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DEAR DR. ROACH: I’m an 88-year-old male. I’ve been losing strength and muscle in my legs, which has caused me to need a walker. I’m currently in a physical therapy program twice a week, and I also do daily strengthening exercises at home.
I’d like your advice on trying a diet supplement of whey protein, hydroxymethylbutyrate, chromium and leucine. It’s widely advertised on the internet with countless testimonials regarding its amazing success in restoring strength and endurance for elderly users. -- R.C.O.
ANSWER: I believe in evidence, not testimonials. There’s good evidence that the elderly benefit from dietary protein when trying to build muscle, but you can do this by having an extra ounce of chicken or a few ounces of tofu, which have as much protein as a serving of the supplement.
The data on hydroxymethylbutyrate are mixed, while chromium isn’t effective to help build muscle. You can save your money and choose a higher protein diet.
One supplement that I’d recommend much more than the one you’re considering is creatine. There’s abundant evidence that 5 grams of creatine a day, especially when taken before exercise (such as your physical therapy), can improve strength and functional performance better than exercise alone.
The whey protein supplement that you asked about is about $2 per day online, while creatine is about $0.50 per day — even less if you buy bigger containers.
DEAR DR. ROACH: You didn’t mention the risks or benefits of using melatonin to help with sleep. I use a 1-mg dose to ensure that I have a good night’s sleep and have heard from several health experts that it’s safe for long-term use. Do you concur? -- B.W.
ANSWER: In large studies, melatonin was found to be modestly effective in helping people sleep. My clinical experience suggests that fewer than half of those who take it have a really good response.
However, there’s high-quality evidence that melatonin is safe in the short-term future, but there’s not quite as robust evidence that it’s safe for long-term use. Still, for people in whom it’s working well, and for those who need medication, melatonin is one of the safest long-term options.
Because the Food and Drug Administration doesn’t regulate melatonin as a drug, there’s always the potential that what you’re buying doesn’t contain as much melatonin as you think. A 2017 paper found that the amount of melatonin in over-the-counter tablets varied widely, with one chewable tablet that was labeled 1.5 mg actually containing 9 mg.
Batch-to-batch variability was also poor. More than 25% of OTC melatonin products contained serotonin, which can potentially be a problem when taken with other drugs. As always, I recommend getting products that have been independently tested for purity and quality, such as those that are labeled “USP.”
There’s a prescription medication for sleep called ramelteon (Rozerem) that uses the same melatonin receptor as melatonin itself. It’s been shown to be safe and modestly effective, but it’s much more expensive than melatonin.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2026 North America Syndicate Inc.
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