People used to think that if they ate a certain animal, they would acquire some of the characteristics of the eaten animal. People now think that if they ingest certain chemicals that enhance the performance of a laboratory rat, they too would develop greater power.
Athletes, and others, are in constant search for the latest supplement— hopefully legal— that might enhance their performance and make them better athletes. But, for most supplements, the evidence is weak, or completely lacking. Nonetheless, there are a few dietary supplements, including caffeine and creatine, that have been shown to help.
A novel type of nutritional supplement has shown up in the market: the “pre-workout” supplement. Basically, pre-workout supplements are supposed to give you the extra boost of energy you need during extreme workouts.
Recently, a nutraceutical company called Cellucor has launched a product in this class of supplements, the “C4 Extreme,” which the company represents as “the most explosive pre-workout intensifier.” Apparently many athletes agree with that assessment for C4 Extreme has becomeone of the most widely used pre-workout supplements in the market.
But does it really work? Is it safe? Is it true that it is based on “new” science?
Description of the product
C4 Extreme is a sports supplement in the pre-work out class of nutraceuticals specially designed for strength athletes. Athletes looking for an explosive workout, sustained energy, and enhanced focus take C4 Extreme on a regular basis by (Cellucor.com).
Although the main claim for C4 Extreme is that it contains a newly designed —patent pending—ingredient, namely, “NO3 technology creatine nitrate”, this product also contains a combination of over a dozen other active ingredients, including traditional vitamins (Table 1), stimulants (caffeine), energy-producing agents (“explosive energy blend”), agents that act as hydrogen ion buffers (-alanine), protein recovery nutrients (amino acids), antioxidants, and nitric oxide precursors (arginine AKG) (Table 2).
Table 1. C4 Extreme Supplement Facts: Traditional Nutrients
But by far the most interesting ingredient in C4 Extreme is one found in its “explosive blend,” which includes a natural ingredient called Mucuna pruriens, a type of legume only found in the tropics: it has been shown to improve sexual function in rats, used as antivenom medicine against snakebites, and shows promise in the treatment of Parkinson’s disease (Amin 1996). It also contains L-DOPA, which is converted in the body into dopamine. Maybe this is why Cellucor chose to incorporate Mucuna pruriens into its formula.
History or development of the product
There is little information on Cellucor because it is a new start-up company that was founded in 2002. Poul Bodholt and Robert Wood, who saw a gap in the nutraceutical industry, and thought that the gap could be filled with a new type of product, founded Cellucor.
Basically, they realized that most pre-workout supplements were centered round the consumption of carbohydrates, so they decided to develop a new type of product that took advantage of the latest scientific research on performance enhancing supplements, which included combinations of amino acids, protein, creatine, and caffeine. Bodholt and Wood were particularly impressed with a class of supplements called “nitric oxide boosters,” which were not only supposed to improve performance but also speed recovery.
So, Cellucor began to develop a novel line of products that incorporated various combinations of performance enhancing supplements, with C4 Extreme becoming one of their most successful products in its special class of pre-workout supplements. A search of Cellucor’s website shows dozens of sports supplements for other types of workouts, explosive, sustained, and post-workout sport supplements.
Mechanism as to how the product works
Companies are always making all sorts of claims about their products, and Cellucor is no exception (consider their “explosive energy blend”). This is what Cellucor has to say about its product:
“C4 Extreme is powdered energy. Harnessing unparalleled NO3 technology and exclusive, premium ingredients such as Creatine Nitrate, C4 Extreme is a more advanced than any pre-workout supplement in its class, possessing the power to ignite your mind, muscles, and workout regimen, workout after workout after workout.” (Cellucor).
Furthermore, “NO3 is Nitrate, an advanced compound that delivers unbelievable muscle pumps and amplifies the effectiveness of every ingredient in C4 Extreme. Cellucor is utilizing a new compound where NO3 has been fused to Creatine to create Creatine Nitrate; according to a UCLA study, Creatine Nitrate is 1000% more water soluble than either Creatine Monohydrate or other creatine derivatives. Unmatched water solubility ensures better absorption.” (Cellucor).
Thus, in order to determine the mechanisms responsible for how C4 Extreme works, we have to examine the properties of each of the four performance enhancing supplements in this product (Table 2).
Research evidence that supports or disproves the product
The first problem in trying to assess whether there is enough scientific evidence to support or disprove a product is that ingredients such as the pre-workout supplements found in C4 Extreme are commonly tested in isolation, so there is no way to determine how they interact with each other. Nevertheless, we can do the same and analyze each of the sports supplements separately, starting with creatine nitrate, its star ingredient.
