Hydrocycitric Acid, Garcinia Cambogia, Appetite Suppression and Weight Loss

by Georgy Kharchenko

Posted on Saturday 9th of July 2011

Many studies have been performed on ephedra. Clinical studies have been performed on an 8-week, randomized, double-blind, placebo-controlled clinical study on the short-term safety and efficacy for weight loss of a supplement containing ephedra (ma huang) and guarana (containing caffeine). Sixty-seven overweight participants were given either a placebo or the supplement and monitored at the end of the study. Weight and fat loss, hip circumference, and serum triglycerides were all reduced in the treatment group. The common reported side effects were dry mouth, insomnia, and headache. The authors mentioned that the long-term safety of this supplement needed further investigation.

Zahorska-Markiewicz et al. (2001) performed a study on adrenergic drugs to find out if they were able to change the concentrations of serum neuropeptide Y in obese women. The concentrations of neuropeptide Y is postulated to be a counter-regulatory factor that can prevent weight increase. The adrenergic drugs selected for the study were ephedrine and caffeine or combinations of ephedrine, caffeine, and yohimbine. The 13 obese participants were instructed to follow a very low calorie diet along with either a placebo or one of the treatments. Physical examination, heart rate, blood pressure, heart rate variability, and neuropeptide Y serum tests were measured for all the participants. No serious side effects were observed from treatment, and the authors concluded that this was because they used such low concentrations of the adrenergic drugs. Further, the low concentrations of treatment drugs resulted in no change of plasma neuropeptide Y or cardiovascular changes being observed.

Molnar et al. (2000) performed the first clinical study of a caffeine-ephedrine combination in adolescents. Either a placebo or a caffeine-ephedrine mixture (300 mg of caffeine and 30 mg of ephedrine daily for those under 80 kg; and a 600 mg-60 mg combination daily for those over 80 kg) was given to the adolescents for 20 weeks. Body weight decreased by more than 5% in 81% of the treatment group and in 31% of the control group. Adverse events did not differ between groups.

Pasquali and Casimirri (1993) reviewed the results of ephedrine treatment in different groups: in unselected obese subjects, low-energy adapted obese women, ephedrine combined with caffeine, and ephedrine with underfeeding. In their studies they did not find a synergistic advantage in using ephedra with caffeine as other studies have noted. However, they did conclude that ephedrine either alone or with caffeine could promote fat loss while preserving free fatty mass and therefore is useful to a large population of obese subjects in weight loss treatment. The purpose of this study was to examine the cases of ephedrine use to elucidate the population that benefits most from ephedrine treatment and which other treatment regimens (e.g., caffeine, low-calorie diets) should be combined.

The AHPA recommends that the daily dosage should be no more than 100 mg in four divided doses of not more than 25 mg ephedrine alkal-oids. The German Commission E recommends a single dosage of ephedra.

The role of BAT in stimulation of thermogenesis in humans was unknown. Humans are known to have BAT in the interscapular subcutaneous tissue, and an ephedrine-induced thermogenesis response in humans had been observed. Therefore, BAT was theorized to play a significant role in temperature regulation, and it was thought that BAT in obese adults might have a diminished thermogenic ability. In a first study, the interscapular tissue was examined for thermogenic response after ephedrine stimulation, and it was found to be no different in heat production to white adipose tissue in the lumbar area. In a second study, perirenal BAT was examined for thermogenic response and found to be active only in one subject of five. In the single subject, it was estimated that BAT thermogenesis could account for 15% of the ephedrine-induced increase in the body's oxygen consumption.

As a follow-up to the 1985 study, Astrup et al. (1986) investigated the effect of £-adrenergic stimulation to glucose (or diet) induced thermogenesis. The oxygen consumption reflected by 3 months of ephedrine treatment by five female subjects was sustained at a 10% elevated level. Additionally, the thermogenesis induced by glucose was increased during treatment compared with control (the group that was studied after termination of 3 months treatment). The respiratory quotient also indicated that more lipid was oxidized in the treatment group.

