Speed Up Your Recovery with the Power of Amino Acids!
How Amino Acids Aid Recovery Post-Surgery and Post-Injury
Recovering from surgery can be a challenging and physically demanding process. The strain that surgery and injury place on the body can lead to loss of lean body mass, systemic inflammation, and delayed recovery. Recent scientific research has shown that having an energy surplus and a steady supply of amino acids can be used to offset the physical stress and energy demand caused by surgery and accelerate the recovery process.
Understanding the Role of Amino Acids in the Body
Before delving into the benefits of amino acid supplements for surgery recovery, it's important to understand their role in the body. Amino acids are the building blocks of proteins, particularly in the growth and repair of muscle tissue. More importantly, we do not use protein directly but break it down and reuse the amino acids to make our own proteins like enzymes, hormones, and neurotransmitters. We also use amino acids in key processes like detoxification in the liver.
There are three categories of amino acids: essential, conditionally essential, and non-essential. Essential amino acids need to be consumed in our diets because the body cannot make them. Conditionally essential amino acids become necessary for individuals in specific situations including illness, and stress. Non-essential amino acids can be made in our body, however, depending on our health status that may not lead to optimal levels for health.
The Physiological Processes Behind Muscle Loss
The processes leading to muscle loss involve a scenario where muscle protein breakdown surpasses muscle protein synthesis. Essentially, the body dismantles muscle proteins quicker than it can replenish them - a state of catabolism, culminating in a net loss of muscle.
Various factors increase the likelihood of finding ourselves in a catabolic state, including the release of stress hormones during injury recovery, a calorie deficit due to loss of appetite, and the inflammatory process of recovery.
While local inflammation is needed for healing post-surgery or injury, chronic inflammation impedes tissue repair and exacerbates muscle loss. Hence ensuring sufficient resources is the key to avoiding a chronic state of inflammation and catabolism.
Scientific Evidence
Numerous studies have explored preserving lean body mass post-surgery, focusing on protein breakdown, amino acid oxidation, hormone manipulation, and insulin stimulation. The balance of nutrients has been identified as a key element in preserving muscle mass and function.
A study published in Anesthesiology found that an infusion of amino acids in postoperative patients resulted in a positive protein balance and other beneficial metabolic effects. The amino acids suppressed protein breakdown and redirected amino acids toward protein synthesis. The study concluded that even short-term use of amino acids after surgery can inhibit protein breakdown and stimulate protein synthesis.
Another study, published in the Journal of Bone and Joint Surgery, investigated the impact of amino acids on muscle loss in patients undergoing knee replacement surgery. The study found that supplementing with essential amino acids mitigated muscle atrophy, resulting in smaller losses of muscle compared to a placebo group.
A recent paper by Tommelen et al. 2023 essentially refutes the idea that there is a limit on how much protein the body can use. One hundred grams resulted in a stronger, longer muscle-building phase than 25 grams. And we know recovery after surgery likely increases the demands by 25-50 grams per day and 500 kcal. So get your protein and amino acids!
These scientific findings support using amino acids as a valuable tool in preventing muscle loss and enhancing recovery following surgery.
Strategies for Preserving Muscle Strength and Function During Recovery
The loss of muscle mass and a decline in strength during recovery can significantly affect one's ability to resume normal activities and increase the chance of depression. In extreme cases, this can be a contributing factor to mortality rates, underscoring the importance of minimizing muscle loss to speed recovery.
A key element in muscle protein synthesis is the activation of mTOR. Leucine, one of the essential amino acids, plays a pivotal role in mTOR activation. Leucine can be considered a trigger for protein synthesis, and insufficient levels will negatively impact mTOR activation. Ensuring your amino acid supplement provides at least 3-4g of leucine per meal will promote maximum protein synthesis.
Another key challenge post-injury or post surgery is reduced appetite. If you’ve had significant tissue trauma from surgery or injury, and you are dealing with the side effects of anesthesia and pain medications it should not be surprising to find yourself in a catabolic state. This is the time to eat anything palatable, ensuring a calorie surplus to keep metabolism high, and repairing those damaged tissues by supplying the building blocks of tissue repair with a well-formulated amino acid supplement.
Amino acid therapy and exercise, are two key components of minimizing muscle loss and depression during recovery.
In addition to amino acid therapy, other strategies that can aid in preserving muscle strength and muscle function during recovery should include vitamin and mineral supplementation, resistance training, and quality sleep.
