Super Shred

Pooled across nine randomized controlled trials in 911 adults, oral (L-)carnitine produced 1.33 kg more weight loss than control (95% CI -2.09 to -0.57) and a 0.47 kg/m2 greater fall in BMI (95% CI -0.88 to -0.05). Meta-regression found the weight-loss advantage over control shrank significantly as treatment duration lengthened.⁸

A dose-response meta-analysis of 37 randomized controlled trials in 2292 adults found oral l-carnitine lowered body weight 1.21 kg and fat mass 2.08 kg versus control, with no significant effect on waist circumference or body fat percentage. The modelled maximum was near 2000 mg per day by mouth, five times the 400 mg of carnitine injected per vial; only the body-weight effect survived restriction to high-quality trials.⁹

Thirty trained men took oral salbutamol 16 mg per day or placebo across 11 weeks of supervised full-body resistance training. Lean mass rose 1.8 kg more than placebo (95% CI 0.5 to 3.1), while echocardiographic posterior, septal and relative wall thickness increased, muscle citrate synthase and 3-HAD activity fell, and time to exhaustion did not improve where placebo gained 7%. That daily oral dose is eight times this vial's albuterol.¹⁰

Nineteen female and 21 male well-trained adults inhaled 800-1600 ug salbutamol per training day across six weeks of endurance and interval training. Fat mass fell 0.8 kg versus placebo in females only (95% CI -0.5 to -1.6; sex-by-treatment p = 0.048), with no fat loss in males. Maximal oxygen uptake gains were blunted in both sexes, and quadriceps strength fell 39 N/m versus placebo in females.¹¹

Fifteen patients dependent on long-term home parenteral nutrition were randomized to 2 g choline chloride added to their parenteral feed or usual feed for 24 weeks. Liver attenuation on CT rose 13.3 versus 5.8 Hounsfield units at four weeks and serum ALT and AST fell versus placebo; steatosis recurred 10 weeks after choline stopped. That daily amount is roughly twenty times the vial's whole 100 mg MIC blend.⁵

The only pooled inositol evidence is off-target for fat loss: across nine randomized trials in 612 women with polycystic ovary syndrome, oral myo-inositol at doses the review did not standardise lowered triglycerides more than metformin (SMD -0.49, 95% CI -0.74 to -0.24) and caused fewer adverse events (RR 0.14). The comparator was metformin rather than placebo, and no difference appeared in testosterone or sex-hormone binding globulin.¹²

In a randomized placebo-controlled crossover in 12 trained men, six 4 mg oral doses of salbutamol raised the myofibrillar fractional synthesis rate over placebo after quadriceps resistance exercise (0.079 versus 0.066 %/h) and turned net leg protein balance positive, with higher Akt2 and PKA-substrate phosphorylation. Protein breakdown rose alongside synthesis, and myostatin and FoxO1 mRNA were higher than placebo.¹

In 12 healthy men given slow-release oral salbutamol or placebo without a training programme, quadriceps strength rose 12 +/- 3% from baseline by day 14 and dominant-leg hamstring strength 22 +/- 6% by day 21, while placebo did not change. Grip strength, body weight, skinfold thickness and lean body mass were unchanged in both groups, and non-dominant hamstring strength returned to baseline.¹³

Pooling five randomized placebo-controlled trials in 121 resistance-trained men, oral adenosine triphosphate at 400 mg per day increased maximal strength over placebo (mean difference 8.13 kg, 95% CI 3.36 to 12.90), with no advantage for maximum repetitions or peak anaerobic power. Every reviewed protocol was oral, in trained men only, at eight times the 50 mg of ATP in one vial.¹⁴