Supplement Performance - Bodybuilding Supplement Update

“I subscribe to about 15 different magazines from Barron's to National Geographic to

Muscular Development. The one magazine that is regularly stolen by the Postal Service

is Muscular Development.” Anonymous, T-mag.com message board

Are Adverse Effects of Ephedra Exaggerated?

Ephedrine is classified as a sympathomimetic drug and central nervous system

stimulant. Its ability to act as a sympathetic agonist and increase thermogenesis

(production of heat) has led to its use in weight loss/fat loss. In most dietary supplements,

ephedrine used to appear as an extract from one of two herbs: ephedra or Ma huang.

Although the ephedra species have a long tradition of use (more than 5,000

years) for respiratory ailments, the U.S. Food and Drug Administration (FDA) recently

decided to ban ephedra-containing supplements. The pharmacokinetics of ephedrine

following ingestion of supplements formulated as concentrated ephedra extracts is

distinguishable from that of synthetic ephedrine found in conventional dosage forms.

Nevertheless, the FDA didn’t ban ephedrine.

Ephedrine has also been coupled with both caffeine and aspirin to further

enhance its effectiveness (i.e., ECA). Ephedrine stimulates the release of norepinephrine

(noradrenaline), which in turn stimulates the synthesis of prostaglandins by the activated

tissues. Aspirin inhibits the synthesis of prostaglandins and serves as a prostaglandin

blocker and thereby may prevent inhibition of norepinepherine release.

In addition, ephedrine is used as a performance-enhancing substance (ergogenic

aid). For example, Dr. Jacobs and co-workers reported that ephedrine ingestion, either

alone or in combination with caffeine, can lead to a significant increase in the number of

repetitions that can be performed and the total amount of weight that can be lifted during

weight training. In fact, the magnitude of the ergogenic effect is highly significant for gym

rats since only 90 minutes after ingesting caffeine plus ephedrine, a 16 percent

improvement in bench press performance was reported.

Is Ephedra Toxic?

In a comprehensive study by Drs. Blechman and colleagues at the New York of

School of Medicine and City and County of San Francisco Hall of Justice, the

investigators reviewed all autopsies in their medical examiners’ jurisdictions, from 1994 to

2001, where ephedrine or any of its isomers were detected. Toxicology testing results

were tabulated and anatomic findings in ephedra cases were compared to those in a

control group of drug-free trauma victims.

Of 127 ephedra cases identified, 33 were due to trauma, i.e., an injury caused by

an extrinsic (outside of a body) agent. Furthermore, more than 88 percent (113/127) of

the decedents also tested positive for other drugs, the most common being cocaine and

morphine. The authors stated, “What is most surprising about the results of this study is

that of the cases where only ephedrine alkaloids were detected, only one possible case

of ephedrine toxicity occurred in San Francisco from 1994 to mid-1999. This data

contradicts the recent well-publicized case reports suggesting that large numbers of

ephedrine-related deaths were occurring and that only a fraction are being reported to the

FDA.” Based on this study, one could conclude that the adverse effects of ephedra are

greatly exaggerated.

Ephedra and Adverse Clinical Events

Some feel that ephedra may pose significant risk. Dr. Andrews and co-workers at

the Beth Israel Medical Center reviewed the available literature and concluded that more

stringent oversight by regulatory authorities is required to minimize the incidence of

adverse events. However, the authors rightly stated that, “No clinical trial has reported

major adverse cardiovascular events (stroke, myocardial infarction, or malignant

arrhythmias) associated with the use of ephedra alkaloids for weight loss.”

They also cited numerous case reports purportedly showing that adverse

cardiovascular and cerebrovascular effects, including stroke, myocardial infarction and

sudden death, are related to ephedra use. Many of these case reports are very dubious

and some of them had nothing to do with ephedra products.

For example, Dr. Andrews et al. stated, “Myocardial ischemia has also been

reported when ephedra alkaloids are combined with other medications that cause

increased adrenergic tone, such as bupropion,” citing the case report by Dr. Pedersen et

al. (My reference [4]). In reality, the patient´s medication history revealed recent

commencement of bupropion (Zyban®) for smoking cessation and pseudoephedrine as a

non-prescription influenza remedy.

