Kim Ross, DCN, CNS, LDN, FMCP⁺

Ashwagandha and Women's Libido: Supporting Sexual Wellness Beyond Desire

1. Key Points
2. Women’s Libido: A Common and Layered Concern
3. Ashwagandha as an Adaptogenic Botanical
4. KSM-66 Ashwagandha®: Clinical Evidence in Women
5. Sleep, Stress and Emotional Well-Being
6. Clinical Takeaway
7. Pure Encapsulations® Nutrient Solutions^‡
8. Resources

Key Points

1. Women’s libido concerns are common in clinical practice and may reflect changes in desire, arousal, lubrication, orgasm, satisfaction, energy, sleep quality, stress load, emotional connection or comfort with sexual activity.
2. KSM-66 Ashwagandha^®, a standardized ashwagandha root extract, has been evaluated in randomized, placebo-controlled studies using 300 mg twice daily for 8 weeks, with reported support for several patient-reported sexual wellness domains.
3. Ashwagandha may also support sleep quality and stress resilience, which are clinically relevant when libido concerns occur alongside poor recovery, high stress load, or emotional depletion.^‡

Women’s Libido: A Common and Layered Concern

Overall female sexual function concerns were reported in 39% of women, with desire-related concerns reported in 29%,¹ making women’s libido concerns common enough that practitioners should feel comfortable asking about them directly. Yet, “libido” is often used as shorthand for a more layered clinical picture. Women may be describing changes in desire, arousal, lubrication, orgasm, satisfaction, energy, sleep quality, stress load, emotional connection or comfort with sexual activity.

This distinction matters. Supporting libido is not simply about targeting desire. It starts with understanding which domain has changed and what else may be contributing.

Ashwagandha as an Adaptogenic Botanical

Ashwagandha (Withania somnifera) is traditionally classified as an adaptogen, meaning it is used to support the body’s ability to adapt to physical and emotional stressors. From a clinical perspective, adaptogenic support may be understood through three broad functions: supporting normal system function, building resilience to stress and supporting performance under physical or emotional demands.² Research has explored its role as an antioxidant, healthy cytokine agent and mitochondrial regulator, while noting its role in stress resilience, sleep, cognitive, immunologic and metabolic functions, physical performance and sexual function, making it a clinically relevant botanical for women’s health and well-being.^{2,3 ‡}

KSM-66 Ashwagandha®: Clinical Evidence in Women

Although much of the historical discussion around ashwagandha and sexual function has focused on male reproductive and hormone health, its relevance for women appears to be broader than hormone support alone. Proposed mechanisms include effects on GABAergic signaling, stress-response physiology, neurotransmitter activity and antioxidant defenses. Clinically, these pathways may matter when changes in libido occur alongside fatigue, high stress load, poor recovery or difficulty with arousal and satisfaction.^{2 ‡}

For women’s libido, KSM-66 Ashwagandha^®, a standardized ashwagandha root extract, has been evaluated in randomized, placebo-controlled studies measuring patient-reported sexual wellness outcomes.^3,4

These studies are clinically useful because the outcomes reflect what patients often describe in practice. A woman may report “low libido,” but further conversation may reveal that the primary concern is arousal, lubrication, orgasm, satisfaction or a reduced sense of sexual connection.

Sleep, Stress and Emotional Well-Being

A woman’s libido does not exist in a vacuum. Sleep disruption, occasional stress, emotional depletion and poor recovery may influence a woman’s capacity for interest, arousal, pleasure and connection.

Ashwagandha may be relevant here as well. A systematic review and meta-analysis highlighted four trials that used KSM-66 Ashwagandha® and found it had significant effects on overall sleep quality and sleep onset latency, with the strongest effects reported at doses of 600 mg/day or higher, and with use for at least 8 weeks.⁵ In adults with self-reported high stress, 300 mg twice daily of ashwagandha extract was associated with improvements in moods and perceived stress and reductions in morning cortisol compared with placebo.^{6 ‡}

For practitioners, this broadens clinical conversation. Ashwagandha may offer support for sexual wellness domains while also supporting pathways that commonly intersect with libido, including sleep quality, stress resilience, emotional well-being and recovery. ^‡

Clinical Takeaway

When a patient reports low libido, start by asking what has changed: desire, arousal, lubrication, orgasm, satisfaction, energy, sleep, emotional connection or comfort with sexual activity. Ashwagandha may be a useful botanical consideration when the clinical picture includes changes in sexual wellness, especially when concerns occur alongside poor sleep, high stress load, or diminished resilience. ^‡

As always, individualize care. Review medications, hormonal stage, alcohol intake, relationship context and pelvic health concerns. Refer or collaborate when pain, medication-related concerns, trauma history, significant emotional distress, pelvic floor concerns or relationship safety concerns are present.

Pure Encapsulations^® Options for Targeted Nutritional Support^‡

FemiVive features KSM-66 Ashwagandha^®, clinically shown to enhance physical and psychological aspects of female sexual response with continued use. This formula also provides maca (Lepidium meyenii) root, also known as Peruvian ginseng, which has adaptogenic properties.^‡
Suggested Dose: 2 capsules, 1-2 times daily, between meals.

Ashwagandha with KSM-66 Ashwagandha^®, provides support for occasional stress. Contains withanolides, which are key constituents that play an important role in the herb’s physical and mental health benefits.^{7 ‡}
Suggested Dose: 1 capsule daily, with or between meals.

Resources

For additional information that includes diet and lifestyle recommendations for supporting women’s health, refer to the resources listed below:

Women’s Libido & Sexual Wellness Protocol^‡: Designed by our scientific and medical advisors to help you deliver the most effective care to support women’s libido.

Stress Management & Relaxation Protocol^‡

Sleep Protocol^‡

Emotional Well-being Protocol^‡

To learn more about the research on selected nutrient solutions, download the following:

• FemiVive

Drug-Nutrient Interactions Checker: Provides valuable information on potential interactions between your patients' prescriptions, over-the-counter medications and nutritional supplements.

You can also explore Pure Encapsulations^® to find On-Demand Learning, Clinical Protocols and other resources developed with our medical and scientific advisors.

