Exploring fat loss supplements and drugs: L-carnitine, yohimbine, & more | Peter Attia & Derek MPMD
Summary
TLDRThe transcript discusses the use of L-carnitine for fat loss and muscle growth, noting its presence in red meat and its role in energy production. It also addresses concerns about TMAO conversion when ingesting high doses and the potential benefits of injecting L-carnitine for better bioavailability. The conversation further explores the effectiveness of caffeine for appetite suppression and fat oxidation, comparing it to other stimulants like yohimbine, which can increase adrenaline signaling but may not be as reliable for daily use.
Takeaways
- 🥩 Carnitine is found in red meat and may be deficient in some diets, playing a role in incorporating free fatty acids into the mitochondria for energy production.
- 💉 L-Carnitine injections are used by some to bypass low oral bioavailability and potential TMAO conversion issues associated with oral intake.
- 🚱 Concerns about homebrewing L-carnitine injections include the risk of contamination and the lack of proper sterilization methods.
- 🏥 Compounded versions of L-carnitine are available from pharmacies, which may offer more safety in terms of manufacturing processes.
- ⚠️ The risks of using non-FDA approved or improperly manufactured injectables can be severe, including contamination and health complications.
- ☕ Caffeine is a reliable stimulant for increasing energy expenditure and suppressing appetite, with a well-established safety profile.
- 💊 Yohimbine is an alpha-2 adrenergic antagonist that can increase adrenaline signaling and potentially enhance exercise performance and libido.
- 🔄 The effects of L-carnitine on muscle growth and testosterone expression are anecdotal and not well-supported by clinical trials.
- 🌱 Vegans or those with low meat intake may benefit more from L-carnitine supplementation due to potential deficiency.
- 🏋️♂️ Caffeine is recommended for most people, especially in a calorie deficit, for its ability to increase gym performance and metabolic output.
- 🤔 The use of yohimbine is more situational and may not be as universally applicable as caffeine, depending on individual needs and responses.
Q & A
What is L-carnitine and why is it used by some people for fat loss?
-L-carnitine is an amino acid present in red meat that helps incorporate free fatty acids into the mitochondria for energy production. It is also implicated in indirect processes like androgen receptor content in muscles. People use it to potentially increase the expression of what can be achieved with testosterone input, aiming to get more out of less androgen.
Is it necessary to take super physiologic doses of L-carnitine if you have a sufficient diet?
-If you're getting enough L-carnitine through your diet, taking super physiologic doses, such as injecting 500 milligrams, may not be necessary. It's not analogous to creatine, and you might not saturate muscle stores, but it's not something you'd want to inject in large volumes.
Why do some people prefer injecting L-carnitine instead of taking it orally?
-The oral format of L-carnitine has low bioavailability, around 10 to 15%, requiring a much higher dose to achieve the same effect as an injection. Additionally, there's a potential risk of TMAO conversion when ingesting large amounts of carnitine and choline, which can be avoided by injecting.
What are the concerns with homebrewing L-carnitine injections?
-Homebrewing L-carnitine injections can be risky due to the challenges of properly sterilizing the water and ensuring the product is safe for injection. Without proper knowledge and equipment, this process can lead to health risks.
How can one ensure the safety of L-carnitine injections if not homebrewing?
-One can opt for compounded versions of L-carnitine made in a pharmacy that adheres to good manufacturing practices. It's important to vet the pharmacy to ensure the product is safe and effective.
What is the role of caffeine in appetite suppression and fat oxidation?
-Caffeine is known to increase energy expenditure and has appetite-suppressing qualities. It is considered reliable and safe for use, with the FDA suggesting an upper tolerability limit of 400 mg per day.
How does caffeine affect energy levels during a calorie deficit?
-Caffeine can help attenuate an energy deficit by increasing metabolic output and providing a boost in the gym. It's a reliable way to support energy levels, especially when nutrient deprivation makes it difficult to fuel everyday activity.
What is yohimbine and how does it differ from caffeine in terms of effects?
-Yohimbine is an alpha 2 adrenergic antagonist that raises adrenaline signaling significantly. Unlike caffeine, which is an adenosine receptor antagonist, yohimbine induces a more racy and aggressive energy feeling, but it's not as euphoric.
How does yohimbine affect exercise performance and libido?
-Yohimbine can enhance exercise performance by increasing adrenaline, providing a boost in energy. Interestingly, it can also enhance erections and libido, which is unusual for a stimulant.
