Supplement Breakthroughs & Baldness...

[ Q ] I have noticed there has not been much for breakthroughs on the supplement front as far as weight loss of supplements for gaining muscle. Is there anything on the research front that we have to look forward to that may be the next big break through?

A: Dear Stan,

It does seem like there has been a lull in new and useful research looking at building muscle, but it does exist. Research looking into fat loss has been a lot more interesting and there may be some very interesting natural and pharmaceutical drugs coming out in the very near future.

For example, a new compound called oleylethanolamide or OEA for short looks promising. A recent study published in the journal Nature (2001;414:209-212) looked at OEA, which is a compound produced in the small intestine in response to food and may be a key to permanent fat loss and appetite control.

As expected, researchers are looking to produce synthetic versions to mimic OEA that may be more potent and resist being broken down by the body which would give them a longer biological activity. Most interesting perhaps, the effects of OEA appear to be quite different from other appetite suppressants.

Most natural and pharmaceutical made appetite suppressants work at the level of the brain. However, and most interesting, OEA did not have the same effect on appetite when injected into the rats brains, which suggests that OEA acts on the brain indirectly. This is important as it may be yet another pathway to explore in appetite suppression and may have less side effects than many drugs that work directly via the brain.

The recent study in Nature found rats injected with OEA ate significantly less food and gain weight at a slower pace than rats not given OEA. It also appears OEA is regulated by food intake as rats that were given less food had lower levels of OEA. This lead the researchers to conclude that OEA is involved in appetite control and satiety (i.e., feelings of fullness). Further studies will now investigate exactly how OEA works and of course see if OEA works as well in humans.

Another one is the recent discovery that the gene PPAR-gamma, when activated, appears to be the final stage of fat production. The work was done by Bruce Spiegelman, a professor of cell biology at Harvard Medical School, and was published in a recent issue of the journal Genes and Development.

According to Dr. Spiegelman in a recent interview for Harvard Magazine, "Although many factors affect fat genesis, it ultimately comes down to the amount and activity of PPAR-gamma. You can call it the master regulator of turning uncommitted or unspecialized cells into fat cells." Could a magic pill be developed to block the activity of PPAR-gamma and render all diets and exercise obsolete? According to Dr. Spiegalman, the answer is probably no.

Again, human metabolism is far more complicated than that, and in truth, the production of fat is ultimately an issue of energy balance not just fat storage. Also, many people are under the false impression that fat, in particular fat cells, are just dead weight and play no role in human health and metabolism.

People think of they could just get rid of all their fat cells, life would be great. Wrong. Recent research is finding that fat cells directly regulate-in conjunction with an incredibly complex feedback mechanism-our entire metabolisms.

Humans born without fat cells suffer from swollen, diseased livers, and Spiegelman's lab has made genetically engineered mice that lacked fat cells. They turn out to be very sick animals with fat filled organs, especially the liver. Dr. Speiegelman points out that if there are not enough fat cells available for energy storage, the fat simply accumulates somewhere else. It can damage organs by building up in the liver, blood vessels, or pancreas.

So, it appears blocking PPAR-gamma, via some drug or what ever, may be a bad idea. However, some partial block may prove to be both safe and effective, and you can be sure researchers are looking for that golden goose as we speak. How does one naturally down regulate PPAR-gamma?

I don't know if any supplements at this time that will have that effect (though I suspect Omega-3 lipids may do it), I suspect the answer to naturally down regulating PPAR-gamma will be the same answer under everyone's nose as it always has: don't eat so freakin much food and get off the couch!

On the health front, PPAR-gamma may also have direct connections to diseases such as diabetes and cancer.

Recent research reveals that PPAR-gamma is the target of drugs currently given to more than a million diabetics, but the role of PPAR-gamma in insulin sensitivity, has not been fully elucidated. Interestingly the anti-diabetes drug rosiglitazone is being tried on prostate cancer patients to see if it can prevent progression of the disease.

Scientists have found that switching PPAR-gamma production off stops fat cell production, but switching PPAR-gamma on reduces tumor growth in several different cancers including prostate cancer. Could drugs that all ready appear to affect PPAR-gamma, such as rosiglitazone, be the next big find in bodybuilding and longevity? The answer is far from known, but it should turn out to be very interesting research in the next few years.

Let's not forget leptin, which continues to be a hormone of great interest to researchers regarding its many effects on the metabolism. Another hormone that is getting a great deal of attention right now, and rightly so, is Ghrelin. Ghrelin may prove to be a most interesting hormone and a true anabolic hormone, but it will take some time to sort it all out. One recent study called "Ghrelin---not just another stomach hormone" (Wang G, Lee HM, Englander E, Greeley GH." Regul Pept 2002 May 15;105(2):75-81) suggests Ghrelin has effects on GH. Below is the abstract:

"Growth hormone (GH) secretagogues (GHSs) are non-natural, synthetic substances that stimulate GH secretion via a G-protein-coupled receptor called the GHS-receptor (GHS-R). The natural ligand for the GHS-R has been identified recently; it is called ghrelin.

Ghrelin and its receptor show a widespread distribution in the body; the greatest expression of ghrelin is in stomach endocrine cells. Administration of exogenous ghrelin has been shown to stimulate pituitary GH secretion, appetite, body growth and fat deposition.

Ghrelin was probably designed to be a major anabolic hormone. Ghrelin also exerts several other activities in the stomach. The findings that ghrelin is produced in mucosal endocrine cells of the stomach and intestine, and that ghrelin is measurable in the general circulation indicate its hormonal nature.

A maximal expression of ghrelin in the stomach suggests that there is a gastrointestinal hypothalamic-pituitary axis that influences GH secretion, body growth and appetite that is responsive to nutritional and caloric intakes."

That's just the tip of the iceberg looking at a wide range of hormones that may turn out to build muscle, take off bodyfat, prevent various diseases, etc. However, we have all seen the news over some big discovery over the latest greatest hormone, only to have it be a big bust when they try it out on humans. Though I am sure some day that magic pill everyone wants will be a reality, it will probably be further in the future than we would like.

[ Q ] I am a bodybuilder who has been experiencing typical male pattern baldness for the past few years and have a family history of hair loss. My use of steroids on and off over the years has not helped much either. Though I would like to follow your recommendations in your article on hair loss, is there any single formula you could recommend that might include virtually everything you recommend?

I know there are literally hundreds of new products out there claiming incredible results, but I don't know who to trust, which is why I come to you. I know Will Brink always gives the straight scoop. Can you help me?

A: Dear Josh

I'm glad you consider me to be a no BS "answer guy" and I will try to not let you down. In fact, there is a single formula for hair loss, or male pattern baldness (MPB) that has virtually everything I would recommend and them some! The product is called Proxiphen and is produced by a Dr. Proctor out of Texas.

Dr. Proctor is probably one of the foremost experts on MPB and one of the good guys in an otherwise shady industry. If you read my book Priming the Anabolic Environment, you may recall I mention Dr. Proctor in the "Avoiding Side Effects" chapter. Proxiphen contains minoxidil, as well as the prescription agents phenytoin and spironolactone (a potent topically-effective antiandrogen) SODs, copper peptides, TEMPO, PBN... over a dozen active ingredients in all.

As far as I am concerned, Proxiphen will grow significantly more hair on people than any other agent or formula currently available. Another plus is that Dr. proctor never sits on his success with Proxiphen in that he is constantly adding new compounds to the formula is they show promise for MPB.

The only thing I would probably recommend in addition to Proxiphen would be 1mg per day of Finasteride (Proscar). The combo of Proxiphen and Finasteride will grow hair on just about anyone in my view.

Ok, now for the bad news.

Ok, it's not really bad news but it's something you will have to take into consideration and deal with. Because it contains prescription agents, Proxiphen can only be dispensed on a physician's diagnosis of hair loss. This is not as big a deal as you may think, but you will have to see your doctor to get an official diagnoses of MPB.

You do not have to travel to TX to get it, but your Doc will have to communicate with Dr Proctor for you to obtain Proxiphen.

Dr, proctor does produce non prescription products that may also be worth a try, but none of them will be as effective as his prescription based product. Dr. proctor can be contacted by going to his web site: http://www.drproctor.com

Will Brink Interview

We briefly caught up with him to ask him few pertinent questions about diet, nutrition, fitness, his book Diet Supplements Revealed. If there is one thing Will Brink is well known for, is he does not pull punches or beat around the bush.

He tells it like it is, which is much as anything, is his trademark to those who know him.
[ Click Here For The Full Interview ]

Steroids, School Tests & GHB.

[ Q ] I read an article in ESPN magazine which blaimed the death of some wrestler on steroids and linked steroid use to all sorts of deaths and pother problems. Did you read that article and what is your opinion on that?

A: Yes, I read the article... Some times I don't know why I even try anymore. Every time I think we are making some headway over the truth about things such as anabolic steroids, supplements, and other controversial topics, up pops some new hysterical article claiming creatine causes brain cancer or steroids caused the death of some athlete.

One of worst was a recent article published in ESPN (June addition) magazine regarding the death of wrestler Davey Boy Smith and was called "Canaries in the coal mine." While we should appreciate ESPNs attempt to enlighten the public about the deaths of athletes, the article is full of the type of steroid hysteria, myths, incorrect assumptions, half truths, and out right fabrications so common in articles on this topic.

