Fibromyalgia, natural treatment options part II

Fibromyalgia is one of the most common topics that I get asked to write blog articles about.  To be certain, Fibromyalgia affects an estimated 5.8 million Americans.  Of these millions of Americans, women are more commonly affected than men.  If you suffer from this condition, make sure to read my original article on fibromyalgia–Fibromyalgia, new treatment option. My previous article highlights some of the key features of fibromyalgia.  Unfortunately, there is a paucity or lack of research into natural treatment options for fibromyalgia.

Symptoms of Fibromyalgia Syndrome:

· Widespread pain

o Pain in specific areas where pressure is applied, “pressure points.”

o Diagnosis: widespread aching pain for at least three months and have a minimum of 11 locations on your body that are abnormally tender under relatively mild, firm pressure

· Fatigue and sleep disturbances.

· Irritable bowel syndrome (IBS).

o Constipation/bloating, abdominal pain.

· Headaches and facial pain

· Heightened sensitivity.

· Depression/Anxiety

Fibromyalgia treatment options:

1. Conventional analgesics
2. Antidepressants
3. Muscle relaxants
4. Lyrica (pregabalin)–First FDA approved drug for Fibromyalgia

Pregabalin for Fibroymalgia:

This randomized, placebo-controlled trial of 300, 450, and 600 mg/d of pregabalin monotherapy demonstrated that all 3 doses were efficacious for up to 14 weeks for the treatment of fibromyalgia and were well tolerated by most patients. These results provide evidence that pregabalin is an important treatment option for patients with fibromyalgia. (Arnold et al, 2008).

Natural treatment options:

1. Acetyl l-carnitine (2 capsules of 500mg taken daily)
2. ?Dietary Soy (see below)
3. S-adenosyl methionine (Natural anti-inflammatory, analgesic, and antidepressant)
4. Magnesium (see below)
5. Melatonin
6. ?Chlorella (see below)
7. ?Omega-3 fatty acids.

Dietary Soy Supplement for Fibromyalgia:

Results of statistical analysis using the separation test and intent-to-treat analysis revealed no benefit of soy compared with placebo. (Wahner-Roedler et al, 2008)

• No current evidence to support the use of soy in patients with fibromyalgia.

S-adenosyl methionine for Fibromyalgia:

Some herbal and nutritional supplements (magnesium, S- adenosylmethionine) and massage therapy have the best evidence for effectiveness with FM. Other CAM therapies such as chlorella, biofeedback, relaxation have either been evaluated in only one randomised controlled trials (RCT) with positive results, in multiple RCTs with mixed results (magnet therapies) or have positive results from studies with methodological flaws (homeopathy, botanical oils, balneotherapy, anthocyanidins and dietary modifications). Another CAM therapy such as chiropractic care has neither well-designed studies nor positive results and is not currently recommended for FM treatment. (Sarac et al, 2006)

• best evidence for magnesium and s-adenosyl methionine for fibromyalgia
• limited evidence for chlorella

Melatonin

Preliminary evidence indicates that melatonin, a molecule that is endogenously produced and is available as an over-the-counter supplement, may be effective in treating the pain associated with this syndrome. Although melatonin is commonly known as a sleep aid (sleep/wake problems are common in FM sufferers), it has a variety of other beneficial effects that may account for its potential benefits in the treatment of FM  (Reiter et al, 2007).

• Melatonin is potentially beneficial for people with fibromyalgia.
• Though it is available over-the-counter in the U.S., there are potential side-effects from melatonin use.

Lifestyle remedies

1. Maintain a healthy lifestyle
2. Ensure that you get adequate sleep
3. Reduce stress
4. Exercise regularly
5. Support groups

My conclusions:

• Overall, there is limited evidence to support the use of dietary supplements for fibromyalgia.
• There is some limited evidence to support the use of acetyl l-carnitine, magnesium, s-adeonsyl methionine, and melatonin for fibromyalgia patients.
• The use of dietary supplements for fibromyalgia is not a heavily researched topic–additional studies are required to support the use of the above dietary supplements for these patients.

