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 can’t be sure that the information on the label is correct or that the product contains what it says it contains. In short, you may not get what you pay for.

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:


  • Supplement manufacturers claim that taking creatine supplements helps prevent muscles from becoming tired during workouts. In theory, this enables a person to do more challenging and longer workouts.
  • The amount of creatine in a typical supplement is many times the amount you would naturally get from food.
  • Studies on creatine have shown mixed results. There is no consensus as to whether creatine supplements actually improve muscle strength or athletic ability.
  • Creatine has some side effects. These include: dehydration, diarrhea, kidney problems, muscle cramping, and weight gain.
  • People who have kidney problems and who are taking diuretics (“water pills”) should not take creatine.
  • The long-term risks from using creatine supplements have never been studied.


[and Related Substances Including Androstenediol, Norandrostenedione, and Dehydroepiandrosterone (DHEA)]

  • Androstenedione, androstenediol, and norandrostenedione are steroid precursors–chemicals the body uses to produce steroid hormones, like testosterone. Taking supplements that contain these substances may cause short-term increases in the body’s testosterone levels, which manufacturers claim helps to increase muscle size and strength.
  • Some studies have been done on the use of these steroid-precursor supplements. Most of these studies have shown that their use does not improve strength or muscle size.
  • Studies also found that the use of these supplements may have very serious health effects, including the risk of prostate, testicular, and pancreatic cancer. They may also cause a person to become aggressive and easily angered (“‘roid rage).
  • Sale of Androstenedione as a dietary supplement is banned by the FDA.
  • These supplements may interact with many medications, especially medications for depression, bipolar disorder, and seizures.
  • It is not considered safe for children or women who are pregnant or breastfeeding to take supplements of this type.

 Caffeine and Ephedrine (Ephedra) Combination

  • These (and other stimulants) are often found in “energizing” supplements, including energy drinks and “shots,” as well as some weight-loss supplements. They are supposed to increase energy as well as decrease appetite.
  • Women who are pregnant or breastfeeding and people with high blood pressure or heart problems should not take ephedrine.
  • Ephedrine may interact dangerously with many types of medications.
  • Some people have had strokes, or gone into heart failure after taking ephedrine.
  • Ephedrine is banned by the FDA
  • Caffeine is safe in small amounts, but it may increase the effects of ephedrine and other stimulants

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 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, or call (847) 698-6227] to determine whether a website is a licensed pharmacy in good standing.

For more information, see the FDA’s Guide to Dietary Supplements: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm153239.htm

All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff.

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