This weeks closes the Supplement Series with perhaps the most important topic: 5 supplements to avoid. These supplements and supplement ingredients are easily found over the counter and online. However, they are not just banned by most sports governing bodies, they are downright dangerous.
1. NO (Nitric Oxide)
NO is produced naturally in the body either from L-arginine or nitrites and nitrates. In the body, NO dilates blood vessels and decreases vascular resistance. This increases blood flow throughout the body. One can see, therefore, that athletes would be interested in this ingredient that claims to increase oxygen and nutrient delivery to exercising muscles, effectively increasing tolerance of exercise and better recovery. In fact, NO is a main ingredient in two currently very popular supplements: NO Explode and Jack3d. However, the research is inconclusive as to the actual effectiveness of NO. In addition, most research has only been conducted with young, healthy males. Of most concern are the many adverse side affects associated with using NO. Because NO causes vasodilation (widening) of the blood vessels, there is a potential for a quick decrease in blood pressure, resulting in dizziness, headaches, lightheadedness, nausea, vomiting, loss of balance, or even fainting. NO may also increase the risk of bleeding, as well as effect the body's electrolyte balance (especially dangerous if you have kidney or liver disease). These affects have been seen even when following the label's recommendations for dosing. Bottom line, NO's effectiveness and safety are unproven. Combine that with the fact that this ingredient is banned by most sports governing bodies and the message is clear: don't take it.
2. DHEA (Dehydroepiandrosterone)
DHEA is not an anabolic (muscle building) steroid, but is an androgen/testosterone precursor sold over the counter in many stores. However, it is also produced in your body by the adrenal glands. Because it is a precursor to the production of testosterone, it is marketed as having an anabolic steroid effect. However, research involving supplementation of DHEA showed no resulting increases in testosterone levels; no changes in strength or body composition were found. Reported adverse effects of taking DHEA include hair loss, hirsutism and voice deepening in women and irreversible gynecomastia in men. There is also concern for an increased risk of uterine and prostate cancer. Therefore, DHEA has not been proven safe or effective. In addition, this ingredient has been banned by many sports governing bodies.
Androstenedione is an "androgenic" steroid that has not been proven to be anabolic, or muscle building. Like DHEA, it is an androgenic prescursor. However, research has shown that supplementing with Androstenedione is not actually effective at increasing and maintaining levels of testosterone in the body, nor does it have any positive affect on body composition or strength compared to a placebo. One study actually showed that its supplementation led to muscle breakdown instead of building. What research does show, however, is adverse effects on high-density lipoprotein (the good cholesterol) and coronary heart disease risk. This ingredient is banned by many governing bodies; the Anabolic Steroid Control Act of 2004 classified androstenedione and 48 other prohormones as controlled substances. Therefore, the lack of evidence as an ergogenic aid combined with its adverse effects and illegal status in sports make it a poor choice for athletes.
4. HGH (Human Growth Hormone)
HGH is also actually synthesized in the body. The anterior pituitary gland produces HGH, and its metabolic effects are mediated by the hormone insulin-like growth factor-1 (IGF-1). HGH is often prescribed in men over 60 years of age to increase lean body mass, decrease fat mass, and slow the thinning of skin. You can see why this particular product eventually caught the attention of athletes, despite that fact that it is essentially unstudied in younger populations. It is theorized that HGH in athletes enhances amino acid and glucose uptake in the muscle, stimulating protein synthesis and potentially allowing the body to use more free fatty acid as energy during exercise. However - again - that has not been proven. HGH is a drug only available to the body via injection (i.e. not when taken from a product bought over the counter or on the internet); it is too large of a molecule to be absorbed if taken by mouth. Therefore, any over the counter products labelled as precursors, secretagogues or releasers of HGH are simply false advertising. However, there are adverse effects even when taking the injectable, prescription HGH. These include insulin resistance, glucose intolerance, oedema, and decreased endogenous HGH secretion, as well as cardiovascular concerns with long-term use. Bottom line, this is a supplement full of claims and speculation with no research to back it up in the young, athletic population. In addition, this too is banned by most sport governing bodies.
Ephedrine, classified as an herb and sold as a dietary supplement, is known for its stimulant properties. Therefore, athletes are often tempted to use it to ward off fatigue and increase energy. Ephedrine is also marketed as an appetite suppressant, making its use rampant by wrestlers attempting to "make weight". It has been proposed that Ephedrine is ergogenic via a glycogen-sparing mechanism, but this has not been proven in research. The most concerning part of this supplement are the reported adverse effects with this type of drug (sympathomimetic drugs). Shockingly in the early 2000's, 64% of all adverse reactions to herbs in the US came from ephedra-containing products, despite representing only 0.82% of sales. There is a high incidence of cardivascular and central nervous system effects, including an increased risk of haemorrhagic stroke. In a 22-month review, 140 adverse events related to its use were found- 10 involved death and 13 resulted in permanent disability. Dosages were not high, but actually in the range of most over the counter products sold today. Therefore, while it is theorized that this supplement may be ergogenic due to a stimulant effect, safety reasons alone warrant avoiding this; Ephedrine is banned by most sport governing bodies.
Don't take any chances. Regardless of the claims, avoid these 5 supplements at all costs!
Source: Juhn, M. Popular sports supplements and ergogenic aids. Sports Med. 2003;33(12):921-939