Thursday, April 29, 2010

Do smart drugs really work? by Jerry Brainum

While most of the adverse publicity related to "doping" has to do with the illicit use of various anabolic drugs, such as anabolic steroids, growth hormone, and others, there is another kind of doping that is becoming increasingly prevalent. Those who engage in what is called pharmacological neuroenhancement, are not interested in building a world-class physique, or setting world athletic records, although in some cases, these uses do overlap. Instead, users of smart drugs, as they are often called, are seeking to maximize brain power. This could involve an increase in memory, learning, and attention, along with an increased level of concentration and focus. Such possible benefits are attractive to all whose activities involve intensive use of their brains.While these drugs are popular among students, academics, and even many scientists, the salient question is: do smart drugs really work?
      Various smart drugs have been touted for their alleged brain-boosting activities for years. Most of these drugs are not approved for medical use in the United States, but are often approved for use in treating various brain disorders in European countries. Their efficacy in the treatment of clear-cut neurological deficits, as exemplified by such disorders are Alzheimer's disease and other forms of dementia, had led to the belief that they could also enhance the cognition or thinking ability of healthy people. But the problem here is that those with brain disease usually have deficits in the production and release of brain neurotransmitters and other chemicals that doesn't exist in normal brains. The drugs work by promoting an increased synthesis and release of various brain chemicals in those with brain pathology who aren't releasing these vital brain chemicals. But in those whose brains are normal and releasing sufficient amounts of neurotransmitters and other brain substances, using the various smart drugs does little or nothing. The fact that countless healthy people have reported definite positive effects from these drugs only underscores the power of positive belief. In short, if you think something will work, it just might, but not from any intrinsic activity of the drug.
      Among the most popular of the more recent smart drugs are modafinil and methylphenidate. Modafinil is sold under the trade name Provigil, while methyphenidate is sold as Ritalin and other names. Ritalin has been a controversial drug for years, used mainly in the treatment of attention deficit disorder in children.Ritalin is similar in structure to amphetamines, or "speed," although its actions in the brain more resemble that of cocaine. In fact, it provides all the brain stimulation effects of cocaine minus the well-known euphoria associated with cocaine usage. Similarly to cocaine, Ritalin works by incresing brain levels of dopamine and norepinephrine. Ritalin was initially synthesized in 1944, and found to have stimulant effects in the brain ten years later. Among the effects associated with Ritalin use are increased attention, decrease in mental fatigue, and increased alertness, Considering these properties, it's not hard to understand why it's so popular among students cramming for exams.
      Provigil first came to the attention of the public when it was disclosed that it was used extensively by the military, particularly fighter pilots, who used it to stay awake and alert during extended missions.The actual medical indication of Provigil is to treat narcolepsy, or a sudden onset of sleep, and also to treat excessive daytime sleepiness.Similarly to Ritalin, Provigil also increases brain levels of dopamine and norepinephrine. But Provigil goes a few steps furthur that does Ritalin. For example, Provigil increases levels of histamine in the hypothalamus structure of the brain, in an area that controls alertness.It also interacts with brain chemicals called orexins or hypocretins, that are related to wakefulness.Some studies suggest that Provigil promotes the release of brain-stimulating neurotransmitters, such as glutamate, while blunting those related to brain sedation, such as GABA. Thus, when you consider how both Ritalin and Provigil work in the brain, it appears that there must be some legitmate science behind the use of both drugs for purposes of neuroenhancement--or is there?
     A recent study analyzed several past studies that examined the brain effects in regard to enhancement  of Provigil and Ritalin in healthy people.The study found no neuroenhancement effect for Ritalin, except for a positive effect on memory.There was no effect on increased attention, and the study authors think that the popularity of Ritalin relates more to just getting high than any true brain enhancement effects.For Provigil, brain enhancement effects were found, but mainly for those who were sleep deprived. In such people, Provigil effectively increased attention.No effect, however, was found for any inmprovements in memory,mood, or motivation.Another effect noted with Provigil was a tendency to be overconfident in relation to cognitive ability. This means that in those who use Provigil, there is a tendency to think that they are smarter than they really are. Other studies show that Provigil appears to work better in terms of brain enhancement in those who with lower IQs. It has also been used by athletes, which led to its being banned by the World Antidoping Agency in 2003. This was mainly done because it was thought to provide an amphetamine-like action in athletes.
      As for safety, Ritalin can cause a few serious heart problems, including disorders of normal heart rhythm. Provigil has been linked to some serious skin condition syndromes, although it's officially listed as a schedule-4 drug, meaning that it has a low potential for abuse. But the study that analyzed the use of both drugs by healthy people for purposes of brain enhancement concluded that Ritalin was ineffective, and there wasn't enough convincing evidence to suggest that Provigil would work well in this regard, either.For those who want to increase brain power, but avoid using drugs, consider a few natural brain nutrients. These include acetyl L-carnitine, ginkgo herb, vinpocetin, and others. These nutrients don't work as rapidly as drugs, but they not only promote brain activity, but also offer brain protection through various mechanisms, including antioxidant effects.