1. Vechiu C, Zimmermann M, Aubuchon-Endsley N, et al. J Womens Health. Published online 2026. doi:10.1177/15409996251410095
2. Nobari H, Parnian-Khajehdizaj N, Johnson K, Ramos-Álvarez JJ.Nutr Metab (Lond). 2026;23(1). doi:10.1186/s12986-026-01093-5
3. Dongre S, Langade D, Bhattacharyya S.Biomed Res Int. 2015;2015. doi:10.1155/2015/284154
4. Ajgaonkar A, Jain M, Debnath K. Cureus. Published online 2022. doi:10.7759/cureus.30787
5. Cheah KL, Norhayati MN, Yaacob LH, Rahman RA. PLoS One. 2021;16(9 September). doi:10.1371/journal.pone.0257843
6. Chandrasekhar K, Kapoor J, Anishetty S. Indian J Psychol Med. Published online 2012. doi:10.4103/0253-7176.106022
7. Jamnekar PP, Dehankar TJ, Bedre R V., Dharan BG, Agravat B, Agravat H. Cureus. Published online 2025. doi:10.7759/cureus.96183

⁺Dr. Ross is a paid consultant for Pure Encapsulations.

Kim Ross, DCN, CNS, LDN, FMCP⁺

The Importance of DHA During Pregnancy

1. Key Points
2. Why DHA Matters During Pregnancy
3. Assessing and Recommending DHA Intake in Clinical Practice
4. Pure Encapsulations® Nutrient Solutions^‡
5. Resources

Key Points

• DHA is an omega-3 fatty acid that is highly concentrated in the fetal brain and nervous system.
• Maternal transfer of DHA increases substantially during late pregnancy, when fetal brain and eye development are especially active.
• Many pregnant patients do not meet seafood intake recommendations, making DHA intake an important point of assessment in prenatal nutrition counseling.
• Prenatal dietary DHA intake may help support healthy birth weight and healthy pregnancy progression, in addition to its foundational role in fetal neurodevelopment.^‡

Why DHA Matters During Pregnancy

Docosahexaenoic acid (DHA) is an omega-3 long-chain polyunsaturated fatty acid and the dominant omega-3 fatty acid in the brain, as well as the most abundant omega-3 fatty acid in the nervous system. Because of its central role in neural structure and function, consuming dietary DHA is especially important during pregnancy.

DHA is involved in placental development early in pregnancy and continues to accumulate in the fetal brain throughout gestation, with the most rapid accretion occurring from approximately weeks 29 to 40, a period of accelerated brain and retinal development. DHA is also critically involved in neuronal growth and synapse formation during fetal development and early life, which helps explain why maternal DHA status before conception, during pregnancy and during lactation is clinically relevant.^{1,2 ‡}

Assessing and Recommending DHA Intake in Clinical Practice

A practical issue in clinical care is that many women enter pregnancy with suboptimal DHA status, often due to low seafood intake or a dietary fatty acid pattern that does not support adequate omega-3 status.¹ Early assessment is therefore important. A brief review of seafood intake can help determine whether a patient is likely meeting DHA needs through food alone.

Pregnant women are advised to consume 8 to 12 ounces of low-mercury seafood per week.^3–5 Salmon is a particularly rich source of DHA, providing approximately 1.2 grams per 3-ounce serving.⁵

For patients with low seafood intake, food aversions or inconsistent intake of DHA-rich foods, supplementation may be considered. Several professional groups suggest a minimum of 250 mg/day of DHA plus EPA during pregnancy, with some recommending an additional 100 to 200 mg/day of DHA and others suggesting 600 to 1,000 mg/day, ideally beginning by 20 weeks gestation.⁵

Clinical Takeaway

DHA warrants clinical consideration during pregnancy because it supports fetal brain, nervous system and eye development. It may also contribute to healthy pregnancy progression and birth outcomes. From a practice standpoint, assessing DHA intake early, encouraging regular consumption of lower-mercury seafood (8-12 ounces per week) and identifying whether additional dietary or supplemental DHA support is needed can help promote adequate intake, ideally by 20 weeks gestation.^‡

Pure Encapsulations^® Options for Targeted Nutritional Support^‡

DHA Ultimate is a supercritical CO2 extracted DHA fish oil that supports healthy neural and cognitive function.^‡ Epidemiological studies indicate that a high intake of DHA is associated with healthy cognitive function in adults as well as infants born to mothers with a diet high in DHA.^6,7
Suggested Dose: 2 softgel capsules daily, with a meal

EPA/DHA Essentials is an ultra-pure, microfiltered fish oil concentrate that supports cardiovascular health and daily wellness.^‡
Suggested Dose: 1-2 softgel capsules daily, with a meal

Resources

For additional information to help you deliver the most effective care for women’s health from preconception to postpartum, refer to the resources below:

Women’s Fertility Support Protocol

Pregnancy Support Protocol

Postpartum Care Protocol

Supporting Female Fertility with Nutrition: Blog

To learn more about the research on selected nutrient solutions, download the following:

• DHA Ultimate

Drug-Nutrient Interactions Checker: Provides valuable information on potential interactions between your patients' prescriptions, over-the-counter medications and nutritional supplements.

You can also explore Pure Encapsulations^® to find On-Demand Learning, Clinical Protocols and other resources developed with our medical and scientific advisors.

1. Basak S, Mallick R, Duttaroy AK. Nutrients . 2020;12(12). doi:10.3390/nu12123615
2. Ghazal RM, Naffaa MM. Exploration of Neuroprotective Therapy. 2025;2025(5). doi:10.37349/ent.2025.1004107
3. Bramante CT, Spiller P, Landa M. JAMA Pediatr. 2018;172(9):801-802. doi:10.1001/jamapediatrics.2018.1619
4. Hibbeln CJR, Spiller P, Brenna JT, et al. Prostaglandins Leukot Essent Fatty Acids. 2019;151. doi:10.1016/j.plefa.2019.10.002
5. NIH. Omega-3 Fatty Acids - Health Professional Fact Sheet. Office of Dietary Supplements. 2019.
6. Jackson PA, Reay JL, Scholey AB, Kennedy DO. Br J Nutr. 2012;107(8). doi:10.1017/S0007114511004041
7. Tahaei H, Gignac F, Pinar A, et al. Nutrients. 2022;14(3). doi:10.3390/nu14030518

⁺Dr. Ross is a paid consultant for Pure Encapsulations.

