Dear Dr. Jeff: Are sports performance-enhancing drugs dangerous? What about other body-building supplements? ?J.P.
Dear J.P.: It is estimated that 40 percent of the U.S. population is currently using some kind of dietary supplements and that over 80 percent have tried one some time in the past. People are currently spending over $18 billion per year on supplements. Seems like a lot!
But is it a problem?
Certainly, many dietary supplements are simply just vitamins. Though generally unnecessary for those who eat a reasonable diet, if taken in recommended doses, multivitamins are unlikely to cause any harm.
What about the sports supplements, specifically? Protein supplements, especially "amino acids" preparations, are very popular for muscle building and body sculpting. Creatine is a popular "performance enhancer," heralded for "muscle refueling" by boosting cellular ATP production. "Weight gainers" supply extra calories for rapid weight gain and bodybuilding. Do they work? Are they dangerous?
Although they cannot claim activity in the treatment of any specific medical condition or disease, all dietary supplements are allowed to claim an "effect" on bodily structure or function.
The federal Food and Drug Administration (FDA) is not required by law to review evidence of the efficacy or safety of dietary supplements. In fact, there is no legal requirement that these claims meet the same scientific standards required even for conventional foods.
Protein supplements? There is no evidence whatsoever that they offer any advantage over dietary protein. Amino acids? Even GNC acknowledges that there is "little scientific support and/or minimal health benefit" to taking them.
Creatine? Over 30 percent of people who take it do not even retain it in their muscle tissues long enough to utilize it. Studies have shown, though, that taken for five to six days by sedentary or moderately active people, supplemental creatine will improve performance and delay muscle fatigue during short-duration, high-intensity exercise like weight lifting. Wow! All that for only a couple of dollars per day!
And the side effects and risks of supplemental creatine? Muscle cramping and diarrhea are not uncommon. There have been reports of kidney damage from creatine supplementation. Certainly, people with kidney disease should not risk taking it.
And then, of course, there are steroids, now produced and marketed by an enormous, world-wide industry (just Google "performance-enhancing steroids," and you'll see what I mean). Anabolic steroids are available in a wide array of forms and doses. They can be injected intramuscularly, ingested in pill or liquid form, or absorbed through topical creams. Some are "recommended" in 12-day cycles, others in combination to offset side-effects. Anabolic steroids will likely help you build up muscle mass, but put most simply and clearly, they are illegal and dangerous.
Side-effects range from severe acne to mood swings, from unwanted fat redistribution, facial hair growth, and voice changes in women to breast development, testicular shrinkage, and impotence in men. Steroid abuse can also lead to liver failure, heart failure, and stroke.
What's the bottom line here? Steroids should never be used as a sports "supplement."
Never.
Other dietary supplements may also be unsafe. The efficacy and safety of most supplements are neither assured nor monitored. The supplement industry is essentially unregulated and preys successfully and profitably on our insecurities, anxieties, and fantasies?insecurities, anxieties, and fantasies that industry marketing strategies help to create and perpetuate.
Fundamentally, J.P., with very few exceptions, supplements are simply unnecessary.
A balanced and nutritional diet, and a well-planned training program, can safely and predictably help you reach your goals.
Be well!
Jeff Benson, MD
Dudley Coe Health Center