The few good scientific studies available on these “dietary” supplements suggest that they either are ineffective or, at best, produce only slight changes in performance. More disturbing, they can contain powerful and potentially harmful substances, such as:
Androstenedione, which can upset the body’s hormonal balance when it metabolizes into testosterone and estrogen, and may cause premature puberty and stunted growth in adolescents.
Creatinine, a substance produced by the body that can help generate brief surges of muscle energy during certain types of athletic performance. Many others who use creatine monohydrate, a supplement used as a derivative, can gain up to 15 pounds and gain muscle mass. However, it is mostly water retention. After you stop taking the supplement, you will lose the weight and feel less strong. Again, nothing lasts a lifetime. Another negative side is that you can’t constantly use creatine since this would cause your body to permanently stop producing creatinine (body produces it naturally). You can be on it for just a couple of month and then take it again a year later.
Ephedra, a herbal stimulant that acts like an amphetamine (“speed”) and that some investigators hold responsible for dozens of deaths and permanent injuries.
“All you have to do to get these products is walk into a food-supplement store,” says Gary Wadler, M.D., a New York sports-medicine specialist and adviser to the White House Office of National Drug Control Policy. That’s because a federal law, the 1994 Dietary Supplement Health and Education Act, allows supplements to be sold to consumers of any age without rigorous safety testing and without meaningful oversight of product quality.
Little is known about the long-term safety of these products in adults, and even less about their effect on youngsters. However, if the supplement industry has its way, at least ever-increasing numbers of week-end athletes will consume some of these products.
“Sports nutrition isn’t just for hard-core athletes any more,” Anthony Almada, president of a California supplement company, told an industry journal. “It’s for anyone seeking energy improvement,” he said, or “a woman who wants to tone her body and lose a few pounds, or a person who rides a bike and wants to perform like an athlete.”
Nutrition Business Journal, a trade publication that tracks the industry, estimates that 4 percent of American adults have taken a sports supplement at least once, including 1.2 million who use the products regularly.
Adolescents are using sports supplements at least as enthusiastically as adults are, according to a national survey conducted in 1999 for Blue Cross and Blue Shield Association. The survey found that 6 percent of youths ages 15 to 16 and 8 percent of 17- and 18-year-olds had taken a sports supplement; the vast majority of users were male. About one in four respondents said they knew someone who took the products.
Teenagers and adults seem to be taking the supplements for the same reasons. The first is to develop bigger muscles. Bodybuilding magazines such as Muscle & Fitness and Flex bulge with ads from supplement makers pushing these products.
For many young adults making a good impression is very important, especially when it comes to impressing the opposite sex. For boys, building big muscles and having the “Arnold Schwarzenegger” or “Incredible Hulk” look is, to some extent, essential to their survival. Going to the gym every single day and pumping iron feeds their obsession with their bodies. Only a small percentage of these young men are genetically predisposed to building huge muscles without the help of any sports supplements. For others, using products such as creatine is becoming increasingly popular.
To Marc, creatine “seems like a magical way to gain muscle effortlessly, to look good, impress girls and guys, etc.” (Children quoted here responded to a Consumer Reports questionnaire and are identified by first name and age only to protect their privacy.) Marc said he was tempted to try creatine because a friend, who “seemed unnaturally muscular for his age”, said it was from taking the supplement. However, sometimes the adults push youngsters to take the pills. “My football coaches suggested I take creatine to bulk up for this year’s season,” said Cyrus, 17.
The second motivation for using such supplements is to have extra energy to burn, either to improve athletic performance or as an aid to losing weight.
Heather, 16, said friends who use an ephedra supplement “are always telling everyone how much weight they have lost, and bragging and bragging.”
You don’t need to live near a nutrition specialty store to purchase these products. According to industry estimates, 28 percent of sports supplements are sold in mass-merchandise stores and another 17 percent by trainers and through direct marketing and the Internet.
