Hello everyone, my name is Daniel Kim. I am a physician at OSU and the head of research and development for formula AM. I do not wish to take attention away from the original purpose of this thread, which is to promote Jury Room’s happy hour, but I feel that I should take a moment to address some of the common misconceptions about formula AM that have been voiced in this thread.
However, before I do so please allow me to tell you a little bit about myself. I am originally from Cleveland but I have lived in Columbus for the past 11 years. I attended The Ohio State University as a student in the Early Admissions Pathway program and graduated with a bachelor’s degree in Biology. I then went on to graduate from medical school at The Ohio State University College of Medicine and Public Health. Currently, I am in my third year of residency at The Ohio State Medical Center and specializing in the field of Physical Medicine and Rehabilitation. I have several years of research experience, which were conducted at the James Cancer Center under the direction of Dr. Michael Caligiuri & Dr. Robert Baiocchi. I also am a published author (Blaser B.W., Roychowdhury S., Kim D.J., et al. 2005. Donor-derived IL-15 is critical for acute allogeneic graft-versus-host disease. Blood. 105(2);894-901) and have been awarded several research scholarships for my work. In developing formula AM I enlisted the help of Dr. Kyle Kent, a Ph.D. in Food Science and Nutrition, former nutrition & beverage innovation specialist at Nestle, current director of Imagination to Burn -a food and beverage development firm, and current professor of Basic Food Science at OSU.
There was a comment made that “the oxygen infused beverage fad of the late 90’s early 2000’s was killed when claims were proven unsubstantiated.” I do not know to which specific claims or specific papers the original poster is referring to but after researching the topic for over a year I have not encountered any studies that have disproved the effectiveness of oxygen infused beverages in the context of combating the toxic effects of alcohol. I have however come across several studies that are actually much to the contrary and to which I will reference in the following sections.
A second comment was made that the effectiveness of oxygen infused beverages is based on “junk science”. Again, while this may be true in the context of other applications, I can assure you that the principles that formula AM is based off are sound and have been well researched/published in several prominent peer-reviewed scientific journals that span a 40+ year period. I will expound upon these principles below.
Another comment was made that simply “taking a deep breath” would provide one with more oxygen than formula AM would. This is only true if the goal is to deliver more oxygen to the body’s peripheral tissues and organs OTHER than the liver. I will explain the reasoning behind this in the following sections.
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I’ll start with a brief primer about how the body processes alcohol. The body possesses several protective mechanisms that serve to eliminate alcohol and its toxic byproducts.
1. Gastric alcohol dehydrogenase (ADH)
2. Hepatic (liver) alcohol dehydrogenase
3. Microsomal ethanol oxidizing system (MEOS)
4. Catalase
All of the these processes, with the exception of gastric ADH, occur in the liver and require oxygen either directly as an enzymatic substrate or indirectly as an essential component of an energy producing process called the electron transport chain.
Several scientific studies have documented an increase in oxygen uptake in the livers of rats after exposure to ethanol as well as a significant decrease in the rate of ethanol elimination in environments that are low in oxygen. Additional studies have documented a significant increase in the rate of ethanol elimination in both monkeys and humans as determined by blood alcohol measurements after intravenously or enterically administered alcohol was followed by ingestion of superoxygenated fluids. Increases in the rate of ethanol elimination as high 60% have been reported. The most recent of these studies was conducted in 2010. Conversely, no measurable increase in the elimination rate of ethanol has been shown in studies where pure oxygen was administered to rats, cats, and dogs via inhalation, not ingestion. I can of course provide citations for these studies upon request.
An understanding of the basic anatomical makeup of the liver is necessary to understand why only INGESTED oxygen and not inhaled oxygen allows the liver to do its job more effectively. Basically the liver is a giant filter for blood. It is in fact the largest internal organ in the human body and for good reason. Approximately 25% of the body's total blood volume flows through it every minute, meaning the entire circulating blood volume in the average human body (~5 liters) flows through the liver every four minutes. The liver is also unique in that it receives blood from two very different sources. The first is the systemic blood supply, which most people are familiar with: the heart, which receives blood from the veins, pumps blood to the lungs, where it is oxygenated in exchange for CO2 and subsequently pumped back out to the tissues via the arteries where oxygen is again exchanged for CO2, which is carried back to the heart via the veins, and so on and so forth.