References:

Arnold LM, Russell IJ, Diri EW, Duan WR, Young JP Jr, Sharma U, Martin SA, Barrett JA, Haig G. A 14-week, randomized, double-blinded, placebo-controlled monotherapy trial of pregabalin in patients with fibromyalgia. J Pain. 2008 Sep;9(9):792-805.

Wahner-Roedler DL, Thompson JM, Luedtke CA, King SM, Cha SS, Elkin PL, Bruce BK, Townsend CO, Bergeson JR, Eickhoff AL, Loehrer LL, Sood A, Bauer BA. Dietary Soy Supplement on Fibromyalgia Symptoms: A Randomized, Double-blind, Placebo-controlled, Early Phase Trial. Evid Based Complement Alternat Med. 2008 Nov 6.

Sarac AJ, Gur A. Complementary and alternative medical therapies in fibromyalgia. Curr Pharm Des. 2006;12(1):47-57.

Reiter RJ, Acuna-Castroviejo D, Tan DX. Melatonin therapy in fibromyalgia. Curr Pain Headache Rep. 2007 Oct;11(5):339-42.

Warning for green/black tea drinkers!

Green Tea/Black Tea:

Green Tea is a very popular drink not only in Asian countries, but throughout the world.  In western nations, black tea is probably even more popular.  Green tea itself has many potential health benefits including promoting weight loss as well as beneficial effects on glucose tolerance (potentially beneficial for people with diabetes).  Both green as well as black teas are rich in polyphenols which are antioxidants.  Despite the many potential health benefits of both green and black teas, a recent study suggests that there maybe one important adverse health-related effect related to tea consumption.

Folic Acid:

Folic acid is an important vitamin for several reasons.  Deficiencies of folic acid have been linked to the following conditions:

• cardiovascular disease
• growth retardation
• megaloblastic anemia
• neural tube defects (in children born from mother’s who have deficiency during pregnancy)
• depression
• increased levels of homocysteine

A recent study published in the journal, Biopharmaceutics & Drug disposition (Alemdaroglu et al, 2008), suggests that drinking either green or black tea may actually lower the bioavailablity of folic acid.

Study Results:

At the 0.4 mg folic acid dose, green and black tea reduced the mean C(max) of serum folate by 39.2% and 38.6%

Study conclusion:

The present results suggest an in vivo interaction between tea and folic acid with even low concentrations of green and black tea extracts yielding decreased bioavailabilities of folic acid.

Important Implications:

• Pregnant women may want to eliminate or at least restrict their consumption of both green/black.  Lower folic acid bioavailability is a potential risk for neural tube defects.
• For those who do consume green/black teas, you will want to ensure that you don’t take your vitamins (containing folic acid) with tea.

Reference:

Alemdaroglu NC, Dietz U, Wolffram S, Spahn-Langguth H, Langguth P. Influence of green and black tea on folic acid pharmacokinetics in healthy volunteers: potential risk of diminished folic acid bioavailability. Biopharm Drug Dispos. 2008 Sep;29(6):335-48.

Related articles:

Does Green Tea promote weight loss?

Green Tea and Glucose Tolerance/Diabetes

Green Tea–effects on glucose tolerance

Recent studies highlights protective benefits of Green Tea

dietary supplement green tea black tea folic acid pregnancy pregnant women jarret morrow

Dietary Fiber–Cheat Sheet!

Dietary fiber–Isn’t  that stuff that you find in certain foods that make them taste really bad?  Well, sometimes, but not always…  Though I personally cringe at the thought of sitting down to a breakfast of Bran Buds or similar types of cereals, we should be more cognizant of our dietary fiber intake.  Most people fail to consume the recommended amount of dietary fiber or what’s commonly referred to as “roughage” in our diets.  Many people simply lack an understanding of the importance of dietary fiber, how much they actually need to consume per day, or what the difference between soluble and insoluble fiber.  For those people, here is Dr. Morrow’s Dietary Fiber Cheat Sheet!

