Thursday, November 29, 2012

Human Study: OTC Supplement Doubles T-Levels & Boosts Erections More Than Tadalafil - Too Good to Be True?

Just to make sure you don't suffer from withdrawl symptoms until Adelfo posts the next update on his current contest prep, I thought I'd share a photo that shows where he is currently at - not bad for someone of whom a handful of you have been shocked to hear that he eats at least 200g carbs per day and ice-cream almost every evening, right?
It's Thursday and before I'll get to a question on a very recent study I received via the SuppVersity Facebook page, I will brief you on the line-up of today's installment of the SuppVersity Science Round-Up on the Super Human Radio Network. By now, most of you should actually be familiar with the modus operandi: In case you cannot listen live at 1PM EST, you can always download the show ~2h later either from the "Physical Culture for Your Ears" menu in the sidebar of the SuppVersity, or right over at www.superhumanradio.com - obviously, you can also wait for tomorrow's SuppVersity Science Round-Up Seconds, in which I am providing some additional information on things we have discussed and post selected topics that did not make it into the show.

Apropos topics, the first topic we are going to address does actually pertain to the second part of this post and revolves around a recently published paper by Fabrizio Iacono et al. whose results do - just as SuppVersity reader Mark, who pointed me towards this article, says - look "too good to be true".

Now, upon closer scrutiny it turns out that they may well be "true", but are not just as "good" as they may initially look like. From this testosterone-laden topic we are then going to proceed with topics revolving around male and female longevity, optimal workout types and intensities for different trainees, the health effects of garlic, colostrum and chocolate and related topics.

I could mention more, but am afraid that this will just increase the risk of rushing through the items too quickly. Optimally, you just tune in live and pick up the rest in "print" in tomorrow's SuppVersity Science Round-Up Seconds!

200% increase in total and 130% increase in free testosterone

Just a reminder: Taurine has also (rodent) data showing up to 180% increases in testosterone and that's not exclusively in the sick and old.
This subheading sounds as if I was to pimp the "revolutionary new testbooster" by "whatever company" that will get you muscular and ripped in no time, right? Well, in the end it could well be the text of an advertisement, yet not one from any of the usual suspects but rather one for TRADAMIX®, a blend of "three natural substances with an 'anti-aging' effect on the tissues of the male genitourinary apparatus" (Tradapharma Sagl. 2012) - I know, without the usual "-bols", "-diols", or at least some indirect references to illegal anaobolic substances in the product name, this does not sound like it would work, but the +200% increas in total and +130% increase in free testosterone are for real and documented in a peer-reviewed study involving seventy patients (67.3± 3.7 years) with stable marital relations and reduced libido, with or
without erectile dysfunction who received either the infamous PDE-5 inhibitor Tadalafil (5mg/day) or two servings of the aforementioned 'testicular anti-aging supplement' (Iacono. 2012).

But before we even get to the testosterone levels, let's tackle the main problem of these guys and the actual research interest of the scientists from the University “Federico II” of Naples in Italy first. After all, the main outcome of the study at hand were the improvements in sexual desire and erectile function and those were almost identical in both groups - from 16 to 33 and 16 to 31, in the supplement vs. drug groups, respectively. If you go by the results of the international index of erectile function (IIEF) questionnaire (see figure 1, left), on the other hand, the dietary supplement yielded actually outperformed the blockbuster prescription drug by almost 10%:
Figure 1: Results of international index of erectile function (IIEF) questionnaire and RigiScan (device to measure penile tumescence and rigidity continuously that's used to differentiate vascular from psychogenic erectile dysfunction) before and after 2 months of treatment with Tradamixina and Tadalafil (Iacono. 2012).
What's probably even more impressive, though, are the differential effects of Tradamixina vs. Tadalafil on the RigiScale values (see figure 1, right). The RigiScale is an etablished means to differentiate psychogenic from organ-related (vascular) erectile dysfunction (Basar. 2001) and the fact that there was a significant reduction of RigiScale positive subjects in the Tradamixina group does already suggest a possible reason for the initially mentioned 200% increase in total and 130% increase in free testosterone (see figure 2).
Figure 2: Total and free testosterone levels before and after the administration of Tradamaxine (2 servings per day) or Tadalafil (2mg/day) to Seventy patients (67.3± 3.7 years) with stable marital relations and affected by reduced libido for 2 months (data based on Iacono. 2012)
What this underlying reason is? Well, probably reduced systemic inflammation, which leads to reductions in cortisol, blood glucose, insulin resistance, oxidative damage to the testes etc. and thus simply facilitates the restoration of normal testosterone levels.

