial dysfunction, chronic inflammation, neuromuscular deterioration, and physical inactivity. Accordingly, interventions that influence appetite, oral intake, nutrient handling, fatigue, metabolic resilience, and physical function may be relevant within multimodal sarcopenia care. Kampo medicine, a traditional Japanese system of standardized multi-component herbal formulations, may be positioned as a nutrition-relevant multi-target intervention; however, its clinical evidence base for sarcopenia remains heterogeneous and largely indirect.MethodsWe conducted a narrative review of published clinical, translational, and mechanistic literature addressing sarcopenia, frailty, cachexia, nutrition-related muscle wasting, the gut–muscle axis, systems pharmacology, and representative pharmaceutical-grade Kampo formulations. Searches were performed in PubMed, Scopus, and Web of Science from database inception to May 2026 using prespecified combinations of disease-, mechanism-, and formula-specific terms, supplemented by an additional search for Juzentaihoto/Juzen-taiho-to and related transliterations in response to peer review. Evidence was interpreted according to whether it directly evaluated sarcopenia outcomes or indirectly addressed nutrition-relevant domains such as appetite, fatigue, inflammation, mitochondrial function, physical activity, or neuromuscular symptoms.ResultsSarcopenia shares important pathophysiological features with frailty and cachexia, including chronic inflammation, impaired mitochondrial function, anabolic resistance, reduced food intake, fatigue, and neuromuscular dysfunction. Several Kampo formulations, including Ninjin’yoeito, Rikkunshito, Hochuekkito, Juzentaihoto, Hachimijiogan, and Goshajinkigan, have been associated with biological or clinical domains potentially relevant to appetite regulation, oral intake, inflammatory balance, gut microbiota-related pathways, metabolic resilience, and functional support. Nevertheless, direct evidence using standardized sarcopenia criteria and validated endpoints remains limited.ConclusionKampo medicine is best regarded as a hypothesis-generating, nutrition-relevant complementary approach within multimodal sarcopenia care rather than as an established stand-alone therapy for muscle loss. Future studies should use standardized diagnostic criteria, prespecified sarcopenia endpoints, rigorous safety monitoring, and transparent reporting to determine whether selected Kampo formulations can improve clinically meaningful nutrition-related and muscle-related outcomes.