What is dietary fiber, again?

Dietary fiber is a relatively broad term that includes many plant components that share the characteristics of being indigestible.  This means that dietary fiber is not digested, absorbed by the body , or used for energy.  There are two main sources of dietary fiber–soluble fiber and insoluble fiber.  *Note many plant sources include both soluble and insoluble fiber.

Insoluble fiber does not dissolve in water and does not get broken down by bacteria in the intestine.  Instead, it essentially absorbs water to help to increase bulk and to soften stool.  The net effect of insoluble fiber is that it promotes regular bowel movements.  Additionally, insoluble fiber helps us to feel full which may reduce obesity.  It also may reduce our risk of developing hemorrhoids.

Food sources of Insoluble fiber:

1. Whole-wheat products
2. Corn bran
3. Brown rice
4. Certain vegetables (Carrots, celery, tomatoes)

Soluble Fiber differs from insoluble fiber in that it dissolves in water and additionally is broken down by bacteria in the intestine.  Soluble fiber helps prevent cholesterol from being absorbed by the intestines and is thought to help minimize the rise in blood sugar following a meal.

Sources of Soluble fiber:

1. Oatmeal
2. Beans
3. Fruits such as apples, plums, kiwi, pears, blackberries, strawberries, raspberries, peaches, citrus fruits, dried apricots, prunes, and figs.
4. Some vegetables (dried peas, beans, and lentils)

Potential Health Benefits of Dietary Fiber:

1. Helps prevent constipation
2. May reduce risk of colon cancer
3. May reduces LDL cholesterol and cardiovascular risk
4. May reduce the risk of developing type 2 diabetes
5. Helps to increase satiety and reduce caloric intake

How much dietary fiber do you need per day? (New guidelines)

1. 25 g for adult women

2. 38 g for adult men

How much of each type do you need?

It really doesn’t matter so much, both types are important, just try to consume more fiber!

“Few fiber supplements have been studied for physiological effectiveness, so the best advice is to consume fiber in foods.” (Slavin et al, 2008).

Useful links:

Vegetarian Protein: Not just for Vegetarians

Live Life 365 Fiber Videos and Articles

References:

Bazzano LA. Effects of soluble dietary fiber on low-density lipoprotein cholesterol and coronary heart disease risk. Curr Atheroscler Rep. 2008 Dec;10(6):473-7.

Slavin JL. Position of the American Dietetic Association: health implications of dietary fiber. J Am Diet Assoc. 2008 Oct;108(10):1716-31.

Omega-3 fatty acids in rheumatoid arthritis?

Rheumatoid arthritis (RA) is a common, debilitating condition, that has a different etiology or cause than the more common form of arthritis, osteoarthritis.  Rheumatoid arthritis is a systemic autoimmune disease in which the immune system causes inflammation and attacks the joints.  Systemic means that it can causes inflammation organs throughout the body–not only inflammation of the joints and surrounding tissues.  In fact, rheumatoid arthritis affects approximately 1% of the population–with women being affected 3x more commonly than men.  Further, rheumatoid arthritis can be a common cause of disability.

For the many suffers of RA, NSAIDs or non-steroidal anti-inflammatory drugs are often used to treat the pain associated with it.  NSAIDs have potentially serious side effects including, but not limited to gastrointestinal tract and cardiovascular system.  The results of a recent study published in the journal, Rheumatology, suggests that cod liver oil containing omega 3-fatty acids, may help people who suffer from RA to reduce their consumption of NSAIDS in the management of their RA pain (Galaraga et al, 2008).

