Sunday, September 9, 2012

Rhodiola Rosea and Sports Performance

Rhodiola rosea
Rhodiola rosea is a very interesting herb in that there is contradicting evidence to its benefits in athletic usage.

I now refer to chapter 16 (Supplements and sports foods) of Burke and Deakin's (eds) book "Clinical Sports Nutrition," 4th ED, McGraw Hill, Sydney 2010.

In a Belgian study by De Bock et al, modest but statistically significant improvements in VO2 max were established in subjects who were supplemented with Rhodiola rosea. (1) In this study, subjects consumed 200 mg of Rhodiola rosea extract one hour prior to exercise (200-mg Rhodiola rosea extract containing 3% rosavin + 1% salidroside plus 500 mg starch).  The improvement in VO2 max ranged from just under 4% to 6% in test subjects.

Burke and Deakin concluded that, "compared with placebo, supplementation with Rhodiola rosea produced increased time to exhaustion in cycling protocol. No effect seen on muscle strength, or measures of reaction time and responsiveness to stimuli."

It must be noted that these improvements were seen only in acute supplementation. Chronic supplementation with Rhodiola rosea showed no change in endurance or aerobic capacity.

In another study, acute Rhodiola rosea ingestion "decreases heart rate response to sub-maximal exercise, and appears to improve endurance exercise performance by decreasing the perception of effort." (2) So it seems that Rhodiola rosea can help in sports performance.

A very recent study published in the British Journal of Sports Medicine, however, showed no benefits with acute supplementation of Rhodiola rosea. (3)

Research elsewhere likewise did not reveal similar benefits. Recently, the University of Rome published the results of a study concerning the effects of Rhodiola rosea in 14 trained male athletes. (4) The researchers found that one month supplementation with Rhodiola rosea did reduce lactate levels and parameters of skeletal muscle damage after exhaustive exercise session.  But no improvements were established for VO2 max or max HR in test subjects.

Optygen is a very popular supplement amongst triathletes. Recently, the effects of this Rhodiola rosea extract-containing dietary supplement (Optygen) were evaluated among 17 elite amateur competitive cyclists. (5) The cyclists were randomly assigned to ingest six capsules/day for four days and then three capsules/day for an additional 11 days. The Optygen was claimed to provide 100mg R. rosea extract/capsule, standardised to a minimum 2.5 per cent salidroside and 3 per cent rosavins. Also included in Optygen was 333mg Cordyceps sinensis mycelia biomass with a claimed minimum 7.5 per cent cordycepic acid. All cyclists performed a graded exercise test on a computer-interfaced bicycle ergometer until exhaustion/low pedal rpm. The group receiving the Rhodiola rosea-containing extract performed no better than placebo in all measures of performance.

Although this supplement is relatively safe for athletes (6), the results of clinical research thus far are ambivalent and inconclusive at best. Due to the lack of clinical evidence, I cannot advise triathletes and endurance athletes to supplement with this herb, unless, of course, their finances and conscience allow them to do so.

References:

1. De Bock K, Eijnde BO, Ramaekers M, Hespel P.  Acute Rhodiola rosea intake can improve endurance exercise performance. Int J Sport Nutr Exerc Metab. 2004 Jun; 14(3):298-307.

2. Noreen, Eric E.; Buckley, James G.; Lewis, Stephanie L; Brandauer, Josef; Stuempfle, Kristin J. The Effects of an Acute Dose of Rhodiola Rosea on Endurance Exercise Performance. Journal of Strength & Conditioning Research May 2012. Published ahead of print.

3. D Muniz-Pumares et al. Effects of acute supplementation with Rhodiola rosea and L-carnitine on exercise performance, cognitive function and cortisol in healthy active volunteers. Br J Sports Med 45:A1 doi:10.1136/bjsports-2011-090606.2

4. Parisi A, Tranchita E, Duranti G, Ciminelli E, Quaranta F, Ceci R, Cerulli C, Borrione P, Sabatini S.  Effects of chronic Rhodiola rosea supplementation on sport performance and antioxidant capacity in trained male: preliminary results.  J Sports Med Phys Fitness. 2010 Mar; 50(1):57-63.

5. Earnest CP, et al. Effects of a commercial herbal-based formula on exercise performance in cyclists. Med Sci Sports Exerc 2004; 36:504-9.