I am in NO WAY a defender of anabolic steroid use per se, but I am stickler for the facts. For example, the author states "Smith died of a heart attack while beside her in bed; the medical examiner suggested that prolonged steroid use was to blame. The medical examiner can "suggest" what ever he wants.

The fact is I have spoken at length to the ex medical advisor for the WWF - Mauro Di Pasquale, M.D. - and his response was, the wrestlers:

"...led ridiculously hectic lifestyles where they ate poorly (fast foods, restaurants, and junk food) most of the time. Never mind that genetically some of these guys are doomed to die young unless they lead Spartan lifestyles to offset their genetics - something they obviously don't do. But of course it's the steroids they blame." He went onto say... "I know because I was the WWF medical advisor and drug control officer for over 5 years..."

The author then attempts to make a connection between another old time wrestler, Bill Graham, and his many medical problems when he states "Graham turns 59 on Friday. And he's been spending a lot of time in bed lately. The man who had "The Body" way before Jesse Ventura is on his sixth hip.

His immune system is shot from all the infections that are feasting on one another. He has virtually no movement in the ankles. He's lost four inches from his 6'4" frame because of a collapsing lower spine. And his liver, ravaged by hepatitis C, is leaking like a sieve."

What do I have to say to that?

Hogwash!

On Graham's immune problems, steroids are now being used with AIDS patients (who of course have seriously compromised immune systems) to improve their health and well being due to loss of LBM. You can't have it both ways and anabolic steroids are not inherently immuno suppressive and there is not a single study showing any links to anything that Graham suffers from and steroids.

Though some, but not all, steroids cause liver stress (which is NOT the same as liver failure) they do not cause hep C, so there's no reason to make the connection!

The author also brings major league baseball players into it by stating "...But ballplayers who put on circus-like muscles are just kidding themselves if they think they're not in danger. A study recently published in the International Journal of Sports Medicine found that 62 Finnish power-lifters suspected of using steroids died at a rate five times higher than average.

As Bryan Alvarez points out in the new issue of his Figure 4 wrestling newsletter: "The causes of death were strikingly similar [to wrestling deaths]: Three committed suicide, three had heart attacks, one passed away after falling into a coma (likely drug-related) and one died of non-Hodgkin's lymphoma."

This statement is full of incorrect statements:

1. They may be kidding themselves but truth is they are at far higher risk from most of the other drugs they may take given to them by their doctors and or OTC drugs they use for simple pain, etc.
2. A study that "suspects" steroid use is not study at all, but a sham.
3. What on earth is similar between suicide, heart attacks, coma, non-Hodgkin's lymphoma?

The only one of the bunch you could even remotely link to steroids would be the heart attacks (steroids often lower HDL while using them but returns back to normal when one stops) and that has yet to be shown in the data that athletes using steroids or not die at higher rate from any of the above over non athletes.

If we are seeing a greater number of deaths in wrestlers due to any steroid related illness beyond and above that of the general public and or other athletes, it has yet to be shown and the cause of those deaths is far more likely due to life style choices and other drugs being used.

Anabolic steroids do have their risks and are not harmless drugs by any means, but if we don't start giving athletes the facts on these drugs they will continue to ignore the media and their doctors about the dangers of steroids.

In my view, that's far more dangerous then the drugs themselves!

People interested in a solid review of the potential dangers of steroids I suggest: Street. C., Antonio A., and Cudlipp, D. "Androgen Use by Athletes: A Reevaluation of the Health Risks." Can. J. Appl. Phys. 21(6): 421-440. 1996. This is probably the most unbiased and accurate review on the topic so far.

[ Q ] I follow your articles and column every month. One article in particular I really enjoyed was about the many uses of whey, from depression to performance.

It was very interesting. One thing I have suffered from is depression which seems to get worse if I am under stress, like studying for a test. Can whey also help me perform better on my school tests as well as being a great protein source for my bodybuilding efforts?

A: Dear Scott,

The answer is... drum roll... a big maybe. There was a recent study that looked at whey and cognitive performance that may of interest to you. As mentioned in my previous articles (Click here for my articles), one recent study examined whether alpha-lactalbumin-a major sub fraction found in whey which has an especially high tryptophan content-would increase plasma tryptophan levels as well reduce depression and cortisol concentrations in subjects under acute stress considered to be vulnerable to stress.

The study found the ratio of plasma tryptophan to the other amino acids tested was 48% higher after the alpha-lactalbumin diet than control getting casein, another milk based protein. This was accompanied by a decrease in cortisol levels and higher prolactin concentration.

The researchers concluded that the "Consumption of a dietary protein enriched in tryptophan increased the plasma Trp-LNAA ratio and, in stress-vulnerable subjects, improved coping ability, probably through alterations in brain serotonin."

This effect was not seen in the sodium-caseinate group. The study was in the American Journal of Clinical Nutrition (2000 Jun;71(6):1536-1544).

Recently the same group of researchers examined if whey protein could improve cognitive performance under stress. Cognitive performance declines under chronic stress exposure and it's theorized that the effect of chronic stress on performance may be partially due to reduced brain serotonin levels. As the previous study found, whey can increase serotonin levels by dramatically increasing Tryptophan levels, an amino acid which is the direct precursor to seratonin production.

The study looked at twenty three "high stress-vulnerable" subjects and 29 "low stress-vulnerable" using a double-blind, placebo-controlled, crossover design. After each group was given either whey or casein (used as control), all the subjects where given a memory-scanning task and blood samples were taken to measure the effect of dietary whey or casein on plasma levels of Tryptophan vs other large neutral amino acids (aka the Trp-LNAA ratio).

The plasma Trp-LNAA ratio is considered to be an indirect indication of increased brain serotonin levels.

Similar to the other study, they found a significantly greater increase in the plasma Trp-LNAA ratio after consumption of whey diet than after the control (casein) diet.

Most interesting was a significant improvement in the memory test was observed only in the high stress-vulnerable subjects and not the low stress vulnerable-subjects. These results are very interesting and telling, as they show that people who are not naturally inclined to be particularly vulnerable to stress, didn't have an improvement in memory tasks.

However, people who are particularly prone to stress and are put under stress, may benefit greatly from the use of whey and other nutrients known to improve seratonin levels. Because whey has so many other known benefits, such a possible cancer prevention, immune enhancement, and many others, whey should be a staple food supplement in any anti aging regimen, bodybuilding nutrition, or disease protocol.

The study was called "Whey protein rich in lactalbumin increases the ratio of plasma tryptophan to the sum of the other large neutral amino acids and improves cognitive performance in stress-vulnerable subjects" and was published in the American Journal of Clinical Nutrition (Vol. 75, No. 6, 1051-1056, June 2002).

[ Q ] My question pertains to GHB. I hear so many conflicting things about this drug I am now totally confused! Does it build muscle? Is it dangerous? What exactly does it do? Where do people get it?

Depending on what you read and who you listen to, it's either the best thing since protein powder or a toxic killer date rape drug. Help! Thank you for your time.

A: Dear Art,

I can fully understand your confusion over GHB. I will attempt to clear it all up for you and MMI readers. First things first.

What is it?

GHB (gamma-hydroxybutyrate) is found naturally in every cell in the human body. It is in fact considered a nutrient not a drug. Of course the FDA and other government agencies have now listed it as a drug and banned its sale, but that is as much politically motivated as anything.

Truth be known GHB is a safer, less expensive, and very effective alternative to the multi billion dollar sleeping pills industry as L-tryptophan was, another safe and effective nutrient banned by the FDA.

To date, not one single study has found any toxic effects from GHB on either humans or animals. GHB is completely metabolized into carbon dioxide and water, leaving absolutely no residue or toxic metabolites. In fact metabolism is so efficient that GHB can no longer be detected in urine only five hours after it's taken.

What there has been are a handful of people winding up in emergency rooms after taking large doses of GHB and combining it with other drugs (most notably alcohol) and this is where GHB gets its bad rap and gave the FDA the excuse it needed to ban the sale of GHB (and its chemical cousin GBL).

As with all compounds both natural (i.e. booz, GHB, etc) and synthetic (various drugs, etc), the use of GHB requires it be used in the correct dose and with some common sense and respect for it's potential problems.

GHB has many potential therapeutic uses and is considered to have a very low toxicity profile. In some European countries, it's used as a general anesthetic, for sleep disorders, an aid to childbirth and a treatment for alcoholism. It also is reported to be a great aphrodisiac.

However, GHB does have a potential for abuse because it gives the user a feeling of euphoria not unlike having a few strong glasses of booz. Unlike booz however, it does not leave the person with a hangover the next day and does not appear to be toxic to the liver or any other organ.

Is it 100% safe?

Of course not! At very high doses, it can cause a rapid, rhythmic contraction and relaxation of muscles similar to muscle spasm or seizure. GHB can also cause intense drowsiness and deep sleep often mistaken as a coma due to the unarrousability of the person.

Other possible minor side effects are drowsiness, dizziness, nausea, and vomiting. At very high doses, there can be a rapid loss of consciousness and possible cardiac and respiratory depression can occur.

Back when GHB was legal, I had a medical doctor friend of mine take a huge dose by mistake only to wake up on the floor the next day feeling no worse for wear other than a slight headache!

It is not something a person should take, and go drive a car for example or ever mix with other tranquilizers (e.g. barbiturates, opiates, Valium, Xanax, Thorazine), or alcohol. Only a moron would do that right?

What does it do?