If you know how google works, it'll take you maybe 5 minutes and a credit card and you'll have a couple of pounds of the ingredients right on the way to your doorstep.
Yep, you heard me right: A boost of +200% just brought those guys who started with 10ng/dl below the already way too broad normal range from 260-1080ng/dl (values may vary from lab to lab) in a quasi hypogonadal state, back to midrange levels of 680ng/dl.
Real world implications for healthy young men: The chance that a healthy, fit individual with normal testosterone levels would see a boost of 200% in his total or 130% in his free testosterone levels is not low, it is simply ZERO!
Notwithstanding, Tradamixina (or rather its ingredients) is actually more than just a cilialis alternative. While the latter is a short term solution to get rid of the symptoms of an underlying disease, the combination of Ecklonia Cava, tribulus, and d-glucosamine + n-acetyl-d-glucosamine could actually tackle the most frequent cause of erectile dysfunction, which is the triad of inflammation, insulin resistance and arteriosclerosis (for more details see info-box to the right).

So how does this stuff work? Although investigations into the mechanism by which the provision of Tradamaxine did work its magic was actually not part of the study, it's actually not difficult to hypothesize what may be the underlying cause of these unquestionably astonishing results. Firstly, the brown algae Ecklonia Bicyclis (better known as Ecklonia Cava!)of which each serving has 150mg has a very high content of sterols, polyphenols and tannins and is probably the main active ingredient of a formula which includes 396mg of tribulus and 144mg of d-glucosamine and n-acetyl-d-glucosamine as a 'support'. The phlototannins 7-phloro eckol and 6,6′-bieckoll that have been isolated from Ecklonia, a marine brown algae which has been used for centuries in traditional medicine in Asia, are more or less unique with respect to the potency of their antioxidant activity (Li. 2009). In conjunction with tribulus, d-glucosamine and n-acetyl-d-glucosamine, which also exhibit a certain degree of anti-inflammatory activity, a decrease in systemic inflammation is the most likely cause of the profound pro-sexual and pro-hormonal effects of this blend, which is yet by no means as unique as the producers would have it.
Bottom line: It is no coincidence that erectile dysfunction has been identified as a "harbinger of cardiovascular clinical events" (Thompson. 2005) and "a sentinel event for CAD [coronary artery disease]" (Irekpita. 2009). So if you are in the unlucky situation to suffer from vascular (and not physogenic) erectile dysfunction, and had the choice between a drug that will ameliorate the symptoms, i.e. Tadalafil, or a supplement that will treat the underyling cause, the decision for the supplement and against the lifestyle drug should be obvious, right?

Still, there is one, ... no, actually there are two things I would like to ask you, before you run all spiked up to the next best supplement shop: Firstly, how accurate would you say is the authors' claim that there was "no conflict of interest", if no one else, but the lead author of the study, has been granted a patent on the formula on April 4th, 2012 (US2012/089722 A1)? And secondly, do you really believe that it is a mere coincedence that the researchers deliberate use the hardly known appellation Ecklonia Bicyclis for a brown algae all of you probably know as Ecklonia Cava (see "Ecklonia Cava Polyphenols Help Shed Weight Even in The Presence of a Slight Caloric Surplus") throughout the whole paper without mentioning once that it is better known as "Ecklonia Cava"? I am well aware that studies are expensive and need to be financed and I am by no means suggesting that the results are - as Mark suspected - "too good to be true" (remember. the men were hypogonadal to begin with), but this paper does still have a somewhat peculiar aftertaste.

References:
  • Basar MM, Atan A, Tekdogan UY. New concept parameters of RigiScan in differentiation of vascular erectile dysfunction: is it a useful test? Int J Urol. 2001 Dec;8(12):686-91.
  • Iacono F, Prezioso D, Illiano E, Romeo G, Ruffo A, Amato B. Sexual asthenia: Tradamixina versus Tadalafil 5 mg daily. BMC Surg. 2012 Nov 15;12 Suppl 1:S23.
  • Irekpita E, Salami TA. Erectile dysfunction and its relationship with cardiovascular risk factors and disease. Saudi Med J. 2009 Feb;30(2):184-90. 
  • Li Y, Qian ZJ, Ryu B, Lee SH, Kim MM, Kim SK. Chemical components and its antioxidant properties in vitro: an edible marine brown alga, Ecklonia cava. Bioorg Med Chem. 2009 Mar 1;17(5):1963-73.
  • Thompson IM, Tangen CM, Goodman PJ, Probstfield JL, Moinpour CM, Coltman CA. Erectile dysfunction and subsequent cardiovascular disease. JAMA. 2005 Dec 21;294(23):2996-3002. 
  • Tradapahrm Sagl. Tradamix. 2012 < http://www.tradamix.com/en/ > retrieved on 11/29/2012.

