Adverse effects associated with arginine alpha-ketoglutarate containing supplements

Area of Science:

• Sports Medicine
• Cardiology
• Pharmacology

Background:

• The athletic performance supplement market is substantial, with many products marketed to enhance exercise capacity.
• A popular category of supplements claims to increase nitric oxide (NO) production, a vasodilator crucial for blood flow.
• Arginine alpha-ketoglutarate (AAKG) is a common ingredient purported to boost NO levels by providing L-arginine.

Observation:

• Three male patients presented to the emergency department with adverse effects after using supplements marketed for NO production.
• Symptoms included palpitations, dizziness, vomiting, syncope, and headache.
• Clinical examinations, electrocardiograms (ECGs), and laboratory tests, including methemoglobin levels, were largely unremarkable in the observed cases.

Findings:

• The adverse events reported in these patients, such as palpitations and dizziness, could potentially be attributed to excessive vasodilation caused by elevated NO levels.
• While AAKG is the suspected active ingredient, other underlying causes for the symptoms cannot be definitively ruled out.
• The case series suggests a possible association between AAKG-containing supplements and adverse physiological responses.

Implications:

• Athletic performance supplements containing AAKG may be associated with significant adverse effects requiring medical intervention.
• Healthcare providers should consider supplement use when evaluating patients presenting with unexplained cardiovascular or neurological symptoms.
• Further research is warranted to elucidate the mechanisms and prevalence of adverse effects linked to NO-boosting supplements.