Kim Ross, DCN, CNS, LDN, FMCP⁺

The Role of Dietary Fiber in Weight Management

1. Mechanisms Tying Dietary Fiber to Weight Management
2. Fiber Characteristics That Influence Weight Management Outcomes
3. Clinical Application
4. Pure Encapsulations® Options for Targeted Nutritional Support^‡
5. Resources

Key Points

1. Dietary fiber may support weight management through several mechanisms. These include greater satiation and satiety, slower gastric emptying, healthy glycemic responses, and colonic fermentation that may influence appetite-related signaling.
2. Not all fibers behave the same way. Viscosity, fermentability dose, and food matrix all matter clinically. This helps explain variable patient responses.
3. A practical target for many adults is to consume 25 to 30 grams of fiber per day, or about 14 grams per 1,000 kcal. Increase intake gradually to improve gastrointestinal tolerance.
4. Literature now extends the conversation beyond "bulk and regularity". It now focuses on microbiota-mediated, metabolic and gut-brain mechanisms relevant to long-term weight management.

Mechanisms Tying Dietary Fiber to Weight Management

Fiber is a practical nutritional tool in weight management because it can improve the patient's experience with food. Meals built around fiber-rich foods are often more filling. They can help soften hunger intensity between meals and may also promote a healthy postprandial glucose response.¹

Dietary fiber influences weight management through several organs and physiological mechanisms.^1–3

1. In the upper gastrointestinal tract, fiber can increase chewing time and meal volume. Depending on the type, fiber can also slow gastric emptying. These effects may support satiation during meals and satiety between meals, helping patients feel full sooner and remain satisfied longer.^‡
2. In the small intestine, dietary fiber can slow nutrient absorption which may contribute to a more gradual postprandial glycemic response. This may support healthy blood glucose and insulin. It also supports more stable energy and appetite regulation.^‡
3. In the colon, gut microbiota metabolizes fermentable fibers into short-chain fatty acids. These may participate in gut-brain and enteroendocrine signaling. This includes pathways involving hormones that modulate hunger and satiety, such as glucagon-like peptide-1 (GLP-1), peptide YY, cholecystokinin (CCK) and ghrelin.

These mechanisms suggest that fiber may support weight management not through a single effect, but through coordinated actions on digestion, healthy glycemic response, appetite signaling and energy intake.^‡

Dietary Fiber Characteristics That Influence Weight Management Outcomes

A key clinical takeaway is that fiber should not be viewed as a single intervention. Fibers differ in viscosity, fermentability, solubility, particle structure and food matrix. These characteristics influence their physiological effects.^2,4

Soluble fibers, such as psyllium, beta-glucans, pectins and inulin, dissolve in water. This may affect gel formation, glycemic response and microbial fermentation. Insoluble fibers, such as flaxseed, wheat bran, cellulose and some hemicelluloses, often relate more to stool bulk and intestinal transit. Unfortunately, these categories do not fully predict physiological response.^1,4

More viscous dietary fibers, such as psyllium, glucomannan and beta-glucans from oats and barley, are generally more relevant for gastric emptying, fullness and a healthy postprandial glycemic response. More fermentable fibers, such as inulin, fructooligosaccharides, resistant starch and some oligosaccharides, may exert greater effects in the colon through microbial metabolism and short-chain fatty acid production.^1,4

Whole food sources, such as legumes, berries, chia seeds, vegetables and intact whole grains, deliver additional variables. These include food form, cellular structure and accompanying nutrients, all of which can modify physiological response.

These differences help explain why one patient may notice better satiety and appetite control, while another experiences more prominent effects on stool quality, glycemic response or digestive tolerance. Research suggests that baseline gut microbiota composition may also influence responsiveness to specific fibers, supporting growing interest in more personalized nutrition approaches.^5,6

Clinical Application

Current guidelines suggest that adults benefit from consuming approximately 25 to 30 grams of fiber per day or about 14 grams per 1,000 kcal consumed. Notably, population intake remains well below recommended levels.⁴

Keep advice simple and direct for patients.

• Encourage patients to build meals around fiber-rich foods such as legumes, vegetables, fruit, nuts, seeds and intact whole grains, increasing intake gradually to improve gastrointestinal tolerance.
• Add one fiber-rich food to each meal as an initial step.
• Set expectations appropriately. Fiber may support weight management, but it is not a stand-alone solution.^‡

Fiber’s benefits are strongest when included in a diet that improves food quality, satiety and adherence. In that way, fiber helps support a healthy eating pattern for physiological and behavioral sustainability.^‡

Pure Encapsulations^® Options for Targeted Nutritional Support^‡

Arabinogalactan (AG) is a fermentable prebiotic fiber found in high concentrations in North American larch trees.
Suggested Dose: 1 capsule, three times daily, between meals

PureLean^® Satiety is designed to support relaxation and moderate appetite to promote healthy weight management^†. It offers clinically researched DNF-10^® to moderate caloric intake and promote satiety^‡
Suggested Dose: 1 capsule, 1-2 times daily, with meals.

Resources

For additional information that includes diet and lifestyle recommendations for supporting weight management, refer to the resources listed below:

Weight Management Protocol: Designed by our scientific and medical advisors to help you deliver the most effective care and support weight management.

Drug-Nutrient Interactions Checker: Provides valuable information on potential interactions between your patients' prescriptions, over-the-counter medications and nutritional supplements.

You can also explore Pure Encapsulations^® to find On-Demand Learning, Clinical Protocols and other resources developed with our medical and scientific advisors.

