The Risk of Taking Compound GLP-1s

Posted on August 20, 2026 by Patrick Hercules

Over the past few years, GLP-1 medications, such as semaglutide and tirzepatide, have become a popular way to help people lose weight.

However, some patients and healthcare providers have turned to compounded versions of semaglutide and tirzepatide called compounded GLP-1 antagonists.

Glucagon-like peptide-1 or GLP-1 antagonists are a class of medications that mainly manage blood sugar levels in people with Type 2 diabetes. In 2024, nearly one in three Americans taking a GLP-1 drug said they were getting it from a compounding pharmacy.

Compounded GLP-1 antagonists are custom-mixed weight loss medications made by certain pharmacies, not drug companies, and use the same active ingredients as the brand names, but they don’t have approval from the U.S. Food and Drug Administration (FDA) for safety or effectiveness, and some compounded GLP-1 drugs have additional ingredients or alternate chemical forms of the active drugs.

This is why the FDA has warned against taking compounded versions of semaglutide and tirzepatide, as they don’t undergo regulatory testing for safety, quality, or effectiveness. They also issued a warning about a spike in overdoses and adverse side effects largely attributed to dosing errors with these drugs, due to them coming with syringes for people to draw the medications themselves, unlike brand-name GLP-1 injections that come in prefilled pens.

In 2024, the FDA raised concerns about the increased risk of dosing errors, improper storage, and fraudulently labeled GLP-1s from compounding pharmacies. Consequently, hundreds of people reported serious problems, including dangerous dosing mistakes, where patients got five to twenty times more than the proper dose.

By April of 2025, the FDA had logged over 520 reports linked to compounded semaglutide and 480 for compounded tirzepatide.

Additionally, U.S. poison centers have seen a nearly 1,500% increase in calls related to overdose or side effects of injectable weight-loss drugs since 2019. What’s more, as of April 30th, 2025, poison centers have managed 3,633 GLP-1 agonist-related exposure cases and 22,966 cases from 2019-2025.

The common side effects of GLP-1 antagonist poisoning include:

Nausea and vomiting
Constipation and diarrhea
Abdominal pain

Other symptoms and side effects to watch out for include:

Signs of severe dehydration such as fainting and confusion or not urinating for eight hours.
Pancreatitis, which usually feels like sharp pain in your upper abdomen and back.
Gastrointestinal symptoms that don’t improve when you eat smaller meals or take anti-nausea medications.
Gastrointestinal symptoms that grow worse rather than easing the longer you’re on the drug.

However, there are instances when it might be appropriate for a person to take a compounded drug, such as when a patient’s medical need can’t be met by an FDA-approved drug, or the FDA-approved drug is not commercially available.

If taking a compounded GLP-1 is your only option, it is important to confirm if it is coming from a 503B-registered outsourcing facility, rather than an unregistered seller, and that you remain under close medical supervision while using it.

Other clues that your compounded prescription may not be legitimate:

It does not require a prescription.
The pharmacy is not located within the U.S.
The medication arrives in packaging that is damaged, open, labeled in a foreign language, or has no expiration date.
Unusual delivery methods. Delivery methods other than injections and oral pills, such as sublingual drops and dissolving tablets, have not been tested in clinical trials.
Vague or proprietary ingredient lists. Products marketed as “personalized” blends with added vitamins or other ingredients, without a clear clinical rationale, are often designed to promote those additions to sidestep regulations rather than to benefit the patient.

If you need help locating a licensed online pharmacy, you can use the FDA’s BeSafeRx program. For more information about the Bariatric Surgery Services at Flushing Hospital or procedures performed by our doctors, please call 718-408-6977 or 718-670-8908.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Emotional Fatigue

Posted on August 4, 2026 by Patrick Hercules

When stress from negative or challenging life events occurs repeatedly without adequate recovery, you may find yourself feeling emotionally worn out and drained. This is known as emotional fatigue or exhaustion. Although emotional fatigue is most associated with workplace burnout, it can happen outside occupational contexts in:

Anyone whose emotional labor consistently exceeds their capacity to restore

Caregivers supporting ill or dependent family members

Individuals processing prolonged grief, trauma, or stress

People in chronic, conflict-heavy relationships

Parents of young children or children with complex needs

Emotional fatigue falls between ordinary stress, which most people can bounce back from quickly, and clinical disorders such as major depression or anxiety disorders. If it is left unaddressed, it frequently progresses toward both.