27 comments:

  1. Excellent post. Just recently got my bloodwork done and sadly my t levels came back below the acceptable range [7.9 on 10-39] so I think I might give this compound a shot. I am 24 only so a bit unsure about the whole TRT thing and there doesn't seem to be a whole lot of effective solutions out there so I will see if I can get anything out of this supplement.

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  2. hhmmm, i notice the compound has tribulus in it, has this not been proven time and time again to have no benefit on testosterone levels?

    Jon

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  3. I think it was recommended for ED? I think that nothing matches Icariin in this regard though

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    1. for some reason the text of this report is not coming up on my computer. Very interested in the name of he compound. At 66 yrs old, interested in every aid available.

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    2. Sleep and a whole foods diet = best testosterone booster available.

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    3. Yawn.....really?

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    4. well, I sleep an average of 8 hours every single night, my diet is stellar and based on whole foods (eggs, salmon, lean meat, sirloin steak, EVOO, EV coconut oil, nuts, LOADS of vegetables and at least half a kg of berries every day, sweet potatoes, brown rice, oats. Never touched a PH or steroid. I workout 4x a week and have built good amount of strength (200kg deadlift, 130 kg front squat for reps, 75 OP for reps , BW pull ups +30 kg for reps I am 24 and hypogonadal. Now come and tell me about good diet and the importance of sleep... Oh and for the record I might have one drink every three months and don't smoke.

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    5. Genetics beats environment every time buddy. Congrats on getting your life in check, now if only you could change your genes...

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    6. Maybe... but being 24 and hypogonadal could be environmental. Also, one can build strength without testosterone.

      How is your Estrogen and LH? Have you been prescribed TRT?

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    7. Hey Stephen,

      My LH is bang in the middle of the range and it's next to impossible to get E2 tested over here in the UK. No TRT as of yet, I am gonna see an endo in Feb after I've just seen an absolute idiot of a doctor who wanted to put me on SSRI :O Also, he believes that protein powders (which I don't take anyway) are sprinkled with steroids which might be causing my condition. And he says that my free t % is just fine so there's no need to worry. I guess he is on too many anti depressants himself to have the presence of mind allowing to differentiate between the total free t and %age.

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    8. Well your not alone with your experience in the UK as far as your doctor. I ended up finding a pretty good general physician but I don't rely on just one. I also found a HRT Dr. to get a much better handle on sex hormones. I am also not on TRT.

      It is possible that with your supplements that you are getting things you don't know or not getting what you think at least in the US. However, I am pretty sure that steroids are not in any supplements.

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    9. It certainly is within the realms of possibility that bulk supp manufacturers that I used to get most of my supps from are indeed cutting their goodies with some fillers but if that is the case I doubt that any filler will induce such a strong anti t reaction.

      I have to say I pretty much gave up on the entire health care system after my disappointing experience. I do intend, however, to carry on with my own supp/diet/lifestyle research in order to determine the cause. This of course, will be coupled with regular bloodwork. I started taking tongat ali (http://www.ncbi.nlm.nih.gov/pubmed/21671978) maca and mucuna pruriens in a (rather slim) hope that this will ameliorate my condition.
      So far, I've been self medicating with NADH, tyrosine and high doses of coq10 to keep me going in my rather stressful line work.
      Well done on sourcing a good doc, not a small feat by any stretch of imagination. I would be reluctant to go the TRT route just yet given my age and possible fertility issues, I presume this is the same for you?

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  4. not sure if hypogonadism is sth that you inherit (have you got any studies to support this?) also because the problem never run in my family but it is a nice attempt of a hunch all the same.

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    1. I never said it was inheritable, only that it was genetic. In other words, contributing environmental factors - judging from what you said about your lifestyle - seem to be minimal at worst and non-existent at best, so your hypogonadism is the unfortunate result of something within your genetic code. My point was that you can manipulate your environment all you want, and this may even serve to *switch* certain genes on/off (hence getting adequate sleep and eating healthy are *natural* testosterone boosters), but ultimately everything comes down to your personal genetic blueprint.

      I feel like the above paragraph might come across as slightly rude or paternal/defensive, but its not. I am merely explaining myself, so imagine some random dude talking to you with a smile =D

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    2. I would also point towards lifestyle issues and overtraining. That's often associated with dropping SHBG, with more T floating around freely you are basically signalling your hypothalamus that everything is fine.