1. Akhlaghi M. Crit Rev Food Sci Nutr. 2024;64(10). doi:10.1080/10408398.2022.2130160
2. Mocanu V, Madsen KL.Clin Transl Med. 2024;14(10). doi:10.1002/ctm2.70018
3. Deehan EC, Mocanu V, Madsen KL. Nat Rev Gastroenterol Hepatol. 2024;21(5). doi:10.1038/s41575-023-00891-z
4. McKeown NM, Fahey GC, Slavin J, van der Kamp JW. BMJ. 2022;378. doi:10.1136/bmj-2020-054370
5. Wang C, Qin S, Shi J, et al. Carbohydr Polym. 2025;368. doi:10.1016/j.carbpol.2025.124097
6. Murga-Garrido SM, Hong Q, Cross TWL, et al. Microbiome. 2021;9(1). doi:10.1186/s40168-021-01061-6

⁺Dr. Ross is a paid consultant for Pure Encapsulations.

By Amy Doyle, MS, CNS⁺

Putting Pep in Their Step: Supporting Patients with Age-Related Muscle Decline

1. Introduction
2. How Muscle Mass and Strength Change with Age
3. The Mitochondria’s Role in Muscle Health
4. Exercise and Nutrition Interventions for Age-Related Muscle Decline
5. Nutrients to Support Age-Related Muscle Decline
6. Pure Encapsulations® Nutrient Solutions
7. Summary
8. Resources

Introduction

Skeletal muscle is the predominant tissue in the human body, comprising 40% of overall body weight.¹ We rely on our skeletal muscle for numerous physiological functions including movement, maintaining posture, generating force, metabolism and respiration.¹

As people age, so do their skeletal muscles.

How Muscle Mass and Strength Change with Age

Age-related muscle decline can begin at age 30.³ More pronounced in sedentary individuals, muscle mass can be lost at a rate of 1% per year.² Loss of muscle mass can also be accompanied by atrophy of muscle fibers and reduced muscle function and strength. This gradual decrease can progress, with an individual losing up to one-third of their muscle mass by age 80.²

Loss of muscle mass and strength in older individuals could contribute to fall risk, reduced mobility, loss of independence, and ability to perform daily functions.²

The Mitochondria’s Role in Muscle Health

Skeletal muscle is a tissue with high energy demands and mitochondria are primarily responsible for meeting this demand. Mitochondria not only power muscle contraction by supplying ATP, they also undertake other critical functions, including moderating intracellular calcium, cell proliferation, apoptotic signaling, regulation of redox states and immune response.³

Well-functioning mitochondria are essential for maintaining cellular homeostasis and muscle health. Cellular mitochondrial health is maintained by growing the mitochondrial pool through mitochondrial biogenesis, through preserving fusion and fission and by ensuring the removal of altered mitochondria through mitophagy.

Mitophagy is a selective autophagy process that serves as the mitochondria’s own quality-control mechanism and involves removing and recycling altered mitochondria.⁴ Mitophagy helps preserve only healthy mitochondria for the mitochondrial pool.

Just as skeletal muscle function can change as the human body ages, mitochondria are also subject to the effects of aging, as shown in the illustration below. These age-associated changes in mitochondria can lead to altered mitophagy.^5,6,7,8

When mitophagy is altered, it can lead to accumulation, rather than clearance of altered mitochondria.

Accumulation of these mitochondria can contribute to energy deficit and changes in the balance between anabolic and catabolic processes — important determinants of muscle mass, function, motor neuron and muscle fiber health.^8,9,10

Mitochondria can quickly adapt to changing conditions triggered by systemic or cellular challenges.³

Supporting mitochondrial function helps reduce loss of muscle mass and function and benefit overall health, specifically by enhancing mitochondrial dynamics and mitophagy.³

Both sedentary and physically active are susceptible to age-related muscle decline, yet the degree of severity is highly variable and dependent upon multiple risk factors beyond mitochondrial health, including hormone and cytokine balance, malnutrition and degree of physical activity.¹¹

Exercise and Nutrition Interventions for Age-Related Muscle Decline

Lack of exercise is believed to be the leading risk factor for age-related muscle loss.¹¹ Both resistance and aerobic training have been shown to improve the health of skeletal muscle by impacting mitochondrial quality and increasing muscle strength and function in older patients.^11,12,13,14

Individually tailored exercise programs can support healthy aging and be a means of prevention and intervention for age-related muscle decline.

In clinical studies demonstrating the benefits of aerobic, resistance or combined exercises, exercise was performed at least 2-3 times per week, for 30-60 minutes each session, for at least 8-12 weeks.^12,13

When recommending exercise as a therapeutic option for patients, the duration of sessions, amount of weight, distance, and number of exercises should increase gradually based on each individual’s capability and improvement.

Forty percent of older individuals do not meet the recommended .8g/kg protein intake requirements in their diet.¹⁵ Poor protein intake, combined with decreased absorption and intake of other nutrients that are essential for muscle health like amino acids and vitamins and minerals, put older individuals at a greater risk of reduced muscle protein synthesis or “anabolic resistance” and muscle loss.¹⁶ In addition, changes in mitochondrial function that also occur with aging can contribute to oxidative stress and favor catabolism of the muscle.^17,18,19

Two ways to support age-related muscle decline in the older patient involve assessing their protein and antioxidant intake. Recommended adequate protein in the older patient is 0.8 gm/2.2 lbs of body weight up to age 65, and 1 gm/2.2 lb of body weight after age 65.²⁰

Adherence to a Mediterranean diet, which promotes a high intake of proteins, fibers and polyphenols, combined with an individualized exercise regimen can be an effective approach to age-related muscle changes in the aging patient.

Nutrients to Support Age-Related Muscle Decline

Along with adequate protein, a phytonutrient rich diet and exercise, focusing on nutrients that support cellular, mitochondrial and muscle health can help improve patient outcomes.

B vitamins are essential to basal mitochondrial function, serve as metabolic coenzymes and/or methyl donors.^‡

PQQ provides B vitamin-like activity with unique antioxidant properties. PQQ supports mitochondrial, neuronal and cellular function, at least in part, by activation of Nrf2 and antioxidant gene expression. PQQ may also help to maintain cytokine balance.^‡

Amino Acids are the building blocks for all proteins, making them essential for several body functions, including fluid balance, enzyme production, cellular repair and energy metabolism.^25,26 Proper intake of amino acids is important for the synthesis, repair and metabolism of muscle, cells and tissues.^‡

Creatine is an energy carrier that is naturally present in muscles, brain and other organs. It clinically studied to increase body strength, build muscle mass, and support recovery from strenuous exercise. Creatine also promotes growth factor signaling and glycogen storage to support gains in muscle strength.^‡

Pure Encapsulations^® Nutrient Solutions

Pure Encapsulations^® offers high-quality supplements that are FREE FROM unnecessary additives and many common allergens for patients who may need support for age-related muscle changes. We offer nutrients individually and in combination to meet all your patients’ unique needs.^‡

Klean Athlete^® is a Pure Encapsulations partner brand.