The thermogenic effect of ephedrine was studied in five overweight women. A single oral dose of 1 mg/kg body weight was given to the five women and studied by indirect calorimetry before, during, and 2 months after chronic treatment of ephedrine (20 mg perorally 3 times daily). The extra consumption of oxygen caused by the single dose of ephedrine was 1.31 before treatment, 7.0 after 4 weeks of treatment, 6.91 after 12 weeks of treatment, and 1.21 after treatment stopped. The serum T3:T4 ratio increased significantly after 4 weeks of treatment but decreased below the starting value after 12 weeks of treatment. The body weight of the five women participating in the study declined significantly after treatment (2.5 kg at 4 weeks and 5.5 kg at 12 weeks). The sustained increases in oxygen consumption after a single dose of ephedrine at 4 and 12 weeks of treatment shows an increased thermogenic response from an acute dose during chronic administration of ephedra (Astrup et al., 1985).

Weight Loss

Pyruvate supplements are typically marketed to enhance weight loss and increase energy levels. Pyruvate is a salt form of pyruvic acid a three-carbon molecule derived from the breakdown of glucose. The form of pyruvic acid found in dietary supplements is combined with various minerals such as sodium, calcium, magnesium, and potassium to improve stability. In the body, glucose (six carbons) is split into two pyruvic acid molecules (three carbons each) in the end stages of cellular glycolysis. When enough oxygen is present, pyruvic acid can be converted into acetyl coenzyme A in the mitochondrion of the cell to produce energy. Because glucose (the chief sugar used by cells for energy) is broken down in the body into pyruvic acid, an increased level of pyruvic acid in the body is theorized to enhance a cell's ability to generate energy.

Clinical data, though limited, supports the effect of pyruvate as an effective supplement for weight loss. The problem, however, is that most commercial products contain less than 1 g of pyruvate per serving or about 20-50 times less than the levels shown to be effective in the available clinical studies. Even in the studies of multigram feeding that show a benefit in pyruvate supplements, the more than 20 g of pyruvate used was only marginally effective in inducing weight loss.

In general, the clinical support for pyruvate as either a weight loss aid or a way to boost energy levels is weak. A handful of human studies from the same laboratory (Stanko et al., 1992a, 1992b, 1994, 1996) have shown that daily consumption of 22-44 g of pyruvate over 3-4 weeks can help improve loss of body fat and body weight and may help to slow weight regain and reaccumulation of body fat following a weight loss diet. Overall, the difference in weight loss between the pyruvate supplement and placebo groups was not large, amounting to approximately 1.1-1.6 kg (about 2-3 Ib) additional weight loss in the pyruvate groups.

Boozer (2002) studied the long-term safety of a supplement containing ephedra (80 mg/day ephedrine alkaloids) and kola nut (192 mg/day caffeine) in a 6-month, randomized, double-blind, placebo-controlled study. In the treatment group, small changes in blood pressure and increased heart rate were noted, without increased cardiac arrhythmias. Dry mouth, heartburn, and insomnia were reported more often in the treatment group.

The authors concluded that the supplement containing ephedra and caffeine was able to promote weight loss without significant adverse effects.
30 mg. For children over the age of 6, the recommended dosage is 0.5 mg total ephedrine alkaloids per kilogram of body weight (maximum daily dosage of 2 mg/kg).

Warnings have been issued by both the U.S. Food and Drug Administration (FDA) and Health Canada on the use of ephedra-containing supplements, and ephedra supplements are largely banned for sale in the United States (certain low-dose "raw" ephedra supplements were not part of the ban and can be found in some health food stores). Possible side effects listed by the German Commission E are tachycardia, restlessness, irritability, insomnia, urinary disturbances, nausea, and vomiting. Higher dosages or overdose may cause dependency, significant increase in blood pressure, and cardiac arrhythmia (Blumenthal et al., 1998).

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