.

.
marylin monroe
Showing posts with label salbutamol. Show all posts
Showing posts with label salbutamol. Show all posts

Albuterol / Salbutamol Doping Works! Cyclists Just Have to Take One Pill For a 4.1% Increase in Peak Power. Plus: Its Chronic (Ab)Use Makes Their Training More Efficient

Inhaling salbutamol, which is the most appropriate way to combat asthma, will not provide the same beneficial effects to athletes as taking a much higher doses pill and thus "going systemic" will (Norris. 1996; Koch. 2013)
Salbutamol (INN) or "albuterol", as it is called in the US, is a short-acting β2-adrenergic receptor agonist. Just like its longer-acting brother clenbuterol, it has been developed to be used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease; and just like its brother clenbuterol, it has been and still is abused by athletes all around the world as a doping agent. For good reasons?

Well, a recent study from the University of Copenhagen would suggest just that. After all, the scientists from the Department of Nutrition, Exercise & Sports, Section of Integrated Physiology found acute and long(er) term beneficial effects of salbutamol (ab)use on peak power in their subjects, 20 male endurance athletes competing in classic cycling (n = 6), mountain biking (n = 7), and triathlon (n  = 7).
Learn more about Clen- / Albuterol at the SuppVersity

Albuterol Can Improve Glucose Metabolism

The Myostatin <> Clenbuterol Connection

Higenamine Useful "OTC Clenbuterol"?

Full ROM ➯ Full Gains - Form Counts!

Battle the Rope to Get Ripped & Strong

Up Your Squat by 25% With Sodium Bicarbonate
The subjects were competitive at highest national level of their class. Included subjects had a weekly training volume of 14.9 ± 1.0 h/week and a VO2max of 69.4 ± 1.8 mL/min/kg. The athletes had no history of asthma or airway symptoms and had never used anti-asthmatic medication such as beta2-agonists. Needless to say that this changed with the onset of the study, in the course of which the subjects were randomized to either a salbutamol (SAL) (n = 10) or a placebo "supplement" (PLA) (n = 10).
Didn't this have terrible side effects? The subjects in the active treatment group experienced only minor acute side effects, including tremor and tachycardia. Over the course of the intervention, these side effects surpassed within a few days. No side effects were reported in PLA.
At the beginning of the study, there were no differences in subject characteristics between the groups. Just like the "drug free status", this changed after only one day (!) on 8 mg salbutamol (Ventoline®, GlaxoSmithKline, Brentford, UK).
Figure 1: Effects of acute and chronic (2 week) administration of salbutamol / albuterol on peak power during wingate tests (left) and maximal voluntary contractile force in competitive cyclists (Hostrup. 2014)
As you can see in Figure 1, the drug increased the peak power during the first Wingate test by 4.1 ± 1.7% (P < 0.05). Its "chronic" ingestion for two weeks, lead to increases of 6.4 ± 2.0 and 4.2 ± 1.0% in peak power during the first and second Wingate test. Unfortunately, we don't know if a complete month would have brought about even greater increases in peak power, which would then not necessarily have been due to accumulating effects of the drug, but rather the result of an increased training efficacy (~15h of training per week). Interestingly, the provision of salbutamol did not have an effect on maximal voluntary contractile force (MVC), exercise performance at 110% of VO2max or isometric endurance (all could have been accomplished by adding caffeine, though).

Due to the short study duration, it would have been stupid to measure increases in muscle size or reductions in body fat, as they have repeatedly been observed in rodent studies with albuterol's longer-acting beta-agonist cousin, clenbuterol (you can read up on the less-known muscle building effects beta agonists and their relation to myostatin in "The Myostatin <> Clenbuterol Connection - More Muscle, Less Fat: Is an Orphan Nuclear Receptor the Missing Link?" | more).
Unlike the inhaled microgram-doses of albuterol, which have been shown to have no significant acute ergogenic effects in cyclists by Norris (1996) and Koch (2013), for example,  Ventoline (8mg) pills deliver the results "chemical athletes" are looking for.
Bottom line: While the scientists obviously draw the politically correct conclusion that "the present study supports the restriction of oral salbutamol in competitive sports" (Hostrup. 2014). I can afford to say that Hostrup et al. were able to show that "salbutamol doping" works, when the drug is taken in significant amounts, orally. Even taking it once and to monetize on the 4.1% increase in peak power could help athletes attain an unfair advantage that can well make the difference between victory and defeat.