Klean Athlete^® is our dedicated sports nutrition brand designed to power peak performance through optimal health. By harnessing the science of sports nutrition, Klean Athlete^® delivers safe, NSF Certified for Sport^® supplements to support healthy, active lifestyles. Klean Athlete^® is trusted by over 350 professional and collegiate sports teams and is the preferred brand of many of the world’s top coaches, trainers and health professionals.^‡

Cellular Health

Renual enhances mitochondrial renewal to support energy output/energy production. Features Mitopure^™ Urolithin A to power muscle function, increase cellular energy and promote healthy aging. Research indicates that urolithin A enhances autophagy, the natural process of cellular renewal in which the body degrades and recycles cellular components, as well as mitophagy, the clearance and recycling of older mitochondria. Resveratrol offers support for longevity, metabolic health, and mitochondrial function.^27,28 CoQ₁₀ is a key nutrient used in the energy production pathway. ^29‡
Suggested Dose: Take 2 capsules, 1-2 times daily, with or between meals.

Ultra B Complex w/PQQ combines essential B vitamins with PQQ to support cellular energy production and mitochondrial bioenergetics and function. It also contains alpha lipoic acid and luteolin for enhanced antioxidant and cellular support.^‡
Suggested Dose: Take 1 capsule, 1-2 times daily, with meals.

Muscle Health

Creatine supports muscle strength, performance and recovery^‡ It promotes growth factor signaling and glycogen storage to support gains in muscle strength and supports quick conversion of ADP to ATP energy.^‡
Suggested Dose: 1 1/2 tsp daily mixed with 8 oz of water or beverage of choice.

KLEAN Isolate^™ supplies 20 grams of high-quality whey protein isolate in each serving. The dietary protein provided by Klean Isolate^™ supplies essential amino acids, including branched chain amino acids that participate in many of the body’s metabolic and physiologic systems. With no additional flavorings or sweeteners, Klean Isolate^™ can easily be added to any beverage to enhance daily protein and amino acid intake.^‡
Suggested Dose: Adults take 1 scoop daily mixed with 10-12 oz. of water or other beverage (cool or room temperature), or as directed. For best results, take within 45 minutes after being active.

KLEAN Plant-Based Protein^™ by Klean Athlete^® supplies a blend of pea and organic brown rice protein to provide amino acids for muscle protein synthesis. ProHydrolase^® enzymes are included to break down protein for increased amino acid absorption and to ease digestion, along with Sunfiber^® for gastrointestinal health.^‡
Suggested Dose: 1 scoop daily mixed with 10-12 ounces of water or other beverage, or as directed by a trainer, coach or health professional.

Digestive Support

Digestive Enzymes Ultra w/ Betaine HCl contains an extensive profile of betaine HCl and digestive enzymes to support protein, carbohydrate, fat, fiber and dairy digestion while promoting enhanced nutrient bioavailability and absorption. Encourages optimal gastric pH with betaine HCl, which is important for the enhanced digestion of protein and other nutrients for daily wellness and healthy neurotransmitter synthesis.^‡
Suggested Dose: 2 capsules with each meal, or as directed by a health professional.

Summary

Loss of muscle mass and strength can significantly impact an individual’s well-being and ability to live independently. Providing patients with targeted, personalized nutrition and exercise interventions to enhance anabolic processes and cellular health can greatly influence their quality of life now, and as they age.

Pure Encapsulations^® provides uniquely formulated products made with high-quality, pure ingredients backed by verifiable science to complement your plan of care.

Resources

• Age Related Muscle Loss Protocol^‡

Drug-Nutrient Interactions Checker: Provides valuable information on potential interactions between your patients' prescriptions, over-the-counter medications and nutritional supplements.

You can also explore Pure Encapsulations^® to find On-Demand Learning, Clinical Protocols and other resources developed with our medical and scientific advisors.

