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Viagra as Diet Pill? One Day, Perhaps (nytimes.com)
52 points by youngerdryas on Jan 29, 2013 | hide | past | favorite | 47 comments


Considering the large quantities of Viagra some people are already taking on a regular basis, shouldn't any weight loss effects in humans been noticed by now?


As far as I can tell, the maximum approved daily dose of Viagra is 100mg. If a 150 lb man takes that, you're looking at about 1.5 mg/kg/day, which is an eighth of what they gave the rats in this study. If I'm reading this other study (http://informahealthcare.com/doi/abs/10.1080/004982599238687) correctly, we could probably roughly triple the equivalent dose in rats to account for their more rapid clearance of sildenafil. So we're still looking at 2-3 times a large dose for humans, taken over an extended period of time.

So we can reason right off the bat that this is an atypical use case. Glancing at experience reports on the internet, it appears pretty rare for people to exceed 100 mg doses, and even rarer for them to keep using it day after day for a week at a time. The one segment of the population we might expect to approach the level of usage tested in this study would be male porn stars. That's a group that is probably concerned more with building muscle than losing weight, so it seems unlikely that they'd be in a position to notice that particular effect.


Yeah, if you're a human male and consuming 200-300 mg of sildenafil daily, you are likely going to see other issues: both health (priapism), and social (uh, see: priapism).


There are studies of high dose chronic viagra use in patients with pulmonary arterial hupertension. The high dose groups in these studies received 240mg a day. I've had a brief look at the reported outcomes and there is no data on weightloss. This paediatric study of the same condition mentions that one patient withdrew due to weightloss: (http://m.circ.ahajournals.org/content/125/2/324.long)

Of course, these patients are quite unwell, aren't trying to lose weight, and if sildenafil made their condition better might have had a better appetite and eaten more, so it's hard to draw too many conclusions.


Maybe users ascribed weight loss to increased... activity.


This explains all the ripped 60 year olds at my gym


There's a new fad called Cenegenics which is basically a bodybuilding regimen, replete with steroids given under the rubric of "hormone replacement", for old men. They're running television ads featuring a shredded-looking 72-year-old doctor.


What's wrong with working out and supplementing your decreasing hormone levels with artificial testosterone? I may be reading your comment in the wrong light, but I think the research on health benefits here are fascinating. Once you move away from the stupidity of people juicing to get as big as Ronnie Coleman and away from the use of them by people under the age of ~40, hormone replacement is actually pretty great. Women have been taking estrogen for years and it's not frowned upon.


A few inaccuracies in your comment:

Estrogen will induce breast and uterine cancers unless it is given with progesterone. Hardly zero side-effects. It is considered proper to only administer estrogen alone to women with severe symptoms of menopause.

For the purpose of contraception, the COCP uses low levels which inhibit further hormone release by acting on the pituitary gland; it effectively simulates the state of pregnancy. Even this has risks especially for women with coagulation disorders.

With regard to your comments about men receiving hormone supplementations: the problem here is that testosterone production doesn't actually decrease as you get older. Or at least, falling testosterone seems to be the result of, and not the cause of, age and lifestyle related changes and declines.

This result was shared with my med school class by one of the principle investigators of the 2011 study in the links; I apologise for using science daily Links as I don't have access to research journals ATM

http://www.webmd.com/healthy-aging/news/20110607/testosteron...

http://www.sciencedaily.com/releases/2011/06/110607121129.ht...


Thanks for the information... It's a topic I've only briefly read about on a few occasions, so my knowledge clearly isn't too in depth.


Anyone familiar with when hormones (steroids/HgH/precursors) started being scheduled as drugs in the US?

Anyone bothered to ask why they are scheduled at all?

We spend all of this time talking about elite competitive and, frequently, professional athletes using them, WHY???

Next thing you know, they're going to "schedule" websites...

WHY?


Anabolic steroids are rife with side effects. In men they make the testes shrivel, they make you develop "bitch tits", they alter your mood and make you more aggressive. Women turn into smaller men with excessive steroid use; they develop lantern jaws, deep voices, and facial and body hair.

I suppose the side effects could be managed, but do you think your average gorilla juicehead with "bigorexia" is going to be smart about controlling when and how much he takes? Fuck no.

That is, I suppose, why they're illegal; they have costly side effects and cause a psychological dependency. I don't agree with banning them, but I can't say I approve of the way they're used by bodybuilders and competitors.


But is that a problem from using those chemicals at all, or a problem from having too much in the system?


All of these are propaganda because they represent an edge use case. Fructose is horrible for the human body in quantities almost all Americans consume it in on a normal basis.

Obesity, Insulin-Resistance, Impotency, Diabetes, Cardiac, Auto-Immune...the list goes on!