Additionally, a recent meta-analysis assessing the pain relieving effects of omega-3 PUFAs (polyunsaturated fatty acids) comprised of 17 randomized controlled trials involving  in patients with rheumatoid arthritis concluded the following:

“The results suggest that omega-3 PUFAs are an attractive adjunctive treatment for joint pain associated with rheumatoid arthritis, inflammatory bowel disease, and dysmenorrhea.”

Specifically, omega-3 fatty acid consumption lowered:

1. patient assessed pain
2. physician assessed pain
3. duration of morning stiffness
4. number of painful and/or tender joints
5. Ritchie articular index
6. nonselective nonsteroidal anti-inflammatory drug consumption

References:

Galarraga B, Ho M, Youssef HM, Hill A, McMahon H, Hall C, Ogston S, Nuki G, Belch JJ. Cod liver oil (n-3 fatty acids) as an non-steroidal anti-inflammatory drug sparing agent in rheumatoid arthritis. Rheumatology (Oxford). 2008 May;47(5):665-9. Epub 2008 Mar 24

Goldberg RJ, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. 2007 May;129(1-2):210-23. Epub 2007 Mar 1.

Related posts:

Natural treatment options for Rheumatoid Arthritis

Lifestyle change, fish oil, and red yeast rice vs. Simvastatin to reduce cholesterol?

High cholesterol is a serious risk factor for cardiovascular disease.  Though the efficacy of statin type medications are well-established, the compliance rate of these drugs can be lowered by patient concerns over side-effects as well as medication costs.

Key points:

• Lifestyle change (read Mediterranean diet/aerobic exercise), fish oil (dietary supplement), and red yeast rice (dietary supplement) lowered LDL cholesterol (bad cholesterol) similarly to medication (Simvastatin).

• The combined therapy with lifestyle change etc, also lowered trigylcerides more than Simvastatin.

• Both red yeast rice and Simvastatin have the potential to cause a dangerous side effect known as rhabdomyolysis (see comments).

A recent, open-label trial, compared two interventions for people with hypercholesterolemia (Becker et al, 2008).  The first group received conventional treatment with 40mg/d of Simvastatin while the second group received an intervention which included education on diet (mediterranean diet), exercise (aerobic), as well as daily consumption of red yeast rice (hong qu) and fish oil capsules.

Intervention:

Group 1:  40mg /day of Simvastatin

Group 2:  Mediterranean diet education, instructed to exercise (aerobic exercise) by an exercise physiologist., consume capsules of both red yeast rice  [(Each capsule had a total monacolin content of 5.3 mg, of which 2.53mg was monacolin K (lovastatin)] and fish oil (3 capsules daily)

Results:

• Statistically significant reduction in LDL-C levels in both the AG [alternative treatment group] (-42.4%+/-15%) (P<.001) and the simvastatin group (-39.6%+/-20%) (P<.001).
• No significant differences were noted between groups.
• The AG (alternative treatment group) also demonstrated significant reductions in triglycerides (-29% vs -9.3%; 95% confidence interval, -61 to -11.7; P=.003) and weight (-5.5% vs -0.4%; 95% confidence interval, -5.5 to -3.4; P<.001) compared with the simvastatin group.

Safety:

“In the simvastatin group, 3 patients experienced musculoskeletal symptoms. One completed the protocol, taking 40 mg of simvastatin daily until the end of the study. Two patients stopped their simvastatin regimen for 3 days, per protocol. Their CK levels were normal, and they completed the study taking 20 mg/d.”

“In the AG, one patient had a basehne CK level of 232 U/L, which increased to 1532 U/L on routine testing at the completion of the study. He was completely asymptomatic, was engaged in vigorous exercise the night before his blood test, and was taking 3 capsules of RYR twice daily. After the study was completed, medication and exercise were stopped, and his CK level returned to normal. Two patients noted heartburn that resolved when they were switched to equivalent doses of a liquid form of fish oil (ResQ 1250 liquid) from the same manufacturer.”

Conclusion:

“Lifestyle changes combined with ingestion of red yeast rice and fish oil reduced LDL-C in proportions similar to standard therapy with simvastatin.”

