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POSSIBLY EFFECTIVE

• Chronic kidney disease (CKD). Oral alpha-ketoglutarate appears to improve markers of amino acid metabolism and prevent secondary hyperparathyroidism in patients with CKD on hemodialysis. Details: Several small clinical studies in patients on hemodialysis show that taking calcium alpha-ketoglutarate seems to improve biochemical markers, including blood levels of urea and phosphate, when compared with pre-treatment (5311,30784,30785). Furthermore, one small clinical study shows that taking calcium alpha-ketoglutarate 4.5 grams daily for 36 months decreases serum levels of parathyroid hormone in these patients, suggesting that calcium alpha-ketoglutarate might decrease the risk of secondary hyperparathyroidism (30785).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Aging. It is unclear if oral alpha-ketoglutarate can prevent signs and symptoms of aging. Details: A small observational study in healthy adults has found that taking a specific product (Rejuvant, Ponce De Leon Health Inc.), providing calcium alpha-ketoglutarate 2 grams and vitamin A 900 mg (males) or vitamin D 25 mg (females), daily for 4-10 months is associated with an 8-year reduction in biological age, as measured by DNA methylation testing (111124). The validity of these findings is limited by a lack of randomization and placebo control.
• Aging skin. It is unclear if topical alpha-ketoglutarate is beneficial in patients with aging skin. Details: A small clinical study in healthy Chinese females shows that applying alpha-ketoglutarate cream to the face daily for 8 weeks improves skin firmness and reduces the severity of crow's feet wrinkles, nasolabial folds, and forehead skin wrinkles when compared to baseline (111125). The validity of these findings is limited by a lack of control group.
• Athletic performance. It is unclear if oral alpha-ketoglutarate improves athletic performance. Details: A small clinical trial in adults shows that taking alpha-ketoglutarate (Evonik Rexim SAS) 0.2 grams/kg daily for 5 weeks increases exercise tolerance, power output, and muscle torque when compared with placebo (18113). Another small clinical study in middle-distance runners 14-17 years of age shows that taking a specific L-arginine alpha-ketoglutarate product (AAKG 1250 Extreme Mega Caps, Olimp Laboratories) 2.5-3.75 grams, combined with a calcium hydroxymethylbutyrate product (HMB 1250 Mega Caps, Olimp Laboratories) 2.5 grams, 3 times daily attenuates reductions in countermovement jump height during a 12-day intensive training camp when compared with placebo. Markers of muscle damage and stress were similar in both groups (106032). It is unclear if the findings from this study are due to alpha-ketoglutarate, other ingredients, or the combination.
• Bariatric surgery complications. Although there has been interest in using oral alpha-ketoglutarate for bariatric surgery complications, there is insufficient reliable information about the clinical effects of alpha-ketoglutarate for this purpose.
• Idiopathic interstitial pneumonia. Although there has been interest in using oral alpha-ketoglutarate for idiopathic interstitial pneumonia, there is insufficient reliable information about the clinical effects of alpha-ketoglutarate for this purpose.
• Inflammatory bowel disease (IBD). Although there has been interest in using oral alpha-ketoglutarate for IBD, there is insufficient reliable information about the clinical effects of alpha-ketoglutarate for this purpose.
• Ischemia-reperfusion injury. It is unclear if intravenous alpha-ketoglutarate can prevent ischemia-reperfusion injury during or after heart surgery. Details: A small clinical study in male patients undergoing heart surgery shows that intravenous administration of alpha-ketoglutarate 28 grams with blood cardioplegia reduces several markers of ischemia when compared with a control group, suggesting that alpha-ketoglutarate might prevent ischemic injury during heart surgery (5312,5313).
• Liver disease. Although there has been interest in using oral alpha-ketoglutarate for liver disease, there is insufficient reliable information about the clinical effects of alpha-ketoglutarate for this purpose.
• Osteoarthritis. Although there has been interest in using oral alpha-ketoglutarate for osteoarthritis, there is insufficient reliable information about the clinical effects of alpha-ketoglutarate for this purpose.
• Osteoporosis. Although there has been interest in using oral alpha-ketoglutarate for osteoporosis, there is insufficient reliable information about the clinical effects of alpha-ketoglutarate for this purpose.
• Rheumatoid arthritis (RA). Although there has been interest in using oral alpha-ketoglutarate for RA, there is insufficient reliable information about the clinical effects of alpha-ketoglutarate for this purpose.
• Small intestinal bacterial overgrowth (SIBO). Although there has been interest in using oral alpha-ketoglutarate for SIBO, there is insufficient reliable information about the clinical effects of alpha-ketoglutarate for this purpose.
• Tendinopathy. Oral alpha-ketoglutarate has only been evaluated in combination with other ingredients; its effect when used alone is unclear. Details: A small clinical study in patients with insertional Achilles tendinopathy shows that taking two sachets of a specific combination product (Tenosan, Agave s.r.l.), each containing methylsulfonylmethane 550 mg, arginine-L-alpha-ketoglutarate 500 mg, hydrolyzed collagen type I 300 mg, Vinitrox 125 mg, bromelain 50 mg, and vitamin C 60 mg, in addition to extracorporeal shock wave therapy (ESWT) improves pain and function when compared with ESWT alone (19321). It is unclear if these findings are due to alpha-ketoglutarate, other ingredients, or the combination. More evidence is needed to rate alpha-ketoglutarate for these uses.

