Dr. James Manos (MD)
April 9, 2023
Herbs & dietary supplements that may increase endurance and stamina in athletes
Image (free to use): The Kigali Peace Marathon (February 6, 2019), Uploaded by the user Isma250, Retrieved from: Wikipedia. Link: https://en.wikipedia.org/wiki/File:Aerial_view_of_the_kigali_peace_marathon.jpg
Many people take herbs and dietary supplements to enhance their performance in sports. Often there is no medical evidence that these supplements help. They may also be dangerous. Dangerous unlicensed substances (that are taken without the consultation of a doctor; some consult a gymnast or a personal trainer, but they have no medical knowledge) that many athletes take to improve their performance may be life-threatening, such as ephedra, thyroxine, ephedrine, diuretics (‘water pills’, e.g., taken from boxers to lose weight before the match), excess caffeine (also contained in the herb Guarana), iodine, anabolic steroids and other hormones (such as erythropoietin (EPO) used by cyclists for increasing blood hematocrit), etc.
Most athletes over-exaggerate with protein and consume massive amounts! The nephrologist is the only medical specialist who can estimate nitrogen balance and protein intake. Most consult a gymnast or personal trainer who does not have a medical education.
Dietary protein supplements are often too high in protein levels. Some that have animal protein sources, such as beef, contain elevated levels of cholesterol & saturated fatty acids and are unhealthy. Even whey protein has low levels of fat & cholesterol. However, it has many health benefits due to the branched-chain amino acids (BCAAs) it contains. It also contains immunoglobulins that may boost the immune system.
Contrary to the yolk, the white part of the egg has no cholesterol, and many bodybuilders consume it as an excellent protein source (used to compare other proteins). There are no guidelines for the total amount of eggs consumed daily or weekly. Some medical sites say that healthy people can eat about 1 egg daily. The number of eggs people with high blood cholesterol and/or high disease can eat daily relates to total cholesterol consumption. Some medical sites agree with the old instructions for people with high cholesterol and/or heart disease to not consume more than three eggs weekly, including those used in food. Some call eggs the ‘perfect food’ because the ratio of amino acids in eggs is remarkably close to the rate that the human body needs, and they have an HBV of nearly 1.0, which is ideal.
High protein will disturb nitrogen balance and may increase blood urea nitrogen (BUN). It is contraindicated in people with kidney failure – chronic kidney disease (CKD).
A healthy, active person needs about 0.36 grams of protein per pound of body weight. The average American of 150 pounds consumes over one hundred grams of protein a day, or about 0.67 grams of protein per pound, or almost twice what they need, as he/she only needs 54 grams!
Foods from animal sources (dairy foods, eggs, meat, poultry, fish) have the best combination of amino acids and produce the least waste; these are the ‘high biological value’ (HBV) foods. Some call eggs the ‘perfect food’ because the ratio of amino acids in eggs is very close to the ratio that the human body needs, and they have an HBV of nearly 1.0, which is ideal. The egg's white has no cholesterol that is only contained in the yolk of the egg (Reference (Retrieved October 7, 2015): http://nephron.org/nephsites/adp/index.htm/protein_ckd.htm ).
Extra protein intake is more important in bodybuilding. As a safe and healthy protein source, I recommend soy and spirulina. Soy decreases cholesterol with its isoflavones. The American Heart Association (AHA) recommends taking at least 25 grams of soy protein per day, which may lower LDL – -cholesterol (also called ‘bad’ cholesterol) by 5% and reduce the risk of heart disease.
Spirulina is a superfood with myriads of nutrients.
Spirulina is a green alga-rich source of protein and an excellent choice for people on a diet or with medical problems and for athletes and bodybuilders. It is called the ‘astronauts' pill’ and has a detoxifying effect, helps the body's immune system, and offers stamina. It is rich in amino acids, carbohydrates, minerals, vitamins, and essential fatty acids.
Many athletes need iron supplementation to avoid anemia.
Colostrum (the 1st milk) from beef may help the immune system.
Tart cherry may help patients with osteoarthritis.
Beetroots offer nitrogen and may increase performance.
L – arginine and citrulline (e.g., in watermelon) are amino acids that cause relaxation of the arteries' inner walls and may help increase performance.
L – carnitine & propionyl – L – carnitine are amino acids with many benefits.
Arnica montana is an herb used more for muscle problems, sprains & strains.
Herbs & dietary supplements that may increase endurance and stamina in athletes
(With green color are the herbs & dietary supplements that I personally consider more important for this issue)
· L-Carnosine (a human study showed that the carnosine concentration could be essential in determining high-intensity exercise performance).
