The Truth about “Ergogenic” Supplements

By Adam Morse, D.O.Dept of Orthopedic Surgery

Garden City HospitalGarden City, MI

Introduction• Nutritional/Dietary Supplementation is a very lucrative

buisness in the United States• Consequently there are millions of dollars spent

annually on claims of weight loss, muscle building, and performance enhancement

• They include Vitamins, Minerals, Anabolic Steroids, Amino Acids, Digestive Enzymes, Methylxanthines, Ephedrine, Fatty Acids, Coenzymes, Laxatives, Ginseng, Diuretics, Aminopolysaccharides, and many other products/extracts.

Introduction

• With millions of claims being made in the industry, patients will be turning towards physicians to answer questions about them

• Information sources are numerous, but the following was from a presentation at the May, 1999 annual AOSSM: an NFL perspective, meeting presented by Leslie Bonci, M.P.H., R.D.

Androstenedione

• Adrenal Hormone• (+) Acts like testosterone, produces as

anabolic effect, increasing lean muscle mass, and a decrease in body fat

• (-) Testosterone spike, increased aggression, mood swings, banned by the NFL

• Wouldn’t recommend it

Dehydroepiandosterone (DHEA)

• Adrenal Hormone• (+) Anabolic effect• (-) Increases testosterone levels, banned by

the NFL• Under no circumstances

Tribulus Terrestris

• AKA- Tribestan, Triboxin• Plant hormone• (+) Anabolic effect• (-) Increases testosterone levels, banned by

the NFL• Don’t use this

Gamma-Hydroxybutyrate (GHB)

• Cellular component• (+) Anabolic effects• (-) Sedative effect similar to EtOH and

tranquilizers, not approved for sale in the United States

• Very powerful drug, may cause seizures or a comatose state

Yohimbine

• Supplement derived from tree bark• (+) Anabolic effect, increased virility• (-) Stimulant, no anabolic effect, can cause

dizzyness nervousness, HA, nausea, vomiting, increased BP, can interfere with BP medication and increase toxicity of psychotherapeutic medications

• Don’t bother

Vanadium

• AKA- Vanadyl sulfate• A non-essential trace mineral• (+) Anabolic effect, enhances insulin action• (-) No proven anabolic effect, at doses >10

grams / day can cause abdominal pain, cramping, green tongue, diarrhea, and weight loss

• No reason to take it!

Boron

• A trace mineral• (+) Increases testosterone levels• Involved in cellular function• >50 mg per day can decrease appetite and

digestion• In a multivitamin supplement it is OK,

otherwise more is not better!

Chromium

• Essential mineral involved in blood sugar control

• (+) Increases lean body mass, decreases fat• (-) May be helpful in diabetics in regulating

blood sugar levels• Safe dose is 50-300 mcg/day, and more is

not better

Branch Chain Amino Acids• Essential Amino Acids (isoleucine, leucine, and

valine)• (+) Delay fatigue by sparing the bodies fuel source,

glycogen, increases growth hormone levels and muscle mass

• (-)May decrease fatigue, may cause nausea, vomiting, and diarrhea, may inhibit absorption of other amino acids causing an imbalance

• Not necessary with proper diet

Conjugated Linoleic Acid

• Naturally occurring fatty acid found in beef, lamb and dairy products

• (+) Increased muscle gain, decreased body fat, antioxidant

• (-)No effect on performance observed• Not necessary, better to eat beef, lamb, and

dairy products

Creatine• Muscle fuel occurring naturally in meat and fish, and

produced in the liver from 2 nonessential amino acids (glycine & arginine)

• (+) Increased speed and muscle mass, and decreased effort of exertion

• (-) Provides extra energy for short-burst activity• Causes water retension of 4-7 lbs, possibly later

converting to muscle• Dose- 5gms qid for 7 days then 2 gms q day

Beta-hydroxy-beta-methyl-butyrate (HMB)

• Amino Acid Derivative, not an essential nutrient

• (+) Increased muscle mass, improved muscle repair

• (-) 1 study showed prevention of protein breakdown with intense strength training

