Interactions for Caffeine

Caffeine is a central nervous system stimulant drug used as an aid to stay awake, for mental alertness due to fatigue, and as an adjunct with other drugs for pain relief. Caffeine is available alone as a nonprescription drug, in combination with other nonprescription drugs, and in prescription drug combinations for relief of pain and headache.

Common names: Cafcit, Caffedrine, Enerjets, NoDoz, Quick Pep, Snap Back, Stay Alert,Vivarin Combination drugs: Anacin, Darvon Compound, Fioricet, Fiorinal

Summary of Interactions for Caffeine

In some cases, an herb or supplement may appear in more than one category, which may seem contradictory.

✓ May be Beneficial: Depletion or Calcium interference
 Avoid: Adverse interaction Ephedra Tobacco
 Check: Other Guaraná

Side effect reduction/prevention None known Supportive interaction None known

Reduced drug absorption/bioavailability None known

Interactions with Dietary Supplements

Calcium In 205 healthy postmenopausal women, caffeine consumption (three cups of coffee per day) was associated with bone loss in women with calcium intake of less than 800 mg per day.  In a group of 980 postmenopausal women, lifetime caffeine intake equal to two cups of coffee per day was associated with decreased bone density in those who did not drink at least one glass of milk daily during most of their life.  However, in 138 healthy postmenopausal women, long-term dietary caffeine (coffee) intake was not associated with bone density.3 Until more is known, postmenopausal women should limit caffeine consumption and consume a total of approximately 1,500 mg of calcium per day (from diet and supplements).

Interactions with Herbs

Guaraná (Paullinia cupana) Guaraná is a plant with a high caffeine content. Combining caffeine drug products and guaraná increases caffeine-induced side effects. Ephedra Until 2004, many herbal weight loss and quick energy products combined caffeine or caffeine-containing herbs with ephedra. This combination may lead to dangerously increased heart rate and blood pressure and should be avoided by people with heart conditions, hypertension, diabetes, or thyroid disease.

Interactions with Foods and Other Compounds

Food Caffeine is found in coffee, tea, soft drinks, and chocolate. To reduce side effects, people taking caffeine-containing drug products should limit their intake of caffeine-containing foods/beverages. Tobacco Smoking can increase caffeine metabolism, decreasing effectiveness. Smokers who use caffeine-containing drug products may require higher amounts of caffeine to achieve effectiveness.


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EPINEPHRINE (Adrenaline)

Epinephrine—also called adrenaline—is a synthetic human hormone available as an orally inhaled, nonprescription drug to relieve temporary shortness of breath, chest tightness, and wheezing due to bronchial asthma.

Epinephrine is also available as a prescription drug used by injection in emergencies, including acute asthma attacks and severe allergic reactions. Summary of Interactions for Epinephrine In some cases, an herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about
the summarized interactions.

Common names:

Adrenaline, Adrenalin, Ana-Gard, AsthmaHaler, AsthmaNefrin, Bronchaid, Bronkaid Mistometer, Bronkaid Mist,Brontin Mist, Epifin, Epinal, EpiPen, Epitrate, Eppy/N, Medihaler-Epi,Primatene Mist, S-2, Sus-Phrine


✓ May be Beneficial: Supportive Coleus*
 Avoid: Adverse interaction Caffeine

 Check: Other Magnesium
Vitamin C
Depletion or interference None known
Side effect reduction/prevention None known
Reduced drug absorption/bioavailability None known

Interactions with Dietary Supplements

Interactions with Dietary Supplements Vitamins and minerals Intravenous administration of epinephrine to human volunteers reduced plasma concentrations of vitamin C. Epinephrine and other “stress hormones” may reduce intracellular concentrations of potassium and magnesium.  Although there are no clinical studies in humans, it seems reasonable that individuals using epinephrine should consume a diet high in vitamin C, potassium, and magnesium, or should consider supplementing with these nutrients.

Interactions with Herbs Ephedra Ephedra is the plant from which the drug ephedrine was originally isolated. Epinephrine and ephedrine have similar effects and side effects.  Until 2004, ephedra— also called ma huang—was used in many herbal products, including supplements promoted for weight loss. While interactions between epinephrine and ephedra have not been reported, it seems likely that such interactions could occur. To prevent potential problems, people should not be taking both epinephrine and ephedra/ephedrine-containing products.

