Ammonia inhalation for enhancing physical performance and exercise tolerance in physically active individuals and athletes: a systematic review
DOI:
https://doi.org/10.47197/retos.v68.112376Keywords:
Ammonia inhalation, ammonium, performance, sport-specific skills, strengthAbstract
Introduction: Ammonia inhalation (AI) has gained popularity among differing athletic populations and physically active individuals. However, studies have investigated the effect of AI on various aspects of physical performance and exercise tolerance and reported contradictory findings.
Objective: Therefore, the aims of the study were to examine the effects of AI on physical performance and exercise tolerance in athletes from different competition levels and physically active individuals.
Methodology: PubMed, Mendeley and Cochrane Library databases were searched for original articles in English from inception to June 2024 according to PRISMA statement. In total 750 records were found, of which eight met the inclusion criteria.
Results: These studies included 120 men and 22 women. Among the analysed physical parameters, the most commonly employed were strength and cardiorespiratory measures, level of perceived exertion, neuromuscular output and sport-specific test performance.
Discussion: Four out of the eight studies reported positive effects of AI, while no statistically significant changes in these parameters were found in three studies.
Conclusions: However, in one study examining postural stability in golfers, the use of AI led to a decrease in performance component. Only one study investigated professional athletes.
References
Adams, W. M., Hosokawa, Y., & Casa, D. J. (2016). Body-Cooling Paradigm in Sport: Maximizing Safety and Performance During Competition. Journal of Sport Rehabilitation, 25(4), 382–394. https://doi.org/10.1123/jsr.2015-0008
Ahn, H., & Ko, J. (2022). The Effect of Olfactory Inhalation on KPGA Golfers’ Putting Performance, Pos-tural Stability and Heart Rate. International Journal of Environmental Research and Public Health, 19(19), 12666. https://doi.org/10.3390/ijerph191912666
Alvarez-Rayón, G., García-Rodríguez, J., Martínez-Quintero, F., Escoto Ponce De León, C., & Ortega-Luyando, M. (2022). Uso de sustancias ergogénicas entre hombres mexicanos practicantes de musculación: Un estudio transversal (Use of ergogenic substances among in Mexican men that engage in weight training: a cross-sectional study). Retos, 46, 801–808. https://doi.org/10.47197/retos.v46.89712
Ardern, C. L., Büttner, F., Andrade, R., Weir, A., Ashe, M. C., Holden, S., Impellizzeri, F. M., Delahunt, E., Dijkstra, H. P., Mathieson, S., Rathleff, M. S., Reurink, G., Sherrington, C., Stamatakis, E., Vicenzino, B., Whittaker, J. L., Wright, A. A., Clarke, M., Moher, D., … Winters, M. (2022). Implementing the 27 PRISMA 2020 Statement items for systematic reviews in the sport and exercise medicine, musculoskeletal rehabilitation and sports science fields: The PERSiST (implementing Prisma in Exercise, Rehabilitation, Sport medicine and SporTs science) guidance. British Journal of Sports Medicine, 56(4), 175–195. https://doi.org/10.1136/bjsports-2021-103987
Bartolomei, S., Nigro, F., Gubellini, L., Semprini, G., Ciacci, S., Hoffman, J. R., & Merni, F. (2018). Acute Effects of Ammonia Inhalants on Strength and Power Performance in Trained Men. Journal of Strength and Conditioning Research, 32(1), 244–247. https://doi.org/10.1519/JSC.0000000000002171
Bender, J. M., & Popkin, C. A. (2024). Ammonia Inhalants: Use, Misuse, and Role in Sports Performance. Sports Health: A Multidisciplinary Approach, 16(5), 706–710. https://doi.org/10.1177/19417381231217341
Campbell, A. K., Williamson, C. E., Macgregor, L. J., & Hamilton, D. L. (2022). Elevated arousal following acute ammonia inhalation is not associated with increased neuromuscular performance. Euro-pean Journal of Sport Science, 22(9), 1391–1400. https://doi.org/10.1080/17461391.2021.1953150
Capistrán, R. F., Lever, A. P., Zorrilla, C. F., Husny, E. R., & González, A. G. (2000). Daño broncopulmonar por inhalación masiva de amoniaco. Anales Médicos de La Asociación Médica Del Centro Médico ABC, 45(3), 128–133.
