Arginine Alpha Ketoglutarate

Arginine: How it works?

• Arginine-alpha-ketoglurarate (AAKG) has the main role in acting as an ergogenic aid to increase nitric oxide in the bloodstream resulting in vasodilation.

• This occurs by supplying the precursor for nitric oxide synthase (NOS), l-arginine. l-Arginine is then metabolized into l-citrulline, producing nitric oxide in the process.

• This nitric oxide production would then in turn cause vasodilation which would increase oxygen and nutrient delivery to muscles resulting in muscle hypertrophy.

What is it used for/dosage?

• AAKG is used for muscle hypertrophy

Evidence for or against its different uses:

• There is much less published data on AAKG compared to l-arginine, and

  from the data examined, the efficacy is unclear.

• A double-blind placebo trial examined the biomarker effect on a 7-day AAKG

  supplementation (NO2 Platinum) on various biomarkers.

• This included 24 active males who were prescribed 12 g/day or a placebo for 7 days resistance

  training. Three samples were collected at intervals of prior to initiation of

  exercise, immediately post-exercise, and 30 min after exercise.

• The results suggest that AAKG increased plasma l-arginine levels, but the increase in

  nitric oxide after exercise were not statistically significant between the sup-

  plementation group and placebo group, suggesting AAKG did not have any

  influence on nitric oxide levels

Safety concerns, side effects, and precautions:

So far, there have been four adverse events published while taking AAKG supplementation.

• In a case series published by Prosser and colleagues, there

  were three patients with adverse events after ingesting AAKG.

• The first was a 22-year-old male who ingested three “NO2 Platinum” tablets who subse-

  quently developed palpitations, dizziness, generalized numbness, and persis-

  tent vomiting.

• He was admitted overnight for observation and was discharged

  the next day. The second patient was a 21-year-old male who ingested one

  tablet of a “nitric oxide” tablet who developed palpitations and near syncope

  while lifting weights.

• He was admitted and required IV fluids with resolution of his symptoms the following day.

• The third was a 24-year-old male who had palpitations and a headache 45 min after AAKG ingestion. He was treated with acetaminophen and sent home.

• The only other adverse occurring after AAKG supplementation recorded was a patient who underwent laser in situ keratomileusis procedure. Postoperatively, the patient developed subconjunctival hemorrhages, dilated circumcorneal vessels, and corneal infiltrates—the authors hypothesize that the vasodilatory and antithrombotic effects lead to these complication

Interactions with medications:

• There have been no documented interactions of AAKG with other medications.

Key Web Sources

• Reid J, Skelton G, Clark M, Boucher A, Willoughby DS. Effects of 7 days of argininealpha-

  ketoglutarate supplementation using NO2 platinum on brachial artery blood flow and the

  levels of plasma Larginine, nitric oxide, and eNOS after resistance exercise. J Int Soc Sports

  Nutr. 2010;7 https://doi.org/10.1186/1550-2783-7-S1-P22.

• Prosser JM, Majlesi N, Chan GM, Olsen D, Hoffman RS, Nelson LS. Adverse effects

  associated with arginine [alpha]-ketoglutarate containing supplements. Hum Exp Toxicol.

  2009;28(5):259–62. https://doi.org/10.1177/0960327109104498.

• Randhawa S, Abowd M, Sharma A, Weiss JS. Anterior segment complications of a nutritional

  supplement. J Cataract Refract Surg. 2007;33:918–20.

• Campbell B, Roberts M, Kerksick C, et al. Pharmacokinetics, safety, and effects on exercise

  performance of l-arginine α-ketoglutarate in trained adult men. Nutrition. 2006;22(9):872–81.

  https://doi.org/10.1016/j.nut.2006.06.003.