Coleus A test tube study demonstrated that the bronchodilating effects of salbutamol, a drug with similar actions in the lung to epinephrine, were significantly increased by the addition of forskolin, the active component of the herb Coleus forskohlii.  The results of this preliminary research suggest that the combination of forskolin and beta-agonists might provide an alternative to raising the doses of the beta-agonist drugs as they lose effectiveness. Until more is known, coleus should not be combined with epinephrine without the supervision of a doctor.

Interactions with Foods and Other Compounds


Epinephrine can increase blood pressure and heart rate.5 Caffeine, especially in large amounts, can also increase heart rate. When given with phenylpropanolamine , a drug with effects similar to epinephrine, caffeine has been shown to produce an additive increase in blood pressure. Caffeine is found in coffee, tea, soft drinks, chocolate, guaraná (Paullinia cupana), nonprescription drugs, and supplements containing caffeine or guaraná. While no interactions have been reported between epinephrine and caffeine, people using epinephrine can minimize the potential for interactions by limiting or avoiding caffeine.



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EPHEDRINE AND PSEUDOEPHEDRINE interactions with herbs.

Common names: Balminil Decongestant, Boots Child Sugar Free Decongestant Syrup, Boots Decongestant Tablets, Bronalin Decongestant Elixir, CAM, Drixoral N.D., Eltor 120, Eltor, Galpseud, Novafed, Pretz-D, Pseudofrin, Sudafed,Vick’s Vatronol

Combination drugs: Alka-Seltzer Plus, Allegra-D, Chlor-Trimeton 12 Hour, Claritin-D, Nyquil, Nyquil Hot Therapy Powder, Primatene Dual Action,Theraflu,Tylenol Allergy Sinus,Tylenol Cold,Tylenol Flu NightTime Maximum Strength Powder,Tylenol Multi-Symptom Hot Medication,Tylenol Sinus

Ephedrine and pseudoephedrine are closely related drugs with actions and side effects similar to the hormone epinephrine  (adrenaline). Ephedrine, available in prescription and nonprescription strengths, is sometimes used to dilate bronchi, making it easier for people
with asthma to breathe. Nonprescription ephedrine nose drops and spray are used to relieve nasal congestion due to the flu or hay fever. Pseudoephedrine, a nonprescription
drug taken by mouth, can also be used to relieve this symptom.

Summary of Interactions for Ephedrine and Pseudoephedrine

In some cases, an herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.

✓ May be Beneficial: Supportive Coleus*

 Avoid: Reduced drug absorption/ Tanninbioavailability containing herbs* such as green tea, black tea, uva ursi, black walnut, red raspberry, oak, and witch hazel

 Avoid: Adverse interaction Caffeine Ephedra
 Check: Other Vitamin C

Depletion or interference None known
Side effect reduction/prevention None known

Interactions with Herbs


Ephedra is the plant from which ephedrine was originally isolated. Until 2004, ephedra—also called mahuang—was used in many herbal products, including supplements promoted for weight loss. To prevent potentially serious interactions, people taking ephedrine or pseudoephedrine should avoid using ephedra-containing drug products and should read product labels carefully for ma huang or ephedra content. Native
North American ephedra, sometimes called Mormon tea, contains no ephedrine.


A test tube study demonstrated that the bronchodilating effects of salbutamol, a drug with similar actions in the lung to ephedrine, were significantly increased by the addition of forskolin, the active component of the herb Coleus forskohlii.1 The results of this preliminary research suggest that the combination of forskolin and beta-agonists (like ephedrine) might provide an alternative to raising the doses of the beta-agonist drugs as
they lose effectiveness. Until more is known, coleus should not be combined with ephedrine without the supervision of a doctor.

Tannin-containing herbs

Tannins are a group of unrelated chemicals that give plants an astringent taste. Herbs containing high amounts of tannins may interfere with the absorption of ephedrine or pseudoephedrine taken by mouth.2 Herbs containing high levels of tannins include green
tea, black tea, uva ursi (Arctostaphylos uva-ursi), black walnut (Juglans nigra), red raspberry (Rubus idaeus), oak (Quercus spp.), and witch hazel (Hamamelis virginiana).

Interactions with Foods and Other Compounds


Foods that acidify the urine may increase the elimination of ephedrine from the body, potentially reducing the action of the drug.3 Urine-acidifying foods include eggs, peanuts, meat, chicken, vitamin C (greater than 5 grams per day), wheat-containing foods, and

Foods that alkalinize the urine may slow the elimination of ephedrine from the body, potentially increasing the actions and side effects of the drug.4 Urine-alkalinizing foods include dairy products, nuts, vegetables (except corn and lentils), most fruits, and

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Reported Characteristics
Drug Class: Narcotic/Analgesic (For injection)
Average Reported Dosage: 2.5-10.0 MG (0.25-1.0 ML) every 3 hours.

