Urolithin A for Balance & Stability

Reviewed by SOMA HEALTH's Medical Research Team

Balance feels like a sense, but it is largely a performance. Staying steady on a moving bus, on a dark stair, or on one leg while you pull on a sock is the visible result of your legs producing force quickly and your nervous system directing it. This guide explains why steadiness leans so heavily on lower-body strength and muscle energy, and where urolithin A does, and does not, fit into that picture.

Balance is built on strength, not just sensation

We tend to picture balance as an inner-ear function, and the vestibular system does matter. But moment-to-moment steadiness is mostly a motor task. When your center of gravity drifts, you stay upright by firing the muscles of the ankles, calves, thighs, and hips fast enough to correct it. That correction depends on how much force those muscles can generate and, critically, how quickly, a quality researchers call muscle power. Power tends to decline with age even faster than raw strength, which is one reason older adults can feel steady standing still yet wobble the instant something unexpected happens.

Lower-body strength and power, then, are among the most modifiable ingredients of stability. Stronger legs let you recover a stumble instead of continuing into a fall; they let you climb stairs and step off curbs with margin to spare. This is why balance conversations almost always circle back to the quadriceps, glutes, and calves rather than to the ears alone.

Where muscle energy enters the story

Producing force quickly is metabolically demanding, and muscle relies on mitochondria, the cellular structures that turn oxygen and fuel into usable energy, to meet that demand. Aging muscle tends to show lower mitochondrial capacity, and research on older adults has linked poorer skeletal-muscle energetics with a higher likelihood of recurrent falls. That association does not prove cause, but it fits a coherent idea: muscle that cannot sustain and deliver energy well may fatigue sooner and respond more sluggishly, both of which matter when you need a fast correction. Our mitochondrial health overview goes deeper on why this compartment matters.

Healthy cells keep their mitochondria in good repair through mitophagy, the housekeeping process that clears damaged mitochondria so fresh ones can take over. When mitophagy slows with age, worn units can accumulate and energy output can suffer. Our what is mitophagy page explains the mechanism in plain terms.

What urolithin A is and why researchers study it here

Urolithin A is a gut postbiotic. You do not eat it directly in any meaningful amount; your microbiome produces it from ellagitannins found in pomegranates, walnuts, and some berries. Only a subset of people carry the bacteria needed to make it efficiently, so dietary intake alone leaves internal levels unpredictable. In research settings, urolithin A has been studied for its ability to support mitophagy, which is the mechanistic reason it comes up in discussions of muscle energy and, by extension, the strength that underpins balance.

What the human evidence actually shows

It is important to be precise: to date, human trials have measured muscle strength, endurance, and performance. They have not tested balance, gait steadiness, or fall rates as primary endpoints. So the case for balance is indirect: it runs through the lower-body strength and muscle function that trials have examined.

Proven human safety and mechanism (human)

Andreux and colleagues (Nature Metabolism, 2019) ran the first-in-human study, reporting that urolithin A was safe and well tolerated up to 1,000 mg per day and produced a mitochondrial gene-expression signature consistent with improved mitochondrial biology. It set a safety envelope and a biological rationale rather than a functional outcome.

Strength, endurance, and performance (human)

Liu, D'Amico and colleagues (JAMA Network Open, 2022) studied older adults over about four months and reported gains in muscle endurance. Singh and colleagues (Cell Reports Medicine, 2022) tested 500 mg and 1,000 mg daily arms in middle-aged adults over four months and reported improvements in muscle strength and exercise performance. Because leg strength and endurance are foundations of steadiness, these results are the most relevant human evidence, while stopping short of measuring balance itself.

Newer human signals (human)

A 2024 randomized controlled trial in the Journal of the International Society of Sports Nutrition looked at resistance-trained men over eight weeks, a 2025 Nature Aging trial reported support for immune-cell mitochondrial health in midlife adults over roughly 28 days, and a 2025 trial extended the work to distance runners. These broaden the population base but remain individual studies with varied designs.