Repantis D,et al. Modafinil and methylphenidate for neuroenhancement in healthy individuals: A systematic review.Pharm Res 2010: In press.

©,2012 Jerry Brainum. Any reprinting in any type of media, including electronic and foreign is expressly prohibited


Have you been ripped off  by supplement makers whose products don’t work as advertised? Want to know the truth about them? Check out Jerry Brainum's book Natural Anabolics, available at JerryBrainum.com.

 

The Applied Ergogenics blog is a collection of articles written and published by Jerry Brainum over the past 20 years. These articles have appeared in Muscle and Fitness, Ironman, and other magazines. Many of the posts on the blog are original articles, having appeared here for the first time. For Jerry’s most recent articles, which are far more in depth than anything that appears on this blog site, please subscribe to his Applied Metabolics Newsletter, at www.appliedmetabolics.com. This newsletter, which is more correctly referred to as a monthly e-book, since its average length is 35 to 40 pages, contains the latest findings about nutrition, exercise science, fat-loss, anti-aging, ergogenic aids, food supplements, and other topics. For 33 cents a day you get the benefit of Jerry’s 53 years of writing and intense study of all matters pertaining to fitness,health, bodybuilding, and disease prevention.

 

See Jerry's book at  http://www.jerrybrainum.com

 

Want more evidence-based information on exercise science, nutrition and food supplements, ergogenic aids, and anti-aging research? Check out Applied Metabolics Newsletter at www.appliedmetabolics.com

 

Tuesday, April 27, 2010

Can Anabolic Steroids cause heart failure? by Jerry Brainum

Although the use of anabolic steroid drugs by bodybuilders and athletes has been largely condemned,much of this condemnation is more related to moral issues or issues of fair play. Many have pointed out the possible health dangers of using steroids, which are synthetic versions of testosterone. These suggested health risks include cardiovascular disease, liver problems, and possibly cancer promotion. Frequently lost in the debate about the health risks of using steroids is that more frequently prescribed drugs are far more immediately dangerous and having a higher risk profile compared to steroids.Steroid advocates often point out that significant side effects linked to steroid use are relatively rare, although they do occur on occasion When such problems do happen, it's often related to how much, how many, and how long steroids have been used. As with any other drugs, steroid-based side effects are more likely when larger doses and several drugs are taken for longer periods.

     Based on the existing medical literature on anabolic steroid-induced side effects, steroids provide the highest risk to the cardiovascular system. This is particularly true with the oral steroid drugs. The drugs do this through several mechanisms, such as a lowering of protective high density lipoprotein cholesterol (HDL), a possible rise in blood pressure, and adverse effects on blood clotting factors. But whether these adverse effects will prove significant depends on other factors. For example, most athletes who use steroids are healthy, with few other cardiovascular risk factors. They usually also have low body fat levels, and good heart function as a result of aerobic and weight-training exercise.Indeed, animal studies show that having an abundance of possible protective factors related to cardiovascular conditioning is enough to offset the possible risks imposed by steroid usage.On the other hand, little is known about the cumulative effects on cardiovascular function with long-term extensive steroid use by athletes. A while ago, I wrote an article in Ironman magazine about a study that examined coronary artery calcium deposits in a group of 14 elite professional bodybuilders. The study found that while these bodybuilders showed few CVD risk factors, most did show calcium deposits in their coronary arteries. Just today, a new report has been published in the Journal of the American Medical Association confirming that measuring coronary artery calcium deposits is a good predictor of future heart attacks.