The first thing the reader should consider when reading this drug profile is “what is a narcotic drug doing in a book about bodybuilding chemistry? ” And in no way, assume any good did or could come from its use. Nubain is an injectable pain-killer similar to morphine in action and effect. In fact, the activity is about the same, as is its addictive potential, milligram for milligram. This is because Nubain is a synthetic opiate agonist/antagonist. The only positive aspect of Nubain is the fact that the drug is self-leveling (agonist/antagonist) which mostly prevents potential over-dosing. Dan Duchaine (the original steroid guru) has been credited with introducing Nubain to the athletic world, though its use in sports pre-dates Dan’s commentary. Dan speculated that Nubain maybe a viable anti-cortisol/anticatabolic drug with Lipolytic (fat burning) qualities. Dan was a genius when it came to thinking outside the box. But he missed on this one. (And should not be totally blamed by those addicted to it) Bodybuilders used Nubain (the crazy ones) as an intended thermogenic, anti-catabolic, and as a means of suppressing the pain of injuries from years of balls-out training.

This may have some validity since the drug does reduce an individual’s perception of stress, and is a powerful appetite suppressant. And like any opiate, the drug allowed some reported users to train well beyond the pain barrier threshold resulting in greater muscle fiber stimulation. So a lower perception of stress would slightly reduce total cortisol production. And an appetite fall-off would reduce total calorie intake while increased training intensity would increase calorie expenditure. But the fact is that the drug is no more thermogenic or anti-catabolic than any narcotic…just far more addictive. Some have speculated that Nubain will be replaced by heroin. Don’t laugh, Nubain is scheduled for manufacturer’s discontinuance. If the reader has seen Nubain users during withdrawal, the facts speak unwell for the future.

Dan Duchaine was a very resourceful individual and, though an ass at times, supplied an answer to an urgent request for help to those he cared for. In this case, a client who suffered two prior attempts at kicking Nubain, and was ready for another try out of necessity. Dan’s answer was a drug called Ultram, which is in the same drug class as Nubain but more like the clinical answer to heroin is Methadone. The client had a bit of an attitude but suffered no diarrhea no anxiety, no fever, or coughing, or sneezing. And he stated little or no Nubain craving resulted. He is Ultram/Nubain free still.

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Proscar is a DHT inhibitor. An inhibitor usually prevents something from being
manufactured or converted, rather than simply blocking its receptor-sites. In the case of
Proscar, the drug inhibits 5-alfa reductase enzyme which is the enzyme responsible for
testosterone (nortestosterone converts to NOR-DHT) conversion to DHT
(dihydrotestosterone). As you know by now, DHT is one of the hormones associated with
accelerated balding and prostate enlargement. It is also responsible for many of the
virilizing effects from androgenic steroids. (Like it also hardens musculature)
Proscar is a prescription drug utilized for preventing hair loss. About 83% of users
reported a halt to hair loss. Unfortunately, some also report a reduced libido too. (Most
sport wooded if the wind blew during AAS cycles). Since Proscar inhibits, or atleast
reduces, the conversion of testosterones to DHT, theoretically there would be a greater
anabolic effect possible during AAS cycles. But there was an obvious loss of hardness to
the physique reported as well.

Bodybuilders who were chemically assisted did not have to be concerned with the libido

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This is a drug used to treat high blood pressure (antihypertensive). Bodybuilders
and other athletes using AAS often experience this problem due to increased water
retention and elevated blood counts. The reason this drug is included here is simple: It
raises serum levels of GROWTH HORMONE (GH) by stimulating production from the
pituitary gland. Some athletes reported taking 0.3 mg -0.15 MG on an empty stomach
both when going to bed and upon waking with a total of 0.18 mg per day, maximum.
Personally I disliked the drug due to its many negative side effects such as potency
problems, laziness, vertigo, and a few others. The use of antihypertensive drugs without a
doctor’s guidance is dangerous. Those prone to low blood pressure could die, those with
high blood pressure could miss the safe dosage and do the same.

