Anti-doping

Supplements – Think carefully before you take!

How many times do you hear of an athlete testing positive to a banned substance, and subsequently blaming it on a supplement they’ve taken?nbsp;In reality, over 50% of such cases ARE blamed on a supplement. Hopefully you’ve all sat through an anti-doping session at some time in the past couple of years, and in this session you’ve also heard about the potential risk of taking supplements due to contamination. Whilst it’s easy to assume that they’re just “looking for excuses”, could it really be true?

In my experience, most athletes don’t use supplements very much, however in the lead up to Beijing now is a good time to remind you of some of the potential issues you COULD face.

What is a supplement? 
The definition of a supplement can be a little grey, which is where much of the confusion can lie. In most instances, it can be defined as something which provides a nutrient, or range of nutrients, in larger amounts than those found commonly in food. However, it also can include powders and capsules which are promoted in addition to, or in replacement of, food. Supplements don’t necessarily have to be promoted specifically to athletes in order to be a problem.

Why is there a problem? 
Between 2000-2002, the IOC had an accredited laboratory test 634 sports supplements products from 13 different countries. Of these supplements, 15% tested positive to steroids and prohormones which were on the banned substance list of the WADA code. These substances were not declared on the label of the supplement, and if consumed would have resulted in a positive doping test. Furthermore, 15% also didn’t contain the “active ingredient” which was MEANT to be in there (in other words, if it was a Ginseng supplement there were no traces of Ginseng found in the product). 
If you thought that this would have made manufacturers reassess their quality control procedures and reduce the risk of cross contamination, think again! Just this year a laboratory in the UK tested a range of over-the-counter supplements purchased in the USA. These included products promoted for weight loss, muscle gain, hormone regulators, testosterone boosters, protein supplements, post-workout recovery and energy drinks. Of the 54 products analysed, 25% tested positive for a banned substance which was NOT stated on the label. These banned substances included nandrolone, DHEA, androstenedione, androstenediol and ephedrine (amongst others). The most predominant products to test positive were testosterone boosters (67% tested positive) and weight loss supplements (29% tested positive). 
The same laboratory who undertook these tests also systematically tests products for banned supplements for companies in the UK, Europe and the USA who are wanting to sponsor athletes and provide evidence that their products are safe. It has been reported that of these tests, 2.8% of products have tested positive, and they have also found that even the capsules in which some products are packed have tested positive for banned substances. 

Why is this?nbsp;Some of it is due to inadvertent cross-contamination by using large scale packing equipment to pack a range of products. Unlike the pharmaceutical industry, where all equipment has to be thoroughly cleaned between batches and raw ingredients held securely, the quality control procedures in the supplements industry are not strictly regulated. Therefore, if a batch of product y is packed immediately after product x, which happened to contain a banned substance, there is a risk that there are some remnants of product x still around in the packing equipment which will be mingled with product y. It only takes a minute amount of nandrolone (2.5-5 micrograms) to test positive. There are also potential issues with the storage of the raw ingredients in the same large area. Then, some of it is due to deliberate inclusion of a banned substance in a product without declaring it. In some instances, the source of the raw ingredients is also of concern.

So, what can I do to check? 
That’s the tricky thing. Since the majority of these contaminants aren’t listed on the label, there is no way of checking whether it’s likely to be a problem. You can have a product tested by a laboratory, but that still provides no guarantee for EVERY batch of the product. Calling your National Anti-Doping Organisation (NADO) is unlikely to resolve this question either as, if they test, they are unable to test every batch of every supplement available in your country, let alone throughout the world. So, generally it is recommended that you avoid taking supplements. Alternatively, ask the manufacturer for a written guarantee that the product you’re taking doesn’t contain any banned substances, and make sure you write down EVERYTHING you’re taking if you’re asked to undergo a drug test.
Regardless, if you test positive for a banned substance, no matter how inadvertent it may be, YOU are responsible for this and it will still be considered a positive test.

Don’t be fooled either by products which claim their ingredients are “pharmaceutical grade”. This may very well be the case, however they are not packed in a pharmaceutical plant and are therefore still open to the same risks as any other ingredient. Similarly, while there maybe be organisations in some countries which control the safety of ingredients brought into their country and approve supplements for sale, the internet provides a multitude of options which these organisations cannot control. For example, in Australia you cannot legally purchase DHEA whereas in the USA it’s available even in supermarkets, with no control over purchase.

Are there any exceptions? 

Generally, products manufactured within the food industry or within the pharmaceutical industry are generally safer as the standards within these industries are tighter. Hence, multivitamins or individual vitamins / minerals from a pharmaceutical company tend to be safe, as are sports drinks and some liquid meal supplements (e.g. Ensure, Sustagen).

Final tips:
Think very carefully about the need for a supplement BEFORE taking any.
Find out exactly what the supplement is meant to do and who manufactures it.
Ask the manufacturer for a written declaration that the product contains ONLY what is stated on the label and check carefully where they source their ingredients and how / where the product is packed. Try and get what you are needing from food. 

Dr. Liz Broad, Sports Dietitian

WADA 2017 Prohibited list (This List came into effect on 1 January 2017). 

For additional information visit www.wada-ama.org.