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Adverse effects associated with arginine -ketoglutarate containing supplements

Department of Emergency Medicine and Division of Toxicology, New York City Poison Center, New York University School of Medicine, New York, USA, Jprosser100{at}gmail.com

N. Majlesi

North Shore University Hospital, Manhasset, New York, USA

GM Chan

North Shore University Hospital, Manhasset, New York, USA

D. Olsen

Department of Emergency Medicine and Division of Toxicology, St. Barnabas Hospital, New York, USA

RS Hoffman

lDepartment of Emergency Medicine and Division of Toxicology, New York City Poison Center, New York University School of Medicine, New York, USA

LS Nelson

lDepartment of Emergency Medicine and Division of Toxicology, New York City Poison Center, New York University School of Medicine, New York, USA

The athletic performance supplement industry is a multibillion-dollar business and one popular category claims to increase nitric oxide (NO) production. We report three patients presenting to the emergency department with adverse effects. A 33-year-old man presented with palpitations, dizziness, vomiting, and syncope, after the use of NO₂ platinum. His examination and electrocardiogram (ECG) were normal. The dizziness persisted, requiring admission overnight. A 21-year-old man with palpitations and near syncope had used a "nitric oxide" supplement. He was tachycardic to 115 bpm with otherwise normal examination. Laboratory values including methemoglobin, and ECG were unremarkable. He was treated with 1 L of saline with no change in heart rate. He was admitted for observation. A 24-year-old man presented after taking NO-Xplode with palpitations and a headache. His examination, laboratory values, and ECG were normal. He was discharged. The purported active ingredient in these products is arginine -ketoglutarate (AAKG), which is claimed to increase NO production by supplying the precursor L-arginine. The symptoms could be due to vasodilation from increased levels of NO, though other etiologies cannot be excluded. AAKG containing supplements may be associated with adverse effects requiring hospital admission.

Key Words: arginine -ketoglutarate • ergogenic aid • nitric oxide • nutritional supplement

Human & Experimental Toxicology, Vol. 28, No. 5, 259-262 (2009)
DOI: 10.1177/0960327109104498


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