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Reported Characteristics
Drug Class: Thiazolidinedione (Oral)
Average Reported Dosage: 2-8 MG 1-2 times daily
Water Retention: Moderate (Similar to low dose insulin use in some individuals)
High Blood Pressure: Rare

Avandia is a prescription antidiabetic drug similar in action to Glucophage (Metformin HCI) and belongs to a fairly new class of drugs called thiazolidinediones (Thigh-a-zoe-lid-een-die-owns). Medical use for Avandia is confined to treating type II diabetes. What the drug actually does is increase cell insulin receptor-site number and sensitivity. This in turn allows the body to better utilize insulin and therefore feed cells nutrients they require for repair and growth. The need for drugs such as thiazolidinediones is due to the tendency of cell insulin receptor-site number and sensitivity down-regulation realized by long term diabetic treatments. This means diabetics become resistant to insulin and their cells begin to deteriorate. In fact, insulin resistance is an underlying cause of type II diabetes. Clinical treatment for diabetes has finally begun to address drug / hormone synergy. The most elite bodybuilders polled realized that drug/hormone synergy/activity was the key to maximum growth rates.

And in the case of drugs such as Avandia, the methodology for application was multifaceted. Insulin is probably the most anabolic hormone there is. It was also noted to be highly synergistic with GH, IGF-1, PGF-2, Anabolic/Androgenic steroids, and several other growth inducing chemicals. However, maximum growth also required maximum receptor-site stimulation. (Which obviously is strongly dependant upon receptor-site number and sensitivity) There were several athletes who had hit growth plateaus due to insulin insensitivity. Sometimes this was due to over abuse of exogenous insulin during cycles and protocols. But it was more often due to either an athletes predisposition toward being a border-line diabetic or genetic limitations the endocrine system has placed upon growth. In either case, most of the elite group realized significant growth progress again by utilizing drugs like Avandia. *5-10 pounds of additional mass gain were common during a normal seasons period. Avandia is manufactured by Smith Kline Beech Pharmaceuticals and is provided as 2 MG, 4 MG, or 8 MG tablets. Athletes generally used Avandia in 12 week cycles with a progressive dosage:

Week 1-3 : 2 MG 2 times daily
Week 4-6 : 4 MG 2 times daily
Week 7-9 : 6 MG 2 times daily
Week 10-12 : 8 MG 2 times daily

According to available literature 12 weeks of continuous administration are required for Avandia to reach full effects in most individuals. A note of interest is that theoretically Avandia improved the results realized from IGF-1 use as well as insulin. This is due to the cross over stimulatory effect each of these hormones has upon the opposite receptor-sites. This may have had some positive effects upon GH use since GH converts to, and triggers IGF-1 release. Noted Comments *When athletes administered Avandia, hypoglycemia (Low blood sugar) occurred unless additional carbohydrates were ingested.

The usual ratio of carbohydrates to insulin athletes used was 10 grams of carbohydrates for each I.U. of insulin administered. However, when athletes layered Avandia (or Glucophage) into a protocol that contained insulin or pancreatic stimulators (such as Glipizide) the ratio often increased to 12-15 grams of carbohydrates for every I.U. of insulin. (*See Insulin for more information) *Failure to ingest adequate amounts of carbohydrates resulted in sweating, blurred vision, tremors, headaches, and confusion. Smarter athletes monitored their blood sugar (glucose) levels with test strips or metes.

Liver enzyme values should be checked regularly before, during and after the use of Avandia (or Glucophage) *It should be noted that additional negative side effects factually exist: Black outs, comas, and death to name a few. Insulin drugs were the most dangerous drugs utilized by athletes. FACT! Since growth induced by Insulin and IGF-1/GH use was dependent upon the hormone’s molecules merging with cell receptor-sites, it should seem apparent why Avandia was reported as quite effective for long term progress. Additionally, improved insulin sensitivity translates into an improved muscle to fat ratio body composition.


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Reported Characteristics
Drug Class: Thyroid Hormone Metabolite. (Oral)
Average Reported Dosage: 1 MG per 50 LBS of bodyweight daily.
Noted Comments: Significant stimulator of thyroid activity / suppression of thyroid
function during use.