No wonder so many cyclists (e.g. 45% of the US cyclists participating in the 1996 Olympic Games, for example; Weiler, 1998) claim to have... ah, I mean "have been diagnose" with asthma, ha?
Reference:
  • Hostrup, M., Kalsen, A., Auchenberg, M., Bangsbo, J. and Backer, V. "Effects of acute and 2-week administration of oral salbutamol on exercise performance and muscle strength in athletes." Scandinavian Journal of Medicine & Science in Sports (2014). Accepted Manuscript.
  • Koch, Sarah, et al. "Inhaled salbutamol does not affect athletic performance in asthmatic and non-asthmatic cyclists." British journal of sports medicine (2013): bjsports-2013.
  • Norris, S. R., S. R. Petersen, and R. L. Jones. "The effect of salbutamol on performance in endurance cyclists." European journal of applied physiology and occupational physiology 73.3-4 (1996): 364-368.
  • Weiler, John M., Teresa Layton, and Margaret Hunt. "Asthma in United States Olympic athletes who participated in the 1996 Summer Games." Journal of Allergy and Clinical Immunology 102.5 (1998): 722-726.

Higenamine: PES Introduces New "Fat Burner" to the Market. Potent Thermogenic or Dangerous Stimulant?

Image 1: The reformulated PES Alpha T2
contains higenamine, alpha yohimbine
and 3.3-diiodo-l-thyronine
I just received an advertisement email containing some information about the reformulation of PES popular fatburner Alpha T2 (make sure to read "T2 a Fat Burner for Bulking?" for some details on the thyroid stimulating properties of 3.5-diiodo-l-tyronine the metabolically more active "brother" of the 3.3.-diiodo-l-tyronine in PES Alpha T2) mentioning a compound that is advertised as "an all new beta-agonist", that would have been found to be "more effective" than synephrine. While this claim did not impress me at all, I took the time and dug up some information about "higenamine"...

The adrenergic effects of higenamine (Hig. demethylcoclaurine) have been well established since the 1980s (Park. 1984). In fact, the cardioactive benzylisoquinoline alkaloid isolated from Aconiti tuber has long been used as a cardiotonic in traditional Chinese medicine (Zhou. 2003). Its inotropic effects, i.e. its effect on the contractivity of the heart muscle have been studied in various models and range, dependend on dose, from mild stimulation and a minor but significant increase in the effective refractory period (which would be beneficial for patients with bradyarrhythmias, i.e. slow heart beat, to tachycardia, the medical definition of which is an elevated heart rate that remains >100 beats per minute, even in the rested state (Yu. 1985).

In ancient Rome, high doses of Aconit powder were commonly used to poison unwanted enemies, who then died of a 'sudden and unexpected heart attack'. In that, it should be mentioned that the Romans used the whole plant, which, higenamine aside, contains other Aconites which potentially modified it's effects; interestingly, though Kimura et al. (Kimura. 1995) report that aconitine, another compound derived from aconite extract, does the exact opposite, i.e. it induces bradycardia (slow heart) beat and - if administered together (which is how nature meant it to be ;-) - higenamine and aconitine more or less neutralize each other.Enough of TCM and homeopathy... let's get back on the subject at hand.

Will this stuff burn away your love handles or will it literally break your heart? 
 
In order to answer these questions, we would, first of all,need to know how much higenamine actually is in the product - according to the original PES-writeup the reformulated ALPHA T2 contains 40mg higenamine per serving (2 caps).

Q: Is 40mg of higenamine a dangerous dose?  

A: 40mg taken orally appear to be perfectly save.

Details: According to a 1997 rodent-study on the acute toxicity of higenamine by Lo and Chen (Lo. 1997), orally administered even 2.0g/kg higenamine did no harm in the mouse model. For an adult human being this would translate to 160mg/kg or roughly 13g for someone who weighs 80kg. I would nevertheless refrain from consuming all 90 caps one bottle contains, at once - after all, you are no 160pound mouse, are you?