1. Najm A. et al. Int J Mol Sci. 2024 Apr 12;25(8):4300. doi: 10.3390/ijms25084300. PMID: 38673885; PMCID: PMC11050002.
2. Ali S. et al. Gerontology. 2014;60(4):294-305. doi: 10.1159/000356760. Epub 2014 Apr 8. PMID: 24731978; PMCID: PMC4112511.
3. Burtscher J. et al. Front Public Health. 2024 Jan 10;11:1330131. doi: 10.3389/fpubh.2023.1330131. PMID: 38269379; PMCID: PMC10806989.
4. Faitg J et al. Calcif Tissue Int. 2024 Jan;114(1):53-59. doi: 10.1007/s00223-023-01145-5. Epub 2023 Nov 5. PMID: 37925671; PMCID: PMC10791945.
5. Aging Cell. 2016. 15(6):1132-39.
6. J Orthop Translat. 2020. 23:38-52
7. A Gerontol A Biol Sci. 2018. 17:939-45
8. Ferri E et al. Int J Mol Sci. 2020 Jul 23;21(15):5236. doi: 10.3390/ijms21155236. PMID: 32718064; PMCID: PMC7432902.
9. Kubat GB et al. Mitochondrion. 2023 Sep;72:33-58. doi: 10.1016/j.mito.2023.07.003. Epub 2023 Jul 13. PMID: 37451353.
10. Drake JC et al. FASEB J. 2016 Jan;30(1):13-22. doi: 10.1096/fj.15-276337. Epub 2015 Sep 14. PMID: 26370848; PMCID: PMC6137621.
11. Dhillon RJ and Hasni S. Clin Geriatr Med. 2017 Feb;33(1):17-26. doi: 10.1016/j.cger.2016.08.002. PMID: 27886695; PMCID: PMC5127276.
12. Chen N. et al. Eur Rev Aging Phys Act. 2021 Nov 11;18(1):23. doi: 10.1186/s11556-021-00277-7. PMID: 34763651; PMCID: PMC8588688.
13. Ni HJ et al. Arch Gerontol Geriatr. 2022 Mar-Apr;99:104605. doi: 10.1016/j.archger.2021.104605. Epub 2021 Dec 2. PMID: 34922244.
14. Yarasheski KE et al. Am J Physiol. 1999 Jul;277(1):E118-25. doi: 10.1152/ajpendo.1999.277.1.E118. PMID: 10409135.
15. Morley JE et al. J Am Med Dir Assoc. 2010 Jul;11(6):391-6. doi: 10.1016/j.jamda.2010.04.014. PMID: 20627179; PMCID: PMC4623318.
16. Cochet C et al. Nutrients. 2023 Aug 24;15(17):3703. doi: 10.3390/nu15173703. PMID: 37686735; PMCID: PMC10490489.
17. Cedikova M et alPhysiol. Res. 2016;65:S519–S531. doi: 10.33549/physiolres.933538.
18. Prado CM et al. Clin Nutr. 2022 Oct;41(10):2244-2263. doi: 10.1016/j.clnu.2022.07.041. Epub 2022 Aug 7. PMID: 36081299.
19. Romani M et al. Nutrients. 2022 Jan 22;14(3):483. doi: 10.3390/nu14030483. PMID: 35276842; PMCID: PMC8838610.
20. Age and Aging. 2023;52:10.1093
21. Besora-Moreno M et al. Clin Nutr. 2022 Oct;41(10):2308-2324. doi: 10.1016/j.clnu.2022.07.035. Epub 2022 Aug 17. PMID: 36099667.
22. Espín JC, Larrosa M, García-Conesa MT, Tomás-Barberán F. Evid Based Complement Alternat Med. 2013;2013:270418.
23. Heim KC. In: Antioxidant Polymers: Synthesis, Properties, and Applications. Cirillo G, Iemma F, eds. Taylor and Francis, c. 2012
24. Ryu D, et al. Nat Med.2016 Aug;22(8):879-88.
25. Flakoll PJ, et al. J Appl Physiol (1985). 2004 Mar;96(3):951-6.
26. Shimomura Y, et al. J. Nutr. 2006. 136(2); 529- 532.
27. Timmers S, et al. Cell Metab. 2011 Nov 2;14(5):612-22.
28. Goh KP, et al. Int J Sport Nutr Exerc Metab. 2014 Feb;24(1):2-13.
29. Zheng A, Moritani T. J Nutr Sci Vitaminol (Tokyo). 2008 Aug;54(4):286-90.
30. Yago MR, et al. Mol Pharm. 2013 Nov 4;10(11):4032-7.

⁺Amy Doyle, MS, CNS is an employee of Pure Encapsulations.

By Amy Doyle, MS, CNS⁺

New Research on Clinical Strategies to Support Biological Age

Biological age isn’t the future of care — it’s already reshaping patient expectations today. Patients are prioritizing their health span, and the demand for biological age assessments is expected to triple over the next ten years.

Most patients already understand the value of good nutrition, quality supplements and a balanced lifestyle. But what if these habits could do more than support day-to-day wellness — what if they could actually slow down or even reverse biological age?

A new pilot study published in the ACNEM Journal (September 2025) explored exactly that. Over just 90 days, researchers tracked how structured nutrition, supplementation and lifestyle program affected participants’ biological age using advanced DNA methylation tests. The results were eye-opening: participants reduced their biological age by an average of 2–9 years, depending on the biomarker used.

Here’s what that means and why it matters.

Chronological Age vs. Biological Age: What’s the Difference?

Chronological age is how many years a person has been alive. Biological age, however, reflects how fast a person’s cells are aging.

Scientists measure this using “epigenetic clocks that read DNA methylation patterns. These chemical tags on your DNA change with lifestyle, stress, sleep and nutrition adjustments. Certain clocks estimate overall biological age (like Horvath and PhenoAge), while others measure the pace of aging or cellular changes.

In this study, four clocks were used:

• PC PhenoAge – predicts health span and risk
• DAMAge – measures DNA changes and cellular stress
• Intrinsic Epigenetic Age – cellular aging independent of immune changes
• DunedinPACE – rate of aging per year

What Did the 90-Day Study Involve?

Forty-one adults, aged 30–81, completed a three-month holistic protocol that included:

1. A structured whole-food nutrition plan

• 6 servings of vegetables per day (greens, cruciferous and colorful varieties)
• 1.6–2.0 g protein per kg ideal body weight
• No added sugars and a diet focusing on whole foods

2. Daily movement and strength training

• At least 30 minutes of exercise per day
• Strength training 3 times per week
• Stress-management practices (5–10 minutes daily)

3. Targeted supplement support
Participants received a blend of supplements including:

• Methylated B-complex (with L-5-MTHF and methylcobalamin)
• Resveratrol (100 mg/day)
• Ubiquinol (200 mg/day)
• A nutrigenomic detox complex (sulforaphane, NAC, ALA, curcumin)
• Nicotinamide riboside (100 mg/day)

These ingredients target core “hallmarks of aging,” including oxidative stress, mitochondrial decline, inflammation and epigenetic alterations.

The Results: Biological Age Dropped — Fast

PC PhenoAge

• Decreased 2.3 years on average in just 3 months
• (p = 0.0029; statistically significant)

• Decreased 8.8 years on average
• (p = 0.00019; highly significant)

• Showed small but positive improvements
• Not statistically significant, but directionally favorable

In short, participants became biologically younger and accumulated less cellular changes in just 90 days.

Why Did It Work? A Multi-Pathway Approach

This wasn’t a single “magic bullet”, it was a synergistic lifestyle approach that targeted multiple aging pathways:

Methylated B vitamins support DNA methylation, stress-hormone metabolism, and genomic stability. A vegetable-rich diet provides polyphenols that influence epigenetic regulation.^3‡

Resveratrol supports healthy cytokine balance, improves metabolic markers, and helps to scavenge free radicals which are responsible for skin aging--thanks to its antioxidant activity. Sulforaphane activates the Nrf2 pathway, improving detoxification and antioxidant capacity.^‡

Ubiquinol boosts energy production and reduces oxidative stress. Nicotinamide riboside increases NAD⁺, a coenzyme essential for DNA repair, mitochondrial function, and cellular resilience.^‡

This multi-modal strategy addressed key hallmarks of aging simultaneously, resulting in meaningful biological rejuvenation.

