Sunday, August 14, 2011

Nitrates Work! Even at Low Doses of 300-500mg. Athletes Who Take More or Confuse Nitrates With Nitrites Face Potential Health Risks. First NO2-"Victim" in the ER.

Image 1: With nitrate and nitrite, a
single letter is of literally vital importance.
You probably expected another issue of the famous "Ask Dr. Andro" segment today... ? Well, I have in fact been working on something, but firstly, the topic turned out to be so epic that I could hardly have delivered a post in the usual SuppVersity quality within the next few hours, and secondly, a previous installment of the series on creatine nitrate (cf. Ask Dr. Andro: Is Creatine Nitrate Worth It?), in which I explained why I think that the heavily marketed "revolutionary" creatine supplement probably does not provide any additional benefits beyond supplementing creatine monohydrate and nitrate, individually, urgently needed a follow up.

While the ergogenic potential of creatine monohydrate and its safety are well established (and I do not think I have to recite the whole litany about creatine causing kidney failure, again!? cf. Creatine Save - For Diabetics, As Well!), the studies which show that dietary supplementation with inorganic nitrate (NO3-) reduces whole body oxygen cost during physical exercise (Larson. 2007; Larson. 2010), are pretty recent and have, according to a letter to the editor of the Journal of Applied Physiology by Jon O. Lundberg et al. (Lundberg. 2011), already provoked a case of severe nitrite intoxication in an athlete who obviously wasn't aware of the major difference the "i" which distinguishes the highly reactive nitrite (NO2-) from its harmless precursor nitrate (NO3-) and developed symptoms suggestive of methemoglobinemia (increased oxidation of hemoglobin) after poisoning himself with nitrite salt.
Note! It is unlikely that you will develop methemoglobinemia from reasonable doses of nitrate, even when the lethal dose 50 (LD50 = the dose at which 50% of the subjects / lab rats who ingested the given amount of a chemical die) for nitrite is as low as 100-200mg/kg and thus in the range of cyanide. The reason for that is that, although your body will convert orally ingested nitrates to nitrite, the rate at which this process takes place is limited and this limitation is what avoids the accumulation of nitrite in your blood stream and thus saves the iron-containing oxygen-transport metalloprotein in your red blood cells from being oxidized.
Image 2: Beetroot juice is probably your
safest source of dietary nitrate (NO3-)
(image from
This case of unintentional nitrite poisoning goes to show that caution should be exercised, when you are buying and consuming nitrate salts for performance issues. Yet, although salpeter (nitrate salt) is readily available as a food conservative from your local grocery story, I personally would advice against its consumption and tend towards more natural sources of nitrate to elicit the desired ergogenic effects. In fact, the slow controlled release of nitrite from dietary nitrate as it is found in beat root juice (100-200ml would suffice to get into the effective range of 200-300mg nitrate, cf. Ask Dr. Andro: Is Creatine Nitrate Worth It?) may have additional desirable health effects on blood pressure (Larsson. 2006; Lundberg. 2008) and could be used as an adjunct in the treatment and prevention of ischemic conditions such as myocardial infarction and peripheral artery disease.

A final word of caution goes out to the real bros out there: When even nitrite salt can give you hypothension and oxidize your the oxigen carrying metalloprotein in your red blood cells, nitroglycerine and amyl nitrite, both drugs that are prescribed to patients with heart disease, may literally give you the "longest lasting pump of your life" - a pump that lasts until you drop dead to the floor.