Image 2: Seeds of Aconitum nepellus.
The whole plant contains Aconites,
their concentration is yet particularly
high in the roots of the plant.
If we take into account the results of a 1996 study of the same authors (Lo. 1996), which found that oral bioavailability of higenamine in rabbits, is somewhere between 2.84% and 5.5%, and assume similar bioavailability in humans (rabbits are certainly not the most adequate model for human metabolism), one serving of alpha T2 would effectively deliver no more than 1.14mg-2.2mg of higenamine to your blood stream. This does not sound particularly potent, especially, if you consider the short terminal half-life of 22min (the short half-life does not contradict PES' claim that subjects in their tests felt effects of higenamine for 60 minutes; remember half-life != clearance). It took a dose of 50mg/kg, i.e. 4mg/kg to kill 50% of the mice in the aforementioned study by Lo (Lo. 1997). For our standard human being, weighing 80kg this would equal 320mg or 145x the maximally absorbed amount of higenamine in one serving of Alpha T2 - all that under the hypothetical assumption that we can translate absorption-kinetics observed in a rabbit model to human beings by using a standardized formula that is solely based on the ratio of body weight to surface area of man or rabbit respectively. Before we are trying to speculate about "effective dosages", however, we should initially establish that higenamine is in fact more than a inotopic agent in the arsenal of traditional Chinese medicine; or, in other words, that it does "burn" fat.
A note of caution! If you are taking blood thinning or antiplatelet medications, you should be aware that higenamine itself is a weak anticoagulant (Pyo. 2007; 2008). That being said anybody without respective health conditions should not be too worried and might even benefit from higenamine's anticoagulant effect, of which Yun-Choi et al. (Yun-Choi. 2002) found that it particularly antagonizes epinephrine induced aggregation. With epinephrine being elevated by the beta-adrenergic effects of higenamine, the latter effectively counters its own negative side effects (again, in healthy individuals).

Q: Will taking higenamine help me lose fat?

A: Higenamine is a beta-1 and beta-2 adrenergic agonist, meaning that it will raise your heart rate (beta-1) and help with lipolysis, i.e. the release of triglycerides from your fat cells, but you will still have to "burn" that fat on your own.

Figure 1: Chemical structure
of higenamine (Bai. 2008)
Details: The number of studies that are relevant to our fatloss question is relatively limited and studies from the late 1990s and early 2000s seem to suggest that, despite its stimulating effects on cardiomyocytes (heart muscle cells), higenamine would rather make you tired than spike you up: Shin et al. (Shin. 1999), for example, observed a decrease in tyrosine hydroxylase activity and consequently dopamine content of PC12 cell lines. This downregulation of the dopamine content in cells that, among various other functions, also synthesize, store and secrete catecholamines, would initially suggest the opposite, i.e. a calming and fat-sparing effect - after all, catecholamine induced beta-oxidation is what most of the fat burners out there are all about. More recently, however, Bai et al. (Bai. 2008) identified higenamine as the active, i.e. beta2-adrenergic ingredient, in Radix Aconiti Lateralis Preparata; results, which have since then been confirmed by Tsukiyama et al. (Tsukiyama. 2009) for higenamine isolated from Nandina domestica Thunberg. If you add to that the beta-1 agonistic effects observed in a study by Kimura et al. (Kimura. 1994) you have - just as PES promises - a synephrine analogue.

That being said, the aforementioned study on higenamine's effects on bronchoconstriction by Bai et al. (Bai. 2008) also provides useful information about the potential applicability of Aconti as a "fat burner". The scientists had used an in-vitro cell model, to elucidate the beta2-adrenergic activity of an extract from Aconiti Lateralis Preparata (RALP); and though the latter had not been specifically standardized for its hygenamine content, chromatographic and mass spectrometric analyses revealed that the active ingredient in the extract was in fact the same bioactive plant-alkaloid PES is now introducing to the supplement market. Other than Bai et al., who were interested in the ameliorative effects higenamine, as a beta2-agonists could exhibit on bronchoconstriction, our interest, however, is directed at its use as "fat burner". I assume, most of you will be familiar with the notion that commercially available pharmacological beta2-agonists, above all clenbuterol and its short acting relative albuterol, are widely (ab-)used by bodybuilders and fitness competitors as fat burners and/or ergogenics. Consequently, it stands out of question that higenamine will further liposlysis and may thus facilitate fat loss, the question is yet, to what extend?


Q: How effective is higenamine compared to prescription and over-the-counter beta-2 agonists?

A: It will work, and it is probably more potent than regular (and I guess even methyl-)synephrine. Data on its actual fat loss effects, is yet still not available.

