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Synephrine, arginine, citrulline - Which pre-workout ensures that you're "on fire"?

As I pointed out previously, my initial idea to cherry pick only the most interesting study results that were presented in form of of poster presentations at the Twelfth International Society of Sports Nutrition (ISSN) Conference and Expo in 2015 didn't work out. The number of interesting studies is is simply too much for a single waredownloadsoft article to discuss them all.

Accordingly, I am now posting the 2nd serving of what is going to be a multi-part series of articles with brief discussions of the most significant results of the >20 studies and short references to those that didn't make the waredownloadsoft cut in this, previous and future installments of this series for one reason or another.

• Synephrine More Ergogenic Than Thermogenic? There was not just one, but two poster presentations and a full paper that has been published only days ago on synephrine containing supplements at the ISSN meeting and on the ISSN website, respectively. Synephrine? Yes, that's the supplemental non-starter, ah... I mean allegedly powerful fat burner from orange peels. The one with promising fat loss results in rodents, but discouraging results in practice.
  
  Luckily, the studies that were presented in form of posters by scientists from the Texas A&M University (Jung. 2015 & Dalton. 2015) at the ISSN meeting did not deal with synephrine as fat burner. Rather than that, Jung et al. and Dalton et al. took a look at the short- and long-term safety of synephrine as a pre-workout. A pre-workout that contained either 3g beta alanine, 2g creatine nitrate, 2g arginine AKG, 300mg N-acetyl tyrosine, 270mg caffeine, and 15mg Mucuna pruriens, alone (PLA) or the same baseline ingredients and synephrine.
  

  Figure 1: Number of reps on sets 1-3 & 4-6 in the control and treatment conditions (Ratamess. 2015)

  Now, the fact that some synephrine in your preworkout won't kill you is not really exciting. I have to admit that. What is exciting... at least sort of, though is the fact that the questionable thermogenic turned out to be an effective ergogenic in the already published and thematically related study by Ratamess and colleagues (Ratamess. 2015). A study that shows that p-synephrine of which previous studies indicate that it is a potent, but highly selective β-3 adrenoreceptor may nor be the best fat burner (the good old ephedrine was a pan-receptor activator and clenbuterol & co target the β-3 receptor, maybe that's also why the fat loss results are rather disappointing) , but at least an underestimated ergogenic.

• As the data in Figure 1 goes to show you, the p-synephrine supplement, which was administered to twelve healthy, college-aged men at a dosage of 100mg either alone (S) or in conjunction with 100 mg caffeine (SCF) for three days. On the day on which the subjects participated in a standardized resistance exercise protocol consisting of 6 sets of squats for up to 10 repetitions per set using 80 % of their one repetition-maximum (1RM) with 2 min of rest in between sets, the supplement was ingested 45 minutes before the workout. In comparison to the placebo treatment synephrine alone triggered a significant increase in total repetitions and volume load. When synephrine was combined with 200 mg of caffeine, it also increased the mean power and velocity of squat performance. What did not change in response to either synephrine alone or caffeine and synephrine, though, were the blood lactate levels or the rate of perceived (RPE) exertion the subjects reported on the usual visual analogue scales.
  
  For me personally, that's a surprising result. For the scientists it "indicate[s that] supplementation with S and SCF can enhance local muscle endurance during resistance exercise" (Ratamess. 2015); and I have to admit: They are right. One thing you should keep in mind, though, is that unlike caffeine, where you often see reductions in RPE and thus an effect you will feel, synephrine will - even if it works - do its purported "magic" more subtly.
• The Latest on "Pump Supplements" - Creatine, Arginine, Citrulline, Nitrates -- To make sure that this series is not turning into a 12-part article, I will address the results of Moon's, Suzuki's and Vogel's results in one item (since Moon's paper basically summarizes the results of studies by Falcone and Joy, I won't discuss those separately) .
  
  

  Figure 2: Increases in blood flow volume (BFV) 33 minutes after the ingestion of 1.87g of RC, 3.67g of CP (citrulline content 1.87g), 1.87g of RA, or 3.07g of AP (arginine content 1.87g) before 3 sets of 15 arm curls (Moon. 2015).

