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Branched Chain Amino Acids (BCAAs)

En Español (Spanish Version)

Supplement Forms/Alternate Names:

BCAAs or Leucine, Isoleucine, and Valine (Separately)

Principal Proposed Uses

Amyotrophic Lateral Sclerosis (ALS, Lou Gehrig's Disease); Loss of Appetite (in people with Cancer)

Other Proposed Uses

Muscular Dystrophy; Recovery From Surgery; Recovery From Traumatic Brain Injury; Severe Liver Disease, such as Cirrhosis; Sports and Fitness Support: Enhancing Performance; Sports and Fitness Support: Enhancing Recovery; Tardive Dyskinesia

Branched-chain amino acids (BCAAs) are naturally occurring molecules (leucine, isoleucine, and valine) that the body uses to build proteins. The term "branched chain" refers to the molecular structure of these particular amino acids. Muscles have a particularly high content of BCAAs.

For reasons that are not entirely clear, BCAA supplements may improve appetite in cancer patients and slow the progression of amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease, a terrible condition that leads to degeneration of nerves, atrophy of the muscles, and eventual death).

BCAAs have also been proposed as a supplement to boost athletic performance.

Requirements/Sources

Dietary protein usually provides all the BCAAs you need. However, physical stress and injury can increase your need for BCAAs to repair damage, so supplementation may be helpful.

BCAAs are present in all protein-containing foods, but the best sources are red meat and dairy products. Chicken, fish, and eggs are excellent sources as well. Whey protein and egg protein supplements are another way to ensure you're getting enough BCAAs. Supplements may contain all three BCAAs together or simply individual BCAAs.

Therapeutic Dosages

The typical dosage of BCAAs is 1 g to 5 g daily.

Therapeutic Uses

Preliminary evidence suggests that BCAAs may improve appetite in people undergoing treatment for cancer.1 There is also some evidence that BCAA supplements may reduce symptoms of amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease); however, not all studies have had positive results.2-5

Preliminary evidence from a series of small studies suggests that BCAAs might decrease symptoms of tardive dyskinesia, a movement disorder caused by long-term usage of antipsychotic drugs.6,25-26 BCAAs have also shown a bit of promise for enhancing recovery from traumatic brain injury.29

Because of how they are metabolized in the body, BCAAs might be helpful for individuals with severe liver disease (such as cirrhosis).7,30,33

BCAAs have also been tried for aiding muscle recovery after bedrest, such as following surgery.24

Although there is a little supportive evidence, on balance, current research does not indicate that BCAAs are effective as a for enhancing sports performance.8-15,27,31 One preliminary study hints that BCAAs might aid recovery from long distance running.32

BCAAs have also as yet failed to prove effective for muscular dystrophy.16

What Is the Scientific Evidence for Branched Chain Amino Acids?

Appetite in Cancer Patients

A double-blind study tested BCAAs on 28 people with cancer who had lost their appetites due to either the disease itself or its treatment.17 Appetite improved in 55% of those taking BCAAs (4.8 g daily) compared to only 16% of those who took placebo.

Amyotrophic Lateral Sclerosis (Lou Gehrig's Disease)

A small double-blind study found evidence that BCAAs might help protect muscle strength in people with Lou Gehrig's disease.18 Eighteen individuals were given either BCAAs (taken 4 times daily between meals) or placebo and followed for 1 year. The results showed that people taking BCAAs declined much more slowly than those receiving placebo. In the placebo group, 5 of 9 participants lost their ability to walk, 2 died, and another required a respirator. Only 1 of the 9 participants receiving BCAAs became unable to walk during the study period. This study is too small to give conclusive evidence, but it does suggest that BCAAs might be helpful for this disease.

However, other studies found no effect,19,20 and one actually found a slight increase in deaths during the study period among those treated with BCAAs compared to placebo.21

Muscular Dystrophy

One double-blind, placebo-controlled study found leucine (one of the amino acids in BCAAs) ineffective at the dose of 0.2 g per kilogram body weight (for example, 15 g daily for a 75-kilogram woman) in 96 individuals with muscular dystrophy.22 Over the course of 1 year, no differences were seen between the effects of leucine and placebo.

Safety Issues

BCAAs are believed to be safe; when taken in excess, they are simply converted into other amino acids. However, like other amino acids, BCAAs may interfere with medications for Parkinson's disease.23

Interactions You Should Know About

  • If you are taking medication for Parkinson's disease (such as levodopa), BCAAs may reduce its effectiveness.
References

Cangiano C, Laviano A, Meguid MM, et al. Effects of administration of oral branched-chain amino acids on anorexia and caloric intake in cancer patients. J Natl Cancer Inst. 1996;88:550-552.

Plaitakis A, Smith J, Mandeli J, et al. Pilot trial of branched-chain aminoacids in amyotrophic lateral sclerosis. Lancet. 1988;1:1015-1018.

Testa D, Caraceni T, Fetoni V. Branched-chain amino acids in the treatment of amyotrophic lateral sclerosis. J Neurol. 1989;236:445-447.

Tandan R, Bromberg MB, Forshew D, et al. A controlled trial of amino acid therapy in amyotrophic lateral sclerosis: I. Clinical, functional, and maximum isometric torque data. Neurology. 1996;47:1220-1226.

[No authors listed]. Branched-chain amino acids and amyotrophic lateral sclerosis: a treatment failure? Italian ALS Study Group. Neurology. 1993;43:2466-2470.