6. Fintelmann V, Gruenwald J.  Efficacy and tolerability of a Rhodiola rosea extract in adults with physical and cognitive deficiencies.  Adv Ther. 2007 Jul-Aug; 24(4):929-39.

Saturday, September 8, 2012

Selecting and Purchasing Tongkat Ali

With so many competitors in the market, it is sometimes confusing to tell which source of Tongkat ali is reliable. Manufacturers have been known to use Tongkat ali contaminated with heavy metals. Some adulterate their products with dangerous medications like Cialis or Viagra. Some use Tongkat ali root powder in capsules, instead of the root extract; the root powder is practically ineffective unless it is cooked for a suitable period of time (and who is going to cook the capsules?).

I have found a website managed by Tongkat ali researcher Mr Serge Kreutz to be an useful source of information. Beside the chart comparing various sources of Tongkat ali, he has a series of articles which is very informative for the potential buyer.

I will hereby quote extensively from one of his articles:

Genuine tongkat ali extract is a wonderful enrichment of anybody's health and life. It's proven to help in preventing cancer, it lowers blood pressure (and thereby extends a person's life span), it works against obesity in women and men (and has even been patented for this), it gives men a more athletic appearance (proven in a scientific study with real people), and it makes for a better life overall because it improves libido and sexual pleasure ... and all of this without side effects worth mentioning

With all these pluses, practically everybody has a good reason to add tongkat ali extract to one's daily diet. And actually, in Malaysia, the country that once had forests full of tongkat ali trees (all eaten up), most people indeed use tongkat ali every day. If one checks at a Carrefour or Tesco in Malaysia, one will notice that there are more brands of coffee on sale that do contain tongkat ali than there are coffees without. In Malaysia, even Nestle sells Nescafe with tongkat ali

But tongkat ali has now become scarce. In Malaysia it's meanwhile a protected plant, specifically guarded by forest rangers. In Thailand, tongkat ali root powder, gram by gram, is more expensive than Viagra and weighted on gold scales. The only country where there still is some stock in the wild is Indonesia.

It is therefore not surprising (but nevertheless disappointing) that in order to reduce product costs, many distributors stretch their alleged tongkat ali extracts with all kinds of fillers. And to make sure their cheap raw materials have an effect at all, they may add some sildenafil analogues that can be bought at low prices from dealers of chemical raw products. You're a fool if you consume such junk that isn't even licensed as safe in pets. You won't know whether in three years time, you get a brain tumor or liver cancer (more likely) from it. But even if you could know, it would not be much use because your sources will not take any responsibility anyway.

There are two rules that you have to observe when buying tongkat ali:

Rule ONE is to buy something that is a licensed product. A product that has been registered with the health department of a country. It's your health, and ultimately your life, that you are gambling with. But beware of fake and phony licenses shown on some websites

Rule TWO is to buy something from a proper source. From a company that exists in the real world, not just on the Internet. NEVER buy herbal supplements from an Internet spam site. It doesn't mean that you should not order over the Internet. But look at the website from where you order. Spam sites often make unsound promises. Span sites also typically make outlandish claims. And look at the credentials on their site. Are they genuine? Do the photos on their site prove that the company really exists, or are the photos just stolen on the Internet? Everybody nowadays can do a Google Image search for some impressive laboratory photos, and some glossy pictures of happy elderly couples or muscle-packed athletes. Such photos prove nothing

Do a search on Google on any source you consider. Good search queries are: dubious tongkat ali

Or: tongkat ali scam

You could also go a step further and do a search for a specific source you consider. If they are cheats, it will show. Or write to me. While as a matter of principle, I do not make outright recommendations for sellers, I do reply whether a source is legit or not.

Don't just fall for lower prices. You may get what you pay for: cheap shit instead of genuine tongkat ali extract.

So which source do I personally recommend?

I would only purchase from the well known Indonesian Tongkat ali manufacturer called UD Sumatra Pasak Bumi. It is also the manufacturer I recommend to my patients who ask for Tongkat ali as a supplement. It is a government regulated, pharmacist managed organization that has decades of experience and expertise in producing and extracting the herb. They usually sell in bulk wholesale to various distributors.

Fortunately, they have numerous distributors/resellers all over the world. You can buy the herb from these resellers/distributors especially if they are from your locality.