Any dietary supplement can be marketed without advance testing under current federal law. The only restriction: The label can’t claim the product will treat, prevent, or cure a disease. However, the label can traffic in vague claims like “enhances energy” or “supports testosterone production”. If serious problems are reported, it’s up to the Food and Drug Administration (FDA) to prove they’re real before it can order a supplement off the market or impose other restrictions. To date, that has not happened; however, a few manufacturers have voluntarily recalled their supplements after the FDA warned them of possible dangers.
Sports medicine researchers have tested creatine and ephedra in adults. There has been no systematic testing in minors and, for ethical reasons, there probably won’t be.
Here, then, is what’s known about these supplements and their effects:
Of the sports supplements, “creatine” is the only one that, based on careful, published research, has shown to improve performance of certain athletic tasks. Creatinine is produced by the liver, kidneys, and pancreas; it also occurs naturally in meat and fish. It’s stored in muscle and elsewhere in the body and plays an essential role in producing immediate bursts of energy. Taking supplemental creatine causes a rapid weight gain of perhaps one to four pounds. Scientists believe the extra weight is mainly water retained in muscles. A few well-designed studies have found that creatine enhances performance requiring brief, intense bursts of strength, as in high jumping and weight lifting. Nevertheless, it doesn’t improve the endurance needed for sports like distance running or soccer. There has been no systematic study of creatine’s side effects, but there have been case reports in the medical literature of muscle cramping and the exacerbation of existing kidney problems. Most studies of creatine involved short-term use, so “long-term effects are completely unknown,” says Bernard Griesemer, M.D., director of a pediatric sports-medicine practice in Springfield, Missouri.
Ephedra
The herbal supplement ephedra (also known as Ma-huang) may be the most hazardous of the sports supplements. It contains several stimulants, including ephedrine and pseudoephedrine, active ingredients in over-the-counter cold and sinus drugs. However, while the drugs contain just one active ingredient, almost all the supplements combine multi-ingredient ephedra with at least one other stimulant, usually caffeine or guarana (an herb containing caffeine).
“Ephedrine and caffeine work synergistically,” says Bill Gurley, Ph.D., Associate Professor of Pharmaceutical Sciences at the University of Arkansas. “The effect is similar to taking amphetamines.” The FDA found the combination so dangerous that it banned it from over-the-counter drugs in 1983. Some used this combination with the extra boost of aspirin, which was considered as the most popular fat burner known in the industry. They called it the “Stack”. The International Journal of Obesity published the first well-controlled clinical trial of the herbal combination ephedra and guarana. By the eighth week, the supplements had produced moderate weight loss. (Two very small studies have found that ephedra, in addition to caffeine, slightly increases endurance as well.) However, side effects, notably heart palpitations, forced 8 of the 35 users to drop out of the study. Moreover, in the real world, where no one is overseeing the dosages, the risks may be more serious.
Another group of physicians wrote in The New England Journal of Medicine about a 19-year-old male bodybuilder with no apparent cardiovascular risk factors who suffered a heart attack 15 minutes after taking an ephedra-caffeine energy supplement.
For the past four years, the FDA has been trying to exert its limited authority under a 1994 law to limit the maximum doses in ephedra supplements to 24 milligrams a day.
The industry has vigorously disputed the idea that ephedra is unsafe and has proposed an alternative maximum of 100 milligrams a day, with a label saying “not for use by anyone under the age of 18”. My recommendation is these products have to be avoided at all costs. For younger adults wanting to impress their peers, use your brain instead of your muscles and be more patient. It might take longer to get naturally bigger, but at least you’ll get there alive.
When I mentioned “Anabolic Steroids not Included” in the title of this chapter, I meant not included as a sports supplements. However, talking about it is actually very important for those who are not aware of the irreversible side effects of steroids on your body. Anabolic steroids are the drugs that will make you big, especially for those looking to be unnaturally big. Looking great at the beach is not worth the suffering 5 to 10 years down the road. Nevertheless, why are professional bodybuilders still using anabolic steroids, although they understand their side effects? It’s all about ego and narcissism.