Limitations:

• The study authors also concluded that these results needed to be confirmed in larger trials.
• One issue with this study that clouds the results to some extent is the fact that the alternative treatment group involved several different interventions including implementing the Mediterranean diet, aerobic exercise as well as consuming capsules of both Chinese red yeast rice and fish oil.  As a result, it is difficult to be certain how much of the cholesterol lowering achieved could be attributable to each separate intervention.
• The study itself was an open-label trial which essentially means that the study was not blinded or that both the patients as well as the study authors were aware of the interventions that the patients were receiving.

Related articles:

Lower your cholesterol levels naturally?

Botanical extracts that may improve your cardiovascular health?

Siberian Ginseng for post-menopausal women?

Red grape juice consumption and cardiovascular disease

Do soy nuts lower blood pressure and cholesterol?

Phytostanol supplements for lowering cholesterol

Reference:

Becker DJ, Gordon RY, Morris PB, Yorko J, Gordon YJ, Li M, Iqbal N. Simvastatin vs therapeutic lifestyle changes and supplements: randomized primary prevention trial. Mayo Clin Proc. 2008 Jul;83(7):758-64.

Priobiotics for traveler’s diarrhea?

For many inhabitants of North America, as the winter months approach, we look forward to a warm tropical vacation to escape from the cold.  Popular destinations include Mexico and the Caribbean.  However, many of us share valid concerns about traveler’s diarrhea.  Traveler’s diarrhea is the most common illness that affects travelers.  High-risk areas for traveler’s diarrhea include developing countries in Africa, Asia, the Middle East, and Latin America.

Traveler’s diarrhea is often referred to by many names:  Deli Belly, Bali Belly, Montezuma’s revenge, or Thai dal wave.  As funny as some of these names are, TD is no laughing matter.

Steps to avoid traveler’s diarrhea

1. Only drink bottled water (even to brush your teeth)
2. Avoid eating raw fruits or vegetables
3. Avoid ice cubes that may be made with local water
4. Maintain good hygiene.

Symptoms of traveler’s diarrhea

1. Abdominal cramps
2. Diarrhea
3. Dehydration–mild to severe
4. Nausea/vomiting
5. Lethargy
6. *Fever/Vomiting/bloody stool–more severed form with greater risk of dehydration

Probiotics to prevent traveler’s diarrhea?

Probiotics are dietary supplements that contain bacteria or yeast that are potentially beneficial.  A recent meta-analysis which reviewed 12 randomized controlled trials which met inclusion criteria found that probiotics significantly prevent TD (McFarland, 2007).

Results:

“The pooled relative risk indicates that probiotics significantly prevent TD (RR=0.85, 95% CI 0.79,0.91, p<0.001)”

CONCLUSION:

“Several probiotics (Saccharomyces boulardii and a mixture of Lactobacillus acidophilus and Bifidobacterium bifidum) had significant efficacy”

Safety

“No serious adverse reactions were reported in the 12 trials. Probiotics may offer a safe and effective method to prevent TD.”

My conclusions:

While in medical school, I learned that bismuth containing preparations such as Pepto-Bismol may help to prevent contracting traveler’s diarrhea.

Read:  take it before you develop TD rather than waiting until after!

In fact, a recent study found that these preparations can provide a rate of protection of 65% when taken 4 times per day (Ericcson, 2005).

Additionally, probiotics rather than antibiotics may become the preferred method of preventing traveler’s diarrhea!

For those who are unlucky or unprepared and develop traveler’s diarrhea, the illness is often self-limited, but medical care may be required for more severe cases.  Taking steps to prevent TD will help you get the most enjoyment out of your vacation or travels…

References:

McFarland LV.  Meta-analysis of probiotics for the prevention of traveler’s diarrhea.  Travel Med Infect Dis. 2007 Mar;5(2):97-105.

