|SSM Cardinal Glennon Children's Medical Center|
If you're a competitive athlete or a fitness buff, improving your sports performance is probably on your mind. Lots of people wonder if taking sports supplements could offer fast, effective results without so much hard work. But do sports supplements really work? And are they safe?
What Are Sports Supplements?
Sports supplements (also called ergogenic aids) are products used to enhance athletic performance that may include vitamins, minerals, amino acids, herbs, or botanicals (plants) — or any concentration, extract, or combination of these. These products are generally available over the counter without a prescription.
Sports supplements are considered dietary supplements. Dietary supplements do not require U.S. Food and Drug Administration (FDA) approval before they come on the market. Supplement manufacturers do have to follow the FDA's current good manufacturing practices to ensure quality and safety of their product, though. And the FDA is responsible for taking action if a product is found to be unsafe after it has gone on the market.
Critics of the supplement industry point out cases where manufacturers haven't done a good job of following standards. They also mention instances where the FDA hasn't enforced regulations. Both of these can mean that supplements contain variable amounts of ingredients or even ingredients not listed on the label.
Some over-the-counter medicines and prescription medications, including anabolic steroids, are used to enhance performance but they are not considered supplements. Although medications are FDA approved, using medicines — even over-the-counter ones — in ways other than their intended purpose puts the user at risk of serious side effects. For example, teen athletes who use medications like human growth hormone (hGH) that haven't been prescribed for them can have problems with growth, and may develop diabetes and heart problems.
Lots of sports organizations have developed policies on sports supplements. The National Football League (NFL), the National Collegiate Athletic Association (NCAA), and the International Olympic Committee (IOC) have banned the use of steroids, ephedra, and androstenedione by their athletes, and competitors who use them face fines, ineligibility, and suspension from their sports.
The National Federation of State High School Associations (NFHS) strongly recommends that student athletes consult with their doctor before taking any supplement.
How Some Common Supplements Affect the Body
Whether you hear about sports supplements from your teammates in the locker room or the sales clerk at your local vitamin store, chances are you're not getting the whole story about how supplements work, if they are really effective, and the risks you take by using them.
Androstenedione and DHEA
Androstenedione (also known as andro) and dehydroepiandrosterone (also known as DHEA) are prohormones or "natural steroids" that can be broken down into testosterone. Andro used to be available over the counter, but now requires a prescription.
When researchers studied these prohormones in adult athletes, DHEA and andro did not increase muscle size, improve strength or enhance performance.
Andro and DHEA can cause hormone imbalances in people who use them. Both can have the same effects as taking anabolic steroids and may lead to dangerous side effects like testicular cancer, infertility, stroke, and an increased risk of heart disease. As with anabolic steroids, teens who use andro while they are still growing may not reach their full adult height. Natural steroid supplements can also cause breast development and shrinking of testicles in guys.
Creatine is already manufactured by the body in the liver, kidneys, and pancreas. It also occurs naturally in foods such as meat and fish. Creatine supplements are available over the counter.
People who take creatine usually take it to improve strength, but the long-term and short-term effects of creatine use haven't been studied in teens and kids. Research in adults found that creatine is most effective for athletes doing intermittent high-intensity exercise with short recovery intervals, such as sprinting and power lifting. However, researchers found no effect on athletic performance in nearly a third of athletes studied. Creatine has not been found to increase endurance or improve aerobic performance.
The most common side effects of creatine supplements include weight gain, diarrhea, abdominal pain, and muscle cramps. People with kidney problems should not use creatine because it may affect kidney function. The American College of Sports Medicine recommends that people younger than 18 years old do not use creatine. If you are considering using creatine, talk with your doctor about the risks and benefits, as well as appropriate dosing.
Fat burners (sometimes known as thermogenics) were often made with an herb called ephedra, also known as ephedrine or ma huang, which acts as a stimulant and increases metabolism. Some athletes use fat burners to lose weight or to increase energy — but ephedra-based products can be one of the most dangerous supplements. Evidence has shown that it can cause heart problems, stroke, and occasionally even death.
Because athletes and others have died using this supplement, ephedra has been taken off the market. Since the ban, "ephedra-free" products have emerged, but they often contain ingredients with ephedra-like properties, including bitter orange or country mallow. Similar to ephedra, these supplements can cause high blood pressure, heart attack, stroke, and seizures.
Many of these products also contain caffeine, along with other caffeine sources (such as yerba mate and guarana). This combination may lead to restlessness, anxiety, racing heart, irregular heart beat, and increases the chance of having a life-threatening side effect.
Will Supplements Make Me a Better Athlete?
Sports supplements haven't been tested on teens and kids. But studies on adults show that the claims of many supplements are weak at best. Most won't make you any stronger, and none will make you any faster or more skillful.
Many factors go into your abilities as an athlete — including your diet, how much sleep you get, genetics and heredity, and your training program. But the fact is that using sports supplements may put you at risk for serious health conditions.
So instead of turning to supplements to improve your performance, concentrate on nutrition and training, including strength and conditioning programs.
Tips for Dealing With Athletic Pressure and Competition
Ads for sports supplements often use persuasive before and after pictures that make it look easy to get a muscular, toned body. But the goal of supplement advertisers is to make money by selling more supplements, and many claims may be misleading.
Teens and kids may seem like an easy sell on supplements because they may feel dissatisfied or uncomfortable with their still-developing bodies, and many supplement companies try to convince teens that supplements are an easy solution.
Don't waste your money on expensive and dangerous supplements. Instead, try these tips for getting better game:
Reviewed by: Mary L. Gavin, MD