Diet Supplements and Performance-Enhancing Drugs

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     Young athletes frequently use both diet supplements and performance-enhancing drugs. Children are entering competitive sports at an earlier age, there is a greater emphasis on sports success and there is a social pressure on thinness in females and muscular development in males. In a study done in 2005, 8% of girls and 12% of boys reported using some type of product to improve appearance, gain muscle mass or improve strength. This article considers the effects and side effects of some of the more common supplements and performance-enhancing drugs.

            Creatine: Creatine is an organic acid that helps bring energy to all body cells, primarily muscle. It is used by athletes and bodybuilders. It has been proven to increase muscle mass and improve strength. Doses of 5 to 20 grams a day have not been found to cause side effects. The Mayo Clinic believes that creatine can cause asthma symptoms and recommends that people with allergy or asthma do not take it. It was felt that creatine can cause kidney and liver problems, but studies have not supported this.
            Carnitine: Carnitine is found in red meat and is often added to energy drinks with the thought that it will increase the metabolism of fats and increase energy levels. It has been suggested that carnitine increases the risk of heart disease.

            Steroids: Most of the steroids used by athletes are anabolic steroids that are synthetic derivatives of testosterone. They preserve muscle mass, prevent muscle breakdown and, when combined with strength training, increase muscle mass and strength. They also increase aggressiveness that causes athletes to push themselves harder. Adolescent acceptance of steroid use has decreased slightly with the focus of the media on professional athletes using them. Steroids have many adverse effects. They cause acne, tendon strains and ruptures, excess hair, breast shrinkage in girls and testicle shrinkage in boys, permanent breast enlargement in boys, baldness, increased blood pressure, depression, tumors and withdrawal symptoms. Because steroids have been proven to be so dangerous, newer drugs called steroid precursors have become more popular. These drugs are sold over the counter and have a huge market. They include androstenedione (“Andro”), androstenediol, norandrostenedione, norandrostenediol and DHEA.  These drugs are marketed saying that they increase testosterone but they don't work and, even though they have minimal desired effects, they still have many of the bad side effects of anabolic steroids.

            Protein: Health food stores have many forms of protein which can be added to the diet to increase muscle mass. These should be taken 2 hours before exercise or 1 hour after exercise. Like carbohydrates and fats, protein increases total caloric intake and increases weight. As long as the exercise that goes with the increased weight and muscle mass continues, the “muscle-building” effects continue. However, with age, that extra weight becomes more and more difficult to lose. We all are familiar with the guy who was a “big jock” in high school who, at age 30, is now just big – obese with a huge belly.

            Beta-alanine (“Beta”): This is an amino acid that causes weight gain and increased muscle mass. It also decreases fatigue and increases the total work that muscles can do.  If the dose taken is more than 20 mg per pound of body weight, nerve pain called paraesthesia can occur.

            Human Growth Hormone: This hormone is used to increase height in children who have growth hormone deficiency. When taken by normal people, it increases lean body mass and decreases fat. However, it can decrease exercise capability and cause joint pain and heart, liver and kidney disease.

            Erythropoietin (“EPO”): this hormone can increase the number of red blood cells in the blood stream and therefore give athletes more oxygen-carrying capacity which may improve prolonged athletic performance. However, the increased thickness of the blood can lead to dehydration, stroke and blood clots in the lung and brain.

            Stimulants: Drugs such as ephedrine and caffeine can decrease fatigue and both increase both mental and physical ability. Ephedra used to be a common additive in alternative medicines but was banned by the FDA in 2004 because it caused high blood pressure, altered heart rate, strokes and severe mental abnormalities. Caffeine is a common ingredient in many “power-boost” drinks sold everywhere (often as the ingredient Guarana). Because it helps to mask fatigue, it can help athletes continue in sports when the body needs to rest. It can cause abnormal heart rate and increased blood pressure. Some people who are very sensitive to caffeine report headaches, dizziness and nausea.

            Any drug that alters normal body mechanics or functioning must be used with caution. Even the vitamin and mineral supplements that are taken by most Americans can cause serious medical problems if taken in excess of the body’s requirements. Balanced diet, low saturated fat and low sugar intake with moderate exercise still appear to be the best means of creating and preserving health.