What This Means for Health and Longevity

If your patients already value supplementation and healthy living, this study reinforces something powerful:

Small, consistent daily habits can significantly influence how fast the body ages at the cellular level.

This research shows that:

• Biological age is modifiable
• Improvements can happen quickly
• A holistic approach is more powerful than isolated changes
• Supplements that support methylation, detoxification and mitochondrial health can meaningfully enhance results

While more research is needed, the message is clear; daily lifestyle choices are one of the most powerful tools available for extending health span.

For more comprehensive resources on biological age, refer to:

• The Consumer Longevity Revolution: Mapping the Future of Health, Wealth, and Wellness. Version 1.2. September 2025. LEMON – Dare to Imagine; in partnership with 40+Lab and Kompassium. Available from: https://kompassium.com/wp-content/uploads/2025/12/The-Consumer-Longevity-Revolution-text-29-09-2025.pdf
• Crider KS, Yang TP, Berry RJ, Bailey LB. Folate and DNA methylation: a review of molecular mechanisms and the evidence for folate's role. Adv Nutr. 2012 Jan;3(1):21-38.
• Choi SW, Friso S. Modulation of DNA methylation by one-carbon metabolism: a milestone for healthy aging. Nutr Res Pract. 2023 Aug;17(4):597-615. doi: 10.4162/nrp.2023.17.4.597.
• Borsoi FT, Neri-Numa IA, de Oliveira WQ, de Araújo FF, Pastore GM. Food Chem (Oxf). 2022 Dec 13;6:100155.
• Wu Q, Xiao C, Ouyang B, Farag MA, Yuan Y, Simal-Gandara J, Cao H, Xiao J. Phytomedicine. 2025 Nov 25;148:157495.
• Xia N, Daiber A, Förstermann U, Li H. Antioxidant effects of resveratrol in the cardiovascular system. Br J Pharmacol. 2017 Jun;174(12):1633-1646. doi: 10.1111/bph.13492. Epub 2016 May 6. PMID: 27058985; PMCID: PMC5446570.
• Cao X, Liao W, Xia H, Wang S, Sun G. The Effect of Resveratrol on Blood Lipid Profile: A Dose-Response Meta-Analysis of Randomized Controlled Trials. Nutrients. 2022 Sep 11;14(18):3755.
• Liu K, Zhou R, Wang B, Mi MT. Effect of resveratrol on glucose control and insulin sensitivity: a meta-analysis of 11 randomized controlled trials. Am J Clin Nutr. 2014 Jun;99(6):1510-9.
• Fahey JW, Talalay P. Antioxidant functions of sulforaphane: a potent inducer of Phase II detoxication enzymes. Food Chem Toxicol. 1999 Sep-Oct;37(9-10):973-9.
• Gomes, A. P., et al. Cell, vol. 155, no. 4, 2013, pp. 1624–1638.
• Trammell, S. A. J., et al. “Nicotinamide Riboside Is Uniquely and Orally Bioavailable in Mice and Humans.” Nature Communications, vol. 7, 2016, p. 12948.
• Vreones M, Mustapic M, Moaddel R, Pucha KA, Lovett J, Seals DR, Kapogiannis D, Martens CR. Oral nicotinamide riboside raises NAD+ and lowers biomarkers of neurodegenerative pathology in plasma extracellular vesicles enriched for neuronal origin. Aging Cell. 2023 Jan;22(1):e13754.

By Amy Doyle, MS, CNS⁺

Supporting Motility and Bowel Regularity: A Step-by-Step Approach

1. Introduction
2. Step One: Foundational Assessments and Identification of Subtype
3. Step Two: Investigation of Key Drivers
4. Step Three: Individualized Care
5. Step Four: Track Outcomes and Adjust
6. Pure Encapsulations® Nutrient Solutions
7. Conclusion
8. Resources

Introduction

Altered gastrointestinal motility is one of the most prevalent symptoms of functional bowel GI concerns encountered in clinical practice.¹ Despite its frequency, altered motility remains challenging to address due to its heterogeneity and the influence of gut–brain interactions.

A clinically useful lens for understanding motility concerns involves shifting the focus from symptom suppression to addressing physiology across multiple systems, including digestion, absorption, immune signaling, barrier integrity, microbial ecology and neuroendocrine regulation.

Patient care can differ significantly depending on the patient’s predominant clinical presentation: occasional diarrhea, occasional constipation or mixed bowel patterns - primarily occasional constipation with intermittent episodes of diarrhea.

Rather than being defined by structural changes, motility-related functional bowel concerns are characterized by symptom clusters that reflect shifts not only in motility but also potentially in other core physiological processes, including²:

• Visceral sensitivity
• Mucosal or immune activation patterns
• Changes within the gut microbial ecosystem
• Alterations in central nervous system processing influencing digestive function

This blog outlines a stepwise care strategy to support your decision-making in practice.

Step One: Foundational Assessments and Identification of Subtype

Functional bowel GI concerns can share similar clinical patterns with other health concerns.³ The first step is to perform a comprehensive functional assessment to confirm that the patient’s symptoms are not due to structural changes, non-beneficial microbial exposure or underlying metabolic, enzymatic or molecular contributors.⁴ Additional indications that advanced assessments may be needed include, but are not limited to, unintended weight loss, nocturnal symptoms, changes in iron levels, symptom onset after age 50 and family history.⁴

Step Two: Investigation of Key Drivers

While no single causative factor has been isolated for functional bowel GI concerns, several key drivers have been identified.

Additional assessments can help uncover contributors and support a personalized plan of care. For more information about foundational and supplemental assessments, refer to our Functional Bowel GI Health Protocol^‡.