In Singapore, we have one distributor who is currently only selling the Tongkat ali from eBay. I have personally contacted her on eBay and find her reliable as she is directly verified by UD Sumatra Pasak Bumi (you can see her eBay shop on the Sumatra Pasak Bumi reseller listing).

Tongkat Ali (Eurycoma longifolia) in managing idiopathic male infertility

In view of Singapore's decreasing birthrate, it seems that there is at least one herb which can serve as an appropriate supplement for men with subfertility/infertility or decreased sperm count. In a paper published by clinical andrologist Tambi et al, "Eurycoma longifolia Jack in managing idiopathic male infertility," the study suggests that "treatment with the proprietary standardized extract of Eurycoma longifolia Jack [or Tongkat ali] significantly improves semen volume, sperm concentration, sperm motility and the percentage of morphologically normal sperm in men with idiopathic infertility."

Tambi explains, "Male infertility is a multifactorial disease, with numerous factors contributing to both reduced spermatogenesis and the production of dysfunctional sperm, which are the most prevalent underlying characteristics found in cases of idiopathic male infertility."

In this study, the 75 male participants were selected from "a total of 350 male partners from sub-fertile couples attending the Wellmen Clinic, Damai Service Hospital, Kuala Lumpur, Malaysia" who "were identified as having idiopathic infertility, in the setting of low sperm concentration, decreased motility and abnormal sperm morphology." Each treatment cycle with Tongkat ali lasted 3 months, for a total of 3 cycles. Tambi et al concluded that the "study clearly shows an improvement in the main seminal parameters in infertile patients treated with the proprietary standardized water-soluble extract of Eurycoma longifolia Jack, with significant increases in sperm concentration and the percentage of sperm with normal morphology after each treatment cycle." However, "the exact mechanism of action of this extract at the level of the reproductive cell remains unknown."

Low sperm count in males has many causes. "Among the causes of male infertility, the prominent ones namely idiopathic infertility, followed with varicocele, maldescended testes, infections, hormonal causes and genetic effects," wrote Tambi.

Within the Singaporean psycho-social context, it is most probable that emotional stress, obesity, and age (later marriages) play an important part. If subfertility or poor sperm quality is due to such reversible and non-pathological causes, it might be a good option to use this herbal supplement in the management of this condition. And of course, Tongkat ali can be an option in the management of idiopathic male infertility.

Tongkat Ali enhances testosterone in humans.





As a medical doctor and an athlete myself, I am especially interested in non-exogenous means of raising testosterone levels to enhance health, well-being, and of course, athletic performance. The usage of exogenous testosterone (e.g. testosterone injections or steroids) results in a shutdown of our own body’s production of testosterone by the testes (the Leydig Cells to be exact). Now who would want that? Add to this a myriad of side effects of using anabolic steroids such as transaminitis (altered liver function test), gynaecomastia, and changes in serum lipoproteins/cholesterol.


It would be an epiphany of sorts if we could discover a natural method to tell our body to increase its own production of testosterone, and together with that an increase in virility and anabolism. That began my research into various herbs including Tribulus terrestris, Ginseng, Maca root, Rhodiola rosea, Horny Goat Weed, Ecdysterone/Turkesterone and Saw Palmetto. This is when I came across a traditional Malaysian herb called Tongkat Ali.

If you are keen in researching into the herb Tongkat Ali, also known as Eurycoma longifolia, you must acquaint yourself with Serge Kreutz. Serge Kreutz has “been working in Southeast Asia as a foreign correspondent for German newspapers and radio stations,” and was previously involved in Tongkat Ali clinical research with the Sumatra Pasak Bumi. He maintains an interesting resource on the Tongkat Ali herb in his website testingtongkatali.com.

In one of his articles, he notes a recent patent on Tongkat Ali for athletic benefits. He wrote, “In a move that could well be seen as a major break-through, especially for weight lifting athletes, tongkat ali has now been patented in the US for the inhibition of human aromatase enzyme, as well as increasing or activating the total levels of testosterone, free testosterone, and/or luteinizing hormone, while decreasing the levels of estrogen and estradiol.”

So is there clinical evidence that Tongkat Ali actually raises testosterone?