Dasarathy, S., Mookerjee, R. P., Rackayova, V., Rangroo Thrane, V., Vairappan, B., Ott, P., & Rose, C. F. (2017). Ammonia toxicity: From head to toe? Metabolic Brain Disease, 32(2), 529–538. https://doi.org/10.1007/s11011-016-9938-3
Delleli, S., Ouergui, I., Ballmann, C. G., Messaoudi, H., Trabelsi, K., Ardigò, L. P., & Chtourou, H. (2023). The effects of pre-task music on exercise performance and associated psycho-physiological re-sponses: A systematic review with multilevel meta-analysis of controlled studies. Frontiers in Psychology, 14, 1293783. https://doi.org/10.3389/fpsyg.2023.1293783
Dufka, F., Galloway, G., Baggott, M., & Mendelson, J. (2009). The effects of inhaled L-methamphetamine on athletic performance while riding a stationary bike: A randomised placebo-controlled trial. British Journal of Sports Medicine, 43(11), 832–835. https://doi.org/10.1136/bjsm.2008.048348
Fuentes-Barría, H., Aguilera-Eguía, R., & González-Wong, C. (2023). Enjuagues bucales con carbohidra-tos y su uso en deportistas. Resumen de revisiones sistemáticas (Carbohydrate mouthwashes and their use in athletes. Overview of systematic reviews). Retos, 47, 842–846. https://doi.org/10.47197/retos.v47.96338
Higgins, J. P. T., Altman, D. G., Gotzsche, P. C., Juni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A. C., Cochrane Bias Methods Group, & Cochrane Statistical Methods Group. (2011). The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ, 343(oct18 2), d5928–d5928. https://doi.org/10.1136/bmj.d5928
Kellmann, M., Bertollo, M., Bosquet, L., Brink, M., Coutts, A. J., Duffield, R., Erlacher, D., Halson, S. L., Hecksteden, A., Heidari, J., Kallus, K. W., Meeusen, R., Mujika, I., Robazza, C., Skorski, S., Venter, R., & Beckmann, J. (2018). Recovery and Performance in Sport: Consensus Statement. Internation-al Journal of Sports Physiology and Performance, 13(2), 240–245. https://doi.org/10.1123/ijspp.2017-0759
Kerksick, C. M., Wilborn, C. D., Roberts, M. D., Smith-Ryan, A., Kleiner, S. M., Jäger, R., Collins, R., Cooke, M., Davis, J. N., Galvan, E., Greenwood, M., Lowery, L. M., Wildman, R., Antonio, J., & Kreider, R. B. (2018). ISSN exercise & sports nutrition review update: Research & recommendations. Journal of the International Society of Sports Nutrition, 15(1), 38. https://doi.org/10.1186/s12970-018-0242-y
Maleček, J., Omcirk, D., Skálová, K., Pádecký, J., Janikov, M. T., Obrtel, M., Jonáš, M., Kolář, D., Michalička, V., Sýkora, K., Vágner, M., Přívětivý, L., Větrovský, T., Bendová, Z., Třebický, V., & Tufano, J. J. (2023). Effects of 36 hours of sleep deprivation on military-related tasks: Can ammonium in-halants maintain performance? PLOS ONE, 18(11), e0293804. https://doi.org/10.1371/journal.pone.0293804
Malecek, J., & Tufano, J. J. (2021). Effects of Ammonia Inhalants in Humans: A Review of the Current Literature Regarding the Benefits, Risks, and Efficacy. Strength & Conditioning Journal, 43(6), 76–86. https://doi.org/10.1519/SSC.0000000000000630
Marshall, J. M. (1982). The influence of the sympathetic nervous system on individual vessels of the microcirculation of skeletal muscle of the rat. The Journal of Physiology, 332(1), 169–186. https://doi.org/10.1113/jphysiol.1982.sp014408
McCrory, P. (2006). Smelling salts. British Journal of Sports Medicine, 40(8), 659–660. https://doi.org/10.1136/bjsm.2006.029710
Methley, A. M., Campbell, S., Chew-Graham, C., McNally, R., & Cheraghi-Sohi, S. (2014). PICO, PICOS and SPIDER: A comparison study of specificity and sensitivity in three search tools for qualitative systematic reviews. BMC Health Services Research, 14(1), 579. https://doi.org/10.1186/s12913-014-0579-0
Mujika, I. (2017). Quantification of Training and Competition Loads in Endurance Sports: Methods and Applications. International Journal of Sports Physiology and Performance, 12(s2), S2-9-S2-17. https://doi.org/10.1123/ijspp.2016-0403
