Exploring fat loss supplements and drugs: L-carnitine, yohimbine, & more | Peter Attia & Derek MPMD

Summary

The 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.