Details: From the Bai study we know that the stimulating effects of higenamine on beta2-adrenoreceptors is dose dependent. We also know that the 40mg of higenamine each serving of the reformulated PES Alpha T2 will activate the beta2-receptors to some extent, what we do not know, yet is whether those 2.2mg that could potentially make it to your fat tissue would be enough to "increase your fat burning" (PES official write-up) significantly.
Figure 2: Dose [in mg/ml] response curves of the activity of albuterol, synephrine and higenamine in CHO-β2-AR-CRE-GFP cells.  Data are expressed as the mean percentage of the maximal response of the individual ligand (data adapted from Bai. 2008 and Bay. 2009).
If we now combine the data Gang Bai and his colleagues from the Nankai University  in Tianjin, China, collected for synephrine (Bay. 2009) and higenamine (Bai. 2008) a (I did that for you in figure 2), it seems that  higenamine is milligram by miligram less potent than regular synephrine, let alone its methylated version, which was used in the original formula and is specifically mentioned in the newsletter. But this does not necessarily mean that its absolute potency as a beta2-agonist falls behind, as well, since the values in figure 2 are expressed as percentage of the maximal activation of the individual ligand.

Since we have no data on lypolisis, we have to turn to the anti-astmatic effects of the compounds in order to judge the magnitude of the effect. At a dosis of 1ng/ml, albuterol was about 4x as potent in the ginea pig asthma model used in Bay. 2009, while higenamine at the same dosage exerted about 3/4 or 75% of the effect of salbutamol in the same model in Bai. 2008. Taken together this data suggest that
  • the dose response curve of higenamine inclines more steeply, than the one of synephrine or the presciption drug albuterol, thus finding the right dose could be a little more difficult
  • judged by its effects on bronchoconstriction in a ginea pig model, higenamine would be 75% as potent as albuterol and about 3x as potent as regular synephrine (I suppose methyl-synephrine would be somewhat more potent, but suspect that it would still fall short of higenamine)
Note that the above calculations are of hypothetical nature, as they are based on data from two different studies, despite using identical models and have been calculated on the relative magnitude of the bronchorelaxant effects measured in isolted guinea pig tracheal muscle. Definite conclusions with respect to the lipolytic effects of all three beta2-agonists discussed in this write-up are illegitimate. The above statements must thus be regarded as working hypothesis which still warrant validation by future research!

Concluding remarks

Whether and to what extend the 40mg of higenamine from PES reformulated Alpha T2 actually facilitate "fat burning" does yet remain to be seen, because the dosages from in-vitro data derived in an animal model cannot be translated into dosing regimens for human beings, as it would be the case in an in-vivo placebo controlled study, where rodents were actually supplemented with different amounts of higenamine or the full spectrum of ingredients present in PES' reformulated Alpha T2. Until such data is available all I can say is. The new Alpha T2 probably works just as well, if not better than the old one. I'll leave it up to you to decide whether that was "good" or "bad" ;-)

On a side note: You may have noticed that Performance Enhancing Supplement (PES) products in general and Alpha T2 in particular have been on "blow-out sale" for some time. While this may have been in preperation for the new product line to replace the old one, it is also probable that the PES guys are preparing for future legislative regulations. Synephrine has been way up on the list of substances scheduled to be added to the ban list ever since 2005 (cf. Position Statement of the Council for Responsible Nutrition. 2005). Thus, replacing the methyl-synephrine in the original formula may turn out to be a smart move regardless of whether or not the fat loss effects of higenamine are more or less pronounced than those of methyl-synephrine - at least they could still sell their products, when the FDA strikes again.

Chronic Albuterol Treatment Improves Glucose Uptake in Skeletal Muscle: Could Your Beloved Coffee Do the Same?

Image 1: If there is a connection between asthma and diabetes, it probably isn't related to the use of beta-2 agonists.
What is one of the most dubious ailments among professional athletes? Asthma, right! Asthma is much better than the meat in Lenny Paul's bolognese of which he claimed that it must be responsible for the nandrolone the WADA officials found in his bloodstream 1997. I mean, even if you don't want to say that you used it yourself the truckload of clenbuterol (once used as a standard treatment for asthma) could still be for your poor asthmatic dog like the one professional cylcist, Frank Vandenbroucke, had squirreled away in his house just when the WADA ransacked his house. Now, less than a month after the publication of a study by Hamzeh Elayan, Milos Milic. Ping Sun, Sunir Gharaibeh and Michael G. Ziegler in the Journal of Cellular and Molecular Neurobiology (Elayan. 2012), I suppose that the next top athlete who is going to be busted will probably claim that the salbutamol (a shorter acting "brother" of clenbuterol that is also know as "albuterol" in the US) in his kitchen sink is for his diabetic cat, rodent or even parrot.

