Turn to the sports page in any paper, and the headlines serve as a constant reminder that professional athletes of all stripes have been tempted to step outside the straight and narrow path of good nutrition and hard work to get an edge on the competition. From baseball to bicycling, athletes are under tremendous pressure to be bigger … faster … stronger.

 

Sports medicine providers, however, would be quick to say that these problems don’t occur solely on a professional level. High school and college athletes … as well as some weekend warriors … also look to supplements to help them maximize performance. Often, consumers believe that because supplements are readily available and ‘all natural,’ they are perfectly safe. According to the Food and Drug Administration, however, manufacturers have voluntarily recalled more than 80 supplements for bodybuilding in the past two years because the supplements contained synthetic steroids or steroid-like substances.

 

Unlike prescription drugs, supplements do not have to first prove safety and efficacy before hitting retail markets. The FDA’s oversight of the burgeoning industry was effectively hamstringed by the 1994 Dietary Supplement Health and Education Act (DSHEA). According to a recent study funded by the Natural Products Foundation, what’s at stake are billions of dollars … more than $20 billion annually in consumer sales.

 

William O. Roberts, MD, FACSM, is a nationally renowned sports medicine specialist and professor in the Department of Family Medicine and Community Health at the University of Minnesota. The past president of the American College of Sports Medicine and founding member and past president of the American Road Race Medical Society said there has been an explosion in supplements over the past three-to-four decades. “There’s a lot more access to these kinds of supplements,” he said, “and none of them are particularly proven … and unfortunately, none of them are regulated.”

 

While there are a number of dietary supplements that are undoubtedly beneficial … such as taking prenatal vitamins, the concern is that consumers and athletes don’t readily have information about the dangers of some supplements. Additionally, the names change so frequently that it is easy for dangerous or banned substances to crop up in a new form. Although Roberts said these manufacturers should be prosecuted, he pointed out the companies stop production and restart in a new location so quickly that it is difficult to police.

 

“In some of the studies,” noted Roberts, “around 30 percent of the muscle building supplements have anabolic steroids in them.” He added, “For the most part, if a drug increases your muscle mass, it probably has steroid in it.”

 

Unfortunately, the long-term risks of anabolic steroids are not fully understood, Roberts continued. However, some known risks include atherosclerotic cardiovascular disease because it changes the cholesterol profile, baldness, a change in voice tenor and a shrinking of the testicles. Whether or not an athlete meant to ingest a banned substance, the result is the same. “If there’s testing, you’ll be ineligible for competition,” Roberts stated.

 

He pointed to the recent decision in the StarCaps case in which five NFL players were suspended for the first four games of the 2010 football season for taking the diet supplement StarCaps, which included the banned diuretic Bumetanide. Roberts noted it isn’t uncommon for supplements to include unadvertised contaminants. This particular diuretic was banned because it masks steroid use. The five players impacted by the recent court decision in favor of the NFL argued the league became aware Bumetanide was in StarCaps as far back as 2006 but did little or nothing to warn players. While agreeing it would be preferable to have communicated this knowledge with players, the court did not find the NFL had breached its duties to the players so the suspensions stand.

 

 

Bottom line, according to Roberts, is that athletes probably aren’t going to find a magic pill to make them bigger, stronger, faster and give them more energy. “If they work, they’re probably on the banned list. If they’re not on a banned list, they probably have a banned substance in them not advertised, or they don’t really work.”

 

He concluded, “For the most part, athletes can do best with really good nutrition and good training programs. That’s how you’re going to get stronger, better, faster in a legal, ethical way.”