Urolithin A (ellagitannin metabolite, mitophagy activator)

Urolithin A is a metabolite of ellagitannins (found in pomegranate and walnuts) that gut bacteria produce only in some people. Supplements promote it as a mitophagy activator for anti-aging and longevity. Convincing benefit for this use has not been shown in people, and there is no solid evidence that it slows aging or extends lifespan. What actually supports healthy aging is straightforward: regular physical activity, enough sleep, a balanced diet and not smoking.

Urolithin A as Mitopure (Amazentis) is actively sold as a «natural mitophagy activator» in age-related muscle loss and chronic fatigue. Liu 2022 (Cell Reports Medicine) RCT in 88 middle-aged adults showed 12% muscle endurance improvement on 6-minute walk test at 1000 mg/day × 16 weeks vs placebo; Andreux 2019 (Nat Metab) RCT in 60 elderly – mitochondrial function biomarker increase. Sample sizes small; no multicentre RCTs with functional status, mortality or hospitalisation endpoints. In chronic fatigue syndrome (ME/CFS) NICE 2021 (NG206) recommends pacing and multidisciplinary follow-up; urolithin A is not mentioned. If urolithin A was recommended for persistent fatigue without workup (ferritin, TSH, HbA1c, depression and sleep apnoea screening), consider seeking a second opinion from a general practitioner.

ICD-10: R53 · ICD-11: MG22

Urolithin A is a metabolite of ellagitannins (gut bacteria make it from pomegranate, berries, and nuts) marketed as a mitophagy activator and a supplement for memory and focus. It hasn't shown convincing benefit for this use: there's no solid human evidence that it improves cognitive function. Memory and attention respond to other things – steady sleep, physical activity, treating anxiety and depression, managing vascular risk factors. The compound is harmless in this role, but don't use it in place of approaches with proven benefit, since that risks missing the treatment you actually need.