Creatine Nitrate
Cellucor claims that science “serves as the foundation for their success;” however, a comprehensive search of the National Institute of Health database for scientific medical studies uncovers not a single entry for “creatine nitrate.” The UCLA study alluded to by Cellucor was nowhere to be found, at least not as represented by Cellucor. But there were a number of important separate studies on the efficacy of creatine kinase (CK) and nitrate oxide.
CK is found in cells that suddenly need a lot of energy, like some types of muscle or nerve cells; and has been shown to improve high intensity exercise (Hespel, 2007 and Walliman 1998). Scientists are thinking about using creatine supplements to treat patients with neuromuscular diseases (Little 2008).
There were also many positive studies on nitrate oxide (Bailey 2009 and 2010, and Bloomer 2010). However, even if these studies were able to show that NO3 supplements can increase the levels of nitric oxide in the blood, there is no evidence that supports Cellucor’s claim that this increase in blood nitric oxide leads to better muscle pumps or improved exercise performance.
Beta Alanine
β-alanine supplementation has been shown to be able to improve the performance of athletes involved high-intensity anaerobic activities (Hobson 2012).
Athletes on a regimen of β -alanine supplementation accumulate carnosine in their muscles, which translates into higher total muscle buffer capacity. What this also means is that athletes who want to improve their physical performance during high-intensity exercise can supplement their diets with β -alanine (Little 2008).
Arginine AKG
Studies have also shown that Cr, by itself, or combined with A-AKG can improve muscular endurance in the upper body. Cr taken together with A-AKG supplements can also increase the output of peak power (Pipe 2002).
Explosive Energy Blend
Basically this “explosive energy blend” is a mixture of vitamins (Vitamin C, Vitamin B12, Folate, Niacinamide, Pyridoxine Phosphate), caffeine, and Mucuna pruriens.
Caffeine has been shown by studies to enhance the performance of athletes (Maughan 2011) and the properties of Mucuna pruriens have already been discussed. Vitamins do not provide energy though they may serve as coenzymes, so the active ingredient in Explosive Energy Blend may be attributed to caffeine.
Potential side effects/safety issues
The biggest problem with sport supplements is that athletes seldom wait until they have enough evidence on the efficacy or safety of the product, and tend to place too much reliance on word-of-mouth testimonials. Athletes rarely consult their primary care providers, and sometimes, even their coaches or trainers, before embarking on a new regimen of sport or diet supplementation. Some even enjoy doing it secretly so that they can surprise their trainers.
Worse, most people pay no attention to the warning labels on the product and only focus on the propaganda labelreading the names of the fancy ingredients and their amazing effects over an over again, like some sort of muscle mantra. They are also fooled into believing that “natural” means “safe.” Hemlock is natural.
So let us take a close look at the recommendation and warning labels for C4 Extreme and see whether this is a product we can take without concern.
Recommendations
First, we have the standard warnings not to exceed the recommended dose and to use the product only as directed. More specific recommendations include directions to determine tolerance.
The product also includes an onerous “disclosure to athletes,” which warns that due to “unique” restrictions imposed by regulating sport organizations, either professional or amateur, the company recommends that an athlete check with their professional organizations whether they may take this supplement.
Warnings
The standard warning not to exceed the recommended dosage is repeated. There is also a warning that this product should not be taken by anyone under 18. It then warns not to use certain substances; like synephrine or caffeine, while taking this product. That means that a person on a C4 Extreme regimen has to avoid things like sodas and tea; and of course, any other dietary supplements or medications that may contain products that may interact with any of the ingredients in C4 Extreme. And, there are many active ingredients in all the Cellucor products.
People with certain diseases are warned away from the product: those with heart, liver, kidney, or thyroid disease; any psychiatric disorders, or diabetes, high blood pressure, or with any of a host of other medical conditions must either avoid the product outright or consult a physician. Basically, if there is anything wrong with you medically, C4 Extreme is not the product for you.
And of course, there is a general warning is included for possible side effects, which include the usual concern with dizziness, severe headaches, rapid heartbeat or shortness of breath.
But what is rather worrisome is a section printed in smaller and lighter font at the very bottom of the label with warnings that the nutritional facts listed in the label may or may not be accurate. So, if you really do want to know what is in this product, they recommend you call their customer service department. Just in case.
The main problem with dietary supplements in the United States is the lack of any regulatory body for these types of products. Athletes have no way of knowing whether the claims made by the nutraceutical companies have any truth in them, either regarding their efficacy or their safety.
Professional athletes also have to worry about concerns with doping. Some of these sports supplements may have substances that are banned by their sport organization, and professional athletes who use these products may end up jeopardizing their sporting status, and their health (Pipe 2002).
The bottom line is that anyone who is tempted into including a C4 Extreme regimen into their pre-workout routine should make it a point to first consult with their coach and, of course, with their primary physicians.
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