What You Need to Know about Performance-Enhancing Supplements

Do you want your body to be "ultra-lean, ripped, and strong?" Do you want your "skin to appear paper-thin while your muscles look incredibly hard and vascular?" These are questions that nutritional supplement manufacturers ask in order to sell the latest bodybuilding and performance-enhancing product. Athletes of all ages who are seeking a competitive edge may give in to untruthful advertising strategies. As a result, they can endanger their own health while trying to improve their physique.

There are thousands of nutritional and dietary supplements being sold today, ranging from vitamins, minerals, herbs, and amino acids. However, the Food and Drug Administration (FDA), the government agency that regulates food, drugs, and medical devices, does not test the safety or effectiveness of supplements before they are placed on the market. Consequently, when you buy a nutritional supplement, you may not get what you pay for.

"Labeling with dietary supplements is lightly and loosely regulated," said David Schardt, associate nutritionist at the Center for Science in the Public Interest, a consumer watchdog group. "The labels are often misleading, incomplete and not a good guide to using the product." Larry Bowers, professor and director of the athletic drug testing and toxicology laboratory at the Sports Medicine Drug Identification Laboratory at Indiana University Medical Center, reported that his lab tested a bottle of herbal "medicine" and made an unexpected discovery. "The outside of the bottle said it was a Chinese herbal medicine, but it turned out to be pure steroid. Since there is no regulatory oversight of these compounds and there’s no one checking to see what’s in it, it could be anything."

Not only is there a risk that the label is incorrect, but most nutritional supplements have not been tested for safety. Are there harmful long-term side effects? No one knows for sure. It takes ten to twenty years to do a complete study to determine if a product has long-term side effects. Many popular supplements have only emerged within the last few years. In truth, there are few conclusive studies that have been done on even the short-term side effects of many new products.

Here are some facts about nutritional supplements that have become popular among athletes and body builders:

Creatine

Creatine is a substance that is produced in the human body by the liver and kidneys. It is present in muscle, nerve, and sperm cells.
Supplement manufacturers claim that by increasing creatine in the diet, phosphocreatine concentration increases in muscle; thus, high energy phosphate is more readily available for energy production during muscle contraction.
A few short-term studies have been conducted (none were conducted for longer than three months) on creatine and its effects. However, the studies have resulted in different outcomes. There is no consensus that creatine use translates into increased performance, strength, muscular endurance, or lean body mass.
Creatine is obtained by eating meat. Dosages recommended by supplement manufacturers are far greater than one would be able to ingest via food, but no one knows how much is too much.
One short-term side effect of creatine supplementation that has been consistently observed is weight gain. It is believed that this gain is due to an increase in total body water.
The long-term risks from using creatine supplements have never been studied.

Androstenedione [and related compounds including Androstenediol, Norandrostenedione, and Dehydroepiandrosterone (DHEA)]

Androstenedione, androstenediol, and norandrostenedione are steroid precursors. Theoretically, they could increase testosterone production. DHEA is a hormone that the body converts to androstenedione.
Androstenedione was made popular when baseball player Mark McGuire admitted to using the supplement in 1998.
One eight-week study evaluated androstenedione supplementation in healthy men aged 19-29 years, but no changes in testosterone level, muscle size, strength, or overall body composition were observed.
No long-term studies have been conducted. However, if these substances can increase testosterone production (as the manufacturers claim), they would most likely cause the same adverse effects associated with anabolic steroids (such as hypertension, liver tumors, psychosis, aggression, etc.).
DHEA is banned by the International Olympic Committee (IOC). Androstenedione, androstenediol, and norandrostenedione are also banned by the IOC, the National Collegiate Athletic Association (NCAA), and the National Football League (NFL).

Caffeine and Ephedrine Combination

This combination is often found in "energizing" and diet supplements, and manufacturers claim it increases energy, decreases appetite, and increases metabolism without exercise.
There are many known side effects of taking the herbal product ephedrine (also known as ephedra, ma huang, epitonin, or sida cordifolia). Some of the side effects include insomnia, anxiety, irritability, nervousness, rapid heart rate, nerve damage, psychosis, stroke, memory loss, and drastic increase in blood pressure. The potential for abuse is high; ephedrine-containing products are considered addictive.
When ephedrine is coupled with caffeine, which is a stimulant, the severity and frequency of adverse side effects increase.
At least 17 deaths have been linked to products that combine caffeine and ephedrine.

Everyday new products are advertised, making promises that are often too good to be true. Consumers who desperately want to look and feel better are the unsuspecting guinea pigs for these untested products. Before you decide to buy nutritional supplements, it is important to gather objective information (not from the manufacturers), and to consult with your doctor or another health professional.

The FDA Guide to Dietary Supplements: http://www.cfsan.fda.gov/~dms/fdsupp.html

The FDA has recommended tips and warnings for consumers buying nutritional supplements and medications on the Internet:

Don’t buy from sites that offer to prescribe a prescription drug for the first time without a physical exam, sell a prescription drug without a prescription, or sell drugs not approved by FDA.
Don’t do business with sites that don’t provide access to a registered pharmacist to answer questions.
Avoid sites that do not identify with whom you are dealing and do not provide a U.S. address and phone number to contact if there is a problem.
Don’t purchase from foreign websites at this time. It will most likely be illegal to import the drugs bought from these sites. The risks are greater, and there is very little the U.S. government can do if you get ripped off.
Beware of sites that advertise a "new cure" for a serious disorder or a quick cure-all for a wide range of ailments.
Be careful of sites that use impressive-sounding terminology to disguise a lack of good science or those that claim the government, the medical profession, or research scientists have conspired to suppress the product.
Steer clear of sites that include undocumented case histories claiming "amazing" results.
"Naturally occurring" and "organic" claims on a label do not mean the product is safe.
Talk to your healthcare professional before using any medications for the first time.
Check with the National Association of Boards of Pharmacy [www.nabp.net, (847) 698-6227] to determine whether a website is a licensed pharmacy in good standing.

Consumers who suspect that a site is illegal can report it to the FDA: http://www.cfsan.fda.gov/~dms/ds-rept.html