Muscle Atrophy/Breakdown

Authored by Chris McDermott, APRN, practicing with autonomous authority in Florida

Introduction

Muscle health is often overlooked until it begins to decline—when strength wanes, mobility diminishes, or daily tasks become more difficult. Muscle atrophy refers to the loss of muscle mass, while muscle breakdown involves the degradation of muscle proteins, which, if left unchecked, can lead to atrophy. These processes are not only signs of aging or disuse but may also reflect underlying nutritional deficiencies, metabolic dysfunction, or systemic disease.
At Intercoastal Health, we take a functional medicine telehealth approach to evaluating and treating muscle atrophy and breakdown. By identifying root causes, optimizing nutrient status, correcting hormonal imbalances, and implementing targeted lifestyle strategies, we help patients preserve muscle mass, enhance mobility, and support long-term strength and resilience.

Understanding Muscle Atrophy and Breakdown

Muscle atrophy is characterized by a reduction in the size and number of muscle fibers. It often occurs gradually and may go unnoticed until functional limitations become apparent. Muscle breakdown (also known as muscle catabolism) refers to the process by which muscle proteins are degraded for energy or as part of a response to illness, stress, or nutrient deficiency.
Though some degree of muscle protein turnover is normal and adaptive, chronic or excessive breakdown without adequate regeneration leads to a net loss of muscle tissue. Over time, this can impair mobility, increase the risk of falls, reduce metabolic function, and contribute to poor outcomes in chronic illness.

Symptoms of Muscle Atrophy and Breakdown

Recognizing the early signs of muscle loss is critical to preventing long-term damage. In functional medicine, subtle symptoms are evaluated alongside objective biomarkers and patient history to build a comprehensive understanding of muscle health.
Common Symptoms Include:

• Noticeable loss of muscle mass, particularly in the arms, thighs, or calves
  
• Muscle weakness, often disproportionate to physical activity level
  
• Fatigue, especially during routine tasks
  
• Reduced endurance or exercise tolerance
  
• Difficulty with daily functions such as rising from a chair or climbing stairs
  
• Impaired balance and coordination
  
• Decreased mobility and slower walking speed 

Functional Medicine Evaluation: Biomarkers and Diagnostic Tools

At Intercoastal Health, we utilize a combination of physical assessments, imaging, and laboratory testing to assess muscle health from both a structural and functional perspective.

Identifying the cause of atrophy or breakdown is essential to developing a targeted and effective treatment plan.

Causes of Muscle Atrophy and Breakdown

Functional medicine emphasizes understanding why muscle atrophy occurs—recognizing that it is not simply a consequence of aging but often the result of modifiable lifestyle, nutritional, or physiological factors.
Contributing Factors Include:

• Prolonged Inactivity or Immobilization: Bed rest, injury recovery, or sedentary lifestyle leads to rapid muscle wasting, particularly in the elderly
  
• Sarcopenia (Age-Related Muscle Loss): Begins as early as the 30s and accelerates with inactivity and hormonal decline
  
• Malnutrition or Inadequate Protein Intake: Essential amino acids are required for muscle repair and synthesis; deficiency accelerates catabolism
  
• Chronic Illness: Cancer, COPD, chronic heart failure, and renal disease are all associated with increased muscle catabolism
  
• Neurological Conditions: Disorders such as multiple sclerosis, muscular dystrophy, and peripheral neuropathies impair nerve-muscle communication
  
• Hormonal Imbalances: Low testosterone, hypothyroidism, or excess cortisol impair muscle maintenance
  
• Medication-Induced Myopathy: Long-term use of corticosteroids, statins, or certain chemotherapy drugs contribute to muscle degradation
  
• Inflammation and Oxidative Stress: Chronic inflammation disrupts muscle regeneration and increases protein breakdown 

Clinical Implications and Associated Risks

If unaddressed, muscle atrophy and breakdown can contribute to:

• Increased fall risk and subsequent fractures
  
• Reduced independence and lower quality of life
  
• Impaired immune function, as skeletal muscle provides amino acids critical for immune cells
  
• Slower wound healing and recovery from illness
  
• Exacerbation of chronic disease outcomes, especially in cardiovascular and pulmonary conditions
  
• Polymyositis, an inflammatory muscle disease presenting with weakness and elevated CK 

Muscle loss also contributes to metabolic slowdown and worsened insulin sensitivity, increasing risk for Metabolic Syndrome.

Functional Medicine Approach to Treatment at Intercoastal Health

At Intercoastal Health, we tailor treatment to the individual’s root cause of muscle loss, combining nutritional therapy, movement, hormone balance, and targeted supplementation to support muscle repair and prevent further breakdown.

1. Nutritional and Protein Repletion
   
   • Ensure adequate protein intake (1.2–2.0 g/kg/day)
     
   • Emphasize leucine-rich proteins (eggs, whey, legumes)
     
   • Incorporate anti-inflammatory foods: omega-3s, leafy greens, berries, turmeric
   • Address micronutrient gaps in Vitamin D, B12, magnesium, iron, and zinc
2. Exercise and Resistance Training
   
   • Progressive resistance exercise is the cornerstone of muscle restoration
     
   • Tailored programs improve muscle mass, coordination, and neuromuscular signaling
     
   • Start low-load, high-frequency regimens for deconditioned or elderly patients
3. Hormonal Optimization
   
   • Evaluate and treat testosterone deficiency in men and postmenopausal women
     
   • Address thyroid disorders to regulate metabolism and protein turnover
     
   • Mitigate chronic cortisol effects through lifestyle and stress reduction
4. Targeted Supplementation
   
   
   

   Supplement	Purpose
   Branched-chain amino acids (BCAAs)	Stimulate muscle protein synthesis
   Creatine monohydrate	Enhances strength and energy for resistance training
   Vitamin D3 + K2	Supports muscle strength and bone density
   Magnesium	Aids in muscle relaxation and protein synthesis
   Fish oil (EPA/DHA)	Reduces inflammation and may support muscle anabolism
   CoQ10	Supports mitochondrial function, especially in statin users

    

5. Address Underlying Disease
   
   • Collaborate to manage chronic illness driving catabolism
     
   • Optimize gut health in malabsorption or autoimmune GI conditions
     
   • Evaluate and treat neuromuscular disorders with neurology input

Monitoring and Long-Term Strategy

Muscle health is an ongoing aspect of preventive care. We regularly assess:

• Muscle strength, function, and mass
  
• Laboratory creatine kinase, inflammatory markers, hormones
  
• Dietary and activity logs
• Fall risk in older adults
  Adjustments are made based on progress and evolving medical status.