This is not the way to approach this subject. Not all hormones act on the same receptors, not all hormones are synthetic and not all hormones aromatase.


Obesity is more dangerous than (intelligent) steroid use


Not that I believe that any drugs should be prohibited by law, but to answer your question, go over to YouTube and look at the videos of people setting off the "Lunk Alarm" at Planet Fitness gyms.


You know there's plenty of people in the startup sphere who powerlift or crossfit who are perfectly well-adjusted, normal human beings right?

And perhaps those lunk alarm videos are to protest a series of ads in which powerlifters and bodybuilders are portrayed as narcissistic morons. Having lifted in one of the most serious gyms in London for both groups, I can say this is most certainly not an accurate depiction.


You know there's plenty of people in the startup sphere who powerlift or crossfit who are perfectly well-adjusted, normal human beings right?

Yeah, and those aren't the people in the videos.


The first "lunk alarm" video I ever viewed was of a West Point graduate who got tagged for his deadlift hitting the ground "too loudly". For every obnoxious video you may find, there's tens of threads in various bodybuilding and strength forums of people who were asked to leave for doing very basic and non-disruptive barbell lifts.

Even if every single lunk alarm video was as you described, it wouldn't be sufficient to paint a picture of either the bodybuilding or the strength athletics community.


Even if every single lunk alarm video was as you described, it wouldn't be sufficient to paint a picture of either the bodybuilding or the strength athletics community.

I missed the part where I tried to do that. Help me out?

The videos I'm talking about are the ones where someone sets off the lunk alarm and is politely asked to take a chill pill, and responds by trying to tear the building off of its foundation.


You aren't allowed to grunt when lifting weights at Planet Fitness? Why?

I thought it was well known that sharp breathing can increase strength for a short amount of time. Besides, sometimes when you're doing something really exhausting, you'll grunt involuntarily...


Because Planet Fitness is not a gym intended for people who strength train, that's why.

It's aimed squarely at the cardio and Zumba crowd who feel intimidated by people putting up significant weight.


The NY Times better be careful. Peter Gleason, MD, committed suicide after the FDA/DOJ destroyed his career for discussing off-label usages of prescription drugs.

http://www.justice.gov/usao/nye/pr/2006/2006apr05.html

http://online.wsj.com/article/SB1000142412788732398150457817...


Ugh. The WSJ article is behind a paywall, but from skimming the DOJ page it seems he was prescribing GHB, a drug that is considered to be safer than alcohol.

Think of the children! /s


There are aspects of GHB that are most certainly more dangerous than alcohol. It is much easier to overdose on GHB - several grams will do it. GHB is often used as a recreational drug which explains why it is a controlled substance. Combining it with alcohol can be particularly risky/fatal. I first heard of GHB, for example, in high school, because it's a common date rape drug.


Alcohol is a date rape drug. All drugs are risky, including alcohol.

We should teach our youth not that drugs are bad, but that they are powerful and can be dangerous. Use them if you will but do so wisely.



Ursolic acid (http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjourna...) show promise of similar effects, although through a different mechanism of action.

"As a result, ursolic acid increased skeletal muscle mass, fast and slow muscle fiber size, grip strength and exercise capacity. Interestingly, ursolic acid also increased brown fat, a tissue that shares developmental origins with skeletal muscle. Consistent with increased skeletal muscle and brown fat, ursolic acid increased energy expenditure, leading to reduced obesity, improved glucose tolerance and decreased hepatic steatosis."

Patrick Arnold, the creator of "The Clear" and other designer steroids used by BALCO, currently produces an ursolic acid transdermal that many people claim to have been extremely effective for weight loss.


PA is a brilliant guy that loves human performance and tinkering with the programming of the human body to make it better. HN is just a cold audience for this type of content.

Keep those noses up y'all!

edit - "...programming with the human body to optimize system performance."


Absolutely. Not only that but he regularly posts on forums and responds to e-mails, even those with the most basic of questions.

He's working on a few cognitive products that might interest HN a bit more.


What is his current email address? I just learned about Pat, but he's already my hero. His emails on USENET are hilarious.

http://en.wikipedia.org/wiki/Patrick_Arnold

"Patrick Arnold is an American organic chemist and bodybuilder known for introducing androstenedione, 1-Androstenediol, and methylhexanamine into the dietary supplement market, and for creating the designer steroid tetrahydrogestrinone, also known as THG and "the clear".[1]"

"THG, along with two other anabolic steroids that Patrick Arnold manufactured (norbolethone and desoxymethyltestosterone (DMT), were drugs at the heart of the BALCO professional sports doping scandal.[2] At the time of their creation, they were not on any banned substance list. BALCO distributed these worldwide to world class athletes from a wide variety of sports ranging from track and field to professional baseball and football."