It appears to act as both a metabolite and precursor of the inhibitory neurotransmitter gamma-aminobutyric acid, or gamma-aminobutyrate (GABA). GHB temporarily inhibits the release of dopamine in the brain which appears to cause increased dopamine storage.

When the effect of GHB wears off, there is a release of dopamine, which is why some people pop awake in the middle of the night after taking it for sleep.

Does it build muscle?

Bodybuilders and other athletes have used GHB because of its ability to stimulate the pituitary to release growth hormone (GH). One study found a nine to sixteen-fold increases in growth hormone 30 to 60 minutes after intravenous administration in men between twenty-five and forty years old.

But would that big spike in GH cause increased muscle growth? No one has looked at that issue directly with GHB, but if we go by other studies looking at drugs and nutrients that cause a large short lived spike in GH, the answer would appear to be no.

Short lived spikes of GH appear to have no effects on muscle mass, especially in young healthy athletes with normal GH production. For older people with sub normal GH production, it might have some uses but again, that has not been looked at in the research.

What's the bottom line on GHB?

It is a safe and effective nutrient for uses such as insomnia and general relaxation, but it has abuse potential to the addictive personality and should be treated with caution, common sense, and respect.

It probably will not build any muscle on people, especially healthy athletes. In the US, GHB is not approved and has been banned from over-the-counter sale by the FDA as mentioned above for political and financial motivated reasons. GHB continues to be sold for research purposes, but selling it specifically for human consumption, is not legal, so I recommend staying away from GHB and GBL if you live in the US.

A lot of bodybuilders get it from the "gray market" but I don't recommend it due to the legality and questionable purity of such products. In other countries the laws vary so it may not be an issue.

That should answer all your major questions about GHB/GBL Art.

Muscle Builders...

[ Q ] What is the deal on Maca? It's being pushed as yet another "miracle" muscle builder and all around super food. What can you tell us?

A: Maca (Lepidium meyenii) is a root plant native to Peru. It grows at very high altitudes (13,000-14500 ft above see level) on the Andean plateaus of Peru. It's considered a medicinal food with many uses. Maca is similar to ginseng in that it's considered an "adaptogenic" plant based supplement.

Like ginseng in Asia, Maca has supposedly been used for centuries in South America going as far back as 8000BC during the Inca empire. The concept of an adaptogen basically means that it helps the body adapt to higher levels of stress.

Adaptogens, as the concept goes, are compounds that have different effects on different people depending on their age, sex, and hormonal status. Maca is said to be rich in calcium, magnesium, iron, B-vitamins, and trace minerals such as zinc, iodine, copper, selenium, and manganese.

Maca contains several alkaloids that are said to "nourish" the endocrine glands, including the pituitary, adrenals, pancreas, testes, and thyroid gland. Typical of adaptogenic substances, it is believed to have a wide range of effects that include increased strength and performance, increased sexual desire, improved mental acuity, improvements in people with chronic fatigue syndrome, as well as many others effects.

These effects are clinical observations in patients rather than the results found in controlled published studies. Unfortunately, there is scant published human research that confirms these clinical observations by doctors in Peru and other parts of the world. There are however a few interesting animal studies regarding growth and sexual desire. One study found that cooked Maca, but not raw, increased the weights of several generations of mice.

They also found the serum values of total proteins and albumin were statistically superior for the mice group eating cooked Maca than that of the raw Maca and control groups. Does this make maca a true anabolic agent? At least in mice, it looks interesting but a great deal further research is needed.

Another study in rats and mice examined Maca's effects on sexual desire and erectile dysfunction. Interestingly, the study found the oral administration of a Maca extract enhanced the sexual function of the mice and rats. They concluded "The present study reveals for the first time an aphrodisiac activity of L. meyenii, an Andean Mountain herb." Is Maca a true aphrodisiac? Is it working through hormonal pathways?

Does it increase testosterone in men? Is it a useful aid to athletes? How much is needed to see an affect in humans? Unfortunately, these questions can't be definitively answered at this time without solid human data to support the animal studies, so your money is better spent other places until far more is known.

Learn more about Maca, click here.
1. Canales M, Aguilar J, Prada A, Marcelo A, Huaman C, Carbajal L. Nutritional evaluation of Lepidium meyenii. Arch Latinoam Nutr 2000 Jun;50(2):126-33

2. Zheng BL, He K, Kim CH, Rogers L, Shao Y, Huang ZY, Lu Y, Yan SJ, Qien LC, Zheng QY. Effect of a lipidic extract from lepidium meyenii on sexual behavior in mice and rats. Urology 2000 Apr;55(4):598-602

Ginseng, Addictions, Parents Losing Weight.

[ Q ] I am the father of a 16-year-old boy who stared lifting weight and reading your magazine in the hope he would lose some weight. He has always had a weight problem and became very encouraged after reading your column. However, he has also started taking an ephedrine and caffeine-containing product to help him lose weight.

He claims it is safe and effective for him to do so but I am worried at his age, it could be unhealthy. Your opinion would be much appreciated, as I know he looks to you for much of his information.

A: Dear Mr. Solmn.

It's probably safe for your son to use such a product assuming he (a) does not have any pre existing medical issues such as high blood pressure, etc., and (b) he does not abuse (i.e. take the 'more is better' route favored by young people who don't know any better) the product.

Although we have a great deal of research to date showing such products to be both safe and effective in the vast majority of people using them, we have very little research with adolescents such as your son. However, we do have a recent study that looked directly at this question.

A study published in the International Journal of Obesity and Related Metabolic Disorders (2000 Dec; 24(12): 1573-8) called "Safety and efficacy of treatment with an ephedrine/caffeine mixture. The first double-blind placebo-controlled pilot study in adolescents." found ephedrine/caffeine to be both safe and effective in adolescents.

The study used both 16 male and 16 female obese kids (32 total). They were put on a diet calculated 500 calories below daily energy requirement and given either ephedrine/caffeine (EC) or placebo for 20 weeks. The study was a randomized double-blind placebo-controlled trial. Those weighing less than 80 kg (less than 176lbs) took one tablet three times per day of a product containing 100 mg of caffeine and 10 mg of ephedrine.

Those weighing more than 80 kg (above 176lbs) took two tablets three times per day of the same mixture. As expected, there was a significant drop in body weight in both groups getting the EC mixture vs. the placebo group with a relative body weight decrease by more than 5% in 81% of the EC group, out only in 31% of the Placebo group. Perhaps more important, adverse events (i.e. side effects) were either non-existent to very minor and in fact did not differ between the EC and placebo groups.

According to the authors "Withdrawal symptoms were mild, transient and their frequency and severity were not different between the placebo and active groups. They concluded by saying "According to the present pilot study, EC can be a safe and effective compound for the treatment of obesity in adolescents."

So it would appear from the above study that the effect of EC based products for adolescents is the same as for adults, which is they are safe and effective for weight loss if used correctly and is safe doses. However, what does concern me is adolescents attempting to use such products rather than exercise and diet to lose weight.

At that age, looking for short cuts rather than slow steady work is common, so that is something for you to consider with your son. Combined with a good diet and exercise, the judicious use of EC based products with adolescents appears safe and effective.


"Will always (tries!) to follow his own advice."

[ Q ] I am a female bodybuilder who sticks to a very strict diet most of the time. However, around "that time of the month" I really crave some chocolate. I eat some chocolate and then feel guilty the entire week! How do I break this habit and should I?

A: Dear Melissa.

Interesting you would refer to your monthly chocolate intake as a "habit" as some scientists have argued that chocolate is in fact addictive.

In fact, recent studies have used chocolate as a model for addictive effects of drugs on their brain and one study found chocolate affected the same area of the brain as cocaine! Using a method known as "positron emission tomography" a team of U.S. and Canadian neuroscientists believe they have identified areas of the brain that may underlie addiction and eating disorders.

The research was carried out by Dana Small, assistant professor of neurology, and colleagues at Northwestern University Medical School and published September issue of the journal Brain. No surprise then that chocolate is often reported as the single most craved food when people are interviewed. Ok, so we know that chocolate has some interesting addictive effects not unlike some drugs, but does that make it bad for you per se? The answer is no.

Chocolate contains compounds called flavanoids, which are a large group of plant based compounds known to have a wide range of effects. Lignans and flavanoids are naturally-occurring diphenolic compounds found in high concentrations in whole grains, legumes, fruits and vegetables and chocolate!

In fact, a small bar of dark chocolate contains as many flavonoids as six apples, 4.5 cups of tea, 28 glasses of white wine and two glasses of red wine!

Flavanoids are a large group of compounds including catechin, daidzein, equol, genistein, beta-naphthoflavone (BNF), quercetin, rutin, chrysin, and genistein, as well as many others. For example, the famed "Flavone-X" mentioned in Dan Duchain's articles (which I believe turned out to be chrysin) is a flavanoid as are the recent "methoxy" based products.

Interestingly, recent research showed the consumption of chocolate can have positive cardiovascular effects and according to Carl Keen from the University of California, Davis, at a recent conference, chocolate actually increased antioxidant capacity after volunteers consumed chocolate consumption, as well as other positive effects on blood vessels.

Now here is the interesting twist on all this; they found not all chocolate is created equal to get these positive effects. Apparently, depending on how the chocolate is made, it can contain vastly different amount of healthy flavanoids.

So, Melissa you are off the hook as an occasional chocolate intake may in fact be good for you! Unfortunately, we don't have a list of chocolate bars that tell us whether they have high or low levels of flavanoids but it is known that darker chocolates tend to have higher levels over light chocolate. As for me, I didn't feel bad about my one chocolate bar per week "habit" even before I learned this!