     Another study was also published online today related to athletic use of anabolic steroids. This study featured 12 weightlifters (they could have been bodybuilders, since medical journals often don't differentiate between actual weightlifters and bodybuilders) average age 40, who had used an average of 675 milligrams of anabolic steroids for nine years. They were compared to a control group, same age range, also weightlifters, but who had never used steroids. As expected, the steroid users showed greater muscle mass compared to the non-users. Both groups underwent a test called Doppler echocardiography that uses high frequency sound waves, or ultrasound, to measure the structure and function of the left ventricle, the pumping chamber of the heart that sends out blood to the body. The pumping power of the left ventricle is expressed as ejection fraction, with a normal level at 55 to 70 percent of the blood that fills the heart. But 83% of the steroid users in the study showed an ejection fraction of less than 55%. Only one of the non-steroid users showed a low ejection fraction. While the ejection fraction measurement relates to the pumping ability of the left ventricle, the steroid users also showed a significant impairment in the diastolic activity of the heart, or when the left ventricle relaxes and the heart refills with blood. Left ventricular relaxation was reduced by almost half in the steroid users. Interestingly, there was no significant differences between the steroid and and the non-steroid groups in relation to left ventricle structure.

      Does this mean that those who are long-term anabolic steroids can expect to eventually get heart failure due to a weakness of left ventricular pumping ability? An initial study of only 12 subjects does not yet constitute scientific evidence of a cause and effect relationship between long-term steroid usage and heart failure.The study didn't disclose the precise exercise habits of the study subjects. I have previously discussed the fact that any exercise that places pressure on the heart leads to a compensatory increase in the thickness of the left ventricle, which some refer to as "athlete's heart." Athlete's heart is considered a benign condition, just a muscular adaptation of the heart to exercise. But some emerging studies also suggest that having an enlarged heart can predispose to later heart failure, even among athletes, if regular exercise isn't continued. Since aerobic exercise balances the structural heart changes that occur with athlete's heart, I would think that it's prudent for those who use high dose steroid regimes to also ensure including some aerobic exercise along with their weight-training regimes. I admit that this suggestion is strictly hypothetical on my part, but it does make sense when you consider the scenario discussed above.

Long term anabolic-androgenic steroid use is associated with left ventricular dysfunction. Circulation:Heart failure 2010: in press.

©,2012 Jerry Brainum. Any reprinting in any type of media, including electronic and foreign is expressly prohibited


Have you been ripped off  by supplement makers whose products don’t work as advertised? Want to know the truth about them? Check out Jerry Brainum's book Natural Anabolics, available at JerryBrainum.com.

 

The Applied Ergogenics blog is a collection of articles written and published by Jerry Brainum over the past 20 years. These articles have appeared in Muscle and Fitness, Ironman, and other magazines. Many of the posts on the blog are original articles, having appeared here for the first time. For Jerry’s most recent articles, which are far more in depth than anything that appears on this blog site, please subscribe to his Applied Metabolics Newsletter, at www.appliedmetabolics.com. This newsletter, which is more correctly referred to as a monthly e-book, since its average length is 35 to 40 pages, contains the latest findings about nutrition, exercise science, fat-loss, anti-aging, ergogenic aids, food supplements, and other topics. For 33 cents a day you get the benefit of Jerry’s 53 years of writing and intense study of all matters pertaining to fitness,health, bodybuilding, and disease prevention.

 

See Jerry's book at  http://www.jerrybrainum.com

 

Want more evidence-based information on exercise science, nutrition and food supplements, ergogenic aids, and anti-aging research? Check out Applied Metabolics Newsletter at www.appliedmetabolics.com

 