Emotional fatigue can present itself as emotional, physical, and performance signs and symptoms.

Emotional symptoms include:

Depression

Anxiety

Apathy

Irritability

Difficulty making decisions

Feeling hopeless

Feeling powerless or trapped

Lack of focus or forgetfulness

Lack of motivation

Negative thinking

Tearfulness

Nervousness

Physical symptoms include:

Persistent headaches or migraines

Heart palpitations or chest tightness

Fatigue

Poor sleep

An elevated susceptibility to illness

Nausea or upset stomach

Lack of appetite

Sore muscles or muscle tension

Performance symptoms include:

Performing work duties more slowly

Difficulty completing daily tasks for responsibilities

Failing to meet deadlines

Isolation or avoidance

Increased absences

Lower workplace commitment

You can address emotional fatigue by identifying the stressors you can reduce or prevent. When you are unable to change a stressor because it is out of your control, it is important to focus on the here and now. Try to focus on the various neutral and positive events that are happening. Focusing on these types of events can give you a better perspective about what is happening around you, allowing you to shift your focus away from the stressors.

Your body can often interpret stress as a threat to your survival. When this occurs, your brain releases stress hormones throughout your body, which can contribute to your emotional fatigue. As you focus on neutral or positive events in your life, your brain learns that the threat is not as bleak as it may seem. The amount of stress hormones released decreases, causing you to feel more emotionally balanced.

Some other strategies that can help reduce emotional fatigue include:

Practicing mindfulness to engage in the present moment

Eliminating or minimizing the stressor when possible

Identifying and challenging unhelpful thoughts and replacing them with balanced thoughts

Eating a healthy, balanced diet

Exercising

Getting adequate sleep

When emotional fatigue is addressed early, it often clears considerably with the proper rest and load reduction.

If you are experiencing emotional fatigue, you can discuss your signs and symptoms with a mental health professional. They can help you sort through the causes and symptoms you’re experiencing to determine a plan that will help you regain a sense of well-being.

To learn more about our mental health services or to schedule a virtual appointment, call (718) 670-5316 to speak with our intake coordinator or call (718) 670-5562 to reach the clinic.

BBQ Food Safety Tips

Posted on July 17, 2026 by Patrick Hercules

Summer is a time when we have and/or attend several barbecues or cookouts. However, whether you are hosting or attending, eating outdoors in warm weather can present food safety challenges.

Bacteria in food multiply faster at temperatures between 40°F and 140°F, so the summer heat can create problems. Here are some tips to follow to help keep you and others safe from foodborne illnesses:

Washing your hands is very important. Wash your hands if you are preparing food, serving food, or after using the bathroom. Wash your hands and forearms with soap and warm water for at least 20 seconds. If you are in an outdoor setting without access to a bathroom, use a bottle of water, some soap, and paper towels, or use hand sanitizer.

Keep raw food separate from cooked food to avoid cross-contamination.

Don’t use any plates or utensils that have potentially touched or have been contaminated by raw meat, poultry, or seafood. It is recommended to wash utensils that have touched raw meats if they must also be used to handle cooked meats

Marinate food in the refrigerator, instead of out on the counter. If you want to use some of the marinade as a sauce on your food after it is cooked, keep a separate portion of it to use later. Do not reuse the marinade that contained raw meat

Cook food thoroughly to kill any harmful germs and bacteria that may be present. E. coli and Salmonella can still be present in undercooked meats such as hamburger and chicken, and can cause severe illness, even death. Each food should be at a certain temperature for it to be fully cooked:

- Chicken 165o F

- Hamburgers 160o F

- Pork 150o F

- Hot dogs 140o F

- Leftovers 165o F

- Eggs 145o F

Use a food thermometer to check the temperature of the food. Insert the thermometer into the center of the meat, which is the least cooked part. To check the temperature of hot dogs, go from the end of the hot dog to the center. Be careful not to pass through the meat and touch the cooking surface because you will get a false high temperature reading.