Engaging in regular exercise is crucial for stimulating the retention and rebuilding of tissue. Initially, exercise capacity may be limited, but it is essential to start with aerobic and resistance exercises as soon as possible. Aerobic exercise should aim to elevate the heart rate to 180 minus your age (see Mafetone Method) and could begin with short walks. Likewise, resistance exercise should be scaled up to rebuild strength based on instruction from your health care provider. Some injuries, like tendon and ligament repairs have very specific strengthening protocols that take months to return us to full strength.
Conclusion
Surgery recovery can be challenging, but incorporating amino acids has shown promise in mitigating muscle loss and accelerating the healing process. The addition of amino acids to your supplement regime can optimize recovery, helping individuals retain and regain muscle strength and function. Combined with exercise, proper nutrition, and sleep, amino acids can be a valuable tool in the journey to full recovery after surgery.
It’s time
Personal note:
I’ve been fighting with a shoulder injury that has gotten progressively worse since 2009.
I'll be undergoing a total shoulder replacement this coming week. It’s time, and I’m tired of not being able to do the things that make life fun. And the reality is, it isn’t going to get easier. My recovery will be faster now than at any point in the future…
The recovery timeline is 4-6 months, but in terms of regaining maximum range of motion (ROM) and strength, I've been told that could take 9-12 months. Physiotherapy doesn't begin until approximately six weeks after surgery. The road is long and patience is the key to success.
I plan to keep a record of the process and implement my version of the Lazarus Protocol (credit: Ace Johnson with the original idea and some additions by Bryan Thomas), which includes peptides, red light, CO2, ischemic preconditioning, sensory training for the area, as well as visual and vestibular drills, and of course a ton of amino acids!
Disclaimer: It is important to note that the information provided in this article is not intended as medical advice. It is always recommended to consult with a healthcare professional before making any decisions regarding medication or treatment options.
References:
Trommelen J, Betz MW, van Loon LJC. The Muscle Protein Synthetic Response to Meal Ingestion Following Resistance-Type Exercise. Sports Med. 2019 Feb;49(2):185-197. doi: 10.1007/s40279-019-01053-5. PMID: 30659499. https://pubmed.ncbi.nlm.nih.gov/30659499/
Hirsch KR, Wolfe RR, Ferrando AA. Pre- and Post-Surgical Nutrition for Preservation of Muscle Mass, Strength, and Functionality Following Orthopedic Surgery. Nutrients. 2021 May 15;13(5):1675. doi: 10.3390/nu13051675. PMID: 34063333; PMCID: PMC8156786.
Freund H, Hoover HC Jr, Atamian S, Fischer JE. Infusion of the branched chain amino acids in postoperative patients. Anticatabolic properties. Ann Surg. 1979 Jul;190(1):18-23. doi: 10.1097/00000658-197907000-00004. PMID: 464673; PMCID: PMC1344449.
Dreyer HC, Owen EC, Strycker LA, Smolkowski K, Muyskens JB, Kirkpatrick TK, Christie AD, Kuehl KS, Lantz BA, Shah SN, Mohler CG, Jewett BA. Essential Amino Acid Supplementation Mitigates Muscle Atrophy After Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial. JB JS Open Access. 2018 Jun 4;3(2):e0006. doi: 10.2106/JBJS.OA.18.00006. PMID: 30280129; PMCID: PMC6145559.
Dreyer HC, Strycker LA, Senesac HA, Hocker AD, Smolkowski K, Shah SN, Jewett BA. Essential amino acid supplementation in patients following total knee arthroplasty. J Clin Invest. 2013 Nov;123(11):4654-66. doi: 10.1172/JCI70160. Epub 2013 Oct 25. PMID: 24135139; PMCID: PMC3809795.
Muyskens JB, Foote DM, Bigot NJ, Strycker LA, Smolkowski K, Kirkpatrick TK, Lantz BA, Shah SN, Mohler CG, Jewett BA, Owen EC, Dreyer HC. Cellular and morphological changes with EAA supplementation before and after total knee arthroplasty. J Appl Physiol (1985). 2019 Aug 1;127(2):531-545. doi: 10.1152/japplphysiol.00869.2018. Epub 2019 Jul 25. PMID: 31343947; PMCID: PMC6732445.
Dreyer HC, Owen EC, Strycker LA, Smolkowski K, Muyskens JB, Kirkpatrick TK, Christie AD, Kuehl KS, Lantz BA, Shah SN, Mohler CG, Jewett BA. Essential Amino Acid Supplementation Mitigates Muscle Atrophy After Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial. JB JS Open Access. 2018 Jun 4;3(2):e0006. doi: 10.2106/JBJS.OA.18.00006. PMID: 30280129; PMCID: PMC6145559.