We wouldn’t expect pharmaceutical companies to spend billions in clinical trials on this herb unless this is actually a drug which they can patent, and have exclusive rights on its sales and production. However, the Malaysian and Indonesian government /universities who are interested in cultivating Tongkat Ali as a crop for medicinal purposes have done clinical research in both animals and humans.

Tongkat Ali (Eurycoma longifolia) is now known to possess androgenic properties (1). In human trials, it has been shown to raise total testosterone and dihydroepiandrosterone levels (2, 3, 4, 5, 6, 7, 8).

In a very recent research paper by consultant clinical andrologist Dr Ismail Tambi (Tambi MI et al. Standardised water-soluble extract of Eurycoma longifolia, Tongkat ali, as testosterone booster for managing men with late-onset hypogonadism? Andrologia 2012; 44: 226-230.), Tongkat Ali was shown to alleviate symptoms in older men with late-onset hypogonadism (sometimes also known as "andropause"). In this group of men, testosterone levels were normalized in 90.8% of patients. The results suggest that Tongkat Ali could be useful as a supplement and/or adjuvant in the treatment of andropause.

The abstract of Tambi's paper reads:

"In most countries, millions of people are relying on herbal medicines as remedy for numerous ailments. In South-East Asia, Eurycoma longifolia Jack, also known as ‘Malaysian ginseng’ or Tongkat ali, is used to combat stress and disease and to improve physical strength. Moreover, the compounds of the roots of this plant are reported to have aphrodisiac and testosterone enhancing effects in the rat. Considering that human studies are not available, 76 of 320 patients suffering from late-onset hypogonadism (LOH) were given 200 mg of a standardised water-soluble extract of Tongkat ali for 1month. The Ageing Males’ Symptoms (AMS) according to the standardised rating scale and the serum testosterone concentration were taken. Results show that treatment of LOH patients with this Tongkat ali extract significantly (P<0.0001) improved the AMS score as well as the serum testosterone concentration. While before treatment only 10.5% of the patients did not show any complaint according to the AMS scale and 35.5% had normal testosterone levels, after the completed treatment 71.7% and 90.8% of the patients showed normal values, respectively. Thus, Tongkat ali extract appears to be useful as a supplement in overcoming the symptoms of LOH and for the management of hypogonadism."

There is therefore scientific evidence that Tongkat Ali can raise testosterone levels in men, especially in men with a clinical diagnosis of late-onset hypogonadism (andropause).

References:

1. Hamimatun Saadiah Abdul Razak et al. Combined Effects of Eurycoma longifolia and Testosterone on Androgen-Deficient Osteoporosis in a Male Rat Model. Evidence-Based Complementary and Alternative Medicine 2012, Article ID 872406.

2. Tambi MI. Glycoprotein water-soluble extract of Eurycoma Longifolia Jack as a health supplement in management of Health aging in aged men. In: Lunenfeld B, editor. Abstracts of the 3rd World Congress on the Aging Male, February 7–10, 2002, Berlin, Germany. Aging Male 2002; 6.

3. Tambi MI. Water soluble Extract of Eurycoma Longifolia in enhancing testosterone in males. In: Proceeding of International Trade Show and Conference, Supply Side West, The Venetian, Las Vegas, Nevada, USA. 2003 Oct 1–3.

4. Tambi MI. Standardized water soluble extract of Eurycoma Longifolia (LJ100) on men's health. In: Abstracts of the 8th International Congress of Andrology, 12–16 June 2005, Seoul, Korea. Int J Androl 2005; 28 (Suppl 1): 27.

5. Tambi MI. Standardized water soluble extract of Eurycoma Longifolia LJ100 maintains healthy aging in man. In: Lunenfeld B, editor. Abstracts of the 5th World Congress on the Aging Male. February 9-12, 2006, Salzburg, Austria. Aging Male 2006; 9.

6. Tambi MI. Eurycoma Longifolia jack: a potent adaptogen in the form of water-soluble extract with the effect of maintaining men's health. Asian J Androl 2006; 8 (Suppl 1): 49–50.

7. Tambi MI. Eurycoma longifolia Jack in managing idiopathic male infertility. Asian J Androl 2010; 12: 376-380.

8. Rajeev Bhat. Tongkat Ali (Eurycoma longifolia Jack): A review on its ethnobotany and pharmacological importance. Fitoterapia 2010; 81:669-679.