Refrigerate or freeze food immediately, as you shouldn’t leave food out of the refrigerator, cooler, or off the grill for more than two hours. Never leave food out for more than one hour when the outside temperature is above 90°F

Keep hot food hot and cold food cold. Hot food should be kept at or above 140°F, wrapped well, and placed in an insulated container. Cold food should be held at or below 40°F. Foods such as chicken salads and desserts that are in individual serving dishes should be placed directly on ice or in a shallow container set in a deep pan filled with ice. Drain off any water that pools as the ice melts, and replace the ice frequently

Wipe surfaces often, especially after using them for food preparation, as germs from undercooked meat can grow on vegetables cut or washed on the same surface as meat. Mix and use a sanitizing solution of one capful of chlorine bleach per gallon of water for cleaning work area surfaces. If possible, use separate cutting boards or surfaces for foods that will not be cooked, such as salad

Keep flies away by covering trash containers, and not storing meat wrappers and other trash in open cardboard boxes or uncovered containers, even for a short period of time

Don’t use fly spray or “No-Pest” chemical strips, as they can contaminate your food

Don’t keep food containers out in the open. Instead, place them in a shaded area

Keep plates, cups, utensils, and food covered until they are ready to be used

Handle plates, cups, and utensils where they won’t come in contact with any food

Don’t prepare and serve food if you have been sick with vomiting or diarrhea within the past 24 hours

Don’t wear loose finger or wrist jewelry or fake nails while working with food

Keep plenty of paper towels handy for cleaning your hands and surfaces

If you or a loved one is experiencing symptoms of a foodborne illness, you can receive treatment at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

Summer Health Concerns and How to Prevent them

Posted on July 2, 2026 by Patrick Hercules

Summer is in full swing, so most of our time will be spent outside doing various activities. However, there are many health concerns to consider.

Here are some summer health concerns and how to prevent them:

The human body is made of up to 78% of water, and when it doesn’t get enough, it can’t function properly. In high heat, dehydration can become severe and fatal. To prevent dehydration, it is important to stay hydrated. You can do this by drinking water and eating water-rich foods. Staying properly hydrated can also prevent kidney stones.

Sunburns occur when ultraviolet (UV) rays from the sun cause a radiation burn on the skin. Sunburns can contribute to premature aging of the skin and skin cancer, and can also lead to dehydration, sun poisoning, and infection from severe burns. To prevent sunburn, wear sunscreen containing titanium oxide or zinc oxide every day, even on overcast days. Make sure to cover your entire body, including your ears, eyelids, lips, scalp, and, if exposed, the top of your feet.

Spending time in the sun doesn’t only bring the risks of sunburn and dehydration. It also brings the risk of heat illnesses, including:

Heat rash- a red stinging rash that develops when sweat gets trapped in your glands.
Heat cramps are painful muscle cramps that occur when you sweat so much that your body loses salts and fluids.
Heat exhaustion occurs when the body can’t cool itself through sweating. If it’s not treated, it can quickly turn into heatstroke.
Heatstroke, or sunstroke, occurs when a person’s body temperature climbs to dangerous levels. It’s the most severe heat-related illness and can be fatal.

To prevent heat illnesses, limit the time you spend outdoors. Also, take any symptoms you observe in yourself and others seriously.

Insects are more active during the summer, which means there’s a higher risk of encountering them. Especially for:

Bee stings
Mosquito bites
Tick bites
Ant bites

To prevent bugs from stinging or biting you, wear an insect repellent with the active ingredients DEET or picaridin. Other ways to prevent stings and bites include:

Avoid using scented products.
Drain any standing water.
Put on protective clothing.
Don’t leave any food uncovered outside.