Ericsson CD. Nonantimicrobial agents in the prevention and treatment of traveler’s diarrhea.  Clin Infect Dis. 2005 Dec 1;41 Suppl 8:S557-63.

Battle of the Bulge…

Obesity continues to reach epidemic proportions in developed nations. For people who suffer from obesity, choosing a diet that not only works but one that they are capable of adhering too can be a difficult challenge. A very recent study, published in the New England Journal of Medicine (Shai et al, 2008), compares the results of 3 popular diets in moderately obese subjects over a period of two years.

METHODS:

322 moderately obese were randomly assigned to one of three diets:

• low-fat, restricted-calorie
• Mediterranean, restricted-calorie
• low-carbohydrate, non-restricted-calorie

Low-Fat Diet

“The low-fat, restricted-calorie diet was based on American Heart Association guidelines. We aimed at an energy intake of 1500 kcal per day for women and 1800 kcal per day for men, with 30% of calories from fat, 10% of calories from saturated fat, and an intake of 300 mg of cholesterol per day. The participants were counseled to consume low-fat grains, vegetables, fruits, and legumes and to limit their consumption of additional fats, sweets, and high-fat snacks.”

Mediterranean Diet

“The moderate-fat, restricted-calorie, Mediterranean diet was rich in vegetables and low in red meat, with poultry and fish replacing beef and lamb. We restricted energy intake to 1500 kcal per day for women and 1800 kcal per day for men, with a goal of no more than 35% of calories from fat; the main sources of added fat were 30 to 45 g of olive oil and a handful of nuts (five to seven nuts, <20 g) per day. The diet is based on the recommendations of Willett and Skerrett.”

Low-Carbohydrate Diet

“The low-carbohydrate, non–restricted-calorie diet aimed to provide 20 g of carbohydrates per day for the 2-month induction phase and immediately after religious holidays, with a gradual increase to a maximum of 120 g per day to maintain the weight loss. The intakes of total calories, protein, and fat were not limited. However, the participants were counseled to choose vegetarian sources of fat and protein and to avoid trans fat. The diet was based on the Atkins diet.”

RESULTS:

“The Mediterranean-diet group consumed the largest amounts of dietary fiber and had the highest ratio of monounsaturated to saturated fat (P<0.05 for all comparisons among treatment groups).”

“The low-carbohydrate group consumed the smallest amount of carbohydrates and the largest amounts of fat, protein, and cholesterol and had the highest percentage of participants with detectable urinary ketones (P<0.05 for all comparisons among treatment groups).”

WEIGHT LOSS:

Mean weight loss was (total) [participants who completed study]:

• 2.9 kg for the low-fat group [3.3kg]
• 4.4 kg for the Mediterranean-diet group [4.6Kg]
• 4.7 kg for the low-carbohydrate group [5.5kg]

“The maximum weight reduction was achieved during the first 6 months; this period was followed by the maintenance phase of partial rebound and a plateau.”

CHOLESTEROL REDUCTION:

“The relative reduction in the ratio of total cholesterol to high-density lipoprotein cholesterol was 20% in the low-carbohydrate group and 12% in the low-fat group (P=0.01).”

DIABETIC PARTICIPANTS:

“Among the 36 subjects with diabetes, changes in fasting plasma glucose and insulin levels were more favorable among those assigned to the Mediterranean diet than among those assigned to the low-fat diet (P<0.001 for the interaction among diabetes and Mediterranean diet and time with respect to fasting glucose levels).”

CONCLUSIONS:

“Mediterranean and low-carbohydrate diets may be effective alternatives to low-fat diets. The more favorable effects on lipids (with the low-carbohydrate diet) and on glycemic control (with the Mediterranean diet) suggest that personal preferences and metabolic considerations might inform individualized tailoring of dietary interventions.”