Saturday, April 24, 2010

A fish story by Jerry Brainum

 The health benefits offered by omega-3 fatty acids from fish oil are extensive. Most of these benefits are related to cardiovascular protection. For example, fish oil can lower elevated blood triglyceride or fat levels by 60%. Elevated blood triglycerides are a risk factor for cardiovascular disease onset. Fish oil also seem to stabilize heart rhythms, and can prevent disordered heart rhythms, some of which can result in death. The omega-3 fats found in fish oil consist of EPA and DHA. The fatty portion of the brain contains about 40% DHA, and there are some interesting theories connected to this.For example, one theory suggests that the human brain evolved because early man began eating fish, and by providing DHA the potential of the brain increased, which led to increased intellectual capacity. More modern research points to an involvement of lack of sufficient omega-3 content of the brain and the onset of mental depression. Indeed, some psychiatrists have written that as many as 80% of people are omega-3 deficient. As proof, they note that the largest selling drugs are anti-depressants.While the connection between omega-3 fatty acids and depression onset may be conjecture, it's still a fact that the brain is largely composed of omega-3 fats.
      Several studies have found that in those with degenerative brain disease, levels of omega-3 fatty acids, particularly DHA, or always low. These studies suggest that ingesting sufficient levels of omega-3 fats prior to the onset of brain disease may offer preventive effects. DHA is capable of preventing dementia through various mechanisms. For example, DHA can temper the activity of enzymes in the brain that activate a protein called tau. This is significant because tau is the major constituent of neurofibrillary tangles in the brain, which are considered a hallmark of Alzheimer's disease. DHA also reduces inflammation in the brain, a major cause of most brain degeneration. One way it does this is by reducing the level of an omega-6 fat in the brain called arachadonic acid. This fatty acid is the precursor to various inflammatory substances that are directly related to brain inflammation. DHA also reduces oxidative stress in the brain, and increases levels of brain-derived neurotropic factor, which works to repair damaged brain neurons.
       While it's clear that the omega-3 fats nourish and protect the brain, some have suggested that ingesting fish oil can increase intelligence. Based on this, a recent study examined 867 people, ages 70 to 79, some of whom were provided with a placebo, while others were provided capsules containing 200 milligrams of EPA and 500 milligrams of DHA for two years. The results of the study found no difference in cognitive or thinking ability between the groups ingesting omega-3 and those ingesting the placebo, which consisted of olive oil. All the subjects in the study were healthy, and not suffering any kind of brain problems. Cognitive function didn't decline in either the omega-3 group or the placebo group, leading to the conclusion that fish oil doesn't offer any benefits to older people.
      But the study actually proves little or nothing for several reasons. For one, the dose provided of omega-3 fatty acids (EPA and DHA)  is too meager to promote any changes. For treatment of Alzheimer's, some have suggested doses of  omega-3 over 15 grams a day, far more than was provided in this study. Even for healthy people, the dose used in this study was about one-sixth the suggested daily dosage. In addition, brain changes  occur slowly, and a two-year study wouldn't provide enough time to detect any beneficial effects from using fish oil, except perhaps for treating depression. Finally, studies show that fish oil works best for preventive purposes against brain pathology in those who have the apolipoprotein A4 gene. Having this gene, especially two copies, makes you at higher risk for Alzheimer's disease. But based on the fact that the brain has such a rich content of DHA, and that studies do show protective effects, you would have to be crazy not to ingest fish oil supplements

©,2013 Jerry Brainum. Any reprinting in any type of media, including electronic and foreign is expressly prohibited.


Have you been ripped off  by supplement makers whose products don’t work as advertised? Want to know the truth about them? Check out Jerry Brainum's book Natural Anabolics, available at JerryBrainum.com.

 

The Applied Ergogenics blog is a collection of articles written and published by Jerry Brainum over the past 20 years. These articles have appeared in Muscle and Fitness, Ironman, and other magazines. Many of the posts on the blog are original articles, having appeared here for the first time. For Jerry’s most recent articles, which are far more in depth than anything that appears on this blog site, please subscribe to his Applied Metabolics Newsletter, at www.appliedmetabolics.com. This newsletter, which is more correctly referred to as a monthly e-book, since its average length is 35 to 40 pages, contains the latest findings about nutrition, exercise science, fat-loss, anti-aging, ergogenic aids, food supplements, and other topics. For 33 cents a day you get the benefit of Jerry’s 53 years of writing and intense study of all matters pertaining to fitness,health, bodybuilding, and disease prevention.