· Coenzyme Q-10
· L-carnitine
A study summarized the data on the functionalities of L-carnitine on obesity, diabetes, and as an ergogenic aid. Total lipid, triglyceride, and protein increased during the 3T3-L1 cell differentiation. However, non-esterified carnitine (NEC), acid-soluble acylcarnitine (ASAC), and acid-insoluble acylcarnitine (AIAC) concentrations were lower in the differentiated 3T3-L1 cells. Also, the exogenously added carnitine inhibited the increases in triglyceride and total lipid levels.
In an animal study, L-carnitine supplementation reduced serum leptin and abdominal fat weight caused by a high-fat diet in C57BL/6J mice.
Also, in an animal study, streptozotocin-induced diabetic rats had markedly lower IGFBP-3 than normal rats, and IGFBP-3 was increased by L-carnitine treatment, demonstrating that L-carnitine treatment of diabetic rats modulates the IGFs/IGFBPs axis. Insulin-like growth factor-binding protein 3 (IGFBP3)v is a protein that, in humans, is encoded by the IGFBP3 gene.
A study of Korean diabetics indicated a remarkable abnormality in lipid and carnitine metabolism in Korean diabetic patients.
A study investigated the separate and combined effects of L-carnitine and antioxidant supplementation on carnitine and lipid concentrations in trained and non-trained animals and humans. The results showed that supplementation of L-carnitine and antioxidants improves lipid profiles and exercise ability in exercise-trained rats. Also, exercise training and supplementation of carnitine and antioxidants improved human lipid profiles and carnitine metabolism, suggesting that carnitine and antioxidant supplementation may improve exercise performance.
L-carnitine is a conditionally essential nutrient and is vital in mitochondrial beta-oxidation. As a dietary supplement for athletes, L-carnitine has been investigated for its potential to enhance beta-oxidation during exercise and improve performance.
While some studies have shown a positive impact on VO (2 max) and other performance measures, others have found contradictory results. As such, investigations of a different mechanism by which L-carnitine supplementation could impact exercise and recovery were explored.
An alternate hypothesis was developed based on findings from cardiovascular research that L-carnitine enhances vascular endothelial function. The assumption is centered on improving blood flow to muscle tissues and decreasing hypoxic stress and its resulting sequelae.
Studies have shown decreased markers of purine catabolism, free radical generation, and muscle soreness due to L-carnitine supplementation.
Direct assessment of muscle tissue damage via MRI (magnetic resonance imaging) also indicates the ability of L-carnitine to attenuate tissue damage related to hypoxic stress. L-carnitine is regarded as a safe supplement for athletes and has been shown to positively impact the recovery process after exercise.
· Rhodiola rosea
Studies on whether Rhodiola improves physical performance have been inconclusive, with some studies showing some benefits while others show no significant difference.
A study concluded that acute Rhodiola rosea intake can improve endurance exercise capacity in young, healthy volunteers.
Another study that explored the effects and mechanisms of Rhodiola rosea extract supplementation on swimming-induced fatigue in rats concluded that chronic Rhodiola rosea supplementation significantly improved exhaustive swimming-induced fatigue by the increased glycogen content, energy supply of lipogenic enzyme expressions, and protective defense mechanisms).
· Spirulina
A study concluded that spirulina supplementation significantly increased exercise performance, fat oxidation, and glutathione concentration and attenuated the exercise-induced increase in lipid peroxidation).
· Beetroot
A human study concluded that consumption of nitrate-rich, whole beetroot improves running performance in healthy adults; another study found that six days of nitrate supplementation reduced VO₂ during submaximal exercise and enhanced time-trial performance in trained cyclists).
· Creatine
Creatine is possibly useful for improving the athletic performance of young, healthy people during brief, high-intensity exercise such as sprinting. Many factors seem to influence the effectiveness of creatine, including the fitness level and age of the person using it, the type of sport, and the dose. There is some evidence that creatine ΄΄loading΄΄, using 20 grams daily for 5 days, may be more effective than continuous use.
Although not all clinical studies agree, some conducted in animals and people have shown that creatine supplements improve strength and lean muscle mass during high-intensity, short-duration exercises, such as weightlifting. In these studies, the positive results were seen mainly in young people aged about twenty.
Supplementation with creatine has regularly been shown to increase strength, fat–free mass, and muscle morphology with concurrent heavy resistance training more than resistance training alone. Creatine may benefit in other exercise modes, such as high-intensity sprints or endurance training. More recent research suggests that creatine supplementation in amounts of 0.1 g/kg of body weight combined with resistance training improves training adaptations at a cellular and sub-cellular level.