We want to spend more time near water to cool off as temperatures rise. However, it is important to follow proper safety precautions to avoid drowning risks. Here are some ways to prevent drowning risks:

Learn CPR
Use drain covers on pool drains.
Wear life jackets
Sign up for swimming lessons.

Everybody loves a good summer barbecue or cookout, but sometimes the food we eat doesn’t always love us back. The smoking process that gives smoked meats their flavor also creates harmful substances called polycyclic aromatic hydrocarbons or PAHs and heterocyclic amines or HCAs. The National Cancer Institute warns that PAHs and HCAs are mutagenic, meaning they can cause changes to your DNA that put you at risk for certain types of cancer. You can prevent ingesting these harmful substances by using liquid smoke as an alternative marinade for your meats. Foodborne illness can be a concern for cookout food as well. This is the case for food left out or leftover sitting in the “temperature danger zone” of 40 to 140 degrees Fahrenheit. These temperatures allow bacteria to grow that can make you sick. You can prevent foodborne illness by cooking meats to a safe temperature and throwing any food that has sat out too long in the trash.

Seasonal allergies caused by pollen is a huge problem in the summer as the weather gets warmer and trees, grass, and flowers pollinate. To prevent seasonal allergies, try taking allergy medications before the season starts so your body can build its defense.

These preventative measures can help you enjoy your summer and keep you safe.

If you or a loved one is experiencing symptoms of heat-related illness, you can receive treatment at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486. If you or someone you are with is experiencing an emergency, call 911 immediately.

GLP-1 Microdosing

Posted on May 27, 2026 by Patrick Hercules

Glucagon-like peptide-1 or GLP-1 antagonists are, however, a class of medications that mainly manage blood sugar levels in people with Type 2 diabetes. Medications, such as semaglutide and tirzepatide, have become popular over the past few years to help people lose weight.

Recently, however, some people have been microdosing GLP-1 medications as their preferred way to take these medications. Microdosing means taking much smaller doses than those approved by the Food and Drug Administration (FDA).

People may microdose GLP-1 medications for many reasons, including:

They have hit their target weight goal

They have concerns about the cost of the medications

They are sensitive to the side effects of the medications

They want to just suppress their appetite

They are worried about the supply of the medications

Microdosing GLP-1 medications can come with real risks, including:

Inaccurate doses

Reduced effectiveness

Unpredictable outcomes

Possibility of regaining weight

No data on the long-term effects of microdosing

Minimal oversight

Large clinical trials have confirmed that the standard GLP-1 doses work well when helping people lose weight and manage Type 2 diabetes. What’s more, precise doses have proven benefits for heart, liver, and kidney health. Taking very low doses may not provide the same results.

Additionally, smaller GLP-1 doses may help reduce symptoms such as nausea or an upset stomach. However, microdosing may prevent you from reaching the effective dose needed to make significant changes in your body weight or blood sugar levels. In many cases, the side effects of GLP-1 treatment are temporary. GLP-1 dosage schedules are intended to increase doses gradually to help balance their benefits and potential side effects.

GLP-1 medications affect people differently. Some people may see substantial benefits even at lower doses. However, other people may not see their benefits at full doses.

Before you consider microdosing GLP-1 medications, it is important to speak with a healthcare provider who is knowledgeable about these treatments. Here are some things to consider:

If the GLP-1 medication is off-label, it is an unproven treatment

The health benefits for those who don’t have Type 2 diabetes or a high body mass index (BMI) are unproven

Taking smaller doses doesn’t make them risk-free

As an alternative to taking GLP-1 medications, here are some proven ways to support metabolic and overall health naturally:

Exercising regularly

Eating a healthy, balanced diet

Managing stress

Getting enough restful sleep

Eating certain foods and taking supplements

For more information about the Bariatric Surgery Services at Flushing Hospital or procedures performed by our doctors, please call 718-408-6977 or 718-670-8908.

