Risks of Using Dietary Supplements: A Comprehensive Guide to Doping and Contamination

Risks and Realities of Dietary Supplement Use in Athletics

  • The Paradigm of Risk:

    • There is a significant inherent risk associated with using dietary supplements in competitive sports.

    • Every year, numerous athletes receive Adverse Analytical Findings (AAF) linked to supplement consumption.

    • Athletes found with AAFs due to supplements are still required to serve full suspensions; ignorance of a supplement's contents is not a valid defense.

    • The prevailing mindset should be "use at your own risk."

    • It is the responsibility of the athlete and the coach to investigate and mitigate these risks as much as possible, though they can never be entirely eliminated.

WADA Guidelines and Quality Control Standards

  • WADA Recommendations:

    • The World Anti-Doping Agency (WADA) suggests that athletes exercise "extreme caution" when using dietary supplements.

    • Testing positive from a dietary supplement is a documented reality for many athletes.

  • Geographic Quality Control:

    • Quality control varies significantly by region. For instance, supplements sourced from China often suffer from poor quality control.

    • In Australia, quality standards are generally higher, and specialized batch-testing programs improve safety.

  • Batch Testing Programs:

    • Athletes are encouraged to use products from companies involved in batch-testing programs.

    • Specific mentions include BCS, Bulk Nutrients, and BSC (noting that while they are generally safer, they may still carry products that could cause an AAF).

  • The Myth of "WADA Approval":

    • WADA and other anti-doping agencies do not directly involve themselves in the testing of nutritional supplements.

    • There is no official mechanism within WADA to approve dietary supplements.

    • Any product claiming to be "World Anti-Doping Approved" should be viewed with skepticism, as no such official approval exists.

    • Athletes should instead look for third-party batch-testing verification (e.g., Athlete's Choice or specific mobile apps provided by anti-doping agencies).

Global Statistical Data on Supplement Contamination

  • Historical International Olympic Committee (IOC) Testing (Cologne Doping Laboratory):

    • The Netherlands: approximately 26%26\% of tested supplements were found to be positive for prohibited substances.

    • Austria: 22%22\% positive rate.

    • The United States: Out of 240 different supplements tested, 18.8%18.8\% resulted in an Adverse Analytical Finding.

    • Overall data suggests a risk factor as high as 25%25\% in certain countries for adverse findings in supplements.

  • Australian Specific Research:

    • Supplement usage among Australian athletes is estimated between 40%40\% and 70%70\%.

    • Historical research indicates that 10%10\% to 15%15\% of supplements available in Australia may contain banned substances.

    • Between 2006 and 2013, supplement-related violations accounted for approximately 6.4%6.4\% of all drug testing violations.

    • Doping positives specifically related to supplements in Australia rose from 0 in 2011 to 7 in 2013.

  • United Kingdom (UK) and United States (USA) Infractions:

    • UK: Approximately 8.8%8.8\% of doping violations are related to supplement use (data from 2006–2013), with increases noted in 2012 and 2013.

    • USA: Approximately 7.7%7.7\% of doping violations in the same timeframe were attributed to supplements.

Mechanisms of Contamination and Specific Prohibited Substances

  • Contamination vs. Intentional Addition:

    • Contamination: Cross-contamination often occurs in factories where different products are manufactured on the same lines (e.g., whey protein manufactured on the same equipment as pro-hormones).

    • Intentional Adulteration: Some companies intentionally add prohibited substances to make their products appear more effective. A cited example is a Florida-based company adding nandrolone to protein supplements.

  • Common Product Contaminants (Judkins and Proc, 2012):

    • Stimulants: Often found in pre-workout and energy boosters (e.g., ephedra).

    • Steroids: Frequently contaminate hormone regulators, anti-hormone regulators, antioxidants, energy boosters, muscle builders, and anti-aging products.

    • Diuretcs and Beta Blockers: Identified as common contaminants.

  • Testosterone Boosters:

    • These products carry a high risk of both stimulant and steroid contamination. Recommendation: Athletes should avoid testosterone boosters entirely.

  • Excretion and Detection:

    • Studies on contaminated creatine supplements containing 19-norandrostenedione showed urinary excretion spikes at dosages of 1 μg1\,\mu g, 2.5 μg2.5\,\mu g, and 5 μg5\,\mu g.

    • The spike in urinary 19-norandrolone levels typically occurs slightly over 2 hours2\,\text{hours} after consumption.

  • Contamination Trends:

    • Contamination rates were higher in the early 2000s compared to 2009. Recent data (post-2012) suggests contamination may have flattened to a range of 0%0\% to 1%1\%, though active research in this specific area is currently limited.

Specific Warnings: Methylhexamine and Other Substances

  • Methylhexamine (Dimethylamylamine):

    • A prominent stimulant placed on the Sport Integrity Australia (formerly ASADA) watch list.

    • Frequently found in pre-workout energy drinks.

    • A 2014 warning from Sport Integrity Australia specifically named the following products as containing methylhexamine:

      • JAK3D

      • OxyELITE Pro

      • White Lightning

      • Hemo-Rage

    • During the Olympic Games, 4 athletes registered AAFs for methylhexamine.

  • Other Sources of Prohibited Substances:

    • Traditional Medicines: Musk pod formulations (Traditional Asian Medicine) have been found to contain anabolic androgenic steroids.

    • Contaminated Meat: Meat in China and Mexico has been found contaminated with clenbuterol. Agricultural practices in these regions may involve giving animals clenbuterol, clostebol, nandrolone, or metandienone.

    • Non-castrated Animal Meat: Offal and meat from non-castrated pigs or boars can lead to testing positive for hormones. (Note: A 2021 case involving a US long-distance runner made this claim, though the hormone levels were reportedly too high to be explained solely by meat consumption).

    • NSAIDs: Some evidence suggests Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) can be contaminated with hydrochlorothiazide (a diuretic).

    • Confirmed Steroids: Supplements have been found to contain stanozolol, ostarine, and other anabolic steroids.

Conclusion and Effective Mitigation Strategies

  • Strict Liability: The athlete is solely responsible for what goes into their body. The absence of a substance from a label is not an excuse for a positive test.

  • Food-First Approach:

    • Athletes should prioritize getting their diet correct first.

    • Ensure all macronutrient and dietary needs are met through whole foods.

  • Informed Supplementation:

    • Only after the diet is optimized should an athlete consider a limited number of high-benefit, low-risk supplements.

    • Always use products that have undergone rigorous third-party batch testing.