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HackTwat
03-11-2014, 01:12 PM
Insulin in History and Practice (http://www.ironmagazine.com/2013/insulin-in-history-and-practice/)



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by Mike Arnold
Progression is Inevitable
By their very nature, competitive sports provide a medium for transcending the physical accomplishments of our fellow man. In those who participate at the upper echelon of any sport, the push for physical supremacy can be all-consuming. Often, these individual are willing to go to any lengths to ensure victory. They employ the most advanced training programs, enlist the help of dietary experts, engage in intensive mental preparation, and frequently utilize performance enhancing drugs. They will use anything and everything at their disposal in order to become the best they can be, even if it means risking fame, fortune, and future participation in the sport they love.
We need not look any farther than the television set to see evidence of this. Not long ago Lance Armstrong was stripped of his 7 Tour de France titles. Several of the league’s top baseball players have been suspended and just recently, an entire nation (Haiti) was threatened with being unable to compete at the upcoming Summer Olympics if its athletes continue flopping random drug tests. The point here is not to bring attention to drug testing, but to demonstrate the unyielding commitment of these athletes to physical excellence, as they strive to rise to the top of their respective sport.

Therefore, it should come as no surprise to see insulin take up such a prominent role in competitive bodybuilding. In a sport governed by sheer size, its inclusion makes perfect sense. An ideal companion to AAS, insulin helps build additional muscle tissue at minimal out of pocket expense and according to most, has been largely responsible (along with GH) for the size explosion we witnessed during the 1990’s. Since that time, insulin’s popularity has only grown. What was once viewed as a final resort for the professional BB’r is now considered standard fare among PED users. No longer taboo, it has permeated BB’ing culture all the way down to the local level; to the point where even beginners are including it in their programs. Like it or not, insulin has made its mark and is here to stay.
How it Works
In short, BB’rs use insulin because it promotes muscle growth, increases muscle fullness, and enhances recovery ability, although the manner in which it accomplishes these things is a bit more complex than it might seem. In reality, insulin works to build muscle tissue both directly and indirectly through multiple, distinct mechanisms. Perhaps the most widely recognized of these is its ability to stimulate the uptake of both glucose and aminos acids into muscle cells. This what BB’rs commonly refer to as nutrient shuttling and it is responsible for most of the immediate effects we experience after administering an injection of insulin.
While the body can accomplish this task on its own, it is limited in the amount of insulin it can produce over a given period of time. Through the use of exogenous insulin, we are able to induce a state of hyperinsulinemia that, when in the presence of sufficient carbohydrates and aminos acids, results in an increased rate if of both protein synthesis and glycogen deposition. These effects manifest outwardly through increased muscle fullness, improved muscle recovery, and enhanced growth.
In addition to increased nutrient transport, insulin also works to build muscle tissue by inhibiting muscle protein breakdown. The body is in constant state of flux between breakdown and synthesis, as it attempts to maintain balance between these two necessary and inter-dependent processes. The more we can shift this balance in favor of synthesis, the more rapidly we can accumulate muscle tissue. While this effect is rather short-lived (with shorter acting types of insulin), it manifests quickly and continues to exert this effect as long as insulin is present.
While the majority of insulin’s growth promoting effects are mediated through indirect mechanisms, it ability to increase protein content via DNA transcription and RNA translation is the exception. However, this mechanism is not thoroughly understood, as a proportionately larger amount of research has focused on glucose and lipid metabolism. This is understandable, given the common and potentially life-threatening conditions associated with some of these physiological processes (e.g. diabetes).
Lastly, insulin directly increases IGF-1 bioavailability by reducing IGFBP (insulin growth factor binding protein) concentrations. In the same way that free testosterone is regulated by SHBG, free IGF-1 is also regulated by binding proteins; six of them, to be exact (IGFBP-1 to IGFBP-6). The good news is that insulin inhibits the production of both IGFBP-1 and IGFBP-2. Therefore, chronically elevated insulin levels may lead to a reduction of circulating IGFBP-1 and IGFBP-2 concentrations, consequently increasing IGF-I bioavailability.
Conflicting Advice
While there is no doubt that our understanding of this drug and its potential applications have advanced by leaps and bounds over the last 20 years, the BB’ing community’s opinions on how to best use this drug to build muscle still vary substantially. If anything, I would say that we are even further away from reaching an agreement than we were 2 decades ago. This is attributable to, at least in part, the hormone’s diverse range of affects on our physiology, its interactions with other hormones, and differences of opinion as to what constitutes the ideal balance of side effects to results.
