Abstraction Health

Urolithin A — Research Evidence

Source: PubMed / NCBI · human studies preferred · ranked by evidence qualityLast analyzed: May 26, 2026
🟡Moderate Evidence
20 studies·7 RCTs·13 reviews

The summary below was generated by an AI system (Claude) based on the studies listed. It is a synthesis tool, not a clinical opinion. Read individual studies for full context.

Urolithin A (UA) is a natural compound produced by gut bacteria from polyphenols found in foods like pomegranates, berries, and walnuts. The available research base includes several randomized controlled trials (RCTs) in humans alongside multiple narrative and systematic reviews, suggesting a genuinely emerging — though still maturing — body of evidence. The compound has attracted scientific interest primarily for its ability to promote mitophagy (the cellular process of clearing damaged mitochondria) and support mitochondrial health, with downstream implications for muscle function, aging, immune health, and inflammation.

Key findings

  • Multiple RCTs suggest UA supplementation may improve muscle endurance and mitochondrial health markers in older adults, with one trial specifically focused on this population.
  • An RCT in male athletes found potential benefits for muscle endurance, strength, oxidative stress, and inflammation markers over 8 weeks of supplementation.
  • Direct UA supplementation appears to produce more consistent blood levels across individuals than dietary intake alone, which is limited by gut microbiome variability — a finding from a dedicated RCT on bioavailability.
  • A placebo-controlled trial found UA may help counter age-related immune decline, possibly through its mitophagy-inducing properties.
  • Systematic reviews on nutraceuticals and mitochondrial health support the plausibility of UA's mechanisms, though they cover a broader supplement landscape rather than UA specifically.

Evidence gaps

  • ?Most human RCTs appear to be relatively small and short-term (weeks to a few months), leaving long-term efficacy and safety largely untested in large populations.
  • ?Many of the supporting studies are narrative reviews rather than primary research, meaning much of the mechanistic evidence is synthesized from animal or in vitro studies rather than direct human trials.
  • ?It remains unclear which specific populations benefit most — research spans healthy adults, older adults, and trained athletes, but data in clinical populations (e.g., those with chronic disease, sarcopenia, or age-related macular degeneration) is largely theoretical or review-based at this stage.

Safety summary

Based on the available RCTs, UA supplementation appears to be generally well-tolerated in healthy adults and older populations at studied doses. However, the limited duration and scale of existing trials means the long-term safety profile has not been fully characterized.

Studies (20)

The anti-obesity effects of postbiotics: A systematic review of pre-clinical and clinical studies.

Clinical nutrition ESPEN · 2024 · Eslami M et al.
Systematic Review🟢
Key finding

The anti-obesity effects of postbiotics: A systematic review of pre-clinical and clinical studies.

COI: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
PMID: 39461594DOI: 10.1016/j.clnesp.2024.10.153
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Impact of nutraceuticals and dietary supplements on mitochondria modifications in healthy aging: a systematic review of randomized controlled trials.

Aging clinical and experimental research · 2022 · Lippi L et al.
Systematic Review🟢
Key finding

Impact of nutraceuticals and dietary supplements on mitochondria modifications in healthy aging: a systematic review of randomized controlled trials.

PMID: 35920994DOI: 10.1007/s40520-022-02203-y
View on PubMed

Age-related sarcopenia and altered gut microbiota: A systematic review.

Microbial pathogenesis · 2024 · Wang M et al.
Systematic Review🟢
Key finding

Age-related sarcopenia and altered gut microbiota: A systematic review.

COI: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
PMID: 39142365DOI: 10.1016/j.micpath.2024.106850
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Direct supplementation with Urolithin A overcomes limitations of dietary exposure and gut microbiome variability in healthy adults to achieve consistent levels across the population.

European journal of clinical nutrition · 2022 · Singh A et al.
RCT🟡
Key finding

Direct supplementation with Urolithin A overcomes limitations of dietary exposure and gut microbiome variability in healthy adults to achieve consistent levels across the population.

COI: The authors declare the following competing interests: AS, DD, PAA, WB-B, and CR are employees; PA and CR are board members; and JA and PA are members of the Scientific Advisory Board of Amazentis SA, who is the sponsor of this clinical study.
PMID: 34117375DOI: 10.1038/s41430-021-00950-1
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Effect of Urolithin A Supplementation on Muscle Endurance and Mitochondrial Health in Older Adults: A Randomized Clinical Trial.

JAMA network open · 2022 · Liu S et al.
RCT🟡
Key finding

Effect of Urolithin A Supplementation on Muscle Endurance and Mitochondrial Health in Older Adults: A Randomized Clinical Trial.

Funded by: BLRD VA, NICHD NIH HHS
PMID: 35050355DOI: 10.1001/jamanetworkopen.2021.44279
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Assessment of Urolithin A effects on muscle endurance, strength, inflammation, oxidative stress, and protein metabolism in male athletes with resistance training: an 8-week randomized, double-blind, placebo-controlled study.

Journal of the International Society of Sports Nutrition · 2024 · Zhao H et al.
RCT🟡
Key finding

Assessment of Urolithin A effects on muscle endurance, strength, inflammation, oxidative stress, and protein metabolism in male athletes with resistance training: an 8-week randomized, double-blind, placebo-controlled study.