Celiac Disease Awareness Month

Posted on May 1, 2026 by Patrick Hercules

May is Celiac Awareness Month. It is observed as a time to raise awareness for the more than three million Americans living with celiac disease, an autoimmune condition that causes the immune system to react to gluten, a protein found in foods containing wheat, barley, and rye.

It is estimated that up to 83% of Americans who have celiac disease are undiagnosed or misdiagnosed with other conditions.

When a person has celiac disease, eating gluten triggers an immune response to the gluten protein in the small intestines. The immune system sends inflammatory cells and antibodies to destroy the gluten molecules. Over time, this reaction can damage the lining of the small intestine, which prevents it from absorbing nutrients. This condition is called malabsorption. It can also lead to malnutrition and several other conditions resulting from a lack of nutrients.

The symptoms of celiac disease can vary greatly. They can also be different in children and adults. Digestive symptoms for adults include:

Diarrhea

Fatigue

Weight loss

Bloating and gas

Belly pain

Nausea and vomiting

Constipation

However, more than half the adults with celiac disease have symptoms that are not related to the digestive system, including:

Anemia

Osteoporosis

Dermatitis herpetiformis

Mouth ulcers

Headaches and fatigue

Nervous system injury, including numbness, tingling in the feet and hands, as well as possible problems with balance, and cognitive impairment

Joint pain

Hyposplenism

Elevated liver enzymes

Children with celiac disease are more likely than adults to have digestive problems, including:

Nausea and vomiting

Chronic diarrhea

Swollen belly

Constipation

Pale, foul-smelling stools

For children who aren’t able to absorb nutrients, it may cause:

Failure to thrive in infants

Damage to tooth enamel

Weight loss

Anemia

Irritability

Short stature

Delayed puberty

Neurological symptoms, including attention-deficit/hyperactivity disorder (ADHD), learning disabilities, headaches, lack of muscle coordination, and seizures

Celiac disease is most commonly found in people of Northern European descent. It is estimated to affect 1% of the populations of Europe and North America. A person has a 10% chance of developing the disease if they have a first-degree relative, such as a parent or child, who has it. About 97% of people diagnosed with celiac disease have a recognizable gene variant associated with it.

A person’s genes, combined with eating foods with gluten and other factors, can contribute to celiac disease. However, the precise cause isn’t known. Sometimes celiac disease becomes active after surgery, pregnancy, childbirth, viral infection, or severe emotional distress.

Several risk factors cause celiac disease to be more common in people who have:

A family member with celiac disease or dermatitis herpetiformis

Type 1 diabetes

Down syndrome, Williams syndrome, or Turner syndrome

Autoimmune thyroid disease

Microscopic colitis

Addison’s disease

Many people with celiac disease don’t know they have it. However, two blood tests can help diagnose it:

Serology testing

Genetic testing

It is important to be tested for celiac disease before trying a gluten-free diet. Eliminating gluten from your diet might make the results of the blood tests appear in the standard range.

The first and most important step in treating and the only way to manage celiac disease is to stop eating gluten and adopt a strict, lifelong gluten-free diet. You can’t change the way your body reacts to gluten, but you can prevent gluten from triggering a reaction. Additional treatments may include:

Nutritional supplements

Specific medications

Corticosteroids

Continuous follow-up care

To schedule an appointment with a gastroenterologist or dietitian at Flushing Hospital Medical Center, please call 718-670-5486.

Metabolic Syndrome and How it Can Lead to Heart Disease

Posted on April 29, 2026 by Patrick Hercules

Metabolic syndrome is a group of conditions that increase the risk of heart disease, stroke, type 2 diabetes, and other health problems.

The number of people with metabolic syndrome is increasing, as up to one-third of adults in the U.S. have it.

When a person is diagnosed with metabolic syndrome, they have three or more risk factors, such as:

High blood pressure

High blood sugar

Low levels of HDL, or good cholesterol

High triglyceride levels in the blood

A large waist circumference or an apple-shaped body

Although each of these conditions is a risk factor for cardiovascular disease, when a person has three or more of them and is diagnosed with metabolic syndrome, the chances of them developing a serious cardiovascular condition increase.

