Can DMAA help athletic performance?
BACKGROUND:Finishing fourth in a major championship rarely leads to much joy for the athlete in question. In the Commonwealth Games last October, the English sprinter Katherine Endacott crossed the line fourth in the women's 100 metre final. By the time everything was settled, however, Endacott had the silver medal.
The first place finisher was later declared to have false-started and was disqualified. With that, the Nigerian Damola Osayemi was declared the winner, only to fail the drugs test and allow Endacott to move into second place.
Osayemi tested positive for a drug that goes by several names, most commonly methylhexaneamine or dimethylamylamine (DMAA).
This was added to the World Anti-Doping Agency (WADA) list of banned substances last year and led to several disqualifications of international competitors in numerous sports.
WADA has since moved DMAA to its “non-specific” list which carries lesser penalties. Drugs in this category are deemed to be more likely to be used inadvertently by athletes because they occur in some medications and supplements.
DMAA occurs to a tiny extent in rose geranium oil (which is why DMAA is also called geranamine). This oil does not come from a true geranium plant, but from a South African flower called Pelargonium graveolens.
Geranium oil has become a common ingredient in supplements marketed as sports performance-enhancing agents. However, those taking such supplements may be obtaining a lot more DMAA than they realise.
Part of the problem is that when these products are sold as food supplements, there may be no indication of how much of each ingredient they contain.
EVIDENCE FROM STUDIES
Current interest in DMAA focuses on its use as a stimulant, especially in combination with caffeine.
In 1944, DMAA was manufactured synthetically and patented by the US pharmaceutical company Eli Lilly.
In the 1970s, the company marketed it as a nasal decongestant without much success.
Under 1994 US regulations, DMAA became classified as a dietary supplement because it occurs naturally. It soon appeared in various food supplements as a general stimulant.
When ephedra was banned in 2005 because of safety concerns, DMAA was one of several compounds used in its place in “natural” stimulants and sports supplements.
Researchers at Eli Lilly showed that DMAA used in nasal inhalers had sympathomimetic actions. This means that it has effects similar to adrenaline; hence the interest of athletes and WADA.
These effects include increasing heart rate and blood pressure due to constriction of blood vessels.
However, food supplements containing DMAA are taken orally, and there has been almost no published research on such uses. There are no studies to support its use as a performance-enhancing agent.
PROBLEMATIC ASPECTS
During 2009, authorities in New Zealand became concerned that DMAA was being used increasingly in “party pills”.
Headaches, nausea and even strokes were reported in people who had recently used DMAA pills. A medical report was published at the end of last year in which a 21-year-old man took two DMAA pills along with a caffeine pill and one beer. He quickly developed a massive headache, passed out, and the next day went to an emergency room where they found he had had a brain haemorrhage.
Although case studies like this cannot proof causation, chemically similar stimulants can cause such effects.
Each capsule was found to contain 278mg DMAA. The safe dose is not known, but 25mg is commonly recommended.
RECOMMENDATIONS
Damola Osayemi claims she was using a legitimate medication. Others may take DMAA thinking they are getting a legitimate boost from a food supplement.
Under WADA, such uses will lead to a positive test for a banned substance. DMAA is the latest in a long line of so-called natural stimulants with little or no evidence of effectiveness, and plausible potential for harm.
No matter what name it’s sold under, this is one to run away from.
Dónal O’Mathúna has a PhD in pharmacy, researching herbal remedies, and an MA in bioethics, and is a senior lecturer in the school of nursing, Dublin City University.