COI: No potential conflict of interest was reported by the author(s).
PMID: 39487653DOI: 10.1080/15502783.2024.2419388
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Effect of the mitophagy inducer urolithin A on age-related immune decline: a randomized, placebo-controlled trial.

Nature aging · 2025 · Denk D et al.
RCT🟡
Key finding

Effect of the mitophagy inducer urolithin A on age-related immune decline: a randomized, placebo-controlled trial.

Funded by: Industry (inferred from affiliations)
COI: Competing interests: A.S., D. D’Amico and J.F. are employees, and C.R. is president and delegate of the board of Amazentis SA, which funded this clinical study and provided the investigational product (Mitopure). F.R.G. has received consulting fees from Amazentis. D. Denk has received travel compensation from Amazentis and AbbVie. There are restrictions to the commercial use of SCENITH due to a pending patent application (PCT/EP2020/WO2020212362A1 to R.J.A.). The remaining authors declare no competing interests related to this study.
PMID: 41174221DOI: 10.1038/s43587-025-00996-x
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Evaluating the Impact of Urolithin A Supplementation on Running Performance, Recovery, and Mitochondrial Biomarkers in Highly Trained Male Distance Runners.

Sports medicine (Auckland, N.Z.) · 2025 · Whitfield J et al.
RCT🟡
Key finding

Evaluating the Impact of Urolithin A Supplementation on Running Performance, Recovery, and Mitochondrial Biomarkers in Highly Trained Male Distance Runners.

COI: Declarations. Funding: Open access funding enabled and organized by CAUL and its Member Institutions. This work was supported by research funding from Amazentis SA awarded to L.M.B. and J.A.H. Ethics approval: Ethics approval was obtained from the Australian Catholic University’s Human Research Ethics Committee (2021-36HC), and the study was prospectively registered as a clinical trial (NCT04783207). All procedures were performed in accordance with the standards of ethics outlined in the Declaration of Helsinki. Consent to participate: All participants completed medical history screening to ensure they were free from illness and injury. Comprehensive details of the study protocol were explained orally and provided in writing prior to athletes providing their written informed consent. Consent for publication: Not applicable. Code availability: Not applicable. Data availability: The authors declare that the data supporting the findings of this study are available within the paper and its Supplementary Information files. All raw data are available from the corresponding authors upon reasonable request. Conflict of interest: The authors declare the following competing interests: A.M.F., D.D., and A.S. are employees of Amazentis SA, the sponsor of this clinical study. J.W. has received travel support from Amazentis SA to present findings related to this project at scientific conferences. L.G.K. was an employee of Nestlé Research and Nestlé Health Science, is on the scientific advisory boards of Vital Proteins, NUUN, and RNWY, is a board member of Siftlink, and reports personal fees from Nestlé Health Science, Liquid I.V. and RNWY. J.A.H. is an Editorial Board member of Sports Medicine. J.A.H. was not involved in the selection of peer reviewers for the manuscript nor any of the subsequent editorial decisions. The other authors declare no competing interests. Author contributions: J.W., A.K.A.M., L.G.K., D.D., A.S., L.M.B., and J.A.H contributed to the design of the study. J.W., A.K.A.M., N.T., R.M., A.M., and L.M.B collected and analyzed the whole-body data. J.W. and D.D. analyzed the muscle data. J.W. created the figures and wrote the manuscript with the critical input from the other co-authors. All authors reviewed and approved the final manuscript.
PMID: 40839339DOI: 10.1007/s40279-025-02292-5
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Multi-Species Synbiotic Supplementation Enhances Gut Microbial Diversity, Increases Urolithin A and Butyrate Production, and Reduces Inflammation in Healthy Adults: A Randomized, Placebo-Controlled Trial.

Nutrients · 2025 · Napier BA et al.
RCT🟡
Key finding

Multi-Species Synbiotic Supplementation Enhances Gut Microbial Diversity, Increases Urolithin A and Butyrate Production, and Reduces Inflammation in Healthy Adults: A Randomized, Placebo-Controlled Trial.

Funded by: Seed Health, Inc.
COI: B.A.N. and Z.K. are employees and shareholders of Seed Health, Inc. G.R. and R.J. serve as advisors to Seed Health, Inc. All other authors declare no conflicts of interest. The sponsor (Seed Health, Inc.) had no role in clinical trial operations, which were performed independently by KGK Science Inc. and the final decision to publish was made solely by the authors.
PMID: 40944126DOI: 10.3390/nu17172734
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Evaluation of Urolithin A Efficacy in Heart Failure Patients with Reduced Ejection Fraction: A Randomized, Double-blind, Crossover, Placebo-controlled Clinical Trial.

Reviews on recent clinical trials · 2024 · Jamialahmadi T et al.
RCT🟡
Key finding

Evaluation of Urolithin A Efficacy in Heart Failure Patients with Reduced Ejection Fraction: A Randomized, Double-blind, Crossover, Placebo-controlled Clinical Trial.