• 3 mg / day

Calorad

• Water and collagen• (+) Promotes weight loss• (-) Contains 4 gms poorly absorbed protein

at 14 calories per tablespoon• Expensive, ineffective

Pyruvate• AKA- Fat assasin• Product of carbohydrate metabolism in Kreb’s

cycle of glycolosis• (+) produces weight loss, increases body fat loss• (-) May cause weight loss in obese patients, but

may cause diarrhea and stomach upset at effective doses

• Exercise is safer and more effective

Glucosamine Sulfate & Chondroitin Sulfate

• Aminopolysaccharides that are the structural components of ligamants, tendons, and joints

• (+) Restores articular cartilage, alleviates pain• (-) Stimulates cartilage growth and prevents

cartilage breakdown, alleviates pain comperable to 800mg motrin tid

• Rare side effects includestomach upset, rash, drowsiness, and HA

Carnitine

• Vitamin-like compound involved in breaking down fatty acids

• (+) Decreases body fat• (-) May prevent lactic acid accumulation to

delay fatigue in sprint type activities, D-carnitine may cause muscle weakness

• Not effective, wouldn’t recommend it

Coenzyme Q• AKA: CoQ10, Ubiquinone• Produced by the body in the mitochondria• (+) Enhances performance, delays fatigue,

prevents injury• (-) May be involved in energy release, is an

antioxidant, may be helpful in patients with heart disease

• Safe levels are 60-200 mg/day, very expensive

Digestive Enzymes

• AKA- Bromelain, Trypsin, Phytin• Enzymes from foods• (+) Increased body fat loss• (-) Breaks down protein to amino acids, no

studies to prove these are effective• Probably not worth it

Caffeine• A methylxanthine found in coffee beans, cocoa

beans, cola nuts, and tea leaves• (+) Stimulant, increases plasma free fatty acid

availability thus delaying fatigue, improves reaction time, and reducing perceived effort of exertion

• (-) Stimulant that may cause nervousness, anxiety, HA’s, diarrhea, polyurea, dehydration

• 200-300mg 1 hr prior to an event appears safe and effective, 800mg is max legal limit

Blue Nitro• AKA- Blue Nitro Vitality, Revivarant G, GH

Revitalizer, GHR, Remforce, Renewtrient, Gamma G• Chemical compound- Furanone-di-hydro with gamma

butyrolactone (very potent)• (+) Increases bodies human growth hormone, decreases

fat, increases virility, combats stress, improves sleep• (-) No published studies, interacts with alcohol and

other medications, may cause seizures or a comatose state. Dangerous!!

Dieter’s Tea

• Senna, Cascara, Buckthorn, Aloe• (+) Promotes weight loss and fat loss• (-) Laxative effect causing diarrhea,

vomiting, water loss, dehydration, hypotension, arrhythmia

• Drink regular tea instead

Ephedrine• Drug found in herbal products containing Ma Huang, anti

asthmatic medications, and many cold and cough preparations

• (+) Increases boby fat loss• (-) CNS stimulant, may delay fatigue by sparing glycogen

reserves, can increase BP, RR, HR, or cause insomnia and nervousness

• Do not take with caffiene, theophylline, elavil, or psychotherapeutic medications

• Max dose 24 mg / day

Ginseng• Root from an Asian plant, (Panax Ginseng)• (+) Enhances performance, improves recovery

rate• (-) Immune stimulator, may cause insomnia,

should not be used in patients with elevated BP, on coumadin, or psychotherapeutic drugs

• 100-200mgs / day of 4-7% ginsenosides, 2-3 weeks on, 1-2 weeks off

Hydroxycitrate

• AKA- Citrimax• Fruit acid extract from the Garcinia

Cambogia plant• (+) Decreased body fat, increased muscle

glycogen storage to delay fatigue• (-) diuetic effect, nothing else proven• Don’t recommend this

Thank you

Adam Morse, DOSevere short timer’s syndrome