The Effect of Arginine or Glycine Supplementation on Gastrointestinal Function, Muscle Injury, Serum Amino Acid Concentrations and Performance During a Marathon Run

Abstract

Gastrointestinal bleeding and increased intestinal permeability have been observed in marathon runners. We sought to determine if L-arginine would be useful for prevention of these complications. Twenty-three runners were randomized to receive L-arginine (A) or glycine (placebo) (G), 10 grams 3 times daily for 14 days prior to the 1997 Houston-Methodist Marathon. Serum, stool hemoccults and lactulose:mannitol permeabilities were obtained at baseline, immediately after completion of the marathon and approximately 48 hours later. Runners rated their symptoms of nausea and vomiting, belching and indigestion, abdominal pain and bloating, diarrhea, and extremity pain on a 1-5 scale of increasing severity. The L:M was unchanged in either group during the three collections. Occult bleeding occurred in 8%/20% in A and G groups, respectively, p = NS) immediately post-marathon. No runners had occult bleeding 48 hours post-race. Gastrointestinal symptom scores were minimal to nonexistent. Extremity pain scores were similar for groups A and G (2.1+/-1.4 and 2.8+/-1.6, respectively, (p = NS). Fluid intake was similar between both groups (1875+/-1547 vs. 1506+/-970 ml, p = NS). Serum amylase was normal at baseline and remained virtually unchanged. Serum lipase was normal at baseline and immediately post-race in both groups, but increased at 48 hours post-race (82.2+/-34.3 to 121.5+/-53.3 mg/dl [A], p = 0.02 and 114.3+/-55.7 to 181.9+/-162.2 mg/dl [G], p = 0.09). CPK increased significantly and similarly in both groups immediately post-race, and even more dramatically 48 hours post-race (130.3+/-130.8 to 738.8+/-902.9, p = 0.007 to 1966.5+/-3.166.0 mg/dl [A] and 140.9+/-77.9 to 863.0+/-772.3, p = 0.003 to 5619+/-10636.8mg/dl [G]). Modest post-race decreases were seen in most serum amino acids in both groups. Finish times were longer than predicted (23+/-21 and 9+/-7 min for A and G groups, respectively, p = 0.049). Our study failed to show a clear benefit of arginine supplementation for the prevention of intestinal ischemia/reperfusion injury associated with endurance running, but either a detrimental affect on performance with arginine, or enhanced performance with glycine. Skeletal muscle injury was unaffected by arginine or glycine supplementation. The delayed increase in serum lipase suggests mild pancreatic injury, affected by either arginine or glycine supplementation.

Changes in intestinal microbiota composition and metabolism coincide with increased intestinal permeability in young adults under prolonged physiological stress

“…Specifically, arginine is a precursor to polyamines required for intestinal mucosal growth and repair, and for nitric oxide, a potent vasodilator that may protect intestinal barrier integrity by improving splanchnic perfusion, deterring pathogen invasion, and modulating inflammation (28,54). In support, arginine supplementation has preserved intestinal barrier integrity in various animal stress and intestinal injury models (2), although the effects in humans are less clear (5). Cysteine is an essential component of glutathione, an antioxidant tripeptide critical to maintaining a favorable redox balance in the intestine (10).…”

Systematic review: exercise‐induced gastrointestinal syndrome—implications for health and intestinal disease

“…Because exercise‐induced disturbances to intestinal integrity and endotoxaemia, especially in the reperfusion period after exercise, which may be mediated by free radicals, anti‐oxidant supplementation may prevent further epithelial damage and ameliorate endotoxaemia . L‐citrulline and L‐arginine are precursors for nitric oxide production, which is a potent vasodilator, potentially enhancing blood flow into the intestinal microvasculature reducing exercise‐induced hypoperfusion and ischaemic . Glutamine and bovine colostrum have been proposed to enhance the expression of heat shock proteins (ie, proteins that protect cellular membrane under period of stress), which may protect the intestinal enterocytes, reduce intestinal permeability, and attenuate the development of local inflammatory pathways .…”

The Acute Effects of L-arginine on Hormonal and Metabolic Responses During Submaximal Exercise in Trained Cyclists

“…In animals and in some clinical populations, such as congestive heart failure, stable angina, and pulmonary hypertension, L-arginine ingestion has demonstrated positive effects on aerobic exercise performance and maximal aerobic power (VO 2max ; Maxwell et al, 2001;Bednarz et al, 2004;Mizuno et al, 1998;Nagaya et al, 2001;Ceremuzyński et al, 1997); however, in healthy, physically active or trained males, the research has shown either a positive effect (Bailey et al, 2010;Schaefer et al, 2002), no effect (Bescós et al, 2009;McConell et al, 2006;Sunderland et al, 2011), or a detrimental effect www.IJSNEM-Journal.com ORIGINAL RESEARCH (Buchman et al, 1999) on performance. Thus there is much controversy as to whether L-arginine supplementation can benefit aerobic endurance performance.…”