Thermogenic supplements, including those containing SST (presumably referring to a specific supplement or ingredient blend), are widely marketed for their potential to support weight loss. This article delves into the available research on SST supplements and related thermogenic ingredients, examining their efficacy, safety, and mechanisms of action. We will explore the findings of clinical trials, discuss the potential benefits and risks, and provide a balanced perspective on the role of these supplements in weight management.
The Science Behind Thermogenic Supplements
Thermogenic supplements are designed to boost metabolism and increase fat burning. The word "thermogenic" literally means heat-producing. When your body burns calories, it generates more heat, so supplements that boost metabolism or fat burning are considered thermogenic. Many different types of these supplements are available over the counter. Some contain just one ingredient, while others use a blend of metabolism-boosting compounds.
Sympathomimetic Activity
Compounds that mimic the activity of the sympathetic nervous system (SNS) are known as sympathomimetic because they stimulate thermogenesis and fat oxidation similarly to true SNS activity. Activation of the SNS has been shown to stimulate lipolysis, suppress hunger, and increase satiety, as well as produce a thermogenic effect. However, these signals are dependent on the accumulation of cyclic-adenosine monophosphate (cAMP), which is inhibited by phosphodiesterase. Several other sympathomimetic compounds found in thermogenic supplements are believed to augment the accumulation of cAMP by stimulating β-2 and β-3 adrenergic receptors.
Caffeine is often the main ingredient in commercially available thermogenic supplements due to its ability to increase resting energy expenditure (REE) as well as augment fat oxidation and fatty acid turnover both at rest and during exercise.
Common Thermogenic Ingredients and Their Effects
Several ingredients are commonly found in thermogenic supplements, each with its purported mechanism of action. It’s important to note that while these ingredients may have small, positive effects on metabolism, it’s unclear whether these effects are significant enough to help people lose weight or body fat.
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- Caffeine: A stimulant that increases adrenaline levels, boosting metabolism, reducing appetite, and promoting fat burning. Research suggests that each milligram of caffeine consumed can help burn an additional 0.1 calories in the following 24 hours.
- Green Tea/EGCG: Contains caffeine and epigallocatechin gallate (EGCG), which enhance metabolism and fat burning. EGCG slows the breakdown of adrenaline, amplifying its effects.
- Capsaicin: Found in chili peppers, capsaicin stimulates adrenaline release, speeding up metabolism, burning calories and fat, and reducing appetite.
- Garcinia Cambogia: A tropical fruit containing hydroxycitric acid (HCA), which may block the enzyme ATP citrate lyase involved in fat formation.
- Yohimbine: Derived from the bark of the African yohimbe tree, yohimbine increases the activity of hormones like adrenaline, noradrenaline, and dopamine, potentially boosting fat metabolism.
- Bitter Orange/Synephrine: Contains synephrine, a natural stimulant similar to ephedrine, that can increase metabolism and calorie burning.
Clinical Evidence: Evaluating the Efficacy of Thermogenic Supplements
The efficacy of thermogenic supplements in promoting weight loss has been investigated in numerous clinical trials. However, the outcomes often vary depending on the specific ingredients, dosages, study populations, and methodologies.
Study on a Thermogenic Supplement (TR)
One study utilized a randomized, double-blind, placebo-controlled crossover design to assess the effects of an active treatment containing caffeine, micronutrients, and phytochemicals (TR) versus a placebo (PL) on resting energy expenditure (REE) and other variables in 23 females. The participants, who were moderate caffeine consumers, underwent baseline assessments of REE via indirect calorimetry, heart rate (HR), blood pressure (SBP and DBP), blood variables, and hunger, satiety, and mood states after a 12-hour fast. They then ingested either TR or PL, and all variables were reassessed at 30, 60, 120, and 180 minutes post-ingestion.
The results showed that in the TR group, mean increases in REE of 121 to 166 kcal/d were observed at 30-, 60-, and 180 min post-ingestion (p < 0.01 for all). In contrast, the PL group mean decreases in REE of 72 to 91 kcal/day were observed at 60-, 120-, and 180 min (p < 0.05 for all). Slight increases in SBP of 3-4 mmHg were observed at 30, 120, and 180 min (p < 0.05 for all) post-ingestion of TR, while no effects were observed for DBP. TR also decreased subjective fatigue with no other significant changes in mood states. Glycerol was maintained in TR, while there was a decrease at 30, 60, and 180 min (p < 0.05 for all) post-ingestion of PLA. Free fatty acids increased in TR at 60 and 180 min (p < 0.05) post-ingestion, indicating greater circulating free fatty acids levels in TR vs.