There are several underlying causes of metabolic syndrome, such as:

Being overweight and being obese

Having an insulin resistance

Being physically inactive

Genetic factors

Increasing age

Metabolic syndrome is a serious health condition; however, there are ways to reduce your risk of developing it, such as:

Being more physically active

Losing weight

Eating a heart-healthy diet that is rich in:

Whole grains

Fruits and vegetables

Fish

Another way to reduce your risk of developing metabolic syndrome is working with your healthcare team to monitor and manage your blood sugar, blood cholesterol, and blood pressure.

If you or a loved one is experiencing symptoms of metabolic syndrome, you can receive treatment at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

Things You Should and Shouldn’t Do After Bariatric Surgery

Posted on April 23, 2026 by Patrick Hercules

Bariatric surgery is a life-changing procedure. Following your doctor’s post-operation instructions and making healthy lifestyle changes are essential to avoiding complications and achieving long-term weight loss success.

Patients should expect to have a new lifestyle that combines healthy eating, exercise, and attending regular visits with their healthcare providers. They should also consider these dos and don’ts after bariatric surgery:

What you should do after bariatric surgery:

- Eat slowly and chew food well

- Aim to drink 64oz of fluids daily, taking small sips

- Eat 60g or more of protein daily, starting every meal with it

- Make fruits and vegetables the priority of your diet

- Start walking for five minutes every hour after surgery

- Aim for a goal of 30 minutes of exercise daily after it is allowed to do so

- Take all medications and supplements as prescribed, they will need to be taken for the rest of your lifetime

What you shouldn’t do after bariatric surgery:

- Skip any meals

- Eat red meat early in recovery

- Engage in any strenuous activities

- Lift any objects over 10 lbs. for the first four to six weeks after surgery

- Eat fast food

- Eat or drink anything with natural sugar

- Drink liquids within 30 minutes after eating

- Eat bread, rice, pasta, bagels, or dumplings

- Allow yourself to get too hungry

- Take a bath or go swimming for two weeks after surgery

- Smoke cigarettes or drink alcohol

- Eat snacks loaded with empty calories

- Get pregnant for 12 to 18 months after surgery

- Stop taking medications as directed by your healthcare provider

Bariatric surgery can be a life-changing and life-altering event for those who are trying to lose weight and live a healthier lifestyle. Making diet changes, modifying exercise routine, and following the guidelines set by your healthcare provider and surgical team can lead you to long-term success.

For more information about the Bariatric Surgery Services at Flushing Hospital or procedures performed by our doctors, please call 718-408-6977 or 718-670-8908.

How Microplastics and Nanoplastics Affect Our Long-Term Health

Posted on April 9, 2026 by Patrick Hercules

Microplastics and nanoplastics (MNPs) are plastic particles that fail to break down and have become a major concern for environmental and human health.

These plastic particles are extremely small, as microplastics range from 1 micrometer to 5 millimeters. Nanoplastics are even smaller, as they are less than one micrometer.

There are two types of microplastics, primary microplastics and secondary microplastics. These microplastics typically come from two main sources. Primary microplastics are manufactured at a small size intentionally. Secondary microplastics are formed from the breakdown of larger plastic items.

There are public concerns about the health effects of microplastics and nanoplastics, as they have been found in our bodies because of what we eat, drink, or breathe.

Nanoplastics can behave differently from microplastics or materials that are larger. Their small size means that they may move more easily through biological membranes or interact differently with cells in the body.

Larger microplastics are filtered by the body’s natural defenses, such as the mucus and cilia in the airways, but can still get inhaled into the lungs and even infiltrate the bloodstream or the barriers to the digestive system.

Scientific research has pointed to the likelihood of nanoplastics being far more toxicologically active than microplastics, due to their being small enough to pass through some biological barriers and easily absorbed into the body, which can potentially disrupt and damage internal organs and processes.