Finally, based on the fact that synephrine shares a structural similarity with

ephedra alkaloids, the authors speculated it may thus pose the same risks to consumers

as its banned cousins. However, no evidence was provided to support this notion and the

authors ignored the study by Dr. Penzak and co-collegues, which determined

cardiovascular effects of synephrine and octopamine in normotensive humans. The

results indicated that hemodynamics (heart rate; systolic, diastolic and mean arterial

pressure) didn’t differ between water and Citrus aurantium juice groups (Citrus aurantium

contains synephrine and octopamine).

Questionable Study

Numerous well-controlled clinical studies have shown that the ephedrine-caffeine

combo has little, if any, effect on blood pressure when used as directed. Surprisingly,

there’s a recent study showing that a single dose of ephedra-guarana supplement can

produce significant increases in blood pressure and resting heart rate in healthy young

adults. However, I believe this is a fake report. You see, the first and third authors of this

paper have served as “expert witnesses” in litigation involving manufacturers of dietary

supplements that contain ephedra. These authors are outspoken critics of ephedra

supplements and they just happen to be the authors of the only published study

purportedly showing that a single dose of ephedra-guarana (taken in recommended

doses) can produce significant cardiovascular and metabolic changes. Call me a skeptic,

but this paper smells like bullshit. By the way, some 20 percent of patients have blood

pressures that are significantly higher in the doctor´s office than at home (“white coat

hypertension”) simply because emotions increase the cardiac output and peripheral

resistance and thus arterial pressure.

So, what´s the bottom line? Ephedrine-caffeine supplementation promotes fat

loss, improves exercise performance and is relatively safe when used as directed.

However, ephedrine/ephedra isn’t for everyone and must be used responsibly. It's very

important that you read product labels, warnings and cautions and follow the directions.

Forskolin Cuts Fat and Increases Free T

Some practitioners of traditional Ayurvedic medicine have long used the herb

Coleus forskohlii to treat asthma, heart disease and a range of other ailments. In the

1970s, scientists isolated a chemically active ingredient in the herb and called it forskolin.

Now available in supplement form, this extract is commonly recommended for treating

hypothyroidism, a condition in which the thyroid gland produces too little thyroid hormone.

It has also been suggested that forskolin can:

ı Increase the force of contractions of the heart muscle.

ı Relax arteries and other smooth muscles.

ı Increase lipolysis (the breakdown of storage fat).

A recent study by Dr. Godard and co-workers at the University of Kansas

examined the effects of forskolin on body composition, testosterone, metabolic rate and

blood pressure in overweight and obese men. Thirty subjects were studied for 12 weeks

in this randomized, double-blind, placebo-controlled study. The results indicated that

forskolin supplementation (250 milligrams of 10 percent forskolin extract twice a day)

significantly decreased body fat percentage and fat mass while concurrently increasing

bone mass. Furthermore, the investigators noted that there was a trend toward a

significant increase for lean body mass in the forskolin group. Interestingly, forskolin also

increased free (biologically active) testosterone levels. In summary, this product may be a

useful supplement for gym rats, but well-controlled studies in healthy athletes are needed

before firm conclusions can be drawn.

KIC HMB Decreases Exercise-Induced Muscle Damage

A recent study by Dr. van Somerne and collegues examined the effects of betahydroxy-

beta-methylbutyrate (HMB) and alpha-ketoisocaproic acid (KIC) supplementation

on signs and symptoms of exercise-induced muscle damage following a single bout of

eccentrically biased resistance exercise (muscular damage and soreness occurs more

readily following eccentric exercise than following concentric exercise). Subjects were

assigned to an HMB KIC (three grams of HMB 0.3 grams of KIC daily) or placebo

treatment for 14 days prior to exercise. Simply stated, the investigators reported that

HBM KIC supplementation reduces signs and symptoms of exercise-induced muscle

damage in non-resistance trained males. Whether HMB KIC has similar effects in welltrained

athletes remains to be determined.

HCA Preparations Exert Striking Differences in Efficacy

Hydroxycitric acid (HCA) is otherwise known as Garcinia cambogia and derives

from the dried rind of the Garcinia cambogia fruit. HCA is a popular ingredient in

commercial weight-loss preparations, but studies on its fat-loss enhancing effects are

controversial. In a recent study by Drs. van der Haar and co-workers, published in

Nutrition & Metabolism, the effects of three different HCA-containing preparations

(Regulator, Citrin K, CitriMax®) on food intake and bodyweight were studied in rats. The

conclusion was that these commercially available HCA preparations exert striking

differences in efficacy in inhibiting voluntary food intake in rats. Specifically, Regulator

and Citrin were potent suppressants of food intake, whereas CitriMax® exerted much

smaller effects on food intake.