The results of a human study indicated that creatine (Cr) loading did not positively or negatively influence maximal oxygen consumption (VO2max), critical velocity (CV), and time to exhaustion or body mass. These results suggest that Cr supplementation may be used in aerobic running activities without detriments to performance.
A human study investigating the effects of an acute bout of resistance exercise (RE) on oxidative stress response and oxidative DNA damage in male athletes showed that creatine (Cr) supplementation significantly increases athletic performance. It attenuated the changes observed in the urinary 8-OHdG excretion and plasma MDA. These results indicate that Cr supplementation reduced oxidative DNA damage and lipid peroxidation induced by a single bout of resistance exercise (RE).
The findings of a human study indicated that loading 20 g/day of creatine monohydrate (CM) for 7 days increased mean power (MP) (5.4% increase) from the Wingate anaerobic test (WAnT). Still, it had no effect on strength (1RM LE and 1RM BP), peak power (PP), or body weight (BW).
The findings of a human study indicated that 28 days of polyethylene glycosylated creatine (PEG-creatine) supplementation without resistance training increased upper body strength but not lower body strength or muscular power. These findings supported using the PEG-creatine supplement for rising 1-repetition maximum bench press (1RMBP) strength in untrained individuals.
Note from the writer: it is still inconclusive whether creatine may harm the kidneys.
· Eleuthero (called wrongly by some as Siberian ΄΄ginseng΄΄)
A human study on nine recreationally trained males for 8 weeks showed that 8-week Eleutherococcus senticosus (ES) supplementation enhances endurance capacity, elevates cardiovascular functions, and alters the metabolism for sparing glycogen in recreationally trained males; specifically, the significant finding of the study was the VO2 peak of the subjects raised 12%, endurance time improved 23%, and the highest heart rate increased 4% significantly; the second finding was at 30 min of 75% VO2 peak cycling, the production of plasma free fatty acid (FFAs) was increased, and the glucose level was decreased both significantly over 8-week ES supplementation.
· Panax ginseng
Some studies have used Asian ginseng (Panax ginseng) for athletic performance in people and laboratory animals. Results have been mixed, with some studies showing better strength and endurance, others showing improved agility or reaction time, and others showing no effect. Asian ginseng was also found to reduce fatigue in a study of 332 people.
· Colostrum
A study assessed the effects of 8 weeks of bovine colostrum supplementation versus whey protein during resistance training in older adults. Males (N = 15 subjects, 59.1 ± 5.4 years) and females randomly received (double-blind) 60 g/d of colostrum or whey protein complex (containing 38 g protein) while participating in a resistance training program. The study concluded that colostrum supplementation during resistance training increased leg press strength and reduced bone resorption in older adults. Both colostrum and whey protein groups improved upper body strength, muscle thickness, lean tissue mass, and cognitive function.
· Glutathione
Glutathione (GSH) coordinates the synergism between lipid- and aqueous-phase antioxidants. In a trial conducted in 1985, the scientists documented 1) how exogenous GSH and N-acetylcysteine (NAC) may affect exhaustive exercise-induced changes in tissue GSH status, lipid peroxides [thiobarbituric acid-reactive substances (TBARS)], and endurance and 2) the relative role of endogenous GSH in the circumvention of exercise-induced oxidative stress by using GSH-deficient [L-buthionine-(S,R)-sulfoximine (BSO)-treated] rats. In contrast, to control, an exhaustive exercise of GSH-deficient rats did not decrease TGSH in the liver, muscle, or heart or increase TGSH of plasma; GSSG of muscle, blood, or plasma; or TBARS of plasma or muscle. GSH-deficient rats had approximately 50% reduced endurance, which suggests a critical role of endogenous GSH in the circumvention of exercise-induced oxidative stress and as a determinant of exercise performance.
A study conducted in 1998 examined the effect of glutathione (GSH) and glutathione ethyl ester (GSH-E) supplementation on GSH homeostasis and exercise-induced oxidative stress. Male Swiss-Webster mice were randomly divided into 4 groups: starved for 24 hours and injected with GSH or GSH-E (6 mmol/kg body wt, i.p.) 1 hour before exercise, starved for 24 hours and injected with saline (S); and having free access to food and injected with saline (C). Half of each group of mice was killed either after an acute bout of exhaustive swimming (E) or after rest (R). The authors concluded that 1) acute glutathione (GSH) and glutathione ethyl ester (GSH-E) supplementation at the given doses does not increase tissue GSH content or redox status; 2) both GSH and GSH-E improve endurance performance and prevent muscle lipid peroxidation during prolonged exercise; and 3) while both compounds may impose metabolic and oxidative stress to the kidney, this side effect is smaller with GSH-E supplementation.
Thanks for reading!