Evidence suggests that microplastics may be correlated with health conditions, including:

Chronic degenerative diseases
Cardiovascular disease
Inflammatory diseases, such as inflammatory bowel disease (IBS)

Additionally, existing research has found that microplastics can accumulate in the human brain. They can also be found in plaque formed in our arteries.

Currently, the U.S. doesn’t have regulations around microplastics. However, there are ways to reduce your exposure to microplastics, including:

Cutting back on bottled water
Getting an NSF-certified water filter
Avoiding storing food in plastic containers
Avoiding the reuse of single-use plastics for food and drinks
Avoiding heating plastic
Washing plastic by hand
Keeping your air clean

According to health experts, there are ways you can lower your risk of the health effects linked to microplastics, including:

Eating a balanced diet
Getting enough sleep and exercise
Lowering stress
Seeing preventative care

Unfortunately, plastic is everywhere, and it is hard to avoid. However, it is important to remember that all the plastic we use will end up in a landfill and eventually in our environment and in our bodies. Limiting plastic usage and production will hopefully have a positive impact on future generations.

Losing Muscle As We Age

Posted on March 19, 2026 by Patrick Hercules

As we age, we start to lose muscle mass gradually. This is called sarcopenia.

Sarcopenia, a type of atrophy, is the age-related progressive loss of muscle mass, function, and strength.

Everyone loses muscle mass over time; however, people who have sarcopenia lose it more quickly. Sarcopenia usually begins around the age of 35 and accelerates between the ages of 65 and 80. Rates of this acceleration vary; however, as much as 8% of muscle mass is lost each decade.

The natural aging process is usually the main cause of sarcopenia as the body doesn’t produce the same number of proteins the muscles need to grow, which causes them to get smaller. However, researchers have discovered other possible risk factors of the condition, including:

· Physical inactivity

· Obesity

· Chronic diseases such as chronic obstructive pulmonary disease (COPD), kidney disease, diabetes, cancer, and HIV

· Rheumatoid arthritis

· Insulin resistance

· Malnutrition or inadequate protein intake

· Reduction in hormone levels

· Decrease in the ability to convert protein to energy

· Decline in the number of nerve cells that send messages from the brain to the muscles telling them to move

Sarcopenia affects the musculoskeletal system and is a major factor in increased frailty, falls, and fractures. These conditions can lead to hospitalizations and surgeries, which increase the risk of complications, including death.

This condition can also affect people with a high body mass index (BMI), which is called sarcopenic obesity. People suffering from obesity and sarcopenia have a greater risk of complications than those with obesity or sarcopenia alone.

The most common symptom of sarcopenia is muscle weakness. Other symptoms may include:

· Decrease in muscle size

· Difficulty performing daily activities

· Poor balance and falls

· Loss of stamina

· Trouble climbing stairs

· Walking slowly

A healthcare provider may diagnose sarcopenia after they perform a physical exam and ask you about your symptoms. They may also ask you to complete a questionnaire based on your self-reported symptoms called the SARC-F, which stands for:

· Strength

· Assistance with walking

· Rising from a chair

· Climbing stairs

· Falls

You score each factor with a number between 0 and 2, with the highest maximum and total SARC-F being 10. A SARC-F score of 4 or more warrants more testing.

There is no single test that can diagnose sarcopenia. A healthcare provider may recommend several tests to help diagnose and then determine the severity of sarcopenia. These tests include:

· Muscle tests:

Handgrip test
Chair stand test
Walking speed test
Short Physical Performance Battery (SPPB)
Timed-up and go test (TUG)

· Imaging tests for measurement of muscle mass

Dual-energy X-ray absorptiometry (DEXA or DXA)
Bioelectrical impedance analysis (BIA)

The treatment for sarcopenia usually includes lifestyle changes, as they can treat and help reverse the condition. These lifestyle changes include:

· Physical activity, which includes resistance-based strength training

· A healthy diet

Sarcopenia is not fully preventable. However, there are steps you can take to slow the progression of the disease, including:

· Making healthy food choices

· Exercising regularly

· Attending routine physicals

If you or a loved one is experiencing symptoms of sarcopenia, you can receive treatment at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.