Learn more about why dark chocolate is different, click here.

[ Q ] What is your opinion of ginseng for athletes? Some people make it out to be the best thing since human growth hormone while others say it's worthless. What do you think Will?

A: Ginseng is often called an "adaptogen" which basically means it helps the body adapt to higher levels of stress. Ginseng proponents claim is can cure just about everything ranging from nervous disorders, anemia, poor libido, wakefulness, forgetfulness and confusion, nausea, chronic fatigue, and angina, to name a just few.

Exactly how ginseng supposedly accomplishes all this is unclear and still being investigated. In animals, ginseng appears to have positive effects on metabolism as well as the cardiovascular system, central nervous system, endocrine system, and immune system.

Does it do all this in humans? Several recent reviews that examined the data on ginseng concluded, that while studies with animals show that ginseng (or its active components) may have positive effects, there is generally a lack of controlled research showing it improves performance in humans. There is also some data that suggests ginseng may have estrogenic effects in men, which of course is not what a male athlete wants.

The general consensus regarding the effects of ginseng in humans is that most studies suffer from methodological problems such as inadequate sample size and lack of double-blind, control and placebo designs. Several recent studies have found no improvements in performance from ginseng.

The reason for the contradictory finding between humans and animals may be due in part to the type of ginseng being used, the quality of the ginseng being used, the amount of the ginseng used. For example, there is American ginseng, Indian Ginseng, Siberian ginseng, and Korean ginseng, all reported to have different effects. Also, many ginsengs on the market are known to be lacking in the active ingredient in ginseng, known as "ginsenosides."

One study found that over 85% of ginseng products on the shelves contained virtually no gensenosides. This makes ginseng something of a confusing supplement for athletes, but not a supplement without potential merit or health uses.

Some studies have found ginseng has powerful anti cancer and anti oxidants properties as well as an ability to improve blood sugar metabolism. One recent study found ginseng was able to treat some men with erectile dysfunction! This may be due to ginseng being possibly able to effect Nitric Oxide (NO) production in men, as NO is essential for obtaining an erection.

Clearly, there is a need for research dealing with the efficacy of ginseng, and this research needs to take into account basic, fundamental design considerations if there is to be any hope of establishing whether or not ginseng actually has a place in an athletes supplements regimen.

I have to admit, in the real world, that is reports from people and person use, I have never noticed any performance enhancement (i.e. increases in strength, etc.) from ginseng and I think there are probably better supplements to spend your money on.

Hair Loss, Flax & Gyno, Overtraining...

[ Q ] I know you follow topics such as hair loss and the effects of hormones have on the body. I have read your fine articles on hair loss on your web site.

I know from your writing that the formation of the hormone DHT from testosterone is one important step in hair loss as well as other problems men (and women!) face from both natural metabolism as or drug use. What have you found out there that will prevent this conversion of DHT besides drugs such as Proscar?

A: Dwight. That's a good question. In fact, if one searches the medical and scientific data banks, you can find a lot of information on all sorts of stuff that appears to either block the production of DHT or block DHT by other means (such as at the receptor site).

For example, saw palmetto is often sold as being able to prevent the production of DHT. There are other lesser known nutrients and herbs that show promise. Zinc, copper, cactus flower, fatty acids such as GLA and alpha linoleic acid, as well as others. The problem is that none of them have been looked at in vivo, that is in living animals or people.

Most of these studies come from test tube (in vitro) research. What goes in a test tube and what goes on in an ultra complex biological system (i.e. us humans) is two very different things. Some companies like to make a big deal out of test tube research to sell you something, but I wont recommend these nutrients for preventing DHT related problems until I see either "real world" effects or in vivo research. That's why you didn't see them mentioned in the article. We just simply need more research with these things.

[ Q ] I remember in your book "Priming the Anabolic Environment" you recommended flax oil as a possible way to treat gynecomastia or "bitch tits" in men and I know you recommend flax oil losing fat and general health also.

Would flax have equal benefits for athletic women like me who lift weights and do you still think it helps with gyno?

A: Dear Susan, my recommendations regarding flax oil and other oils high in omega- 3 fatty acids (i.e. fish oils, etc) is the same for women as it is for men. I have found a few table spoons of flax oil per day for most people causes a reduction in bodyfat and improvements in overall health.

Interestingly, a recent study looking at ground flax seeds found effects that are particularly important to women, but may also have applications to men with "gyno." This study found that flaxseed enriched muffins fed to women reduced cancer cell proliferation and tumor growth as well as the drug Tamoxifen (Nolvadex to you muscle heads out there)!

Researchers presented their finding recently at the 23rd Annual San Antonio Breast Cancer Symposium. Although we have many animal studies and in vitro (test tube) studies showing various supplements may effect certain cancers, this is on of the first to show a dietary product like flax can directly effect human breast cancer.

Flax seed is commonly found in the diets of people in several parts of Europe, but people in North America do not generally get flaxseed in their diets. As most people know who have read up on flax in my articles and books, it's a rich source of Omega-3 fatty acids which play a crucial role in thousands if functions in the human body.

However, according to these researchers, the rationale for flaxseed reducing cancer tumor growth in this study may be flax's source of phytoestrogens ( plant precursors of mammalian lignans).

As already mentioned, prior studies found flaxseed reduced the number and growth of tumors in animals. This looked the effects of flaxseed in 29 postmenopausal and 10 premenopausal patients newly diagnosed with breast cancer. They looked at the effects of dietary flaxseed on tumor biology and growth.

The patients were randomized to receive a daily muffin containing 25 g of ground flaxseed or a control muffin (containing no flax). As expected, the 29 postmenopausal women saw significant reductions in tumor cell proliferation compared to controls not getting the flax. According to the researchers conducting the study, the effects are similar to those previously seen with Tamoxifen. Amazing!

We all know that many bodybuilders use Tamoxifen to treat or prevent gyno. As expected, there were no significant adverse effects in the women eating the flax enriched muffins. There saw no significant differences between the two groups caloric and macronutrient intake either . The researchers suggest that the mechanism of action may be through the antiestrogenic effects of the lignans found in flax seeds.

In my opinion, they may be over looking the cancer preventing effects of the omega-3 fatty acids found in the flax also. The study authors mention that consumers have been buying flaxseed oil capsules from health food stores for years. However, in order to get the most benefit, they recommend consuming ground flaxseed rather than consuming whole seeds or taking capsules.

I am not sure I can agree with this advice and it seems to me just another double standard of the supplements vs "real" food bias seen with many researchers and doctors.

The implication of the above study is obvious for women, but men reading this should see the clear potential benefits: flax seeds and high lignan flax oil may be a natural anti estrogen as powerful as Nolvadex and would explain why I have seen reductions in gyno in men taking high amounts of flax oil. Again, it appears I was at least 5 years ahead of the curve on this (patting myself on the back as I write this!).

[ Q ] I have a question of a sexual nature I hope you can answer. Does androstenedione possibly help with erections? I some times have problems in this area and hear androstenedione can help with that.

A: Dear Bill, can andro help with your erections? Possible, but untested. We know of course that the "male" hormone testosterone is involved with male and female libido and the ability to maintain an erection. If androstenedione raises testosterone (via its conversion to testosterone) then it is theoretically possible that it might improve libido and erections in men.

The research to date on the andro products, in particular androstenedione, has been mixed in regards to its ability to raise testosterone (see article "End of Andro?" for more info).

If it does work, considering its short lived effects on testosterone (several hours) it would probably work best taken 30-60 minutes before having sex I would guess. This is only a theory on my part as it has never been studied. Also, you have to realize that human sexuality and libido are very a complicated topic and there are many places along the way, both physically and psychologically, that effect libido.

Testosterone levels are only one small- albeit important-piece of the puzzle. Interestingly, androstenedione, has recently been mentioned in two episodes of priapism in a 30 year old man.

What is priapism you ask?

Priapism is a rare condition characterized by persistent painful erection that occurs unrelated to sexual stimulation or desire. That is, you have a hard on that is not result from being "turned on" and it wont go away. It's associated with certain diseases such as neoplastic syndromes, diabetes, sickle cell anemia, and drugs such as cocaine, anticoagulant therapy, and the some psychotropic medications.

As seemingly humorous as this condition may seem, is is supposed t be quite painful and can cause permanent damage to the penis and your ability to get erections in the future.

A recent case study published entitled "Priapism after androstenedione intake for athletic performance enhancement" (Kachhi PN, Henderson SO. Ann Emerg Med. April 2000;35:391-393.) describes andro as a possible cause of this condition.

The paper goes on to say "The patient admitted to using steroid pills (androstenedione) intermittently over the past year, which he had obtained over the counter from a fitness and nutrition store to enhance performance and physique. He used a generic brand of androstenedione pills, which had no other reported contaminants or additives.

He had ingested these pills every day for 1 week before presentation. He had been told by a friend that these pills would help build muscle size without the risks associated with illegal testosterone products. His previous episode of priapism had also followed the use of these steroid pills."

Do I think the andro was really the cause of this mans priapism? I doubt it very much but I think it's an interesting case study none the less that is worth keeping an eye on. If you try andro to help your woody, don't blame me if it wont go down!

Click here for a full product listing of andro products.

[ Q ] I am often tired for days after I workout. I also notice my strength is down and I get sick more often than others. I am thinking I must be in an over trained state. I am a tri-athlete and it often comes with the territory, though I try to avoid it. What information do you have that would help me? By the way, your e-book was very helpful.