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POSSIBLY EFFECTIVE

• Burns. Oral or enteral ornithine ketoglutarate administration seems to improve wound healing in patients with burn injuries. Details: In patients with burn injuries, taking ornithine ketoglutarate orally or enterally seems to improve wound healing. Doses of up to 30 grams daily for approximately 3 weeks have been evaluated, and the effectiveness of treatment has been compared with protein or maltodextrin controls (2443,67446,67447,67452).
• Wound healing. Oral or enteral ornithine ketoglutarate administration seems to reduce the time to wound healing and scar formation and the rate of complications in patients undergoing major surgery. Details: A small clinical study in females who are overweight and are undergoing major plastic surgery shows that taking a specific brand of ornithine ketoglutarate (Cetornan) 10 grams daily, beginning 5 days before and continuing until 10 days after surgery, improves healing time by an average of 8 days and reduces complications when compared with placebo (67456). Other preliminary clinical research in patients undergoing surgery for oropharynx cancer suggests that enteral administration of ornithine ketoglutarate 20 grams daily for one month after surgery reduces the time needed for wound healing and scar formation, as well as the number of infections (67474).

INSUFFICIENT RELIABLE EVIDENCE to RATE

• Chemotherapy-induced nausea and vomiting (CINV). It is unclear if intravenous ornithine ketoglutarate is beneficial for CINV in patients receiving highly emetogenic chemotherapy. Details: A small clinical study in patients receiving chemotherapy with cisplatin and/or doxorubicin suggests that intravenous infusion of ornithine ketoglutarate 10 grams/m², starting 15 minutes prior to a single chemotherapy treatment and continuing for a total of 60 minutes, is as effective as metoclopramide 2 mg/kg for reducing the severity of nausea and vomiting (67476).
• Child growth. It is unclear if oral ornithine ketoglutarate is beneficial for growth in short-statured, prepubescent children. Details: A small clinical study in short-statured children born at normal weight and aged 2-12 years shows that taking ornithine ketoglutarate 4 grams three times weekly for one year does not improve growth rate when compared with placebo (67467).
• Hepatic encephalopathy. It is unclear if intravenous ornithine ketoglutarate is beneficial in patients with hepatic encephalopathy. Details: A small clinical study in patients with coma and acute or chronic liver disease shows that administering intravenous ornithine ketoglutarate does not improve encephalopathy when compared with dextrose control (2449).
• HIV/AIDS. It is unclear if oral ornithine ketoglutarate is beneficial in patients with HIV. Details: A small clinical study in patients with HIV suggests that taking ornithine ketoglutarate 10 grams daily for 12 weeks does not improve viral load, strength, or body mass when compared with a protein control (67449).
• Postoperative muscle loss. It is unclear if supplementing total parenteral nutrition with ornithine ketoglutarate is beneficial for the prevention of muscle loss after surgery. Details: Small clinical studies in patients undergoing elective abdominal surgery or total hip replacement show that receiving total parenteral nutrition supplemented with ornithine ketoglutarate 280 or 350 mg/kg daily for 1-3 days after surgery might improve postoperative skeletal muscle protein synthesis (2446,2448).
• Pressure ulcers. It is unclear if oral ornithine ketoglutarate is beneficial in elderly patients with heel pressure ulcers. Details: A clinical study in elderly patients with heel pressure ulcers no larger than 8 cm² shows that taking ornithine ketoglutarate 10 grams daily for 6 weeks improves the absolute reduction in wound area and increases the wound closure rate when compared with placebo. Ornithine ketoglutarate was not beneficial for ulcers larger than 8 cm² (67453).
• Stroke. It is unclear if oral ornithine ketoglutarate is beneficial in patients with a recent stroke. Details: A small clinical study in patients with a recent stroke shows that administering intravenous ornithine ketoglutarate 25 grams daily for 5 days improves consciousness when compared with control. However, 5 days after cessation of therapy, this improvement is not observed (2447). More evidence is needed to rate ornithine ketoglutarate for these uses.

(Read more about ORNITHINE KETOGLUTARATE (OKG))

POSSIBLY SAFE ...when used orally and appropriately for up to 3 years (5311,18113,30784,30785,30778). When used topically for up to 8 weeks (111125). ...when used intravenously and appropriately (5308,5309,5310,5311,5312,5313).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

(Read more about ALPHA-KETOGLUTARATE (AKG))

POSSIBLY SAFE ...when used orally and appropriately. Ornithine ketoglutarate has been used with apparent safety at a dose of 10-30 grams daily for 3 weeks (2443,67446,67447,67449,67456). ...when used intravenously and appropriately. Ornithine ketoglutarate 350 mg/kg daily, added to total parenteral nutrition, has been used with apparent safety (2445,2446).

CHILDREN: POSSIBLY SAFE
when used intravenously and appropriately. Ornithine ketoglutarate 15 grams daily, added to total parenteral nutrition, has been used with apparent safety for 5 months (2444).

PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.

(Read more about ORNITHINE KETOGLUTARATE (OKG))

(Read more about ALPHA-KETOGLUTARATE (AKG))

(Read more about ORNITHINE KETOGLUTARATE (OKG))

General ...Orally, topically, and intravenously, alpha-ketoglutarate seems to be well tolerated.

(Read more about ALPHA-KETOGLUTARATE (AKG))

General ...Orally, ornithine ketoglutarate seems to be well -tolerated.
Most Common Adverse Effects:
Orally: Abdominal pain, bloating, diarrhea, nausea, and vomiting.

Dermatologic ...Orally, pruritus has occurred rarely (67466).

Gastrointestinal ...Orally, the most common adverse effects are gastrointestinal in nature, including abdominal pain, bloating, diarrhea, nausea, and vomiting (67449,67453,67466).

(Read more about ORNITHINE KETOGLUTARATE (OKG))