Anabolic Steroids (AS) are synthetic substances related to the male sex hormones (androgens). They promote growth of skeletal muscle (anabolic effect) and the development of male sexual characteristics (androgenic effects), and have other negative side effects. (The term “anabolic steroids” will be used throughout this chapter because of its familiarity, although the proper term for these compounds is “anabolic/androgenic” steroids.)
They are used by doctors for treating conditions that occur when the body produces abnormally low amounts of testosterone, such as delayed puberty and some types of impotence, and also for treating patients with AIDS and other related diseases.
In the United States, they are legally available only by prescription. AS abusers obtain drugs that are made in clandestine laboratories (sometimes with poor quality control standards), smuggled from other countries, or diverted illegally from U.S. pharmacies.
In the United States, supplements such as dehydro-epiandrosterone (DHEA) and androstenedione (street name Andro) can be purchased legally without a prescription through many commercial sources including health food stores. They are often taken because the user believes they have anabolic effects. What are those staggering statistics that are alarming the medical field concerning the abuse of Anabolic Steroids?
o Increase among adolescents, and most rapidly among females. The 1999 “Monitoring the Future” study, a NIDA-funded survey about drug abuse among middle school and high school students across the United States, recorded that 2.7 percent of 8th-graders, 2.7 percent of 10th-graders, and 2.9 percent of 12th-graders reported having taken anabolic steroids at least once in their lives. These figures represent increases of approximately 50 percent since 1991 among 8th- and 10th-graders and 38 percent among 12th-graders.
o Probably widespread among athletes and would-be sports competitors at all levels, although little data is available to provide exact estimates of prevalence. Many anabolic steroid abusers are unwilling to report the practice because the International Olympic Committee and many other amateurs and professional sports organizations have banned anabolic steroids.
o Use is motivated in most cases by a desire to build muscles and improve sports performance. Some individuals are motivated by erroneous perceptions of their own bodies (that is, a mistaken belief that they look underweight or obese).
What are the consequences of using anabolic steroids?
Acne: Increase in testosterone can trigger severe acne.
Baldness: Testosterone fuels hair loss. Get too much too early, and chances are you’ll be saying goodbye to your hair-years before its time.
Breast Development: “Testosterone can lead to fibrous growths under the nipples, creating a resemblance to the early breasts of teenage girls,” says Charles Yesalis, M.D., a steroid researcher. “It’s almost humorous to see these macho Bodybuilders with what look like golf balls under their nipples.”
Reduced Height: Boosting testosterone levels while you’re still growing can cause growth plates to fuse prematurely. “If God had in mind that you’d be 6’2″,” says Dr. Yesalis, “taking steroids could cause you to top out at 5’6″.”
Lousy Personality: Steroids may trigger aggressive behavior and extreme anger.
Shrunken Testicles: Over time, they can shrink to the size of lima beans. Don’t expect a great sex life as a benefit!
Despite all these side effects steroids are still attractive drugs because they are linked to sports excellence and body image. Team sports can build skills in cooperation and competition, and sports performance can enhance self-esteem. Sports figures serve as role models for many young people. Unfortunately, the use of performance-enhancing substances among adult sports figures can influence behavior. Young people understand this, and they want to use these hormones and drugs, too.
For young women, “body image” is a powerful motivator, often based on inappropriate entertainment and media models. More young women are taking steroids to satisfy their perceptions of body image. These drugs can help decrease body fat and breast size, for example. For women, anabolic steroid use can lead to a more man-like appearance and permanent voice lowering.
In light of all these side effects mentioned above, is there still a market for these drugs? Unfortunately, yes. “There are at least half a million American kids from 7th to 12th grade who have used anabolic steroids,” says Charles Yesalis, M.D., a Penn State University steroid researcher.
“Some studies have found that even fifth- and sixth-graders are using them.” Moreover, an even higher number of teens have tried so-called over-the-counter steroids – legal sports supplements like androstenedione, or “Andro” for short.
I decided to include the following information to elucidate the misconception you probably all have about sports supplements. What works, what doesn’t and what is dangerous to your body? All these products have different side effects in different people. Some can tolerate the harshness of these drugs, others might cause irreversible damage to their bodies.