Paracelsus' poison

Brainy Sports Supplements or Voodoo Pseudoscience

It’s very hard to miss that a certain Famous Sports Person has been accused of taking performance enhancing drugs (and is vigorously denying the accusation), splashed as it is throughout all the news media.

While this was a welcome relief from North Korea making yet more histrionic threats of nuclear Armageddon, I was somewhat bemused to see, listed amongst the more serious drugs, that the players received “an extract from pig’s brain used to treat Alzheimer’s, the first milk from a mother cow and a bark extract”

As an Alzhemier’s researcher, I was curious to know what pig’s brain extract it was, and why an alleged anti-Alzheimer’s drug would be given to footballers in the first place. Were they in danger of losing their memories? Forgetting what the ball was for, or what those long poles represented?

It turns out the “pig’s brain extract” is cerebrolysin, a complex mixture of peptides and other substances which have neurotrophic effects. These are hormones which support the survival, development and function of nerve cells. Naturally, hormones which support the survival of nerve cells would be attractive in treating Alzheimer’s disease and vascular dementia, where the central problem is death and dysfunction of elderly nerves in the brain. But for footballers, not so much.

Clinical trials in Alzhemier’s disease shows that cerebrolysin can maintain mental functioning and delay disease progression. However cerebrolysin is about as effective as the currently used drug donepezil. As cerebrolysin has to be injected daily, there is currently no compelling reason to adopt it as a drug. There’s also some evidence that it can help in vascular dementia, although more research is needed.

Still, Alzheimer’s disease is not a significant disease of young, healthy footballers, but a disease of old age. Why would a footballer need cerebrolysin?

Cerebrolysin also has been used in experimental treatment of traumatic brain injury. Traumatic brain injury is something that footballers are likely to be exposed to. Could cerebrolysin be used to as a prophylactic to prevent or limit traumatic brain injury (TBI)?

Pilot studies indicate that people given cerebrolysin recover faster from TBI. This is encouraging, but it is too soon to start using this drug clinically. More importantly there are no studies to show that giving people cerebrolysin before TBI will help them recover or make the damage less.

This doesn’t answer the question “why give footballers cerebrolysin”, giving footballers a drug which hasn’t yet been approved before we even know if it can work as a prophylactic doesn’t seem reasonable. Even if cerebrolysin had zero side effects merely repeatedly injecting yourself has risks, risks undertaken for no good reason.

However, cerebrolysin probably wasn’t even being used for this at least plausible reason (reducing damage from TBI).

Cerebrolysin has a wide underground following for boosting mental performance, and on various body building forums* it is claimed to reduce “brain fog”. At least one newspaper report attributes cerebrolysin use to the desire to improve decision making.

There is a world of difference between slowing loss of cognitive ability in elderly people with dementia and improving mental performance in healthy young adults, and there is no research to show that young adults would benefit cognitively from cerebrolysin.

Why would anyone want to regularly inject themselves with a drug that has no evidence of effectiveness beyond anecdotal reports? Especially as placebo responses are rife in sport and the anecdotal, perceived benefits are almost certainly illusory.

Still, sports people have been known to take significant risks for any form of perceived benefit, including taking the poison strychnine to try and enhance performance, even though strychnine was useless.

Given this history, injecting pig brain extracts is one of the less harmful things sportspeople can do to themselves (cerebrolysin has very few side effects), but it suggests that the sports is particularly susceptible to voodoo treatments of no benefit.

*No, I’m not going to link to them, the body-building boards are very scary places.

UPDATE: Here’s a glossary of “Sports Science” drugs to help you navigate some of the weird and wonderful drugs and treatments out there.