Funded by: Industry (inferred from affiliations)
PMID: 38415449DOI: 10.2174/0115748871279354240209101604
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Impact of the Natural Compound Urolithin A on Health, Disease, and Aging.

Trends in molecular medicine · 2021 · D'Amico D et al.
Review🟡
Key finding

Impact of the Natural Compound Urolithin A on Health, Disease, and Aging.

COI: Declaration of Interests The authors declare the following competing interests: D.A, P.A.A., P.V., and A.S. are employees of Amazentis, C.R. is CEO and a board member of Amazentis, and J.A. is a member of the Scientific Advisory Board of Amazentis.
PMID: 34030963DOI: 10.1016/j.molmed.2021.04.009
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Nutraceutical and Dietary Strategies for Up-Regulating Macroautophagy.

International journal of molecular sciences · 2022 · McCarty MF
Review🟡
Key finding

Nutraceutical and Dietary Strategies for Up-Regulating Macroautophagy.

COI: The authors declare no conflict of interest.
PMID: 35216170DOI: 10.3390/ijms23042054
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A review of pomegranate in prostate cancer.

Prostate cancer and prostatic diseases · 2017 · Paller CJ et al.
Review🟡
Key finding

A review of pomegranate in prostate cancer.

Funded by: NCI NIH HHS
COI: Conflict of interest: The corresponding author, Channing Paller, reports no conflict of interest. Drs. Carducci and Pantuck received prior research support from POM Wonderful, LLC, but have no current conflicts.
PMID: 28440320DOI: 10.1038/pcan.2017.19
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Nutraceuticals/Drugs Promoting Mitophagy and Mitochondrial Biogenesis May Combat the Mitochondrial Dysfunction Driving Progression of Dry Age-Related Macular Degeneration.

Nutrients · 2022 · Lewis Luján LM et al.
Review🟡
Key finding

Nutraceuticals/Drugs Promoting Mitophagy and Mitochondrial Biogenesis May Combat the Mitochondrial Dysfunction Driving Progression of Dry Age-Related Macular Degeneration.

COI: The authors declare no conflict of interest.
PMID: 35565950DOI: 10.3390/nu14091985
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Mitochondria as Nutritional Targets to Maintain Muscle Health and Physical Function During Ageing.

Sports medicine (Auckland, N.Z.) · 2024 · Broome SC et al.
Review🟡
Key finding

Mitochondria as Nutritional Targets to Maintain Muscle Health and Physical Function During Ageing.

COI: In the interest of full disclosure, SCB reports gifts from MitoQ Ltd. who manufacture MitoQ. JAH reports research funding received from Amazentis Inc. who manufacture the urolithin A supplement Mitopure. JW has received conference and travel support from Amazentis Inc. LGK was an employee of Nestlé Research and Nestlé Health Science and reports personal fees from Nestlé Health Science who manufacture n3-PUFAs, urolithin A, GlyNAC, and nicotinamide riboside including multivitamins such as B6 and B3.
PMID: 39060742DOI: 10.1007/s40279-024-02072-7
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Sarcopenia in chronic liver disease: mechanisms and countermeasures.

American journal of physiology. Gastrointestinal and liver physiology · 2021 · Allen SL et al.
Review🟡
Key finding

Sarcopenia in chronic liver disease: mechanisms and countermeasures.

Funded by: Medical Research Council, Department of Health
COI: The views expressed are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. No conflicts of interest, financial or otherwise, are declared by the authors.
PMID: 33236953DOI: 10.1152/ajpgi.00373.2020
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Nutraceutical activation of Sirt1: a review.

Open heart · 2022 · DiNicolantonio JJ et al.
Review🟡
Key finding

Nutraceutical activation of Sirt1: a review.

COI: Competing interests: JJD is affiliated with companies that sell supplements. MM and JO own companies that sell supplements.
PMID: 36522127DOI: 10.1136/openhrt-2022-002171
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Novel insights into prebiotic properties on human health: A review.

Food research international (Ottawa, Ont.) · 2020 · Neri-Numa IA et al.
Review🟡
Key finding

Novel insights into prebiotic properties on human health: A review.

COI: Declaration of Competing Interest The authors declare that they have no conflict of interest.
PMID: 32247494DOI: 10.1016/j.foodres.2019.108973
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Distinct roles of urolithin A and spermidine in mitophagy and autophagy: implications for dietary supplementation.

Nutrition research reviews · 2025 · Borsky P et al.
Review🟡
Key finding

Distinct roles of urolithin A and spermidine in mitophagy and autophagy: implications for dietary supplementation.

PMID: 41404767DOI: 10.1017/S0954422425100292
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Exploring substrate-microbe interactions: a metabiotic approach toward developing targeted synbiotic compositions.

Gut microbes · 2024 · Speckmann B et al.
Review🟡
Key finding

Exploring substrate-microbe interactions: a metabiotic approach toward developing targeted synbiotic compositions.

Funded by: Industry (inferred from affiliations)
COI: Bodo Speckmann and Ellen Ehring are employed by Evonik Industries AG, a developer and manufacturer of probiotic products.
PMID: 38300741DOI: 10.1080/19490976.2024.2305716
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