Supplementing Your Workout- Nick Miller, PharmD

In my second post for National Sports and Physical activity month, I will be discussing workout supplementation. Let me preface the article by saying I am not a kinesiologist, nor a nutritionist and what I will be discussing comes from the perspective of a pharmacist. I am very conservative when it comes to supplementation, and I only make recommendations for things that I would use personally or I would tell my own family to take. I am also a firm believer that good nutrition is the best supplement – whole, natural foods contain cofactors and nutrients that are not present in most pharmaceutical products. Over the counter supplements are not regulated by the Food and Drug Administration in the same way that prescription products are, so if you are going to spend your hard earned dollar on a workout supplement, make sure that it is pharmaceutical grade and from a reputable company (did you know that a lot of OTC products sold in large chains are only “food grade?” That doesn’t sound too appetizing…)

Here are the supplements that I personally take to bolster my strength training:

  1. Protein Powder – This one is one of the most important supplements that you can use to augment your workouts. Even if you are not trying to be the next Mr. Olympia, protein shakes can have beneficial effects on your physique. My personal opinion is that males need to consume at least 1 gram of protein for every kilogram of body weight, and women should consume at least 0.8 grams/kg of body weight. To find out how many kilograms you weigh, divide your weight in pounds by 2.2 and figure out your protein requirement from there. It is very important to drink a protein shake after your workout to aid your body in recovery, and I also try to drink a smaller portion before my workout to give me energy.

We all know that protein is essential to build muscle, but I recommend protein to almost everyone for an additional reason – a meal replacement! You can only get your daily calories from 3 places – carbohydrates (sugars), fats, and proteins. In a typical American diet, we eat more than our fair share of carbs and fats, so adding a protein shake as a snack or meal replacement can serve as an effective addition to your weight-loss regimen. It will help you to feel full, and keep your metabolism burning. The shakes come in great flavors, and can be mixed with plain water, or skim milk if you want it to taste extra sweet.

  1. Caffeine – As a pharmacist who is familiar with the (lack of) regulations on over the counter products in the USA, I do not use “pre-workout” blends to amp me up before my training. Some of these blends are known to contain harsh amphetamine-like stimulant compounds that can lead to cardiovascular issues down the road. I prefer to use pure, unadulterated caffeine to give me energy. I consider caffeine to be a clean and safe stimulant. You can get caffeine from coffee (150-200mg/8oz), tablets (100-200mg each) , or my personal favorite, green tea (50-75mg/8oz). I try and keep my intake below 200mg, as I want to be able to sleep at night. If you have blood pressure issues, stay away from using stimulant products of any type.
  2. Omega 3 – These fatty acids are beneficial for a myriad of different reasons, and I believe that everyone should ask their doctor if they are a candidate for omega 3 therapy. They are present in fish oil capsules, krill oil, and flax seed products. Omega 3’s, while fats themselves, help to decrease the amount of fat circulating in our bloodstream, and have been proven to be beneficial for cardiovascular, brain, and skin health. They can also help with inflammation. I recommend taking at least 1000mg of EPA + DHA omega 3 fatty acids every day. If your bottle of fish oil does not enumerate the amount of EPA and DHA on the supplement facts label, find a new brand as you are being gypped.
  3. Beta-Alanine – This amino acid is a precursor to another amino acid, carnosine. Carnosine helps to clear waste products that are produced during exercise from the muscle cells. (The root “carn” means “flesh” – carnosine is found abundantly in animal meat) Taking carnosine by itself doesn’t really work, as our body breaks it down too quickly for any therapeutic effect to be realized. Supplementing beta-alanine; therefore, allows the body to build more carnosine, and can increase workout endurance by decreasing fatigue. Beta-alanine can cause a “tingling” sensation when taken, that increases in intensity the higher the dose. I take around 3 grams of beta-alanine, and the recommended dosage range used in studies is 2-5gm (1, 2)
  4. Citrulline (L-citrulline or citrulline maleate) – As discussed above with beta-alanine, citrulline is a building-block precursor to another important amino acid, arginine. Arginine is responsible for increasing nitric oxide, a potent vasodilator. Vasodilators increase oxygen-rich blood flow to our muscles, which in turn can increase muscle performance. Be careful, as dosing is different for the two forms of this supplement. L-citrulline has been shown to be effective at doses of 2.4gm/day (3). Citrulline maleate has an additional component that can increase the the generation of energy. The doses of citrulline maleate used in the studies are 8gm/day (4).
  5. Betaine – Also known as trimethylglycine (because it has 3 methyl groups), betaine kickstarts protein synthesis and can increase muscle mass and increase fat loss. It functions as a “methyl donor” in chemical reactions at the cellular level. Methyl donors help to facilitate the formation of many important molecules, and can inactivate harmful ones (homocysteine). The dosing schedule for men looking to add muscle mass is 1.5gm before your workout, and 1.5gm afterwards.
  6. Creatine – Holding the crown as the most well known supplement in body building circles, creatine has long been used to improve athletic performance. Creatine is produced naturally in our bodies and is responsible for generating ATP (the main energy currency of our cells) Creatine has been shown to increase muscle mass and improve performance, and has been studied extensively. When anything has been studied extensively, you can be sure that you will see conflicting information. My opinion is that daily  moderate doses (3-5gm) of high-quality creatine are safe and effective to use, and and others (5, 6, 7) agree with me. However, there is information out there that shows that creatine can be harmful to the kidneys and liver, so if in doubt, ask your doctor.


  1. Derave W, Ozdemir MS, Harris R, Pottier A, Reyngoudt H, Koppo K, Wise JA, Achten E (August 9, 2007). “Beta-alanine supplementation augments muscle carnosine content and attenuates fatigue during repeated isokinetic contraction bouts in trained sprinters”. J Appl Physiol. 103 (5): 1736–43. doi:1152/japplphysiol.00397.2007PMID 17690198.
  2. Hill CA, Harris RC, Kim HJ, Harris BD, Sale C, Boobis LH, Kim CK, Wise JA (2007). “Influence of beta-alanine supplementation on skeletal muscle carnosine concentrations and high intensity cycling capacity”. Amino Acids. 32 (2): 225–33. doi:1007/s00726-006-0364-4PMID 16868650.
  3. Suzuki, T., Morita, M., Kobayashi, Y., & Kamimura, A. (2016). Oral L-citrulline supplementation enhances cycling time trial performance in healthy trained men: Double-blind randomized placebo-controlled 2-way crossover study. Journal of the International Society of Sports Nutrition, 13(1), 1
  4. Pérez-Guisado, J., & Jakeman, P. M. (2010). Citrulline malate enhances athletic anaerobic performance and relieves muscle soreness. The Journal of Strength & Conditioning Research, 24(5), 1215-1222.
  5. Bizzarini E, De Angelis L; De Angelis (December 2004). “Is the use of oral creatine supplementation safe?”. The Journal of Sports Medicine and Physical Fitness. 44 (4): 411–6. PMID 15758854.
  6. Persky, AM; Rawson, ES (2007). “Safety of creatine supplementation.”. Sub-cellular biochemistry. 46: 275–89. doi:1007/978-1-4020-6486-9_14PMID 18652082.
  7. Kim HJ, Kim CK, Carpentier A, Poortmans JR (2011). “Studies on the safety of creatine supplementation”. Amino Acids (Review). 40 (5): 1409–18. doi:10.1007/s00726-011-0878-2PMID 21399917.

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