Mujika, I., Halson, S., Burke, L. M., Balagué, G., & Farrow, D. (2018). An Integrated, Multifactorial Ap-proach to Periodization for Optimal Performance in Individual and Team Sports. International Journal of Sports Physiology and Performance, 13(5), 538–561. https://doi.org/10.1123/ijspp.2018-0093
Pacharra, M., Kleinbeck, S., Schäper, M., Blaszkewicz, M., Golka, K., & Van Thriel, C. (2017). Does season-al allergic rhinitis increase sensitivity to ammonia exposure? International Journal of Hygiene and Environmental Health, 220(5), 840–848. https://doi.org/10.1016/j.ijheh.2017.03.013
Panneton, W. M. (1991). Trigeminal mediation of the diving response in the muskrat. Brain Research, 560(1–2), 321–325. https://doi.org/10.1016/0006-8993(91)91251-U
Peeling, P., Binnie, M. J., Goods, P. S. R., Sim, M., & Burke, L. M. (2018). Evidence-Based Supplements for the Enhancement of Athletic Performance. International Journal of Sport Nutrition and Exer-cise Metabolism, 28(2), 178–187. https://doi.org/10.1123/ijsnem.2017-0343
Perry, B. G., Pritchard, H. J., & Barnes, M. J. (2016). Cerebrovascular, cardiovascular and strength re-sponses to acute ammonia inhalation. European Journal of Applied Physiology, 116(3), 583–592. https://doi.org/10.1007/s00421-015-3313-7
Petrova, M., Diamond, J., Schuster, B., & Dalton, P. (2008). Evaluation of Trigeminal Sensitivity to Am-monia in Asthmatics and Healthy Human Volunteers. Inhalation Toxicology, 20(12), 1085–1092. https://doi.org/10.1080/08958370802120396
Pritchard, H. J., Stannard, S. R., & Barnes, M. J. (2014). Ammonia inhalant and stimulant use among pow-erlifters: Results from an international survey. J Aust Strength Cond, 22, 52–54.
Pritchard, J. D. (2007). Ammonia Toxicological Overview. Health Protection Agency, CHAPD HQ.
Pugh, J., & Pugh, C. (2021). Neurostimulation, doping, and the spirit of sport. Neuroethics, 14(S2), 141–158. https://doi.org/10.1007/s12152-020-09435-7
Richmond, S. R., Potts, A. C., & Sherman, J. R. (2014). The impact of ammonia inhalants on strength per-formance in resistance trained males. J Exerc Physiol Online, 17(2), 60–66.
Rites, A. A., Merino-Muñoz, P., Ribeiro, F., Miarka, B., Salermo, V., Gomes, D. V., Brito, C. J., & Aedo-Muñoz, E. (2024). Effects of peppermint oil inhalation on vertical jump performance in elite young professional soccer players: A double-blinded randomized crossover study. Heliyon, 10(2), e24360. https://doi.org/10.1016/j.heliyon.2024.e24360
Rogers, R. R., Beardsley, K. G., Cumbie, P. E., & Ballmann, C. G. (2023). Ammonia Inhalants Enhance Psy-chophysiological Responses and Performance During Repeated High Intensity Exercise. Re-search Quarterly for Exercise and Sport, 94(4), 1035–1041. https://doi.org/10.1080/02701367.2022.2104447
Seoul National University, Ahn, H., Pathak, P., Panday, S. B., & Kwon, S. (2018). The Effects of Arousal Regulation through Olfactory Inhalation on Static Stability and Heart Rate. Korean Journal of Sport Psychology, 29(3), 219–227. https://doi.org/10.14385/KSSP.29.3.219
Velasquez, J. R. (2011). The Use of Ammonia Inhalants Among Athletes. Strength & Conditioning Jour-nal, 33(2), 33–35. https://doi.org/10.1519/SSC.0b013e3181fd5c9b
Vigil, J. N., Sabatini, P. L., Hill, L. C., Swain, D. P., & Branch, J. D. (2018). Ammonia Inhalation Does Not Increase Deadlift 1-Repetition Maximum in College-Aged Male and Female Weight Lifters. Jour-nal of Strength and Conditioning Research, 32(12), 3383–3388. https://doi.org/10.1519/JSC.0000000000001854
Widdicombe, J., & Lee, L. Y. (2001). Airway reflexes, autonomic function, and cardiovascular responses. Environmental Health Perspectives, 109(suppl 4), 579–584. https://doi.org/10.1289/ehp.01109s4579
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Copyright (c) 2025 Eduard Bezuglov, Evgeniy Achkasov, Timur Vakhidov, Elizaveta Kapralova, Georgiy Malyakin, Evgeniy Lebedenko, Vladimir Frolov, Mikhail Butovskiy; Omid Etemad Arroyo

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