You may read claims for sports supplements that say they can add muscle mass, make muscles work more efficiently, or improve athletic performance. Although some supplements may have these short term benefits, they may also cause short and long term health problems. For many of these drugs, researchers don’t yet know what the long term risks are of these drugs. Read more about some of these drugs and the known and unknown risks of their use.
Anabolic Steroids
These are manmade drugs that mimic male sex hormones. Steroids can help the body make muscle tissue, reduce muscle damage after exercising, and enhance male features. In the past, steroids were only used only by athletes, but in recent years, steroid use by non-athletes has become more common. Now, an increasing number of anabolic steroid users simply want to “look good” which to many people means being big and muscular. Although these drugs have medical uses, such as treating delayed puberty, some types of impotence, and wasting of the body caused by HIV infection or other diseases, when abused, anabolic steroids have these serious health consequences:
- Deepening of the voice, enlargement of the clitoris, hair loss, facial hair growth, and hormone problems in women
- Shrinkage of the testicles, problems with erections, lower sperm count, and increased breast size in men
- Mood swings and aggression
- Change in hair growth patterns
- Acne
- Change in a person’s voice
- Tears in the muscles and tendons
- In adolescence, they can cause bones to stop growing
- Raised cholesterol levels
- Cardiovascular, kidney, and liver disease
- Clotting disorders
- Tumor growth
- Cancer
- Increased risk of HIV and hepatitis (from sharing needles)
- Suicidal depression
Creatine
Creatine is a substance made by the liver and also found in certain foods, like meat. It helps release energy into the muscles. Creatine may help athletes enhance their performance by providing quick energy during high intensity exercise, like sprinting. It can also help athletes recover faster after these activities. However, Creatine may cause these health problems:
- Diarrhea
- Nausea and vomiting
- Stomach and muscle cramps
- Weight gain
- Water retention
- Dehydration
- Kidney, muscle, heart, and liver damage
Safety information about taking Creatine is lacking, and the long term effects of Creatine use are unknown. There is no government regulation of Creatine. So there is no guarantee about the purity or safety of this drug.
Ephedra (Ma Huang)
Ephedra, also called Ma Huang, is a naturally occurring substance derived from botanicals. It is a stimulant has been promoted for boosting sports performance and energy. However, ephedra can cause rapid or irregular heartbeats, high blood pressure, nerve damage, stroke, and memory loss. It has also caused death. In addition, using ephedra with caffeine, even drinking soda, can worsen its medical risks.
It may be particularly dangerous for kids and adolescents, since ephedra can impair the body’s ability to cool itself, and raise the risk for heat-related sickness during exercise. Young people don’t sweat as much as adults, so they don’t have the same ability to adjust their body temperatures while exercising.
On April 12, 2004, the Food and Drug Administration (FDA) banned the sale of dietary supplements containing ephedra. On April 14, 2005, a federal judge ruled against the FDA ban of ephedra. The judge said that ephedra is wrongly regulated by the FDA, because it is treated as a drug and not a food. With all drugs, the FDA requires the manufacturer prove the drug is safe. For other dietary supplements, which are regulated as foods, the FDA has to prove the drugs are harmful in order to ban them. Now, the FDA can’t stop the manufacturer from selling supplements containing ephedra.
Caffeine
Caffeine is a stimulant found in soda, coffee, chocolate, and other foods. There are also pills and suppositories that are made of pure caffeine. Reports have suggested that a higher dose of pure caffeine (not from a drink) before exercising improves performance during prolonged endurance exercise and short-term intense exercise.
However, most studies of caffeine have taken place in laboratories, and not real-life sports events. Side effects of caffeine include anxiety, jitters, problems focusing, stomach problems, trouble sleeping, irritability, and in high doses, heart arrhythmias and mild hallucinations.
Vitamins and Minerals
Vitamin and mineral deficiencies among athletes are uncommon. For these athletes, there is no benefit to taking vitamin and mineral supplements it will not improve athletic performance. Only athletes with a deficiency in a certain vitamin or mineral will benefit from taking a supplement. Athletes without a vitamin or mineral deficiency who take certain supplements may experience harmful health effects.
Protein and Amino Acids
Athletes can meet their protein requirements through diet alone, without taking protein or amino acid supplements. Foods such as fish, meat, eggs, and milk are rich in essential amino acids. Taking massive single doses of protein to accelerate muscle growth doesn’t work. Foods such as milk, yogurt, or an energy bar with at least 10 grams of protein can help an athlete repair muscles after a hard workout. Excessive amounts of protein could cause dehydration, stomach upset, and kidney problems.
Androstenedione (Andro)
Andro is a hormone that naturally occurs in the body. The body converts it to testosterone, which builds muscles and creates male features. Athletes use andro in strength supports, like football. However, if the body has too much androgen, it shuts down its own production of testosterone. Also, it carries many of the same risks as steroids, including stunted growth in adolescents, high blood pressure, heart and liver problems, excess body hair, and shrunken testicles.
In March 2004, the FDA sent warning letters to 23 firms to stop their distribution of dietary supplements that contain androstenedione. FDA will determine whether further actions are necessary if firms refuse to stop distribution of these products. In addition, Congressional leaders are pursuing legislation to classify andro containing products as a controlled substance. This legislation would enable the U.S. Drug Enforcement Agency (DEA) to regulate these types of products as anabolic steroids under the Controlled Substances Act.
Facts about Supplements
Supplements and drugs can interact
For example, ginseng can increase the stimulant effects of caffeine, found in coffee, tea, and soda. It can also lower blood sugar levels, creating the possibility of problems when used with diabetes drugs.
“Natural” does not always mean safe or without harmful effects.
Some supplements come from natural sources but may not be safe. Supplements, like ephedra, come from natural sources but can cause medical problems.
The FDA regulates supplements as foods rather than drugs.
In general, the laws about putting foods (including supplements) on the market and keeping them on the market are less strict than the laws for drugs:
- Research studies in people to prove a supplement’s safety are not required before the supplement is marketed.
- The manufacturer does not have to prove that the supplement is effective.
- The manufacturer does not have to prove supplement quality.
- If the FDA finds a supplement to be unsafe once it is on the market, only then can it take action against the manufacturer and/or distributor, by issuing a warning or requiring the product to be removed from the marketplace.
What’s in the bottle doesn’t always match what’s on the label.
A supplement might not contain the ingredients on the label; contain higher or lower amounts of the active ingredient; or be contaminated.
If you decide to take supplements, follow these tips from the Gatorade Sports Science Institute on how to select supplements. The supplement should:
- Carry USP (United States Pharmacopeia) on the label: USP means that the supplement passes tests for how well it dissolves disintegration, potency, and purity. The manufacturer should also be able to demonstrate that the product passes tests for content potency, purity, and uniformity.
- Be made by nationally known food and drug manufacturers: Reputable manufacturers follow strict quality control procedures. If the company does not answer questions or address complaints, do not use their product.
- Be supported by research: Reputable companies should provide research from peer-reviewed journals to support claims.
- Make accurate and appropriate claims: If statements are unclear or the label makes preposterous claims, it is unlikely the company follows good quality control procedures. If the claims sound too good to be true, be wary.
- Recommend that you talk with a doctor or pharmacist about dietary supplements: These products may interact with prescription and over-the-counter medications as well as other supplements and cause potentially serious adverse effects. Read the product label, follow all directions, and heed warnings.
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