We have seen many different approaches/methods employed by BB’rs over the years, with each possessing its own advantages and shortcomings. When insulin first announced its presence in the early 90’s, programs were simplistic and failed to capitalize on some of insulin’s most fundamental pathways for enhancing muscle growth. As with any new PED, it takes some time to figure out the best way to use it and with Humulin being the first form of biosynthetic insulin to be released to market (and the only type of insulin available at the time), real-world research was still in its infantile stages. At that time, most BB’rs were unaware of insulin’s full range of beneficial effects on protein metabolism and because of its association with diabetes, the drug was viewed almost solely as a glucose transport agent.
Because of this, most chose to administer insulin in combination with carbohydrate post-workout, while little attention was given to protein/amino acid supplementation. There was one primary criteria used for determining which carbohydrate source was used; its rate of digestion. With dextrose being the most rapidly digesting natural carb available and with the majority of people believing that simple sugars were the ideal post-workout carb, dextrose became the carb of choice for insulin using BB’rs everywhere. It was not uncommon to see some BB’rs consume as much as 150 grams of dextrose or more within a few minutes, in an attempt to facilitate maximum glycogen replenishment.
muscletech-cell-tech-osmotic-122211Shortly thereafter things began to change. Through an increased awareness of the actions of insulin within the body and the release of both fast & slow acting insulin’s, BB’rs were no longer content to follow the out-dated recommendations of the early to mid 90’s. They began openly experimenting with variables such as timing, frequency of use, and various nutrient combinations. During that time some of the more well known coaches popularized certain methods of use; a few of which I will touch on before bringing us up to the present.
One program which took a big step forward around the turn of the millennium and which was widely acceptance by both pro and amateur BB’rs alike was a method originally devised by Chad Nicholls. It involved using insulin 3X daily, but only 2 days per week for a total of 6 weekly injections. These injections were administered on a BBr’s training days; particularly when training a weaker bodypart. Chad did not like dextrose, instead preferring to have his clients consume a combination of protein, complex carbs, and simple carbs post-injection. As a result, his athletes enjoyed greater muscle fullness and enhanced protein synthesis in comparison to those who relied solely on dextrose. Chad was also one of the first gurus to address the issue of self-inflicted insulin resistance in relation to exogenous insulin use and develop a program specifically designed to stave off this deleterious effect.
As research continued to demonstrate the importance of pre and post-workout nutrition, many insulin proponents took note and began developing programs which placed greater emphasis on maximizing nutrient delivery during this critical time period. Milos Sarcev was one of the first well known coaches to expound on this idea and devise an entire training program around the use of pre/intra/post workout nutrition in conjunction with insulin.
Of course, there will always be those who subscribe to the more is better philosophy. Some have even recommended that insulin be used with every meal, 7 days per week, on a long-term basis. To the less educated this might sound like a good idea. They figure that insulin is like most other PEDs; that the more they use, the better their results will be and to a degree this is true. The positive effects of insulin are both dose & presence-dependent, but it is also true that chronic, long-term use at sufficient dosages is guaranteed to result in a barrage of physiological disturbances ranging from minor to serious. While initial results with this type of program are usually very good, such flagrant long-term disregard for the delicate feedback mechanisms in place will precipitate a chain of negative events leading to a decrease in results and a barrage of physical side effects. Fat gain, reduced Glut-4 expression, insulin resistance, and ultimately a pre-diabetic state…not to mention all the other negative effects that go along with this condition, are the eventual result.
However, this type of program can be used on a short-term basis to induce rapid gains in muscle size, while avoiding the negative effects listed above. Short bursts of about 1 week work well for this purpose…2 weeks, max, with the concomitant use of the appropriate insulin sensitizers. If one wishes to repeat this program, it should be followed by an off period of approximately equal length, during which time the use of insulin sensitizers is highly recommended.
A recently popularized method, one which has been advocated by both John Meadows (aka, “Mountain Dog”) and myself, revolves around the pre-workout use of insulin in conjunction with a detailed nutrition plan designed to flood the body with specific nutrients during the pre, intra, and post-workout windows. While John’s nutritional strategy varies slightly from my own, we are both strong advocates at using branched chain cyclic dextrins, along with some type of rapidly digesting protein, such as whey/casein hydrolysates. For those looking to limit their caloric intake, I often recommended substituting the hydrolysates for a combination of essential aminos acids and additional leucine, as this will supply the same basic building blocks in a rapidly digesting form. Another benefit of using aminos acids is a reduction in shake volume, which can be helpful for those who are not able to tolerate a large volume of liquid around their workout without becoming nauseous.