When is it appropriate to consider using yohimbine as part of a fat loss strategy?
-Yohimbine might be considered when standard low-hanging fruit options have been exhausted, and there's a need to boost energy in a way that isn't overwhelming or causing an energetic state of deprivation.
What are the potential risks of using injectable L-carnitine from non-pharmaceutical sources?
-The risks include contamination and the possibility of using a product that has not been properly manufactured or tested for safety. It's crucial to ensure the source is reputable and follows good manufacturing practices.
Outlines
💉 Carnitine and Fat Loss Pharmacopia
The first paragraph delves into the topic of L-carnitine, a substance often used in the context of fat loss and muscle enhancement. It is naturally present in red meat and may be deficient in certain diets. L-carnitine is known to aid in the transportation of fatty acids to the mitochondria for energy production and has been implicated in increasing androgen receptor content in muscle tissue, although this is considered fringe literature. The paragraph discusses the use of L-carnitine injections for those who may not get enough through diet, the potential benefits of this supplementation in terms of enhancing the effects of testosterone, and the risks associated with self-injection and sourcing the compound from questionable sources like online vendors or compounding pharmacies. It also touches on the importance of proper manufacturing processes to avoid contamination and health risks.
☕️ Caffeine and Yohimbine for Fat Oxidation and Energy
The second paragraph explores the use of caffeine and yohimbine as aids in fat loss and energy expenditure. Caffeine is highlighted as a reliable stimulant that can increase energy levels, metabolic output, and performance in the gym, while also suppressing appetite. It is considered safe with a recommended upper tolerability limit set by the FDA. Yohimbine, an alpha-2 adrenergic antagonist, is discussed as a substance that can raise adrenaline signaling, potentially liberating free fatty acids for use during exercise. While its energy expending component may not be significant, the adrenaline-inducing effects can enhance workout performance and are markedly different from caffeine's adenosine receptor antagonism. Yohimbine's effects on libido and erectile function are also mentioned, making it an interesting compound for some individuals looking to boost both exercise performance and sexual health.
🤔 The Considerations of Yohimbine Use
The third paragraph continues the discussion on yohimbine, focusing on its specific use cases and potential side effects. It is suggested that yohimbine is not a first-line option for boosting energy during a calorie deficit but rather a tool for those who have exhausted more conventional methods. The paragraph notes that yohimbine may be attractive for individuals seeking an increase in both exercise performance and sexual performance. However, it also cautions against its use due to the potential for anxiety and irritability, and suggests that it should be reserved for specific situations where an acute energy boost is needed without overwhelming the individual's energy or sleep state.
Mindmap
Keywords
💡Carnitine
💡Mitochondria
💡Anabolic Stimulation
💡AR Content
💡Supraphysiological Doses
💡Compounding Pharmacies
💡Caffeine
💡Fat Oxidation
💡Yohimbine
💡TMAO Conversion
💡Allicin
Highlights
L-carnitine is found in red meat and can be beneficial for incorporating free fatty acids into mitochondria for energy production.
L-carnitine may indirectly increase androgen receptor content in muscle, suggesting potential for enhanced testosterone effects.
People often use L-carnitine injections to get more benefits from their diet and anabolic stimulation.
The necessity of L-carnitine supplementation depends on dietary intake and potential deficiency.
High doses of L-carnitine injections may not be necessary if sufficient levels are obtained through diet.
Injectable L-carnitine is often preferred over oral forms due to significantly higher bioavailability.
There are concerns about TMAO conversion when ingesting high doses of carnitine and choline.
Allicin from garlic is suggested to potentially attenuate TMAO conversion in the gut.
Clinical trials on L-carnitine show mixed results, with anecdotal evidence being more prevalent.
Caffeine is a reliable stimulant for increasing energy expenditure, appetite suppression, and gym performance.
Yohimbine is an alpha-2 adrenergic antagonist that can increase adrenaline signaling and energy.
Yohimbine is used for its stimulatory effects on training and potential enhancement of erections.
Ephedrine is a beta-2 receptor agonist that may provide a different type of stimulant effect compared to yohimbine.
Yohimbine's effects are short-lived, making it suitable for pre-workout use in calorie deficit situations.
The use of yohimbine is more case-specific and not as universally recommended as caffeine.
The safety and effectiveness of compounding pharmacies can vary, with some leading to serious health issues.