Richardson MA, Bevans ML, Weber JB, et al. Branched chain amino acids decrease tardive dyskinesia symptoms. Psychopharmacology (Berl). 1999;143:358-364.

Marchesini G, Bianchi G, Rossi B, et al. Nutritional treatment with branched-chain amino acids in advanced liver cirrhosis. J Gastroenterol. 2000;35(suppl):7-12.

Kelly GS. Sports nutrition: a review of selected nutritional supplements for bodybuilders and strength athletes. Alt Med Rev. 1997;2:184-201.

Bigard AX, Lavier P, Ullmann L, et al. Branched-chain amino acid supplementation during repeated prolonged skiing exercises at altitude. Int J Sport Nutr. 1996;6:295-306.

Struder HK, Hollmann W, Platen P, et al. Influence of paroxetine, branched-chain amino acids and tyrosine on neuroendocrine system responses and fatigue in humans. Horm Metab Res. 1998;30:188-194.

Davis JM, Welsh RS, De Volve KL, et al. Effects of branched-chain amino acids and carbohydrate on fatigue during intermittent, high-intensity running. Int J Sports Med. 1999;20:309-314.

Mero A. Leucine supplementation and intensive training. Sports Med. 1999;27:347-358.

van Hall G, Raaymakers JS, Saris WH, et al. Ingestion of branched-chain amino acids and tryptophan during sustained exercise in man: failure to affect performance. J Physiol (Lond). 1995;486:789-794.

Williams MH. Facts and fallacies of purported ergogenic amino acid supplements. Clin Sports Med. 1999;18:633-649.

Wagenmakers AJ. Amino acid supplements to improve athletic performance. Curr Opin Clin Nutr Metab Care. 1999;2:539-544.

Mendell JR, Griggs RC, Moxley RT III, et al. Clinical investigation in Duchenne muscular dystrophy: IV. Double-blind controlled trial of leucine. Muscle Nerve. 1984;7:535-541.

Cangiano C, Laviano A, Meguid MM, et al. Effects of administration of oral branched-chain amino acids on anorexia and caloric intake in cancer patients. J Natl Cancer Inst. 1996;88:550-552.

Plaitakis A, Smith J, Mandeli J, et al. Pilot trial of branched-chain aminoacids in amyotrophic lateral sclerosis. Lancet. 1988;1:1015-1018.

Testa D, Caraceni T, Fetoni V. Branched-chain amino acids in the treatment of amyotrophic lateral sclerosis. J Neurol. 1989;236:445-447.

Tandan R, Bromberg MB, Forshew D, et al. A controlled trial of amino acid therapy in amyotrophic lateral sclerosis: I. Clinical, functional, and maximum isometric torque data. Neurology. 1996;47:1220-1226.

[No authors listed]. Branched-chain amino acids and amyotrophic lateral sclerosis: a treatment failure? Italian ALS Study Group. Neurology. 1993;43:2466-2470.

Mendell JR, Griggs RC, Moxley RT III, et al. Clinical investigation in Duchenne muscular dystrophy: IV. Double-blind controlled trial of leucine. Muscle Nerve. 1984;7:535-541.

Robertson DRC, Higginson I, Macklin BS, et al. The influence of protein containing meals on the pharmacokinetics of levodopa in healthy volunteers. Br J Clin Pharmacol. 1991;31:413-417.

Stein TP, Donaldson MR, Leskiw MJ, et al. Branched chain amino acid supplementation during bed rest: Effect on recovery. J Appl Physiol. 2003;94:1345-1352.

Richardson MA, Small AM, Read LL, et al. Branched chain amino acid treatment of tardive dyskinesia in children and adolescents. J Clin Psychiatry. 2004;65:92-96.

Richardson MA, Bevans ML, Read LL, et al. Efficacy of the branched-chain amino acids in the treatment of tardive dyskinesia in men. Am J Psychiatry. 2003;160:1117-1124.

Watson P, Shirreffs SM, Maughan RJ, et al. The effect of acute branched-chain amino acid supplementation on prolonged exercise capacity in a warm environment. Eur J Appl Physiol. 2004 Sep 2. [Epub ahead of print]

Crowe MJ, Weatherson JN, Bowden BF, et al. Effects of dietary leucine supplementation on exercise performance. Eur J Appl Physiol. 2005 Oct 29. [Epub ahead of print]

Aquilani R, Iadarola P, Contardi A, et al. Branched-chain amino acids enhance the cognitive recovery of patients with severe traumatic brain injury. Arch Phys Med Rehabil. 2005;86:1729-35.

Charlton M. Branched-chain amino Acid enriched supplements as therapy for liver disease. J Nutr. 2005;136:295S-298S.

Crowe MJ, Weatherson JN, Bowden BF, et al. Effects of dietary leucine supplementation on exercise performance. Eur J Appl Physiol. 2005 Oct 29 [Epub ahead of print].

Koba T, Hamada K, Sakurai M, et al. Branched-chain amino acids supplementation attenuates the accumulation of blood lactate dehydrogenase during distance running. J Sports Med Phys Fitness. 2007;47:316-322.

Kobayashi M, Ikeda K, Arase Y, et al. Inhibitory effect of branched-chain amino acid granules on progression of compensated liver cirrhosis due to hepatitis C virus. J Gastroenterol. 2008;43:63-70.

Last reviewed July 2012 by EBSCO CAM Review Board

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Copyright © EBSCO Publishing. All rights reserved.

 
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