Putting it all Together
At this point you may be wondering about the best way to use insulin in order to achieve your goals, but instead of recommending a specific program I am going to provide some guidelines which will hopefully assist you in designing your own program based on your own goals, financial status, and comfort level with the drug. The following recommendations are compatible with the goal of muscle growth.
Insulin should be combined with some type of protein/aminos acids. This is absolutely essential for optimizing protein synthesis. By skipping this step, you will still be able to take advantage of insulin’s glucose transporting effects, but protein synthesis will be hindered.
Insulin should be combined with carbohydrate, particularly complex carbohydrate, as simple sugars alone do not lead to maximal glycogen restoration-muscle fullness.
Pre-workout is the single best time to administer insulin, as exercise improves insulin signaling, Glut-4 expression, and glycogen synthase activity. Therefore, any nutrients which are present at this time are more likely to be utilized for muscle growth and glycogen synthesis.
Pre-workout insulin should be combined with both pre- and post-workout protein/amino acid supplementation, as protein synthesis is increased in response to protein/amino acid supplementation during these times in comparison to the non-training period. Rapidly digesting proteins, such as whey, casein, and beef hydrolysates are an excellent choice at this time.
Pre-workout insulin should be combined with both pre- and post-workout carbohydrate supplementation, as glycogen synthesis is increased in response to carbohydrate supplementation during these times in comparison to the non-training period. Rapidly digesting complex carbs with a high molecular weight, such as Vitargo, Karbolyn, or the newer branched cyclic dextrins are an excellent choice at this time.
Supplements which depend on the presence of insulin for delivery to the target tissue (for example, creatine) should be present in the bloodstream at time insulin is active.
Insulin should be combined with growth hormone (if it is a part of your program), as insulin potentiates the anabolic actions of growth hormone.
Chronic insulin use significantly reduces Glut-4 expression leading to insulin resistance. Glut-4 is a protein responsible for the transportation of glucose & aminos into muscle cells, so if adequate Glut-4 is not present, the body cannot properly utilize the nutrients it has been provided with. The result is a diminished growth response. Signs of Glut-4 deficiency are reduced insulin pumps and hyperglycemia.
Insulin sensitizers, such as Glucophage (Metformin), help prevent/reverse insulin mediated insulin resistance. When used on-cycle, they may allow the BB’r to increase his dose and/or frequency of use while continuing to retain an acceptable degree of insulin sensitivity. Or, for the more conservative individual, insulin sensitizers can be used to help extract maximum benefit from the insulin they do use, allowing them to get better results from less.
Is Insulin right for Me?
This is a decision everyone must make for themselves. Some hold the position that insulin should be used only by professional athletes who stand to make a living from their chosen sport. Others see things differently, believing that anyone who wants to improve their physique should be entitled to the same advantages. There is also disagreement regarding how long a BB’r should be involved in the sport before turning to insulin. Some feel that that a BB’r should wait until they have achieved an advanced level of development, while others think it is fine for anyone to use, regardless of their current development.
Another issue which has been on the table over the last couple years is the danger-safety factor. While some of the dangers of this drug have certainly been exaggerated in recent years, the fact remains that insulin can (and does) kill. With so many differing viewpoints, who should we believe? Some have claimed insulin is a safe, benign drug incapable of causing any real harm and that you would have to be a complete moron to ever die from it, while others have painted it as being so dangerous that you would have to be near crazy to even contemplate using it.
While my view on this drug sits its somewhere in the middle of these two extremes, I will say the following. Proper education is an absolute prerequisite for use. The responsible user who is thoroughly educated with considerable experience is much less likely to encounter any serious problems. For these individuals, the drug is fairly safe. Still, some degree of risk will always remain, as we cannot completely discount the possibility of an accident or mistake taking place (i.e. grabbing your bottle of GH out of the fridge at night, yet failing to realize you accidentally injected Humalog instead, etc) or circumstances arising which are outside our control. These types of accidents/circumstances are rare, but they can and do happen.
When it comes to the irresponsible, uneducated individual with little to no experience, it is a completely different story. In these hands, the possibility of experiencing an adverse event rises considerably. These people have no business using insulin. There is no denying that, as a whole, our community’s views on insulin have changed drastically over the last decade. This practice, once derided by most has now been widely accepted. I suppose this is just the way it is. Bodybuilding is an extreme sport and those who are attracted to it have never been part of the play it safe crowd. Only a BB’r would look at a drug designed to keep diabetics alive and get all excited about using it on themselves. The joy of being a BB’r…I love it.
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