A: Recently I went to a symposium on Over Training Syndrome (OTS) that was put on by a panel of scientists who have looked at OTS is a variety of athletes, ranging from bodybuilders to runners. In many respects, truly defining OTS in athletes has been more difficult to do than expected.

Athletes that suffer from OTS can have alterations in immunity, loss of strength and energy, reductions in testosterone with a rise in the muscle wasting hormone cortisol, and other negative effects.

However, these physiological markers don't appear in all athletes suffering from OTS, so diagnoses is not always easy. Trends with athletes, especially endurance athletes, regarding OTS have been coming to light. The panel of scientists at this symposium had some interesting findings and comments to share with the audience.

Their findings show that many elite athletes experience viral infections and upper respiratory infections (URIs), chronic fatigue, and other problems. Runners who ran a marathon are up to six time more likely to get a URI than runners who trained for the race but did not run it. The researchers also found that the athletes immune systems had half the ability to kill invading organisms vs sedentary controls, showing how hard intense exercise can be on the immune system. They found cortisol and norepinephrine are elevated up to six hours after intense exercise vs non exercising controls.

Relating directly to the immune system: they found a 38% drop in immune cells essential to fighting infection called lymphocytes (T-cells). T-Cells function tests showed the T-cells don't react properly to an immune challenge (e.g bacteria, viruses, etc) for up to 6 hours after exercise.

Natural killer cells (NK cells) needed as a first line defense for immunity were down while pro-inflammitory products such as IL-6 are up 500%! Ouch! For up to a solid week after intense endurance exercise, they found various immune disturbances and other problems. Not good mojo.

The most obvious way to avoid OTS is to avoid overtraining in the first place by cycling intensity levels, ingesting adequate calories, and making sure to get plenty of sleep. Nutritionally speaking, it was found a carb drink immediately following the event helped to greatly reduce immune problems by increasing insulin levels which combat cortisol.

Other nutrients that might help would be whey protein, anti oxidants, flax oil, glutamine, and possibly products like creatine and ZMA, but there is less data on those specifically for OTS. If you are tired all the time, get sick easily, or have a general loss of strength and endurance, you are probably suffering from OTS. Good luck.

ECA Stacks & How Much Protein?

[ Q ] I was told by a trainer in my gym that 30 grams of protein is the upper limit a person can digest, but he could not tell me where that rule comes from. He said it was a "known fact" and walked away when I questioned his source.

So what is the deal with this 30 gram rule? Is this guy full of it or should I worry about it? My stats are: 5'9" and 220lbs with about 10% bodyfat. I lift weights (heavy!) 4 days per week and do aerobics 2-3 day per week.

A: It has been a long debated topic how much protein a person can digest at any one time. Nutritionists and doctors have maintained for decades that "people can only digest 30 grams at a time of protein and any additional protein is wasted or converted to fat." So say the powers that be. Now, I wish I could examine the study or research they are basing this advice on so I could dispute it but I can't.

Why you ask? Because in all my years of searching the medical data banks, talking to researchers, and falling asleep in the medical library after hours of reading, I have been unable to find exactly where this advice comes from or what it's based on.

At one time, I went so far as to offer a reward to anyone who could show me a recent study that showed that 30 grams of protein was the upper limit anyone could digest, regardless of age, weight, and activity levels.

Why is it 30 grams? Why not 28 or 35? Are we saying that the digestive and absorptive abilities of a 285 pound 23 year old football player is the same as a 50 year old 115 pound women? Now digestion is a very complex topic. Many people think you eat some protein, it mixes with some acid or something, gets broken down into amino acids, gets taken up into the body, and everyone is happy. I wish it were that simple.

As with all foods, the breakdown of protein starts in the mouth with the simple chewing of food and the exposer to certain enzymes. In the stomach, food mixes with enzymes and other factors such as lipase, pepsin, intrinsic factor, and of course HCL (stomach acid). It moves onto the small intestine and then the large intestine.

The small intestine is considered the major anatomical site of food digestion and nutrient absorption and is made up of section such as the duodenum, jejunum, and the ileum. Pancreatic enzymes (chymotrypsin, trypsin, etc.), bile salts, gastrin, cholecystokinin, pepidases, as well as many others factors are released here.

The large intestine is composed of the ascending colon, transverse colon, descending colon, and the sigmoid colon, which all play a part in absorbing the nutrients we eat. Sound complicated? It is. Believe me, I am leaving out a great deal of information so you wont fall asleep reading my little column! Suffice it to say, digestion is a very complicated thing and there are many places along the chain of digestion that can both enhance and degrade a persons ability to absorb the foods we eat.

There is no reason to think that among this complicated process that there are not wide individual differences in a persons ability to digest and absorb protein. For some person who is inactive, elderly, and for what ever reason lives with compromised digestion, 30 grams of protein at one sitting might very well be too much for them to handle. By the same token, assuming a 220lbs healthy athlete is unable to exceed 30 grams of protein in one sitting is neither proven by medial science or even logical in my view. So what if the 30 gram rule turns out to be true?

If we examine some of the more recent studies on the protein requirements of athletes done by researchers from both the United States and Canada, we come to some recommended protein intakes that far exceed the RDAs, some times by as mush as 225%! These researchers came to the conclusion that protein intakes for athletes should range from approximately 1.2 grams of protein per kilogram of bodyweight for endurance athletes and up to 1.8g of protein per kg for strength training athletes.

For a 200 pound bodybuilder-a strength training athlete-that would be approximately 164 grams of protein per day (most bodybuilders I know eat considerably more protein per day, but that's for another fight and another article...).

Find out what David Young thinks, click here.

Assuming that 30 grams of protein is the most anyone can digest, absorb, and utilize, this person would have to split his intake into about five meals (164 divided by 30 = 5.47). So, given the advice by many people that 30 grams is all anyone can digest at a single sitting, it appears a person can achieve the goal of 30 grams of protein per meal even with the higher intakes recommended in the modern research (assuming they are willing or able to eat five meals per day).

However, if you happen to eat more than that per meal as a healthy athlete I don't think you have anything to worry about. I wont tell anyone. Me, I would suggest you stick to the one gram per pound of bodyweight rule, which often exceeds the research mentioned above. Also, read the "Protein Myth" article at the BrinkZone site for more info on this topic.

[ Q ] I know the ECA stack works great for losing fat when combined with exercise and a decent diet, but does it work when the person does not exercise? Lazy minds want to know!

A: The combination of ephedrine, caffeine, and aspirin (AKA the ECA stack) has been shown repeatedly in the research to dramatically improve fat loss in people who exercise. Many active people who have added this potent thermogenic combination of ephedrine, caffeine, and aspirin, are able to reduce their bodyfat, while maintaining hard earned muscle.

Personally, I am not convinced the A is needed in the EC stack to be effective or is even needed. I am no condoning sitting on your behind and using the ECA stack to lose weight, but it appears the ECA stack does work on lazy non exercising people as well at active people. A study done by Peak Wellness lab in Greenwich CT, used the ECA stack with people under non exercising conditions (i.e. couch potatoes).

The study-which was given as a Poster Presentation at 97 American College of Nutrition Conference (abstracts #115-116) -found that even people who did not exercise experienced almost a ten pound fat loss in six weeks from taking 20mg of ephedrine, 200mg of caffeine, and 325mg of aspirin three times day.

So what does this all tell us? If the ECA combination works this well on couch pot... err sedentary people, imagine what it can do for people who get up off the couch and kick some butt in the gym. Don't take this information to mean you should not exercise Lisa!

Thanks to the FDA, the "E" (ephedra) is banned by the FDA. Click here for alternatives.

[ Q ] Do I need to load my creatine or not? Personally, I hate the loading phase for many reasons. Can I skip it? Will it still work?

A: Two ongoing controversies have been debated regarding the popular sports supplement creatine monohydrate. Most of the research with this product that showed positive effects had the participants load up on creatine for a week using approximately 20-30 grams a day, followed by a maintenance dose of 5-15 grams a day.

Some research has questioned whether or not the loading phase is really necessary, or even if such high amounts are needed afterwards during the maintenance phase. Researchers from Colorado State University (Medicine and Science in Sports and Exercise, Vol. 29 N0. 5, p [s]251, 1997) found that just three grams per day for fourteen days without a loading phase had a positive effect on bodyweight and performance in off season football players and track athletes.

This study might not put to rest whether or not a loading phase followed by a high dose maintenance intake is needed for the full benefits of creatine, but it does lend more evidence that low intakes without a loading phase does indeed improve performance and increase lean muscle mass in athletes. Though most people I know still load, I would not sweat it it you choose not to.

Is Creatine Loading Necessary?

Yes No

[ Q ] As a competitive cyclist I am interested in the higher fat low fat debate for athletes like myself. In particular, I wonder if I should use a high carb low fat sports bar on long trips or one of the newer higher fat moderate carb bars. What do you recommend?

A: Robert, I cant cover the entire debate over higher fat vs lower fat diets here in this Q & A. I can however give you some insight into the debate by focusing briefly on a study that looked at exactly what you are asking regarding which bar an endurance athlete might want to use.

Certainly the past year or so has seen a dramatic increase in the debate over whether a high carbohydrate/low fat diet versus a higher fat/lower carb approach is superior for athletic performance. As expected, various brands of sports bars that emphasize different ratios of fat, protein, and carbohydrates, have hit the market for a variety of uses.