The second system is called the portal venous system. This is the key to understanding why only INGESTED oxygen, not inspired oxygen, enables your liver to process toxins, alcohol notwithstanding, more effectively. The portal venous system provides your liver with blood that comes from your gastrointestinal tract. After something is ingested it is broken down in the stomach and then transported to the intestines for further breakdown and absorption of nutrients and/or toxins via the portal venous system. Portal venous blood goes directly to the liver for filtering via a large blood vessel called the portal vein. The important thing to keep in mind here is that portal venous blood contains only a fraction of the oxygen found in systemic arterial blood. This is because the oxygen in venous blood has already been absorbed by gastrointestinal tissues in exchange for CO2. Below are the flow progression for both of the liver’s blood supplies to make things a little clearer:
1. Heart > lungs (oxygen is absorbed, CO2 is purged) > SYSTEMIC CIRCULATION peripheral tissues and internal organs including the liver (oxygen is taken up by hepatocytes [liver cells], waste products including CO2 from cellular metabolism are absorbed into the blood) > hepatic vein inferior vena cava > heart > lungs, etc.
2. Heart > lungs (oxygen is absorbed, CO2 is purged) > SYSTEMIC CIRCULATION > peripheral tissues and internal organs including the intestines (oxygen is taken up by cells in the gastrointestinal tract, waste products including CO2 from cellular metabolism are absorbed into the blood) > PORTAL VENOUS CIRCULATION > liver > hepatic vein > inferior vena cava > heart > lungs, etc.
An important distinction to make between portal venous blood and systemic arterial blood is oxygen content. Systemic arterial blood has high oxygen content (~98% saturation) because it comes directly from the lungs. The lungs do a fantastic job of extracting oxygen out of ambient air, which is only 21% oxygen, and placing it into systemic arterial blood. This point is illustrated by the fact that inhalation of pure oxygen, assuming normally functioning lungs, will have only a small effect, if any, on the oxygen content of systemic arterial blood because it is already nearly 100% saturated. Conversely, portal venous blood has low oxygen content (~75% saturation) because it comes from gastrointestinal tissues that have already absorbed oxygen in exchange for CO2. The portal venous system provides the liver with 75% of its total blood supply. The systemic system provides it with the remaining 25%. Simply put, 75% of the blood that is supplied to the liver is low in oxygen. When ingested in solution, oxygen diffuses across the brush border of the intestines, enters portal venous blood and is delivered directly to the liver. This is a phenomenon that has been well documented in medical literature. Again, I can provide citations to these studies upon request.
In regards to electrolytes, it is common medical knowledge that they are essential for normal cellular function, which in large part consists of osmotic homeostasis (maintaining the right amount of water inside and outside of a cellular membrane). Osmotic homeostasis can only be achieved if the correct proportion of sodium and potassium is maintained inside and outside of a cell. Nearly all cellular membranes in the human body contain sodium/potassium pumps that are constantly working to achieve this balance. Plasma in a healthy human body contains a specific proportion of sodium and potassium and is osmotically balanced to be the ideal environment for cells to live in. Normal saline is a synthetic fluid designed to be osmotically similar to plasma. Intravenous infusion of normal saline is a fundamental principle in rapid fluid resuscitation of a hypovolemic/dehydrated patient, usually in 500-1000cc increments. The electrolyte content of formula AM is based off of that of normal saline. formula AM therefore enables the body to rehydrate using two synergistic mechanisms; replenishment of electrolytes and augmented elimination of alcohol. It should be noted that excessive consumption of water alone can actually lead to dangerous electrolyte imbalances like hyponatremia (low sodium), which can ultimately be fatal (http://www.msnbc.msn.com/id/16614865/ns/us_news-life/t/woman-dies-after-water-drinking-contest/#.Tpuu65ua9tM).
I hope I’ve provided everyone with a better understanding of how formula AM works. I apologize for my lack of brevity. What I posted was actually the truncated version of the reasoning behind our beverage. Please know that my partners and I take formula AM very seriously and are not at all in the business of selling "snake oil" or promoting "quackery".
If anyone has any questions or would like to know more about formula AM please do not hesitate to message me or catch me in person at Jury’s Room’s Happy Hour on Wednesday! Thank you for your time. Walker and Liz, my apologies for hijacking this thread. I’ll buy each of you a round or two on Wednesday to make up for it.
-Dan
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