  Moon et al.'s comparison of citrulline's and arginine's ability to increase the exercise-induced vasodilation and blood flow yielded unsurprising results that confirm that citrulline-based ingredients are more effective than arginine-based ingredients for modulating vasodilation and blood flow. Now that alone wouldn't be news-worthy if the scientists had not tested the effects of both, rawe L-citrulline (RC) and raw L-arginine (RA) and, citrulline and arginine bound to a whey peptide (CP and AP, respectively).
  
  I guess I am not going to surprise you, when I tell you that regular arginine was the worst vasodilator in this quartet. What is more surprising, though, is the extent to which the peptide bonding increased the vasodilating effects of regular citrulline and even arginine. With the the former producing 2x higher increases in vessel diameter and 9% higher increases in blood glow volume than regular citrulline (let's not even mention regular arginine | see Figure 2) the effects are pronounced enough to be potentially "feelable" and "visible" during a workout.
  
  

  Citrulline & Glutathione - GSH Amplifies & Prolongs CIT's NO Boosting Effects During + After Biceps Workout | learn more.

  Against that background I would be curious to see, whether the likewise recently reported performance enhancing effects of citrulline Suzuki et al.'s observed in twenty two well-trained young men who consumed 2.4 g / day of L-citrulline or placebo for 7 days and they took 2.4 g of L-citrulline or placebo 1 hour before 4 km cycling time trial on day 8 would be enhanced by bonding citrulline to whey peptides.
  
  I mean, if citrulline-whey-peptides appear to offer the same effects citrulline does, but at a higher efficacy, their beneficial effect on cycling time trial performance of which the Suzuki et al. argue that it was mediated by an up-regulation of plasma NO availability should be superior to that of raw citrulline, as well, right?
  
  And now that we are already talking about what really matters, i.e. performance enhancements, not increases in blood flow, it would also be interesting to see a follow up on the last "pump supplement" study to be mentioned in this installment of the ISSN Research Review: A study by Vogel et al.'s on the vasolidating effects of an arginine-nitrate based pre-workout supplements that shows significant increases in brachial artery diameter. Increases that are quantitatively similar to those Moon et al. observed for citrulline-whey-peptides in the previously discussed study. That does not mean, though that they are equally effective, though. To be able to say that we would need a study in which both agents are compared head-to-head. Unless this study is done and a follow up on Vogel's study proves that the increases in blood flow will actually produce significant performance gains, the only thing I can say about arginine nitrate is: It's interesting, but with respect to its ergogenic effects more studies have to be done.

References:

• Allison, D. B., et al. "Exactly which synephrine alkaloids does Citrus aurantium (bitter orange) contain?." International journal of obesity 29.4 (2005): 443-446.
• Bouza, Brooke, et al. "Exercise and calorie information on menus is not enough to improve food choices in Hispanic adults." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P3.
• Dalton, R., et al. "Safety and efficacy of a pre-wrkout dietary supplement with and without synephrine." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P5.
• Falcone, Paul H., et al. "Acute hemodynamic effects of L-arginine, arginine nitrate, and arginine peptide on exercise-induced vasodilation and blood flow in healthy men." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P10.
• Joy, Jordan M., et al. "A comparison of raw citrulline and citrulline peptide for increasing exercise-induced vasodilation and blood flow." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P18.
• Jung, Y. P., et al. "Effects of 8 weeks pre-workout dietary supplement ingestion with and without synephrine on blood chemistry panel." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P4.
• Moon, Jordan R., et al. "A comparison of citrulline and arginine for increasing exercise-induced vasolidation and blood flow." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P6.
• O'Connor, A., et al. "Short-term powdered tart cherry supplementation encircling an acute endurance challenge potentially increases running performance and attenuates post-race markers of inflammation." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P7.
• Suzuki, Takashi, et al. "Oral L-citrulline supplementation enhances cycling time trial performance in healthy well-trained males." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P52.
• Vogel, Roxanne M., et al. "Acute hemodynamic effects of a multi-ingredient performance supplement on brachial artery vasodilation and blood flow volume following elbow flexion exercise in healthy young men." Journal of the International Society of Sports Nutrition 12.Suppl 1 (2015): P28.