SUMMARY:

For those who have high cholesterol, the low-carbohydrate diet may be the best option. However, for people who also have diabetes, the Mediterranean diet was the clear winner in this study. In contrast, for those who have difficulty restricting their caloric intake, the low carbohydrate diet may be the best option.

Additionally, irrespective of which diet which the participants were randomized to, the weight loss peaked at just 6 months.  Afterward, there was a slight rebound in weight gain which was followed by a plateau phase.  To those who are seeking to lose weight, this suggests that dietary interventions alone may not be the best option.  Choosing the optimal diet along with both an exercise program as well as a strategy to stay focused and adherent to both is more successful long-term approach.

Reference:
Shai I, Schwarzfuchs D, Henkin Y, Shahar DR, Witkow S, Greenberg I, Golan R, Fraser D, Bolotin A, Vardi H, Tangi-Rozental O, Zuk-Ramot R, Sarusi B, Brickner D, Schwartz Z, Sheiner E, Marko R, Katorza E, Thiery J, Fiedler GM, Blüher M, Stumvoll M, Stampfer MJ; Dietary Intervention Randomized Controlled Trial (DIRECT) Group. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. N Engl J Med. 2008 Jul 17;359(3):229-41.

Increase your strength with l-arginine alpha-ketoglutarate?

When I think of body building, I think back to my days working out a gym (early 90’s) filled with guys wearing the baseball cap on backwards, with the tank top and those ridiculously oversized body building sweat pants (the ones inspired by M.C. Hammer). However, fitness advocates now refer to body building as “resistance training” and the popularity of this has broadened over the years. Tiger Wood’s pumped up physique has likely inspired as many golfers to purchase an athletic club membership as he has to purchase a Buick or a Nike driver.

For those who work out at an athletic club, many things have changed. Today, you’re as likely to see a soccer mom lifting kettlebell weights with her personal trainer or a gentleman practicing some new form of mixed martial arts on a punching bag as you are to see an old school body builder doing dead lifts. For all that has changed over the last 15 years from Tai Bo to Pilates or Bikram Yoga, there’s still one thing that hasn’t changed… In the weight room, the measure of a man still remains the same. How much can ya bench?

Today, I came across and interesting study on l-arginine alpha-ketoglutarate (Campell et al, 2006). This particular study involved an 8 week, double-blind trial of l-arginine alpha-ketoglutarate in 35 resistance-trained men. Compared to the placebo group, the resistance-trained men increased their one repetition maximum bench press by 8.82 Kg vs. 2.67 Kg over the 8 week period.

Dose:

Ingest 4 g of AAKG [l-arginine alpha-ketoglutarate ] (three times a day, i.e., 12 g daily)

Results:

Significant differences were observed in the AAKG group (P < 0.05) for:

• 1RM (One repetition maximum) bench press
• Wingate peak power [anaerobic sprint capacity]
• blood glucose
• plasma arginine

No significant differences were observed between groups:

• body composition
• total body water
• isokinetic quadriceps muscle endurance
• aerobic capacity

Conclusion:

“AAKG supplementation appeared to be safe and well tolerated, and positively influenced 1RM bench press and Wingate peak power performance. AAKG did not influence body composition or aerobic capacity.”

Safety:

“The present study is the first to examine the safety and efficacy of AAKG supplementation during resistance training in well-trained men. Results indicated that AAKG supplementation (12 g/d for 8 wk) was well tolerated and produced no significant changes in liver enzymes, liver or kidney function, or hematologic profiles. Moreover, no serious side effects were observed.”

Reference:
Campbell B, Roberts M, Kerksick C, Wilborn C, Marcello B, Taylor L, Nassar E, Leutholtz B, Bowden R, Rasmussen C, Greenwood M, Kreider R. Pharmacokinetics, safety, and effects on exercise performance of l-arginine alpha-ketoglutarate in trained adult men. Nutrition. 2006 Sep;22(9):872-81.

l-arginine alpha-ketoglutarate dietary supplement weight lifting resistance training bench press ergogenic aid

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