Contradictory Outcomes and Safety Concerns
Of the available literature on thermogenic supplements and their impact on metabolic rate and hemodynamic responses, the outcomes seem to be contradictory in the magnitude at which the effect is observed. Furthermore, the safety and efficacy of specific, commercially available multi-ingredient supplements must be evaluated. Stimulant-based supplements often raise concerns for the potential negative impact on hemodynamic variables such as heart rate (HR) and blood pressure (BP).
Further Research on Thermogenic Supplements
Another study examined the effects of a commercially available dietary supplement on RMR and hemodynamic variables in healthy females. The results of the study show that acute ingestion of the thermogenic dietary supplement, which contains caffeine, GTE, guarana seed extract, chromium polynicotinate, and yerba mate leads to a significant increase in RMR in young, healthy women.
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Meta-Analysis and Reviews
- A meta-analysis of RCTs showed a weight loss of 0.9 kg (2 lb) more per month for ephedra-containing supplements compared with placebo. Using adverse event data from 50 trials of ephedra, a 2.2- to 3.6-fold increase in the odds of psychiatric, autonomic, cardiovascular, and gastrointestinal symptoms was estimated.
- One review found that overweight or obese people who consumed green tea supplements daily for at least 12 weeks lost only 0.1 pounds (0.04 kg) and reduced their waist size by just 0.1 inches (2 cm). However, a different review found that individuals who took green tea supplements for the same time period experienced an average weight loss of 2.9 pounds (1.3 kg), regardless of the dose taken.
- A review of 20 studies found that capsaicin supplements can boost metabolism by about 50 calories per day, which could lead to significant weight loss over time.
Safety Considerations and Potential Risks
While thermogenic supplements may offer some benefits for weight loss, they also pose potential risks and side effects that should be carefully considered.
Common Side Effects
Many people tolerate thermogenic supplements just fine, but they can cause unpleasant side effects in some. The most common complaints include nausea, constipation, abdominal pain, and headache. What’s more, these supplements may lead to a slight increase in blood pressure. Supplements containing 400 mg or more of caffeine may cause heart palpitations, anxiety, headache, restlessness, and dizziness.
Serious Complications
Thermogenic supplements have also been linked to much more serious complications. Several studies have reported a link between these types of supplements and severe inflammation of the intestinal tract - sometimes hazardous enough to require surgery. Others have reported episodes of hepatitis (inflammation of the liver), liver damage, and even liver failure in otherwise healthy teens and adults.
Case Study: Synephrine-Induced Coronary Artery Dissection
A twenty-two-year-old male with no significant past medical history who presented with chest pain was found to have ST-segment elevation. Cardiac catheterization showed acute dissection with thrombosis of the distal left main coronary artery. On further inquiry, the patient was found to be on two separate performance-enhancing supplements which contained synephrine, a sympathomimetic chemical which was later attributed as the cause of his acute coronary syndrome. Synephrine acts on alpha-1 adrenergic receptors causing peripheral and coronary vasoconstriction, hypertension, and hyperglycemia. Increased hemodynamic stress on the coronary arteries can lead to fatal dissections.
Lack of Regulation
It’s important to remember that supplements are not regulated as strictly as food or medications. They’re not rigorously tested before going on the market, so it’s wise to be cautious - especially with supplements that contain very high doses of stimulants or a large number of ingredients that could interact in unknown ways.
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Recommendations
Always examine ingredients and speak with your healthcare provider before deciding whether thermogenic supplements are right for you. Due to the slight elevations in blood pressure, caution should be taken for those with increased risk for hypertension or pre-hypertension. For any such patients presenting with acute coronary syndrome, the use of beta-blockers should be avoided.
Alternative Approaches to Weight Loss
Given the potential risks and limited efficacy of thermogenic supplements, it's crucial to consider alternative approaches to weight loss that are supported by robust scientific evidence.
Lifestyle Modifications
- Diet: A balanced, calorie-controlled diet rich in fruits, vegetables, whole grains, and lean protein is essential for weight management.
- Exercise: Regular physical activity, including both aerobic and strength training, helps burn calories, build muscle mass, and improve overall health.
- Behavioral Therapy: Cognitive behavioral therapy (CBT) can help individuals identify and modify unhealthy eating behaviors, develop coping strategies for stress and emotional eating, and improve adherence to lifestyle changes.
Medical Interventions
- Prescription Medications: Several FDA-approved prescription medications are available for weight loss, which work through various mechanisms, such as suppressing appetite or reducing fat absorption.
- Bariatric Surgery: For individuals with severe obesity, bariatric surgery may be an option to achieve significant and sustained weight loss.
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