Triacana is a trade or brand name for the thyroid drug Tiratricol. The body naturally (endogenously) produces T-4/L-thyroxine, T-3/L-triiodothyronine, and T-2 /Ldiiodothyronine. Triacana is simply a synthetic form of these three thyroid hormones natural metabolite product, Triiodothyroacetic acid, or tiratricol for short. This means the body naturally produces Triacana as a metabolic by-product of other thyroid hormones. Triacana is sold in Europe as a prescription synthetic thyroid drug intended to restore natural metabolic rate. And of course it did not take long before bodybuilders began importing the drug with anabolic/androgenic steroids into Canada and the United States. This lead to custom agents adding Triacana to drug alert list and confiscation. Interesting since the chemical itself is not a controlled substance in most of the U.S. at this time. Have no fear though, the FDA and DEA are actively pursuing reclassifying Triacana /Tiratricol/Triiodothyroacetic acid as a controlled substance there. Triacana reaches maximum effects at a daily dosage of about 1 MG per 50 LBS of bodyweight. (Daily, meaning “total”) Since the chemical possesses a 6 hour half-life, this “daily dosage” was reported to be divided into 4 equal dosages. So a 200 pound athlete required 1 MG 4 times daily. Beyond this dosage no subsequent increase in metabolic rate occurs. What many, including the FDA, fail to realize is that Triacana administration will not induce a true replacement metabolic rate like other thyroid hormones. This means any polled athlete was able to increase their metabolic rate only equivalent to the upper range considered normal and acceptable through administration. So an individual whom employed this chemical realized a metabolic rate about equal to a so-called ectomorph only. Which is, in truth, a very significant increase and considered highly effective by all but a few users. This would make Triacana one of the safer thyroid drugs. *I have not found post administration thyroid function suppression from Triacana as of yet. But it is possible if use were prolonged. Obviously someone, somewhere, will somehow find a way to be the one exception who sues and does T.V. talk shows decrying the evils of this drug. No doubt while smoking cigarettes and drinking alcohol. (Another case of a day without the lifeguard monitoring the gene pool)

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T-2 (L-diiodothyronine or 3, 5-diiodo-L-thyronine)

Drug Class: Thyroid Hormone. (Oral)
Average Reported Dosage: 150-600 MCG daily.
*Minor noted suppression of thyroid function during lower dosage short term (30-35
days) administration.

There are two well known synthetic thyroid hormones commonly administered by bodybuilders known as T-4 and T-3. (*See “Synthroid” and “Cytomel” for more info) However, some have not yet heard of another natural thyroid hormone called T-2 or Ldiiodothyronine. The good new is that it is highly active and naturally occurring in some foods such as beef products. It is also non-prescription in many countries…so far. The bad news is that since it works quite well and offers individuals freedom of choice, it probably will not be legal for long.

So far, T-2 seems to be slightly more effective for fat oxidation (burning) than either T-4 or T-3 alone while offering an improved protein sparing-like result. This may be true. T-2 stimulates cellular mitochondria (cellular energy producers) more so than the cell nucleus. This means, unlike T-4 and T-3, T-2 is less likely to activate other cellular functions and more likely to focus upon increased metabolic rate or energy expenditure. Personal experience had shown an excellent synergistic effect between T-2, Norephedrine, and ephedrine plus caffeine. This is due to an interesting interplay between the substances.

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Reported Characteristics
Drug Class: Synthetic Thyroid Hormone. (Oral)
Average Reported Dosage: 100-400 MCG daily.

Noted Comments: Significant suppression of thyroid function during use. Synthroid is a man-made synthetically manufactured version of T-4/L-thyroxine. The average person produces about 76 MCG/d of T-4/L-thyroxine which is then converted by the liver into the more active T-3/L-triiodothyronine. This is true of the oral T-4/L-thyroxine medications as well. The average conversion rate of T-4 to T-3 is about 30-33%/ MCG. Since the conversion of T-4 to T-3 is dependent upon adequate levels of since and selenium, athletes commonly increase daily intake of these minerals during synthetic T-4/L-thyroxine use. As is the case with all thyroid hormone drug use, most athletes were noted as wiser to begin at a lower dosage of 100 MCG/d and slowly progress to their chosen dosage. Daily dosages of T-4/L-thyroxine that exceed 400 MCG will not increase metabolic rate beyond what is realized at 400 + MCG/d. Dosages that were increased too rapidly or that were too high commonly resulted in diarrhea, excessive sweating, rapid heart beat, nausea, vomiting, insomnia and trembling. T-4 drugs suppress endogenous thyroid hormone production significantly. After discontinuance, most athletes experienced a metabolic lag period of 3-15 days before thyroid function rebound occurred. Interesting fact is that most monitored athletes experienced a 120-130 % increase in endogenous thyroid hormones at that point. And some maintain that level permanently. *See guggulsterones for other possibilities.

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