Researchers from the Exercise and science Lab at Central Washington University (Medicine and science in Sports and Exercise, Vol. 29, No. 5, p[s]250, 1997) put some bars to the test containing different amounts of carbs, protein, and fats.

Using well trained cyclists doing 60km time trials, the study found that bars containing the highest ratio of carbs to fats (76% carbohydrates, 15% protein, 8% fat) fared poorly against the bars containing more fats and proteins and less carbs in the times of these athletes.

When the athletes were fed the bars containing at least 30% fat (or more), 40% carbohydrates, and 30% proteins, one hour before exercise, they finished 2-4 minutes faster on the 60km time trial than when they were fed the high carb/low fat bars. Something to consider on your next Tour de France.

Click here for a full listing of protein bars.

[ Q ] I am a bodybuilder who has had HIV for over five years. Though I have had several bouts of illness, I have not progressed to full blown AIDS. I intend to keep it that way!

I took up the great bodybuilding life style about a year before I got HIV from a partner I was living with at the time. My question is, what would you advise for a person in my situation to make sure I stay in good health and never know full blown AIDS?

In particular, I know many people with HIV are using anabolic steroids, but my doctor does not know much about that and seems hesitant to help me find the answers I need about steroids for preventing the muscle wasting caused by HIV.

A: Mark My best advise for you or anyone who has HIV would be to pick up Mike Mooney's and Nelson Vergel's new book "Built to Survive."

This book is truly an A to Z guide on the use of anabolic/androgenic steroids (AAS), supplements, nutrition, and weight training, to prevent the loss of muscle mass from HIV, or other diseases involves with muscle loss (i.e. cancer, MS, etc.). Mike and Nelson have done an exhaustive amount of research on the use of AAS for use with HIV and this is a must read book for people with HIV, medical professionals working with HIV, researchers, or anyone who knows some one with HIV.

It's well written and referenced and designed to be a resource guide for people at all levels of knowledge. As many of you know, the medical profession has been very resistant to use AAS for various diseases, due to the laws and general stigma of AAS. The fact is, an ever growing body of research is showing that AAS has a wide range of uses with HIV, different forms of cancer, various anemias, rheumatoid arthritis, lupus, multiple sclerosis, as well as other diseases.

This book explains in detail the different types of steroids, how to use them, different stacks, avoiding/treating side effects, and other information that can save literally thousands, if not millions, of lives. There is also some useful and interesting discussions on the use of growth hormone (GH) as well as many other drugs for increasing muscle and combating the side effects of the many drugs used to treat HIV.

I think this book will also interest many people without HIV as it is full if good honest info on AAS, GH, diet, and training. 100% of the profits of the book goes towards non-profit HIV organizations. People can find the book at their favorite book store or by calling 800-350-2392 or by going to the www.medibolics.com web site.

Good luck!

Homemade MRP's, Nizoral Shampoo & More...

[ Q ] In you article "Hair today Gone Tomorrow" a while back you recommended Nizoral shampoo for people losing their hair. Do still recommend it and has any new information come to light about its effectiveness for hair loss?

I am looking for something to help with hair loss. Your input would be much appreciated.

A: Ted. I guess I still recommend Nizoral for hair loss. However, I have to say I have not seen anyone grow much hair using Nizoral. Perhaps it adds something to the mix of various products out there but my enthusiasm for it is less than it used to be.

However, a recent study does appear to show that Nizoral (active ingredient Ketoconazole) may in fact help people grow hair and prevent hair loss. The study was published in the journal Dermatology (1998;196(4):474-7) and was called: "Ketoconazole shampoo: effect of long-term use in androgenic alopecia." Though only one small study, the study found that hair density and growth improved over that of regular non medicated shampoo.

So, Nizoral may still hold promise for people who suffer from male pattern baldness (I.e. androgenic alopecia), but alone, I doubt it will do much. Also, a 1% product is now available over the counter but it's unknown if it will work as well as the 2% prescription version used in the study.

[ Q ] What is your favorite weight gainer and meal replacement? Which are the best? I find them all too expensive honestly.

A: The "best" MRP and weight gainer are the ones you make yourself.

My favorite home made MRP goes like this:

• Two scoops whey isolate
• One cup water
• Half cup of favorite juice
• Handful of frozen strawberries
• 5 grams glutamine
• One tablespoon of flax oil or Udo's Choice oil

Blend in the old blender...

This MRP has approximately 370 calories, 36 grams of protein, 23 grams of carbs, and 15 grams of fat (or 40% calories from protein, 24% calories from carbs, and 36% calories as fat), making it a high protein, moderate fat, low carb MRP.

As for a high quality weight gainer:

• One cup whole milk
• One cup water
• 2-3 scoops whey isolate
• One frozen whole ripe banana
• One scoop chocolate ice cream
• 5 grams of creatine
• Two tablespoons of flax or Udo's Choice oil

Calories? Tons. Protein? Plenty. Fat? Enough. Carbs? Who cares? This drink is better suited for the young guy with a super fast metabolism who really needs a lot of extra calories to gain any weight. Not recommended for people over say 25-30 years of age looking to keep the fat off, but when your are a 17 year old kid who can't gain anything, this drink is for you!

As for your cost comment, I don't agree with you. If you sit down and figure out all the things you get in a decent MRP today, combined with the ease of being able to mix it any time or place you want it (unlike the recipes I have listed above), you will find the commercial MRP is probably one of the better bang for the buck supplements out there.

Just try and get 40 grams of protein, a days vitamins, glutamine, and other stuff often found in any good MRP, for around three bucks. If you look at it that way, I think you will find most MRPs to be a great deal for the money. Of course they don't taste like Burger King Whopper...

[ Q ] I have a slow thyroid that is not quite hypothyroidism according to my Dr. He says I am in the "low normal" range and therefore don't need thyroid replacement therapy.

I also had elevated but normal TSH levels, what ever that is. I went to see him because I was feeling tired all the time and had put on some weight for no reason. My workouts were also suffering a little. The Dr, however still insisted I did not require any thyroid medications. What do you think I should do? What can I do? Your help would be much appreciated.

A: For starters, get a new doctor! Seriously though, what you probably have is commonly called "sub clinical hypothyroidism," which means you have thyroid hormones in the low "normal" range. There has been an ongoing controversy for years as to whether or not people with sub clinical hypothyroidism should be treated.

The fact of the matter is, studies suggest such people should be treated. People given thyroid medication with "normal" but low thyroid hormones have shown reductions in cholesterol, improvements in energy and general feelings of well being with no side effects. One recent study (Sept. 1999 Ann. Intern. Med.) also found that people with hypothyroidism had higher levels of homocysteine which were brought down by thyroid medication.

This may also be the case for people with sub clinical hypothyroidism as well. So, you need to find a doctor who does in fact treat people with sub clinical hypothyroidism rather than a doctor who tells you you don't need it. Your symptoms, along with what you are telling me about your tests, point to a need for treatment. Have the doctor run a full thyroid panel, including T4, T3, TSH, free T3 and reverse T3.

Secondly, make sure you are taking in all the nutrients needed for proper thyroid function, such as kelp (which contains iodine), tyrosine, zinc, B vitamins, vitamin C, minerals, essential fatty acids, adequate calories, etc. You might also consider trying the product Metabolic Thyrolean which contains a combination of nutrients that may increase thyroid output in some people. Try this strategy for a month or so and get retested.

If that does not work, that is raise your T4 and T3 levels while lowering TSH, you will probably need to have a doctor prescribe a small dose of thyroid medication. Ok, what about the thyroid medication if you have to go that route? That again has been something of an ongoing controversy in the medical community. There are two main thyroid hormones. Thyroxine (T4) and Tri-iodothyronine (T3). T3 posses about 5 times more activity than T4. The body converts T4 into the more active T3 as needed via an enzyme.

So, the general logic by most medical professionals in the US has been to give people synthetic T4 (brand name Synthroid) and let the body convert it to T3 as needed. Most docs in the US don't use T3 while its more commonly prescribed in other countries. In the old days doctors prescribed natural desiccated thyroid (brand name Armour Thyroid) which is a mixture of T4 and T3 with other naturally occurring constituents found in thyroid such as a rarely talked about compound called T2.

Funny thing is, many doctors, especially alternative practitioners, have found the synthetic thyroid meds did not work as well as the natural Armour thyroid and continued to prescribe Armour rather than the synthetic T4. Thus a controversy arised as the majority of medical professionals feel the simple T4 is fine.

Personally, I think the Armour thyroid is probably superior and some studies suggest that a mixture of T4 and T3 is superior to either alone. For example, a recent study published in the New England Journal of Medicine (NEJM, 340: 424-429, 1999.) found that a combination of T4 and T3 was more effective than T4 alone for improving mood and neuropsychological functions of people with hypothyroidism.

I can also tell you that people who have taken T4 and switched over to Armour have told me many times they feel much better and have more energy. So, my recommendation to you if you end of needing thyroid medication is to demand the Armour product (note to readers: if you already take thyroid meds for some condition you might want to consider telling your doctor you wish to change over to Armour for the reasons I have listed).

With sub-clinical hypothyroidism, most docs will start a person off on a half to a whole grain of Armour thyroid, but that dose may be higher or lower depending on what the doctor feels is needed. Each half grain or Armour has approximately 19mcg of T4 and 4.5mcg of T3. So, there you have it. This information should go a long way to taking care of your thyroid problems and get your energy levels and workouts back on track.

