Healthy Living Heart-Healthy

In a hurry to boost your workout? Don’t do this.

Heart rhythm specialist and cardiac electrophysiologist Dr. Haitham Hreibe educates athletes about supplements.

We all want to get the most out of our workouts, whether that’s burning more fat, building more muscle or getting more energy.

How about a supplement that can tackle all of those things?

Sounds too good to be true? You might be right.

“The fact is, the amount of epinephrine and norepinephrine excreted by the body during exercise far exceed the effect of many of these supplements,” said Dr. Haitham Hreibe, a heart rhythm specialist and cardiac electrophysiologist at Augusta University Health. “Some could even precipitate a health episode, such as atrial fibrillation, if you have an underlying condition.”

The promise of supplements

The labels are big, bold and bright: Explosive energy! Dialed-in focus! Utilize fat for fuel!

But look a little closer and you’ll see a list of ingredients that offer both positives and negatives. A few of the most common include:


What is it: This amino acid is found in seafood and meat. It’s converted then stored in the muscles, where it’s used for energy.

Pros: It’s commonly used to boost muscle mass, strength and performance. National Institutes of Health studies have found some very limited benefit during exercises of short duration (less than three minutes) and variable effects during weightlifting.

Cons: Although it’s recognized as safe, high doses could damage the kidneys, liver or heart, especially if you already have a history of kidney disease, diabetes or other conditions. It can also cause symptoms like cramping, nausea and diarrhea, dizziness, dehydration, weight gain and water retention, heat intolerance and fever.


What is it: As most of us know, caffeine is a stimulant found in coffee, tea and some soft drinks that can help make us more alert.

Pros: Some studies have found that caffeine could provide a “physical boost” during resistance exercises, helping you to lift greater amounts of weight. Others have found that runners could see some aerobic benefit, allowing them to run harder and longer.

Cons: Some supplements contain an amount of caffeine equal to four cups of coffee—400 milligrams—which is the maximum amount recommended for adults. Add in your morning cup of joe, a sweet tea with lunch and a soda pick-me-up in the afternoon, and that supplement just nearly doubled your maximum caffeine intake. The result could be a bad headache, irritability or nervousness, stomach upset, rapid heartbeat and muscle tremors.


What is it: Niacin is a B vitamin that helps turn food into energy.

Pros: Niacin has been used to help increase “good” cholesterol, but more recent studies have found that the therapy hasn’t lowered death rates from heart attack or stroke. In supplements, it can cause skin flushing, which is often marketed as increasing blood flow and, as a result, improving workouts.

Cons: High doses, such as 2,000 to 6,000 mg in a day, could cause severe skin flushing and dizziness, rapid heartbeat, nausea and vomiting, abdominal pain and diarrhea, even liver damage.

Supplements and you

If you’re young and healthy, taking pre-workout supplements are generally safe. “It’s not going to put a strain on your system,” said Hreibe, “although caffeine supplements might give you a headache or cause your blood pressure to go up. And they won’t cause you to develop a heart condition. I’m just not sure if there are any real benefits.”

Still, anyone with a heart condition would do well to steer clear of supplements that include stimulants like caffeine. This includes anyone with atrial fibrillation or other heart rhythm problems, congestive heart failure or coronary artery disease. “Anything that raises the blood pressure and increases the heart rate without increasing the aerobic metabolism of the heart could be harmful,” said Hreibe.

If you have a heart condition, instead of using supplements, boost your workout with real food, like whole-grain toast spread with peanut butter, a protein smoothie with milk, protein powder and fruit, or oatmeal with nuts and sliced banana. Then exercise, with all the heart-healthy benefits that it offers, without supplementation.

“Just exercising increases oxygen levels and conditions muscles, not in an artificial way as is done with supplements,” said Hreibe.

Exercise is good for the heart.

To find out what makes Augusta University Cardiovascular Center for Heart Care the premier heart and vascular center in the area, call us at 706-664-0584 to request a same-day appointment. Ask about our convenient locations so you can access care close to home. Or visit to learn about our heart rhythm services and providers.

About the author

Augusta University Health

Based in Augusta, Georgia, Augusta University Health is a world-class health care network, offering the most comprehensive primary, specialty and subspecialty care in the region. Augusta University Health provides skilled, compassionate care to its patients, conducts leading-edge clinical research and fosters the medical education and training of tomorrow’s health care practitioners. Augusta University Health is a not-for-profit corporation that manages the clinical operations associated with Augusta University.