Long-term vs. short-term effects of beta-2-antagonists

The main message of the results the scientists present in their paper is that the short- and long-term (side-)effects of certain drugs (including those we always believed we know quite well) can be very different, if not diametrically opposed. While acute treatments with epinephrine and b2-agonist drugs have been shown to decrease insulin resistance, Elayan et al. were able to show that only the addition of 50 mg/1,000 ml of the selective b2-adrenoceptor agonist, salbutamol to the drinking water of the exercised mice, was able to improve both the response to a glucose challenge, as well as the insulin response in a rodent model of type II diabetes.
Figure 1: Glucose levels in salbutamol group during insulin tolerance test at 20, 40, 60, 100 and 120 min in week 4 and week 8 (4w-ex / blue and 8w-ex / red) and 5 weeks after cessation of exercise (green); data expressed relative to exercised control group (calculated based on Elayan. 2012)
And though it may be that this effect was particularly pronounced in the older mice in the study at hand, previous studies by Ziegler et al. yielded similar results (protection against overfeeding induced obesity) in younger rodents upon direct administration of exogenous epinephrine.
Note: If you take a closer look at what you see in figure 1 you will notice that the effects of albuterol / salbutamol are not reliant on concomitant exhaustive treadmill exercise; after all, the improved insulin tolerance of the albuterol group persisted 5 weeks after cessation of the exhaustive exercise regimen.
Since the epinephrine output decreases with age, it is still reasonable to assume that lower exercise induced surges in epinephrine in the 8-month old C57BL6 mice of the study at hand may have contributed to the lack of improvement in the insulin tolerance test in exercise only group of the study at hand.

From clenbuterol & co to your morning coffee

Although I would hope that no one here suffers from either "athlete's" let alone real asthma, these results may well have real-world significance for you, as well. After all, the same "bad" hyperglycemic effects that have been ascribed to albuterol, clenbuterol & co, constitute one of the major arguments against the use of caffeine and related stimulants. The first link that pops up, when you type "diabetes coffeine epinephrine" into google, for example tells you how hazardous the adrenaline (=epinephrine) is for insulin resistant patients. And while the author of this article has several studies ready to validate the point she is making, those studies studies looked at the short-term effects of coffee consumption only.

Image 2: Gross, but true! In view of the fact that no more than 250kg of the "cat's poop coffee", Kopi Luwak, are produced every year, 80$ per cup does not seem too expensive. I mean, compare that to your average Starbucks or McCaffee brew! With Kopi Luwak you do at least know whose poop it was that is responsible for its distinctive taste ;-)
As far as the long-term effects are concerned you could however speculate that the decreased incidence of diabetes in habitual coffee drinkers (van Dam. 2005) could - at least in parts - be mediated through the same pathways as those Elayan et al. observed in their rodent study; pathways, of which they speculate that it is mediated by epinephrine induced phosphorylation of AMPK (read all about AMPK here) and subsequently increased expression of the glucose transporters GLUT-4 in skeletal muscle and the ability of beta-2-adrenergic drugs to induce a profound PGC-1alpha response, which has only recently been hailed as yet another target for "exercise in the pill" (cf. "Irisin: Exercise in a pill?"). That the latter, i.e. PGC-1alpha also leads to improved mitochondrial respiration and could thusly help with all sorts of neurological pathologies could also explain why studies such as Maia et al. found an independent negative association (=the more the less) between caffeine intake and the incidence of Alzheimer's disease (Maia. 2002).

From oral stimulants to insulin injections? Probably only if you go totally overboard

Assuming that you don't overdo it on coffee, caffeine (my experience is that from 600mg+ per day and individual doses >300mg the negative side effects prevail), it is thus unlikely that the combined epinephrine release from your morning coffee and your pre-workout supplement will predispose you to develop diabetes. That they are not going to counter the negative effects of bad dietary habits should however be as obvious, as the fact that this does not diminish the potential health hazards of acute doses in the 600-800mg range could pose to non-alcoholic fatty liver disease (NAFLD) patients (cf. "355% Increase in VLDL Due to High Dose Caffeine in Rodent Model of NAFLD")