"Arnold who is also an amateur bodybuilder, initially gained notoriety as "the Father of Prohormones."[4]"

"Arnold was sentenced to three months in prison at Federal Correctional Institution, Morgantown in West Virginia for his role in the BALCO incident.[1]"

http://patrickarnoldblog.com/homemade-steroids-making-users-...

"Patrick currently produces products for the nutritional supplement company E-pharm Nutrition, as well as for Prototype Nutrition. He continues to be perhaps the number one driving force in the advancement of performance enhancing nutritional supplementation."

"Little did people realize though that part of the credit for McGuire’s amazing year was owed to chemist Patrick Arnold and his incredible new product androstenedione (a.k.a.Andro) which McGuire used to help him smash 70 homers that season."

"A week after Arnold took his first dose of liquid mestanolone, his life began to change. At the gym, he was on fire. ... Arnold focused his efforts on a patent he came across while flipping through chemical abstracts. It came from an East German pharmaceutical company called Jenapharm, which produced most of the steroidal compounds used in the former communist nation’s athletic doping program."

"Just as Arnold suspected, norbolethone was so obscure that professional doping programs had no reference sample and thus could not detect it."

https://groups.google.com/forum/?fromgroups=#!topic/diybio/_...


Easiest way to reach him is to make a burner account on ProhormoneForum.com - he's got his own section there where he posts a few times a day.


Caleb Stone of Avant Labs is another great mind in the human performance space.

http://mindandmuscle.net/forum/

"par deus"


This is pretty interesting research but how this plays out in humans could be very different. Mice have significantly more "brown" fat than humans. I could see that playing a role in the rate of conversion. Anyone with more knowledge of the topic care to comment?


Pfizer will use this as a way to extend their patents.


Some background. In the U.S., there are several characteristics that makes a drug something that the FDA approves:

1) The actual chemical makeup of the drug 2) The dosage of the drug 3) The method of administration for the drug 4. What the drug is intended to treat

Therefore, Pfizer can get separate approvals for Viagra if they release 100 mg and 200mg doses. They get separate approvals if the drug is administered through pill or through injection. And they get separate approvals for Viagra if, in one case, Viagra is used to treat erectile dysfunction, and in the other, used to treat, say, ulcers.

So, AFAIK, Pfizer can continue making money off of Viagra for this new intended use, if the FDA approves of it. However, I believe (talking from just layman's interpretation here), that this doesn't preclude someone getting a generic approved for erectile dysfunction, after Pfizer's exclusivity period has run out for that particular intended treatment.

edit: This is a different issue than when they trivially modify the formulation of a drug in order to delay the possibility of a generic use. The regulations are a bit convoluted so take everything I wrote here with a grain of salt. But tl;dr: there's more to an "approved" product than just chemical formulation.


You are correct.

If Pfizer conducted clinical trials and got Viagra approved for a new indication, they could extend their exclusivity two different ways: either through a use patent or through market exclusivity as provide by the FDA.

However, if their patent is around the use of the drug, i.e. erectile dysfunction and that patent runs out, another company could make a generic. That company would not be able to promote the drug for the new indication, but doctors would know the two were the same and could prescribe the generic.


It really shouldn't matter too much. FDA approved indications matter for getting insurance to pay for a drug. Insurance generally doesn't pay for erectile dysfunction drugs or weight loss drugs. The only indication for Viagra (or Revatio, rather, which is the same drug with a different brand name and different indications) that insurance pays for is pulmonary arterial hypertension. Revatio is already generic in the US.

The sensible thing to do would be to just use generic Revatio whenever you want sildenafil (generic name of Viagra and Revatio), regardless of the reason you want it.


My understanding was that one of the criteria for a method-of-use extension is that the patent must not have previously been extended. Since Viagra has already been extended to 2020, I don't think it is eligible for another extension.


I wonder if the researchers at the University of Bonn were funded by Pfizer.


can't wait to see the Argaiv ads w/ the skinny actors smiling away and the low voice at the end warning us that our partners need to know about the side effects, perhaps talking just a bit slower than the normal disclaimers, and with a few more select adjectives about the side effect experience.


So a guy "fed the drug to mice for seven days" and discovered "white fat cells ... were being converted ... at a higher rate than usual."

I give this study a zero for effort. Would it have killed them to study this for longer? Where's my control group that is heavier at the end of the study?


Now, all they have to get it to do is cause tan skin and it's the trifecta.



pssst, for those of you not into nootropics... you can take artichoke extract, which also inhibits phosphodiesterase 5 (PDE5) and elevates cGMP. there are also studies showing that inhibiting this pathway can also restore cognitive function...

http://www.ncbi.nlm.nih.gov/pubmed/21627640#


This Just In: "Average content size of spam emails expected to double"


The obese male population in America is about to get a whole lot more gross




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