 

See Jerry's book at  http://www.jerrybrainum.com

 

Want more evidence-based information on exercise science, nutrition and food supplements, ergogenic aids, and anti-aging research? Check out Applied Metabolics Newsletter at www.appliedmetabolics.com

 

Friday, April 23, 2010

Hoodwinked by Hoodia? by Jerry Brainum

Fat-loss supplements are a big business. In the never ending quest to lose body fat effortlessly, a variety of nostrums are constantly being offered. Such formulas appeal mainly to those who abhor the idea of following a strict fat-loss diet and are too lazy to burn off calories at the gym or in other physical activity. Others, however, do exercise and attempt to diet, only to be met with frustration as the pounds fail to come off rapidly enough, or just don't seem to come off at all. One of the more popular and controversial putative fat-loss supplements in recent years has been an extract of a plant from South Africa known as Hoodia.
    Hoodia looks like a cactus, but isn't. It also smells somewhat like a decaying corpse. But that didn't deter the indigenous San Bushmen of the Kalahari desert from sucking on the root of the Hoodia plant. They did this because of their nomadic existence in the arid Kalahari, where they often went on long treks during which they hardly ate or drank anything. The folk wisdom held that they were able to accomplish this feat because of their use of Hoodia. Eventually, the South African government investigated the alleged potent appitite-supressing effects of  Hoodia in 1963. By the 1980s, the active ingredient of Hoodia was isolated, a substance dubbed P57, because it was the 57th compound tested in Hoodia. In 1995, a patent was issued to the Phytopharm company,who had spent $20 million isolating P57. The company soon sub-licensed the use of Hoodia to the pharmacuetical giant, Pfizer, who provided $21 million for this courtesy. But Pfizer relinquished the use patent in 2003. In that same year, the South African government responded to a grass roots effort to share any profit from Hoodia to the impoverished Sans Bushman. The excuse provided by the government for not doing this previously was that they thought none of the tribe still existed. In fact, thousands of them did.
    Hoodia is thought to work by way of its P57 content. In the brain, P57 is mistaken for glucose, the primary fuel for the brain. This somehow tricks the brain into increasing its ATP level. When ATP levels are high in the appitite center of the brain, appitite is turned off. This is what food usually does. So in essence, Hoodia makes the brain think you just ate a full meal. In an unpublished study commissioned by the company that controls the Hoodia use patent (owned by the South African government), 18 human subjects were divided into a group that either received Hoodia or a placebo. The Hoodia group ingested 1,000 fewer calories a day compared to those in the placebo group. But what really got worldwide attention was a segment of the television news show, 60 Minutes. During that show, reporter Leslie Stahl traveled to South Africa and ingested some Hoodia. She said that she lost her appetite completely and didn't eat anything for the entire day after ingesting the Hoodia. 
     In terms of published proof of the efficacy of Hoodia for promoting weight-loss, the evidence is scarce. In one study of rats P57 from Hoodia was provided to the rats, which resulted in a 50-60% reduction in food intake over a 24-hour period. The problem was that the P57 in the study was injected directly into the rat's brains.In the most recent study, mice were provided P57 either intravenously, or orally. The oral route showed a peak blood level of P57 in just over 30 minutes, and 47.5% of the dose was absorbed. In both the oral and intravenous routes, P57 was eliminated from the body in four hours. But the oral route, while showing absorption into the blood, was not detected in the rodent's brains. This is problematic because the brain is where P57 is supposed to work. The intravenous administration of P57 did show up in the brain, but in very small amounts.
      In addition to the questionable effect of oral Hoodia, most of what is being sold on the market, particularly over the Internet, does not contain any of the active ingredient of Hoodia, P57. Indeed, one estimate is that 80% or more of "Hoodia supplements" are fakes.Adding to the problem is that Hoodia was declared an endangered plant, and the use of actual Hoodia has been curtailed by the South African government. What's needed now is more human evidence of the efficacy of Hoodia, since the active ingredient, P57 appears able to enter the brain only when provided intravenously or injected directly into the brain.

Vamsi L, et al. Bioavailability, pharmacokinetics, and tissue distribution of the oxypregnane steroidal glycoside P57 from Hoodia gordonii in mouse model. Planta Medica 2010: in press.


©,2011 Jerry Brainum.Any reprinting in any type of media, including electronic and foreign is expressly prohibited.     