[ Q ] I know creatine is a safe and research proven supplement for strength and gaining muscle. My question is, does it have any legitimate health uses as well? I ask this because some people continue to say its dangerous without any proof.

A: Manuel. That's a good question. Some recent research does appear to show that creatine has some possible health benefits. For one thing, several studies have shown it can reduce cholesterol by up to 15%. So far, I don't believe anyone knows why it has this effect.

There have also been a few studies that show creatine is very useful for certain rare inborn errors of metabolism relating to energy production. Maybe the most exciting research that will be coming out soon, is studies showing creatine might be very helpful in disease involving a degeneration of the nervous system.

Diseases such multiple sclerosis (MS) and other disease involving the central nervous system (CNS) have recently been shown to be improved by the intake of creatine. In the near future, there will be several published articles on this effect of creatine on MS and other diseases involving the CNS. Of course it's not a cure, but creatine does appear to help with these conditions. If a person has such a condition, its been recommended that a loading dose of 10 grams a day of creatine for a week followed by a 5 gram maintenance dose from then on.

However, it's been my experience that people with such disease are very sensitive to stomach problems and I have gotten reports from people with MS who get diarrhea from the above dosing schedule with creatine. So, my advice would be to start with a low dose like 500mg per day and raise it by 500mg every week until reaching the desired dose, or the dose that does not cause any stomach problems.

[ Q ] What up? I recall you wrote an article on some of the research presented at the 97 ACSM conference a while back. Did you go to the 98 and 99 conferences? Anything interesting to report?

A: Bob, I was not at the 99 conference sad to say. I was however at the 98 conference. As you mentioned, I wrote an article entitled "The 97 Research Review" which was published a few issues back in MMI. The article was based on the research findings from the 1997 American College of Sports Medicine (ACSM) conference held every year.

Well the 98 ACSM conference came and went. It was held in Orlando, Florida. Imagine if you will a temperature of 101 degrees with 90% humidity and one well known bodybuilding writer being forced marched through Disney World by his wife. Talk about catabolic! I have to say the 98 conference was something of a disappointment to me.

The research presented was just not up to snuff in my view as it relates to athletic types (i.e. people interested in gaining muscle and losing fat). OK, make that down right boring. Anyway, there was one study I found both interesting and disappointing. It was called "Use of supplements by Navy Seals," and was presented by the Naval Health Research Center. The study was a survey of 91 Navy SEALS which asked various questions regarding what supplements SEALS use.

The study found that a whopping 78% of the SEALS questioned take supplements! Most common products used, as one might expect, were sports bars, creatine, multi vitamins, and good old protein powders. Of course it makes perfect sense that they would use supplements as (a) we know some supplements can have positive effects on health and performance and (b) SEALS don't win a trophy for a job well done, they get to come home alive.

Second place comes home in the body bag. Meaning, it's life and death for them and they need all advantages they can get their hands on. So, knowing this you would think the Navy would have the top nutritional researchers and nutrition programs in the country figuring out how to help these guys with their nutrition, developing high tech supplements, and making them available to the most elite fighting men in the world right? Wrong.

The survey study also found that most of the information SEALS receive about supplements comes from friends, other SEAL team members, and the media. To top it off, they have to pay for the supplements out of their own freaking pocket! Why don't we just charge them for bullets too!? Their are no programs in place to help these guys in any real sense. They have to fend for themselves. And of course, the majority of nutritionists who work with these guys in the first place don't believe in supplements anyway!

In fact, I spoke with the person who conducted the study and she told me "the SEALS get all the vitamins and protein they need from their food. We don't see any reason they should use supplements..." Can you imagine anyone-much less a registered dietitian- thinking what the Navy serves as food (and I use the term food loosely) could adequately supply the SEALS nutritional needs under the ultra stressful conditions they often find themselves? You don't even want to know some of the other things she said.

It would only make you as red in the face at it did me. I have worked with various police personnel and a given advice to many special forces and special ops types over the years and I have to say I am very disappointed in the above findings. The the attitude of the Navy in not seeing the value of nutrition and supplements in the health and performance of their elite fighting men is ridiculous to say the least.

So, here is what I will do. If anyone reading this is a current member of the special forces and has a question they need answered, I will answer it for free. Of course I can't sit down and figure out a customized supplement program for every SEAL, Ranger, Green Barrett, etc., who writes to me or emails me with a question, but if you have a few simple questions I can answer, feel free to contact me.

Now remember, my phone consult fees aint cheap so make them good questions! Also, you will of course have to prove to me you are a current special forces member for obvious reasons. Even better, if you can talk the base commander or who ever into paying for the flight, I will wave my fees and give your group a talk on supplements and answer every question I am asked. Of course this would be contingent on it not conflicting with my own schedule. Deal?

Big Growth & What Multi?

[ Q ] Dear Mr. Fitness: I am really interested to know if you are aware of any drug or substance that a guy could take or apply directly to his penis that would cause him to hang bigger when flaccid. I guess it's just a guy thing wanting to look well hung when you strip off the jock strap in the locker room.

I know somewhere I have read about bodybuilders doing something along this line. Please let me know if you have any knowledge about this and I very much appreciate any information you can provide.

[ Q ] I find the number and variety of supplements on the shelves just overwhelming and impossible to decider. For example, something as simple as a good multi vitamin is hard to figure out.

I have seen you mention the need for a "good multi vitamin" in your articles but you never mention any brands. Can you tell me what your favorite multi is so I don't have to read a medical text book just to buy that "good" multi vitamin! Thanks.

A: Dear Borris,

Borris. I can sympathize with your confusion regarding the ever growing number of supplements out there. Obviously I cant clear up all the confusion on supplements here in this little column, but I will give you the name of the best multis on the market that I am currently aware of.

Remember, there are other good brands of multi but these are the brands I consider great (at this time). As I mentioned before, The Life Extension Foundation makes some superior products, and their multi vitamin is second to none. Its called the Life Extension Mix and you can contact them by calling (800)-826-2114.

Another superior multi is made by the Slim Science Corporation and is called the Optimal Health Complex. They can be reached at (800)-936-2378. Finally, another first rate multi is made by SuperNutrition and they can by contacted by calling (415)-641-0212. You could not go wrong with any one of these multis and they would make a superior base for any supplement program.

Click here for a full product listing of multi vitamins.

Fat & Hair Loss, Gemfibrozil, Ephedrine...

[ Q ] I am a chemistry student who regularly reads your stuff and the "Intake Update column." I have noticed that fats and fatty acid metabolism seems like a particular interest of yours as you write so much about flax oil.

My question is this, what effects does fat have on hair loss? I am doing research into this and I don't have a clue where to start but it is a topic that really interests me. Thanks for the help and you dont have to print this letter in the cloumn if you dont want to.

A: What effect does fat have on hair loss? That's a tough one to answer with any certainty. It is known that extremely low fat diets (below 10%) can cause hair loss just as a lack of many nutrients can cause hair loss. There is no doubt in my mind that deficiencies in the essential fatty acids (Alpha-linolenic acid and Linoleic acid) in the diet will hinder optimal growth of hair or muscle for that matter, but research is hard to come by that unequivocally proves it.

There are some fats that have been shown to have 5 alpha reductase (5AR) inhibiting abilities. F.Y.I, 5AR is the enzyme that converts testosterone into dihydrotestosterone (DHT) which goes onto make your hair fall out. One study found that Gamma Linolenic acid had strong 5AR inhibiting properties in vitro.

It is also interesting to note that they found certain phospho lipids actually stimulated 5AR! Because the various fatty acids they tested had 5AR inhibiting properties that ranged from strong to none at all, they theorized that "unsaturated fatty acids may play an important role in regulating androgen action in target cells (Biochem J.,285:557-562, 1992)."

Now before anyone reading this runs out to buy Gamma Linolenic acid, this research is far from proof that it would stop or influence hair loss in a positive or negative way. However, it is interesting research none the less and points to the fact that certain fats do play an essential role in every cell in our bodies, including hair growth and hair loss, so eat your flax oil!

On a more theoretical note, being we know that hair loss is ultimately an auto immune reaction brought on by inflammatory processes, and we know that the intake of Omega-3 fatty acid rich oils (i.e. flax oil and fish oils) greatly reduces the production of pro inflammatory prostaglandins and leukotrienes, maybe these fatty acids can help with hair loss if taken in large enough amounts for long enough periods of time. All this is conjecture on my part, but its a great place to start your research Tod.

The following letter was published in the July 96 issue of MuscleMag International

[ Q ] I recently purchased a product called Gemfibrozil 600mg. I like fat burners, but I don't trust this product for my health. Please let me know about it if you can. Do you think it is OK?

A: Wilmar, I am not at all familiar with that product. There are now a million and one fat burners out there. 99% of them totally suck. If the product you are referring is an ephedrine based product, read column #7, issue 166 (April 96) of MuscleMag for my opinion of ephedrine.

Also, I have plenty of good info on fat burning supplements in my book. I also name the brand that, at this time, I think is the best on the market. Best of luck Wilmar.

NOTE: The following letter (below) was sent to me in response to a question that I answered in the July 96 issue of MuscleMag in my Intake Update column (above).

Comment: Dear Will,

Regarding your "Q n A" in MMI's July issue about Gemfibrozil , you should not be so quick to give an answer. "Nutritional talk" is what Intake Update is all about and William Rodriguez's question should have have been fielded by a medical professional as this drug is not a nutritional product such as the "hyped-up" products you regard as "fat burners."