Step Three: Individualized Care

Unique dietary triggers, stress, mood, sleep and exercise can strongly impact symptom levels, making nutrition, lifestyle and targeted supplementation essential components of care.¹⁰

Nutrition directly influences microbial fermentation, motility, immune signaling and epithelial integrity, making it foundational to supporting motility.⁹ For example:

• Occasional diarrhea: A short-term low-FODMAP diet can reduce fermentative load, osmotic activity and gas production, often improving stool urgency and frequency.¹¹
• Occasional constipation: Gradual introduction of soluble fiber supports stool hydration and colonic transit without excessive mechanical irritation.

Dietary changes should be used therapeutically and often temporarily, with structured reintroduction to prevent unnecessary restriction, nutrient depletions and unfavorable microbiome changes.

To explore more dietary strategies that support motility and bowel regularity, refer to our Functional Bowel GI Health Protocol^‡.

Lifestyle considerations include acknowledging stress, mood and the gut-brain connection. Patients with functional bowel GI concerns often present with a broad range of somatic concerns—such as fatigue, sleep disturbances, diffuse musculoskeletal discomfort and cardiopulmonary sensations—that may arise in the absence of identifiable structural changes.¹² Patterns of mood disturbance, including low mood, occasional anxiety and somatic preoccupation can influence how patients process and respond to visceral and extraintestinal signals.¹³

Any stress-management technique that supports physiological downregulation and enhances the body’s relaxation response can help patients feel more empowered in managing their symptoms and can promote greater parasympathetic activity.

Targeted nutraceutical support also differs depending on subtype but should focus on supporting digestion, microbial balance, intestinal barrier integrity and function, cytokine balance and motility.

Step Four: Track Outcomes and Adjust

Clinical outcomes should be tracked for 4-6 weeks at a time and include:

• Stool frequency and form (Bristol scale)
• Abdominal discomfort
• Bloating and gas
• Urgency or incomplete evacuation
• Sleep quality
• Energy levels
• Cycle-related symptom shifts (in women)

Structured dietary and supplement recommendations should be adjusted every 8-12 weeks, based on your patient’s response to care. Laboratory assessments can be completed every 3-6 months as necessary.

Ongoing assessment and refinement of diet, lifestyle and supplement strategies ensure that care remains responsive to changing clinical needs. Compassionate, individualized guidance can help patients build greater resilience, improve daily functioning and experience meaningful progress over time.

Pure Encapsulations Nutrient Solutions

PureGG 25B contains Lactobacillus rhamnosus GG, which is well known for its favorable effects on bowel function, particularly abdominal comfort, bowel motility and occasional diarrhea.^‡
Suggested Dose: 1 capsule daily, with or between meals

Epi-Integrity Powder promotes healthy modulation of mucosal immune responses to support GI integrity in a great-tasting powder.^‡
Suggested Dose: 1 scoop, 1-2 times daily. Add 1 serving to 8 oz of water or juice. Shake or stir until dissolved.

Conclusion

Altered gastrointestinal motility requires a personalized, systems-based approach—one that moves beyond symptom suppression to address the interconnected physiological processes that shape digestive function. By identifying each patient’s predominant symptom pattern, investigating key drivers and applying targeted nutrition, lifestyle and supplement strategies, clinicians can create highly individualized care plans that meaningfully reduce symptom burden and improve daily functioning.^‡

Resources

For more comprehensive recommendations on supporting functional bowel concerns, refer to:

• Functional Bowel GI Health Protocol^‡
• Barrier Builders: Nutrients to Support Mucosal Immune Responses and the Intestinal Barrier
• Unraveling the Complexity of Functional GI Concerns: Understanding Types, Causes and Solutions
• Is It a Leaky Gut? Defining What Lurks Beneath a Patient’s Symptoms
• Nutrient Solutions to Complement the 5R Protocol: A Comprehensive Approach to Maintaining Gut Health

Drug-Nutrient Interactions Checker: Provides valuable information on potential interactions between your patients' prescriptions, over-the-counter medications and nutritional supplements.

You can also explore Pure Encapsulations^® to find On-Demand Learning, Clinical Protocols and other resources developed with our medical and scientific advisors.

1. Bharucha AE, et al. Mayo Clin Proc. 2016 Aug;91(8):1118 1132
2. American Gastroenterological Association. Accessed February 9, 2026
3. Chen M, Ruan G, Chen L et al. Front Endocrinol (Lausanne). 2022;13:817100. doi:10.3389/fendo.2022.817100.
4. Lacy BE, Pimentel M, Brenner DM et al. Am J Gastroenterol. 2021;116(1):17 44. doi:10.14309/ajg.0000000000001036.
5. Schiller LR. Cleve Clin J Med. 2020;87(8):501 507. doi:10.3949/ccjm.87a.19102.
6. Su Q, Tun HM, Liu Q, et al. Gut Microbes. 2023;15(1):2157697. doi:10.1080/19490976.2022.2157697
7. Jeffery IB, Das A, O'Herlihy E, et al. Gastroenterology. 2020;158(4):1016-1028.e8. doi:10.1053/j.gastro.2019.11.301
8. Pozuelo, M., Panda, S., Santiago, A. et al. Sci Rep 5, 12693 (2015). https://doi.org/10.1038/srep12693
9. Robles A, Perez Ingles D, Myneedu K, et alNeurogastroenterol Motil. 2019;31(12):e13718. doi:10.1111/nmo.13718
10. Radziszewski M, Smarkusz Zarzecka J, Ostrowska L. Nutrition, 2023;15(16):3662. Available from: https://www.mdpi.com/2072-6643/15/16/3662
11. Varjú P, Farkas N, Hegyi P, et al. PLoS One. 2017;12(8):e0182942. Published 2017 Aug 14. doi:10.1371/journal.pone.0182942
12. Ohlsson B. Ther Adv Gastroenterol. 2022;15. doi:10.1177/17562848221114558
13. Grover M, Kolla B, Pamarthy R, Mansukhani M. et al. PLoS One. 2021;16. doi:10.1371/journal.pone.0245323.
14. Guandalini et al. J Pediatr Gastroenterol Nutr, 2000:30(1), 54-60.

⁺Amy Doyle, MS, CNS is an employee of Pure Encapsulations.