See Jerry's book at  www.jerrybrainum.com

Tuesday, April 20, 2010

Detecting silent heart disease by Jerry Brainum


Recently, an old acquaintance of mine from the original Gold's gym, Tony Nowak, died suddenly while vacationing in Italy. Tony's abrupt passing got me thinking about heart disease and ways to detect it. A few years ago, I wrote a series of articles in Ironman magazine about various medical tests, with one article in the series focusing on detecting heart disease. My primary message in that article was that the most common blood tests used for detection of cardiovascular risk are more superfical than anything else. You can pass these tests with flying colors,yet still be at serious risk of sudden death. The typical tests include total cholesterol, high density lipoprotein, low density lipoprotein, and triglycerides. While these tests are without doubt important, they don't tell the whole story about what's going on inside your body. To get a through evaluation of your health in relation to cardiovascular risk requires tests that aren't ordinarily part of the typical blood tests ordered by most physicians.
    These out of the way tests include lipoprotein(a), homocysteine, measurements of the size of both HDL and LDL fractions, C-reactive protein,and fibrinogen. These tests can show problems not detected by the usual blood tests, and could easily prove lifesaving. The fibrinogen test is a perfect example of this. The fibrinogen test measures the activity of a protein related to internal blood clotting. When you consider that the immediate cause of most heart attacks involves a blood clot lodged in and blocking a coronary artery, it's not hard to understand the importance of this test, yet few people undergo the test. Studies show that about 250,000 people who have fatal heart attacks have normal cholesterol levels, but they have elevated levels of fibrinogen. Had this been known, many of these people could have survived, despite the fact that none of the usual drugs to treat CVD, such as statins, have any significant effect on fibrinogen levels. The test used to determine elevated fibrinogen levels is called the functional intact fibrinogen test, again, not a test usually ordered by most doctors.
     Recently, researchers from Oregon Health and Science University developed a new fibrinogen test, called the gamma prime fibrinogen test. They developed the test after analyzing 3,400 blood samples, and finding that those with fibrinogen levels in the top 25 percent had a three-times greater chance of having coronary artery disease. These researchers have filed a patent pending on the test, and hope that it will be part of a routine blood test in the future,along with total blood cholesterol and others.In the meantime, what can you do to lower insidious high levels of blood fibrinogen? Women have an advantage in this regard, since estrogen lowers blood fibrinogen levels. This is one of the reasons why pre-menopausal women rarely suffer heart attacks. You also don't want to smoke, since smoking rapidly raises fibrinogen levels. Exercise, particularly aerobics, lowers fibrinogen levels. From a supplemental point of view, 2-3 grams a day of the spice turmeric effectively lowers elevated fibrinogen, as does 6 grams a day of fish oil, 2,000 milligrams a day of vitamin C.
     If you have any close relatives who suffered from, or died from CVD, it would be prudent to have these "accessory" blood tests done, including fibrinogen and others. They could easily prove life saving.



©,2012 Jerry Brainum. Any reprinting in any type of media, including electronic and foreign is expressly prohibited


Have you been ripped off  by supplement makers whose products don’t work as advertised? Want to know the truth about them? Check out Jerry Brainum's book Natural Anabolics, available at JerryBrainum.com.

 

The Applied Ergogenics blog is a collection of articles written and published by Jerry Brainum over the past 20 years. These articles have appeared in Muscle and Fitness, Ironman, and other magazines. Many of the posts on the blog are original articles, having appeared here for the first time. For Jerry’s most recent articles, which are far more in depth than anything that appears on this blog site, please subscribe to his Applied Metabolics Newsletter, at www.appliedmetabolics.com. This newsletter, which is more correctly referred to as a monthly e-book, since its average length is 35 to 40 pages, contains the latest findings about nutrition, exercise science, fat-loss, anti-aging, ergogenic aids, food supplements, and other topics. For 33 cents a day you get the benefit of Jerry’s 53 years of writing and intense study of all matters pertaining to fitness,health, bodybuilding, and disease prevention.

 

See Jerry's book at  http://www.jerrybrainum.com

 

Want more evidence-based information on exercise science, nutrition and food supplements, ergogenic aids, and anti-aging research? Check out Applied Metabolics Newsletter at www.appliedmetabolics.com