Gemfibrozil is a lipid regulating agent which decreases serum triglycerides and very low density lipoprotein (VLDL) and increases high density lipoprotein (HDL). This is a "prescription only" product in the USA. (I am enclosing a drug insert so you can familiarize yourself with it)

Gemfibrozil therapy should not be instituted until proper lab studies can be done to determine if lipid levels are abnormal. More important though, the patient should attempt a program of diet and exercise n weight loss and should have an MD determine whether other factors such as diabetes mellitus and hypothyroidism are contributing factors to their lipid abnormalities before initiating Gemfibrozil therapy.

I hope this helps Mr. Rodriguez and others before they blindly start taking "legend drugs" which can be a dangerous practice.

Sincerely,
Peter Elmen,
R.Ph.,
Madison CT.

Response: Mr. Elmen,

I genuinely appreciate your pointing out my mistake in directing Mr. Rodriguez. However, I fail to see what your beef is here. I offered no medical advice regarding Gemfibrozil and made it perfectly clear that I was not familiar with the product. Unlike yourself, I have not memorized every known chemical prescribed by doctors, especially lipid regulating chemicals because I consider them toxic, a scam, and a waste of time for the majority of people who use them (more on that later).

Now if Mr. Rodriguez had mentioned lipid regulating drugs such as Mevacor, Zocor, Selipram, or even Lopid (a brand name of Gemfibrozil) I would have known what he was talking about and would have directed him appropriately. If Mr. Rodriguez had used language such as "my doctor has put me on...." or " I am taking this product for high cholesterol...," or even "I have a prescription for a product called..." this would have tipped me off to do a Medline search, look in the PDR, and check my trusty Merck Index.

Mr. Rodriguez gave me none of these hints, and so I just assumed it was another name for some new fat burning product that you claim I "hyped-up" when in fact I stated "99% of them totally suck." Where in the world is the "hype" in that statement? Now if you are claiming that a well made "fat burning" product (to use an industry term) is not effective for weight loss, than it is you who was much to quick in offering an opinion.

Research published in the American Journal of Clinical Nutrition (55:246S-282, 1992), International Journal of Obesity (17[6]:343-347, 1993; S:73-78, 1993; 3:S73-77, 1993; 18:99-103, 1994), and the journal Metabolism (41[11]: 1233-1241, 1992; 41[7]:686-688, 1992; 40:323, 1990) have shown conclusively that a mixture of ephedrine, caffeine, and aspirin, in the correct ratios and amounts are very effective and safe for weight loss.

A high quality "fat burner" will follow these ratios and amounts. I will however take the blame for not catching the fact that what Mr. Rodriguez was talking about was a prescription drug. That was my oversight.

As for the lipid regulating drugs you mention that should be "fielded by a medical professional" I could not disagree with you more. If I had figured out that what he was talking about was one of the previously mentioned drugs, I still would have advised him - advised him to throw that drug in the garbage!

I find it laughable that we continue this charade of doctors supposedly helping their patience with "diet and exercise" to lower their cholesterol before initiating drug therapy. Most of this help comes in the form of a lecture from the doctor such as "eat less fat and get some exercise." Some doctors will refer the patient to a nutritionist who is often of little or no help (note: a few nutritionists and doctors are quite good, but the majority of both groups are still stuck in the eat more carbs-don't bother with vitamins-fat is your enemy dogma that got us in this trouble to begin with).

The patient comes back some time later with the same high cholesterol and is put on one of many lipid regulating drugs that continue to increase the profits of pharmaceutical companies. As with the majority of drugs prescribed by doctors, the lipid regulating drugs address the symptom not the cause of the high cholesterol.

I have worked with many people over the years with a variety of health problems, but I am reminded of one person in particular. He was a client who had had a mild heart attack before he came to me. It was found that his total cholesterol was almost 300. His cardiologist put him on Mevacor.

The drug had a marginal effect on his cholesterol levels or LDL/HDL ratios. His liver enzymes were slightly elevated and he got skin rashes that came and went. In general, he told me the drug made him "feel like crap" as he put it. He was not at any time over weight, he ate an "Ok" diet (according to the nutritionist that his doctor sent him to see) and did aerobics regularly. He told me he wanted to get off the Mevacor because it was not working, and his doctor agreed.

The first thing I did with him was put him on high doses of antioxidants and a good multivitamin for three months with no other changes to his diet. This did not have a great effect on his total cholesterol, but it did improve his HDL/LDL ratio. Why? Because a reduction in oxidative stress will often improve the HDL/ LDL ratio.

The next thing I did was reduce his carbohydrate intake, especially some of the so called "complex" carbs such as pasta, breads, and white rice. Though his total carbohydrate intake was reduced, his fiber intake was increased with vegetables, brown rice, oatmeal, beans, etc. After decreasing his carbohydrate intake, I increased his intake of fat! Yes you read that correctly, an increased fat intake.

I added two tablespoons of flax oil and one table spoon of olive oil to his daily diet, and he was told to eat oily fish (salmon, mackerel, etc.) three times per week. He was also taught how to avoid the health degrading fats such as rancid fats, trans fatty acids, and to a lesser degree, saturated fats, which interfere with lipid and glucose metabolism. This had a dramatic effect on his cholesterol levels, bringing him to a total cholesterol that ranged between 230-240.

Finally, I put him on a weight training program and asked him what type of stress he was under (neither his doctor or the nutritionist ever asked him about his stress levels). I came to find out that he was a salesmen in an exceptionally high stress job where his job was on the line all the time.

It has been shown that stress can raise cholesterol by as much as 15%, not to mention the ill effects it has on blood pressure and the immune system. I told him to take up Yoga, Ti-chi, or meditation to work on his stress. He took the advice and began working with someone on mediation. As I expected, the above strategy did not work quickly, but it did work (though it does not work for everyone) . Six months later his cholesterol was 215-220 with a favorable LDL/HDL ratio. The last time I spoke to him it was still dropping.

Feel free to convince yourself this was a "placebo effect" but I don't think the man cares much. Neither did his doctor as he sent me three more of his "non responsive" patients. What were the side effects of this therapy? Chronic good health - a physiological state that the majority of doctors in this country would know nothing about!

A: This is not an easy question to answer and has been an ongoing controversy for some time. The American Medical Association (AMA) Encyclopedia of Medicine defines a drug as "any chemical substance that alters the function of one or more body organs or changes the process of a disease."

This broad definition of a drug was written before modern scientific techniques and a large number of people now feel that this definition needs to be changed. Also, such a broad definition allows government agencies such as the FDA to categorize just about anything they want as a "drug" and take it off the shelves if they think it's dangerous or cutting into the profits of the large pharmaceutical companies (can you say "phen-fen versus ephedrine". )

The problem is, under this definition, now identified compounds and foods could be classified as drugs. Countless foods we eat act as drugs and some contain specific chemicals that act as a drug if we use use the above broad definition of a drug.

For example, small amounts of Valium naturally occur in potatoes and wheat (Biochem. Pharmacol. 37: 3549-59, 1988), chocolate contains an amphetamine like compound (phenylethylamine) which can be found in the human brain and causes euphoria, and coffee contains a chemical that competes with other brain chemicals for opiate receptors in the brain (Nature, 301: 246-8, 1983).

Protein foods high in tyrosine and tryptophan have similar effects on brain chemistry as that of certain anti-depressant medications. Testosterone is considered a drug while various precursor hormones such as DHEA and androstenedione are not and can be purchased by mail order or in some health food stores.

So as you can see, the distinction between foods and drugs, or what makes a drug or not a drug, is becoming harder and harder to quantify. Clearly, what makes a drug is far more complex than was previously believed. So to answer your question; yes ephedrine would have to be classified as a drug under the current terminology, but so would coffee, vitamins, chocolate, and thousands of other things.

Clearly, the definition of what exactly is a "drug" needs to be reexamined. Your father is also correct in saying that because it does not need a prescription does not mean it is not potentially harmful.

However, two points must be made:

1. "Potentially" harmful is the key word here as many things we come in contact with every day are potentially harmful. If a person has a preexisting medical condition such as high blood pressure, heart problems, or others, than the risk from taking ephedrine is higher than its benefit, so you should not use it. If the person does not have any preexisting conditions and does not use high doses of ephedrine, its risk potential is very low.

2. Hundreds of thousands of people are harmed every year by drugs that are prescribed to them by their doctor. This false sense of security of having a doctor prescribe a drug, combined with the medical communities distrust of supplements, causes more damage to our health than you can imagine.

The fact of the matter is the numbers just don't add up when it comes to the warnings medical people make (and the media repeats ad nausiam) of most supplements sold when you compare them to the figures of death and destruction caused by prescription drugs. Should you stop using ephedrine? That's really for you to decide.

If you have no preexisting medical problems that ephedrine could effect and you use it sparingly as you implied, than you are at little risk from using this herb which as been used for thousands of years by millions of people. F.Y.I, I don't personally like ephedrine or herbs that contain ephedrine because I don't tolerate stimulants well due to my type AAA personality, so for me I make the choice not to use ephedrine.

About The Author

Will Brink is a columnist, contributing consultant, and writer for various health/fitness, medical, and bodybuilding publications. His articles relating to nutrition, supplements, weight loss, exercise and medicine can be found in such publications as Lets Live, Muscle Media 2000, MuscleMag In