Homebrewing injectable substances can be dangerous without proper sterilization and knowledge of the process.
Transcripts
okay so let's talk about some of the the
the fat loss pharmacopia uh the fat loss
pharmacopia so um I have friends that
swear up and down by carnitine El
carnitine I think they inject it is that
so tell me about that so the L carnitine
is um present in red meat and depending
on your diet you may or may not be
deficient in it and it is something that
can help uh um incorporate free fatty
acids into the mitochondria and help you
produce energy and and it also is
implicated in certain indirect processes
like AR content in the muscle which is
some of the more Fringe literature but
it seems to in the presence of
sufficient anabolic stimulation actually
increase the expression of what you can
get out of your testosterone input so
this is the main reason why people I
know use it and presumably why a lot of
people use it that you know too is it's
often advertised as get more out of less
Androgen essentially but does
this work if you are getting sufficient
carnitine in your diet do you need super
super physiologic
doses well in general if you're
injecting 500 milligrams for example
like you will be Supra so it's not
something similar to creatine you can
make the argument that endogenously or
through your diet you may be get enough
to satisfy um like maybe you're not
going to saturate muscle stores but I
mean it is is it's not analogous to
creatine but it seems to be at least in
supplemental form and this is something
you inject subq daily depending on the
volume because it is depending where you
get it could be 200 milligrams a
milliliter 500 a milliliter and you can
only put so much oil subq or water sorry
it's waterbased subq before you have
lumps so even though it's more easily
absorbed it's still not something you
want to be injecting milliliters of like
typically subq shots you want so are we
back in the same problem of like where
are people getting this stuff typically
compounding pharmacies or online or
they're making it themselves cuz it is
just an amino acid that you could just
buy anyways so Homebrew sometimes but
the reason they're injecting it
typically is because home brew how are
they sterilizing the water
and I'm not I'm not a chemist who's
going to explain really how you would do
it but it's the same process by which
you would make your underground steroids
presumably so it's like in other words
this is a bad idea yeah yeah maybe this
is an awful idea unless you know what
you're doing cuz some of them are like
pretty I don't know intelligent but I
still wouldn't risk it even if I had the
instruction manual personally yeah so in
general though there is pharmaceutical
not grade but like compounded versions
that are made in an environment that's
been at least fact checked depending on
the rigor of the pharmacy in question of
course because you've done many uh deep
dives into compounding yeah which I
recommend people check out yeah we did
it I think we did an AMA where we
covered the the the ins and outs of
compounding and even with compounding
pharmacies there have been enormous
breaches of um of good manufacturing
processes and that results in
contaminations of legitimate FDA
approved molecules like cortical
steroids that have led to literally
thousands of deaths so you know it's one
thing when people are compounding things
without good manufacturing process that
you'll take orally because the gut is a
lot more forgiving yeah um but the
moment you start talking about things
that are injectable and now you are
injecting something in yourself that's
dirty you know that could be a huge
compromise so yeah anyway I I I uh I I
hope there are ways for people to vet
that stuff yeah um how effective is
caffeine both in terms of its effect on
appetite and potentially its effect on
fat oxidation by the way I did I want to
touch on quarantine quickly the reason
people inject it is typically because
the oral format is only about 10 to 15%
bioavailable so you have to take
literally 10 x the dose to achieve the
same yield outcome and then in addition
to that when you ingest things like
carnitin and choline there is a
potentially unfounded but still
potentially
concerning scenario where there is tmao
conversion so when you ingest a lot of
carnitine like four plus grams to get
your yield that is enough to actually
have some sort of effect that has shown
to have some hopeful AR content up
regulation which is still like a fringe
thing you're seeking that may not be
ultimately
founded you are using an amount that is
going to have some level of conversion
that you could avoid by injecting yeah
so you are averting the need to use as
high of a dose and in addition to that
you are potentially avoiding some level
of risk from gut related circum saying
some people use Allison with it to kind
of like circumvent and try and prevent
TMO conversion what's Allison it's from
garlic and it seems to attenuate TMO
conversion in the gut but it's also like
a fringe application with like a hopeful
outcome that I guess you can measure in
serum your tmao before and after Allison
versus not and see if there's a
difference but are there any clinical
trials that demonstrate any efficacy of
injectable or oral El carnitine with
carnitine the results are mixed some of
it looks promising and then some of it
doesn't so
this is one of those things where you
largely go by anecdotes and with it
being a natural amino acid a lot of