From a physiological perspective NO is not primarily there to make you look vascular and pumped, boys.

If you've read the headline and are asking yourselves "Why on earth would I even want to spend money on cosmetic pump?", you probably need a reminder of the multiple important functions nitric oxide (NO) serves in your body: (1) With their ability to relax the musculature of your blood vessels to increase the blood flow through your veins, normal NO levels are required to guarantee optimal blood flow to every body part; (2) since this includes your sexual organs, normal NO levels are also a prerequisite for normal / optimal sexual function; (3) having enough NO is also required to keep your immune defenses up, because the white blood cells need it in their fight against intruders; and if heart disease, sexual dysfunction and immune health are all things you don't care about (4) you may be interested to hear that your brain and metabolic health critically depend on normal NO levels, as well.
Now that you've got the primer on "nitric oxide beyond the pump" you may be happy to hear that a very common NO supplement, i.e. citrulline, actually delivers. But there's more: In a very recent study, scientists from the Baylor University demonstrated for KYOWA HAKKO BIO CO (so this is sponsored research) that a combined treatment with citrulline and glutathione leads to significant increases in the levels of cGMP, nitrite, and NOx (nitric oxide metabolite) in cells, rodents and humans.

Figure 1: Overview of the design of the "human part" of the study (McKinley-Barnard. 2015).

In the latter part of the study (the human part), the researchers had sixty six participants randomly assigned (in a double-blind fashion) to one of four groups (n = 15 per group) involving 7 days of the oral ingestion of four capsules containing a total daily dose of either: cellulose placebo (2.52 g/day), L-citrulline (2 g/day), GSH (1 g/day), or L-citrulline (2 g/day) + GSH (200 mg/day). Supplementation compliance was monitored by participants returning empty containers of their supplement on day 7, and also by completing a supplement compliance questionnaire.
Each participant ingested all four capsules containing their respective daily supplement dose each evening for six consecutive days until at Visit 3 (Day 7), participants were provided the final daily dose of their respective supplement ingested one hour prior to performing a previously familiarized biceps training program consisting of  3 sets of 15 repetitions with as much weight as they could lift per set (typically 70–75 % of 1RM | 10s rest between sets, only) on a selectorized weight machine (Body Master, Rayne, LA).

Figure 2: Nitrate concentration and change in plasma NOx in rodents (NO metabolites | McKinley-Barnard. 2015).

Figure 2, which depicts data from the rodent study, already suggests that only citrulline or citrulline and glutathione would trigger significant increases in NO production in the 20-22 year-old healthy, well-trained (at least three resistance training sessions per week) participants, while GSH alone would trigger only a minor increases of the nitric oxide levels.

Figure 3: Changes in NO metabolites (NOx) and cGMP levels (McKinley-Barnard. 2015) in the human study.

The data in Figure 3 (left) which tells you that the increase in stable NO metabolites (NOx) in the blood of the subjects in the citrulline + GSH group was the highest. What may surprise you, though, is that the increase in nitric oxide that is obviously partly mediated by an increase in c-GMP (Figure 3, right) levels was not only maintained after the workout, the levels even kept increasing.
This is in contrast to your regular "pump" formula (using only citrulline), where the levels drop back to baseline ( and potentially even lower - after all only 30 min were monitored) after the workout.

Why is that important? Well, if you look back at the "nitric oxide beyond the pump" list from the introductory paragraph, you will notice that almost all of these "beyond the pump" effects are health-relevant during, but also and even more so after the workout.
References:

• Ghigo, D., et al. "Correlation between nitric oxide synthase activity and reduced glutathione level in human and murine endothelial cells." Amino acids 10.3 (1996): 277-281.
• Hofmann, Heinrich, and Harald HHW Schmidt. "Thiol dependence of nitric oxide synthase." Biochemistry 34.41 (1995): 13443-13452. 
• McKinley-Barnard, Sarah, et al. "Combined L-citrulline and glutathione supplementation increases the concentration of markers indicative of nitric oxide synthesis." Journal of the International Society of Sports Nutrition 12.1 (2015): 27.