Medicinal plants in the management of muscle loss and sarcopenia: A narrative review of preclinical and clinical evidence from eight species

BACKGROUND: Muscle loss, whether due to aging (sarcopenia), chronic disease, or disuse, is a major contributor to frailty, reduced mobility, and diminished quality of life. With limited pharmacological options available, there is growing interest in natural therapies that support muscle preservation. This narrative review investigates the potential of eight medicinal plants, Cannabis sativa, Chrysanthemum morifolium, Crocus sativus, Eriobotrya japonica, Glycine max, Olea europaea, Salvia rosmarinus, and Sesamum indicum, in promoting muscle health and mitigating sarcopenia and atrophy. These species were chosen for their prominence in Persian traditional medicine, supporting evidence, and relevance to muscle physiology, while recognizing that other herbs may also be beneficial. METHODS: A literature search was conducted using Google Scholar, PubMed, Scopus, and Web of Science without time restrictions. Studies involving in vitro, in vivo, and clinical trials were included, focusing on the effects of the selected plants on sarcopenia, muscle atrophy, and overall muscle function. RESULTS: The herbs exert protective effects through converging mechanisms, including stimulation of anabolic signaling, suppression of catabolic mediators, enhancement of mitochondrial resilience, and attenuation of inflammatory pathways. These effects were observed consistently in vitro and animal models, with more variable outcomes in human studies. Functional improvements such as gains in muscle mass, fiber composition, and strength were primarily reported in preclinical models, with limited but initial support from clinical trials. CONCLUSION: Medicinal plants offer a multifaceted approach to muscle preservation, with promising relevance for aging, metabolic dysfunction, and disease-related sarcopenia. Despite robust preclinical evidence, clinical translation is limited by methodological variability and dosing challenges.