people that use it it depends on their
Baseline circumstance too the deficient
will obviously get more exactly like you
could sort of see a see a scenario where
somebody's like a vegan and there a huge
benefit obviously then you might see
well maybe the risk is worth the payoff
but if you're an omnivore who happens to
eat red meat I don't know maybe maybe
it's less so I'm sure of you you saw the
data you would not be convinced that
it's worth trying so I'll just put that
out there for people who watch your
stuff I don't think that they would
blindly want to inject this so this is a
the reason people find it very
attractive is because it works through a
different Vector people anecdotally have
seen muscle growth outcomes on the same
dose of anabolics or lesser so and a
grow leaner when they use it so it's not
like there's literature to show when
you're on testosterone plus carnitine
you get better results than just test
but
that's what people claim and seems to be
at least somewhat reproduced anecdotally
but you know that's uh speculative I
would not hang my hat on that and be
like I recommend for sure you take this
so just putting that out there um I
don't think it's a potent fat burner by
any means which is like the subsection
we're kind of talking about as far as
caffeine super reliable one of the best
things you could do you know where the
data lies for upper tolerability and
safety I think the FDA even has like a
threshold amount that they say you're
good to take it's like 400 which which
is pretty significant um and yeah you
can get some level of increased energy
expenditure from that but largely the
benefit from the stimulant category I
would say comes from the increase energy
you have even as you go deeper into a
deficit as well so as you enter into
nutrient deprivation territory it
becomes a lot harder to even move
subconsciously let alone actually fuel
your everyday activity so I'm not to say
you should become a caffeine addict to
support your deficit that's not
necessarily sustainable but it's if you
were going to use something to help
attenuate an energy deficit or you know
one day where you need a bump like
caffeine is certainly a reliable way to
do it that increases metabolic output
but also reliably increases performance
in the gym and has appetite suppressing
qualities and has safety data
simultaneously so I would you know
pretty blindly recommend caffeine for
most people short of like special
circumstances you mentioned yiman
earlier yeah let's say more about that
so that is a alpha 2 adrenergic
antagonist and when it comes to some of
these like
adrenergic type receptors it gets kind
of confusing because some of them will
have like even though it's an antagonist
of the Alpha 2 receptors it will
have stimulatory effects but
contradictory to what you'd expect from
a stimulant that's not vasoconstrictive
the same way you might get from a
amphetamine or like essentially any
other stimulant that works well so this
stuff raises adrenaline signaling very
significantly and there was thought that
it could liberate free fatty acids via
the adrenic signaling that you could
then you know like take advantage of
during exercise now is the energy
expending component of it worth hanging
your hat on I would say no but the
adrenaline inducing component opponent
is substantial enough that some
people really really enjoy the use of it
in their training and get a uptick and
energy that is markedly different than
through a adenosine receptor antagonism
which is CA caffeine yeah so like it
feels much more racy and aggressive than
caffeine and it's almost like a sub how
does it compare to like ephedrin
ephedrin I believe is a beta 2 receptor
Agonist off the top of my head I could
be wrong on that but it is less euphoric
I would say and more like adrenaline
spiking so you feel more like it's
almost borderline anxious to a degree
where you have ay how long does it last
um yohimbine halflife can't recall off
the top of my head but it's relatively
short the type of thing that people take
for the workout when they're in calorie
deficit typically you would take it
before cardio or before training is the
typical application but interestingly
enough it's also used as an
afrc and can enhance erections which is
weird because you wouldn't expect that
from s say and also like that doesn't
seem like the right mix of things to be
super anxious and you know irritable
sure yeah but it has the that's one of
the things where it's like is this a
drug for you cuz if you happen to get an
uptick in performance in exercise
performance and then also you get some
sort of uptick in libido and or enhanced
bedroom performance later in the day
could be attractive it is not something
that is uh I would typically reserve it
for a deficit whereby you have tried all
standard low hanging fruit options and
you're kind of okay now I need to
actually boost my energy in some way
that is not like I'm at my wits end for
I can't lower card do more cardio or
reduce my intake of calories anymore
without it being overwhelming or I'm
just in like a very deprived energetic
state or I got low sleep and I need to
acutely modulate it so I don't use it I
wouldn't use as much as caffeine
caffeine I would like very easily
recommend daily use in a diet I think
this is something that's more use case
specific and not as
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reliable oh
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