Muscle Loss

Muscle loss refers to the breakdown of muscles and is a relatively common condition in older adults and those living with chronic diseases. When experiencing muscle loss, muscles will appear smaller than normal. Lack of physical activity due to injury or illness, poor nutrition, genetics, and certain medical conditions can all lead to muscle loss.

What causes muscle loss?

Many factors can cause muscle loss, including:

  • Poor nutrition
  • Age
  • Obesity
  • Some health conditions
  • Inactivity


The symptoms of muscle loss vary greatly depending on the cause, but may include the following:

  • smaller muscles
  • having one arm or leg that is noticeably smaller than the other
  • experiencing weakness in one limb or in general
  • having difficulty breathing
  • remaining inactive for a length of time


Treatments for muscle loss can also vary greatly depending on the type of loss and any health conditions. Treating the underlying condition causing the muscle loss may help to slow it down. General treatments include:

  • physical therapy
  • surgery
  • electric therapy
  • ultrasound therapy

Muscle loss in liver disease

There are two conditions that cause muscle loss that are common in individuals who have liver disease: age-related muscle loss (sarcopenia) and cachexia.


What is sarcopenia?

Sarcopenia is natural muscle wasting associated with aging. From the time you are born to around middle age, your muscles grow larger and stronger. But at some point, you start to lose muscle mass and function. This is due to age-related muscle loss (sarcopenia).

What causes sarcopenia?

As a person ages, their body produces fewer proteins that help with muscle growth. Fewer proteins causes the muscles to shrink, resulting in sarcopenia. Although aging is the most common cause of sarcopenia, other factors have also been found to be related:

  • Immobility, including a inactive lifestyle
  • Poor nutrition
  • Inflammation. After injury or illness, inflammation sends signals to the body to tear down and then rebuild the damaged cells. Chronic disease can result in inflammation that disrupts this normal process, resulting in muscle loss.
  • Severe stress. Sarcopenia is common in a number of conditions that increase stress on the body, like chronic liver disease.


Symptoms can include weakness and fatigue, which can interfere with physical activity. Decreased physical activity can further shrink muscles. In addition to reduced muscle size, sarcopenia can cause the following symptoms:

  • weakness
  • poor balance
  • difficulty moving
  • become tired more easily


The primary treatment for sarcopenia is exercise. Specifically, resistance training or strength training. These activities increase muscle strength and endurance with weights or resistance bands. Other exercises include fitness training and walking. The proper number, intensity, and frequency of resistance exercise is important for getting the most benefit without risking injury. You should work with a physical therapist to develop an exercise plan. Be sure to talk to your healthcare provider when you begin a new exercise plan.

If you take in fewer calories, protein or certain vitamins and minerals, you may be at higher risk of muscle loss. Below are some important molecules to ensure you are getting enough of:

  • Protein
  • Vitamin D
  • Omega-3 Fatty Acids
  • Creatine

Currently, there are no medications indicated for treating sarcopenia though there are several being looked at by scientists.



What is cachexia?

Cachexia (pronounced kuh-KEK-see-uh) is a complex condition that causes extreme weight loss and muscle wasting and can include loss of body fat. This syndrome affects people who are in the late stages of serious disease like cirrhosis, HIV or AIDS, COPD or congestive heart failure (CHF). People who have cachexia may experience a significant loss of appetite or unintentional weight loss despite consuming a large number of calories.

Cachexia is different from other types of muscle loss because individuals who have it are eating less and experiencing changes in their metabolism, which causes their body to break down too much muscle. Researchers believe cachexia is the body’s response to fighting disease. To get more energy to fuel the brain the body breaks down muscle and fat.

A person with cachexia doesn’t simply lose weight and muscle mass. They get very weak and frail and the body becomes vulnerable to infections. Cachexia can be very serious as it can complicate treatment for cirrhosis. People with cirrhosis who have cachexia can be sensitive to treatments options and other therapies that are necessary to survive.

Cachexia Categories

Here are three main categories of cachexia:

  • Precachexia is defined as a loss of up to 5 percent of your body weight while having a known illness or disease. It’s accompanied by appetite loss, inflammation, and changes in metabolism.
  • Cachexia is a loss of more than 5 percent of your body weight over 12 months or less, when you’re not trying to lose weight and you have a known illness or disease. Several other criteria include loss of muscle strength, decreased appetite, fatigue, and inflammation.
  • Refractory cachexia applies to individuals with cancer. It is weight loss, muscle loss, loss of function, plus a failure to respond to cancer treatment.


People with cachexia lose weight and muscle mass. People can look malnourished or appear at a typical weight. To be diagnosed with cachexia you must have the following:

  1. Lost at least 5% of your body weight within the last 12 months
  2. Have a known illness or disease
  3. Have at least three of these findings:
    1. Reduced muscle strength
    2. Fatigue
    3. Appetite loss (anorexia)
    4. Low fat-free mass index (a calculation based on your weight, body fat, and height)
    5. High levels of inflammation identified by blood tests
    6. Anemia (low red blood cells)
    7. Low levels of the protein albumin


There is no specific treatment or way to reverse cachexia. Getting more nutrition or calories is not enough to treat or reverse cachexia. The goal is to improve symptoms and improve quality of life. Current therapy for cachexia includes:

  • prescribing medications to make you hungrier
  • prescribing medications to improve nausea and mood
  • prescribing medication to decrease inflammation
  • changing diets and prescribing nutritional supplements
  • exercise


This material was adapted from content by:

Conservative Kidney Management 

My Health Alberta


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