      Did you ever hurt your testes? Although that question does not really make sense either if the free testosterone is up... ever abused some natty test-booster with nettle? These can lower SHBG and in some people it won't bounce back.

      Last thing pertains nutrition: Are you eating freaking low carb, although you are already at a very low bf%?

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    3. Adel,

      Lifestyle factors are certainly something I need to scrutinise but in all fairness to myself I think that apart from doing too much in too little time (gym, work) there isn't much that might be dragging me down. But then again, having too much on your plate is likely to bring you down to china town. The question remains, however, whether it likely to cause such a significant drop in t levels in otherwise healthy and active individual.

      I make sure not to overtrain and even dropped the freuquency of the most gruelling lower body workouts to once a week. No tests injuries I know of, (well, except for being hit by a football down there once but then again who hasn't haha). Not sure what can be considered an abuse wrt to nettle but I did use it once when I trialed a PES t booster. It never made me feel good so I never re-ordered. I always thought that low SHBG is a good thing? here is my most recent lab work:
      serum testosterone 7.9 10-39
      serum FSH 6.2 1-11
      serum LH: 4.1 1-8
      serum prolactin: 348 0-500
      hbAlc level- IFFC standarised 40/mmol/mol 20-42
      serum sex hormone binding globin 22 nmol/L 11-71
      two other readings were off:
      serum urea level levels 8.6 2.5-7.5
      ALT 66 3-53
      noteworthy mentions:
      serum cholesterol 4.5 nmol/L 3-5
      serum TSH level 0.93 mu/L 0.3-6
      serum sodium 141 nmol/L 136-145
      serum potassium 4.1 nmol/L 3.6-5.4
      serum ferritin 139 ug/L 30-365

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    4. Also, one year ago my DHEA came back low (I was using PSerine at the time though). I attempted to address the issue and supplemented with it for 5 days at first 25 mg per day than 12.5 but I developed severe insomnia so I dropped it from my regimen. I have some DHEA coming my way but I am hesitant to use without bloodwork so I will have to wait and see if it hasn't bounced back within range. Unless it is something that won't budge without a nutritional intervention?

      Speaking of diet: Diet: A lot of eggs, berries, salmon, chicken, brown rice, potatoes, green veggies, healthy fats. No (minus miniscule amounts of parmesan cheese) dairy, wheat or gluten. Shooting for 150-200 gms of protein every day, about 120 fats and 150 carbs. Not sure about body fat %, judging by my abs around 12% at 94 kg and 1.82 m.

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  5. Since tannins and phenols are characterized as "anti-nutrients", are there any concerns regarding a possible anti-nutrient effect of the polyphenols and tannins in supplements such as Ecklonia Cava, Pycnogenol, Olive extracts,or Resveratrol?

    Btw, wouldn't a supplement with a combination of those 4 be awesome otherwise?

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    1. the whole anti-nutrien business is sort of quacko. Yes, it can be a problem if you consumed them in the 10g range with ever meal, but this is nothing you will be able to afford anyway.

      and yeah that would be an interesting supp - although I am not sure if that would not end up being too much protection, again ;-)

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  6. I ordered up some Ecklonia Cava and have been taking it for about 2 weeks. I do seem to notice a reduced amount of pain from an injury of my hamstring I have been dealing with a long time. I would say it feels like I am taking ibuprofen. Now this may be placebo. I feel nothing that would indicate that it is raising T but I will give it a few more weeks

    I just started up with taking Garlic so perhaps I will get a boost.

    I am going to have my values tested as I had them tested recently and I have a reference.

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    1. well, it's like I said on SHR and wrote: It works in people with low testosterone due to inflammation - so it's an anti-inflammatory primary (which is the case for almost all testosterone boosters by the way)

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  7. I guess we shall see if I have any inflammation besides my hamstring :)

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  8. Anyone else try Ecklonia Cava?

    After going through a bottle (not extract but whole leaf) in larger quantity than the bottle states I find that it is a very effective anti-inflammatory. I take curcumin as well but have not noticed it (although high does Tumeric works well for me). I feel noticeably less stiff, especially in the morning. It is also not expensive which is an added bonus.

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    Replies
    1. How did Ecklonia Cava work out for you in the end?

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    2. Good question. I am not sure. I really think if it has any real impact on testosterone it will take a bit of time. I will continue to take it. It does seem to be an anti-inflammatory but targeted? Still not sure.

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    3. it is also supposed to promote weight loss, though the human data on that is from obese individuals only and that suggests that the mechanism is mainly an alleviation of inflammation.

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    ReplyDelete