OKG

Ornithine alpha-ketoglutarate (OKG)/Drug Interactions:

  • Anabolic agentsAnabolic agents: Several human and animal studies have reported that enteral administration of OKG may exhibit anabolic activity (23; 2; 5; 10; 3; 36; 19; 37). In human research, collagen synthesis increased following use of OKG (33). Theoretically, OKG may interact with anabolic agents such as steroids.
  • Antidiabetic agentsAntidiabetic agents: In human research, supplementation of OKG enterally (10; 19) or intravenously (20) increased insulin secretion. Also, according to literature review, hypoglycemia was experienced by elderly patients being treated with OKG (21). However, according to commentary on this review, hypoglycemia was lacking in the mentioned study, but the effect has been observed in participants administered high doses (20g) of OKG (22).
  • AntiretroviralsAntiretrovirals: In human research, CD4 cell count was slightly increased after 12 weeks of daily oral administration with OKG in HIV-positive patients with involuntary weight loss (23). Theoretically, OKG may interact with antiretroviral agents.
  • Dermatologic agentsDermatologic agents: In clinical research, pruritus has been reported following OKG supplementation (24). Theoretically, OKG may interact with certain dermatologic agents.
  • Gastrointestinal agentsGastrointestinal agents: In a study conducted on HIV patients, gastrointestinal side effects such as nausea, vomiting, abdominal pain, bloating, and diarrhea were reported following the use of OKG supplementation (23). Other clinical research conducted on elderly patients has reported diarrhea (24) and other gastrointestinal adverse events (25). According to secondary sources, doses greater than 5-10g may cause diarrhea and stomach cramps, and the dosage should be increased slowly to avoid digestive upset.
  • Growth hormoneGrowth hormone: In human research, OKG enteral supplementation lowered protein catabolism after injury, along with an increase in the secretion of human growth hormone secretion (19; 10).
  • HepatotoxinsHepatotoxins: Although OKG reduced plasma ammonia concentrations in some clinical research (26), patients with portal-systemic encephalopathy have deteriorated rapidly during OKG treatment, with worsened encephalographic scores, clinical grade of encephalopathy, and blood ammonia levels (11). Theoretically, OKG may interact with hepatotoxins or other agents metabolized by the liver.
  • ImmunostimulantsImmunostimulants: In human research, OKG increased CD4 cell count in HIV-positive patients experiencing involuntary weight loss (23). Theoretically, OKG may interact with immunostimulants.
  • ImmunosuppressantsImmunosuppressants: In human research, OKG increased CD4 cell count in HIV-positive patients experiencing involuntary weight loss (23). Theoretically, OKG may interact with immunosuppressants.
  • Mood stabilizersMood stabilizers: According to secondary sources, OKG may negatively affect mood. Theoretically, OKG may interact with mood-stabilizing agents.
  • Neurologic agentsNeurologic agents: In clinical research, patients with portal-systemic encephalopathy deteriorated rapidly during OKG treatment, with worsened encephalographic scores, clinical grade of encephalopathy, and blood ammonia levels (11). According to secondary sources, OKG may negatively affect mood.
  • Wound-healing agentsWound-healing agents: In clinical research, OKG supplementation reduced urinary elimination of 3-methylhistidine (3), the urinary 3-methylhistidine:creatinine ratio (2), urinary elimination of hydroxyproline (2), phenylalanine concentrations (2), and urinary elimination of retinol-binding protein (RBP) (5), and increased insulin secretion (20), indicating decreased protein catabolism and increased wound healing. Theoretically, OKG may interact with wound-healing agents.

    • Ornithine alpha-ketoglutarate (OKG)/Herb/Supplement Interactions:

  • Amino acidsAmino acids: According to clinical research, using amino acid supplements with OKG-supplemented parenteral or enteral nutrition may increase proline (10; 4; 9; 36), glutamine (10; 4), and ornithine (10). OKG supplementation has been shown to reduce phenylalanine concentrations (2).
  • Anabolic agentsAnabolic agents: Several human and animal studies have reported that enteral administration of OKG may exhibit anabolic activity (23; 2; 5; 10; 3; 36; 19; 37). In human research, collagen synthesis increased following use of OKG (33).
  • AntiretroviralsAntiretrovirals: In clinical research, CD4 cell count was slightly increased after 12 weeks of daily oral administration with OKG in HIV-positive patients with involuntary weight loss (23). Theoretically, OKG may interact with antiretroviral agents.
  • Dermatologic agentsDermatologic agents: In clinical research, pruritus has been reported following OKG supplementation (24). Theoretically, OKG may interact with certain dermatologic agents.
  • GlutamineGlutamine: According to clinical research, using amino acid supplements with OKG-supplemented parenteral or enteral nutrition may increase glutamine (10; 4).
  • Gastrointestinal agentsGastrointestinal agents: In a study conducted on HIV patients, gastrointestinal side effects such as nausea, vomiting, abdominal pain, bloating, and diarrhea were reported following the use of OKG supplementation (23). Other clinical research conducted on elderly patients has reported diarrhea (24) and other gastrointestinal adverse events (25). According to secondary sources, doses greater than 5-10g may cause diarrhea and stomach cramps, and the dosage should be increased slowly to avoid digestive upset.
  • Growth-stimulating agentsGrowth-stimulating agents: In human research, OKG enteral supplementation lowered protein catabolism after injury, along with an increase in the secretion of human growth hormone secretion (19; 10).
  • HepatotoxinsHepatotoxins: Although OKG reduced plasma ammonia concentrations in some clinical research (26), patients with portal-systemic encephalopathy have deteriorated rapidly during OKG treatment, with worsened encephalographic scores, clinical grade of encephalopathy, and blood ammonia levels (11). Theoretically, OKG may interact with hepatotoxins or other agents metabolized by the liver.
  • HypoglycemicsHypoglycemics: In human research, supplementation of OKG enterally (10; 19) or intravenously (20) increased insulin secretion. Also, according to literature review, hypoglycemia was experienced by elderly patients being treated with OKG (21). However, according to commentary on this review, hypoglycemia was lacking in the mentioned study, but the effect has been observed in participants administered high doses (20g) of OKG (22).
  • ImmunomodulatorsImmunomodulators: In human research, OKG increased CD4 cell count in HIV-positive patients experiencing involuntary weight loss (23). Theoretically, OKG may interact with immunostimulants or immunosuppressants.
  • Mood stabilizersMood stabilizers: According to secondary sources, OKG may negatively affect mood. Theoretically, OKG may interact with mood-stabilizing agents.
  • Neurologic agentsNeurologic agents: In clinical research, patients with portal-systemic encephalopathy deteriorated rapidly during OKG treatment, with worsened encephalographic scores, clinical grade of encephalopathy, and blood ammonia levels (11). According to secondary sources, OKG may negatively affect mood.
  • OrnithineOrnithine: In clinical research, using amino acid supplements with OKG-supplemented parenteral or enteral nutrition may increase ornithine (10).
  • PhenylalaninePhenylalanine: OKG supplementation has been shown to reduce phenylalanine concentrations (2).
  • ProlineProline: According to clinical research, using amino acid supplements with OKG-supplemented parenteral or enteral nutrition may increase proline (10; 4; 9; 36).
  • Wound-healing agentsWound-healing agents: In clinical research, OKG supplementation reduced urinary elimination of 3-methylhistidine (3), the urinary 3-methylhistidine:creatinine ratio (2), urinary elimination of hydroxyproline (2), phenylalanine concentrations (2), and urinary elimination of retinol-binding protein (RBP) (5), and increased insulin secretion (20), indicating decreased protein catabolism and increased wound healing. Theoretically, OKG may interact with wound-healing agents.

    • Ornithine alpha-ketoglutarate (OKG)/Food Interactions:

  • Insufficient available evidence.

    • Ornithine alpha-ketoglutarate (OKG)/Lab Interactions:

  • 3-Methylhistidine3-Methylhistidine: In clinical research, OKG supplementation reduced urinary elimination of 3-methylhistidine (3).
  • 3-Methylhistidine:creatinine ratio3-Methylhistidine:creatinine ratio: In clinical research, OKG supplementation reduced the urinary 3-methylhistidine:creatinine ratio (2).
  • AlbuminAlbumin: In cell culture research, OKG was found to increase albumin secretion in a human hepatoma cell line (HepG2) and adult rat hepatocyte cultures; it was noted that L-ornithine in OKG stimulated albumin production through polyamine synthesis (38). Several other trials have also reported increased pre-albumin levels on OKG administration in trauma patients (6), which is an indicator of improved protein metabolism. Albumin levels increased in elderly patients given OKG (33).
  • Amino acidsAmino acids: Using amino acid supplements with OKG-supplemented parenteral or enteral nutrition may increase proline (10; 4; 9; 36; 39), glutamine (10; 4; 39), ornithine (10; 39), arginine (40), and glutamate (although it decreased in hemodialysis patients) (40). OKG supplementation has been shown to reduce phenylalanine concentrations (2). According to a review, nutritional supplementation with OKG may influence muscle glutamate status (41).
  • AmmoniaAmmonia: In chronic liver patients, OKG reduced plasma ammonia concentrations (26). In separate research, OKG increased plasma ammonia in patients with portal-systemic encephalopathy (11).
  • Blood glucoseBlood glucose: In human research, supplementation of OKG enterally (10; 19; 39) or intravenously (20) increased insulin secretion. Also, according to literature review, hypoglycemia was experienced by elderly patients being treated with OKG (21). However, according to commentary on this review, hypoglycemia was lacking in the mentioned study, but the effect has been observed in participants administered high doses (20g) of OKG (22).
  • CD4 countCD4 count: In clinical research, CD4 cell count was slightly increased in patients with HIV after 12 weeks of daily oral administration of OKG (23).
  • Citric acid cycle intermediatesCitric acid cycle intermediates: In healthy exercising males, OKG had a lack of effect on citric acid cycle intermediates, including citrate, malate, fumarate, and succinate (42; 43).
  • GlycerolGlycerol: In human research, OKG decreased glycerol levels (39).
  • Growth hormoneGrowth hormone: According to human research, enteral supplementation of OKG may lower protein catabolism after injury by increasing the secretion of human growth hormone (19; 10; 39).
  • OrnithineOrnithine: In human research, OKG increased plasma ornithine levels (40).
  • Retinol-binding protein (RBP)Retinol-binding protein (RBP): In severe burn patients, OKG reduced urinary elimination of RBP (5).
  • TransthyretinTransthyretin: According to human research, OKG may increase plasma transthyretin concentrations (2; 5).