Taking Power Supplements Safely

Power supplements - also called ergogenic aids - are nutritional products used to enhance athletic performance. They represent a range of substances - including vitamins, minerals, herbs, plant extracts, amino acids, and hormones - and come in a variety of forms - pills, capsules, powders, beverages, even sweets and chewing gum. They are popular among athletes of all types because while their advertising promises increases in energy, power, endurance, and muscle mass with use, they are considered "natural" and therefore a better alternative to anabolic steroids and the associated dangers.

However, not all power supplements are created equal, and misinformation abounds. Therefore, it is important for current and future users to seek accurate information about their actions, instructions for use, and associated risks before purchase and use.

Truth vs. Hype

Because most sports supplements are not regulated by government bodies or even consumer agencies - as are conventional medications - advertisers are more free to make unproven and misleading claims. Of more concern, they are not required to provide information about side effects. The appeal of these advertisements to those particularly vulnerable - teenagers and professional athletes under significant pressure to perform well and look great doing it - is difficult to control. To combat this, knowledge and sound decision-making are crucial.

• The best resources are those with no connection to a company or industry manufacturing or marketing supplements. These include general information websites and medical journals (available through Medline or hospital libraries).
• Note that most sports or alternative health journals may prove more risky, as they sell advertising to supplement manufacturers, and their articles may contain a hidden slant.
• Consult a professional - either a physician, exercise physiologist, or dietitian - preferably one specializing or with significant experience in the fields of sports medicine and nutrition
• Proceed with caution if an "expert" is employed by (1) a supplement manufacturer, or (2) a gym/health club selling or receiving funds from such a company.

Mainstream scientific studies have tested nearly all of the substances found in power supplements. Of note, the following weaknesses are common:

• Many have not been conducted in humans
• Most were too small to draw strong conclusions
• Human studies on power supplements in sport have been conducted primarily in adults, despite teenagers making up a large portion of consumers
• Human studies evaluating a direct connection to common claims have shown little effect with most products.

Exceptions to disappointing results have been found, including those observed with caffeine, creatine, and specific amino acid combinations. Thus far no research has suggested that any supplement can substitute for skill, training, and basic nutrition.

Supplement Safety

Power supplements have been used by millions and for decades with a very small number of life-threatening effects when used according to the manufacturer's recommendations. However, this does not mean they are free from side effects altogether. Further, because they are largely unregulated, some products may contain potentially toxic impurities, hidden ingredients, and even illegal substances that may cause unwanted side effects of their own.

When in doubt, it is advisable to check FDA Consumer Reports (available online) for any significant concerning trends. The following ingredients in power supplements have thus far been identified as high-risk:

• Herbs such as ephedra and Ma Huang contain ephedrine, which has stimulant effects similar to caffeine. However, these ingredients are less predictable and can be more extreme in high doses. They have proven to be dangerous partners to both caffeine and aspirin.
• DHEA, androstenedione, and other steroid substitutes have been observed to increase the risk of cardiovascular disease in some individuals.
• Yohimbine/yohimbe, used to increase the body's production of testosterone (the most commonly used steroid) has been associated with abnormal heart rate and high blood pressure.

Making a Choice

It is still largely up to the consumer to take precautions in purchasing and using power supplements, from both financial and safety perspectives. The following are key tips in making the best possible choices:

• Carefully research each product, ingredient, and company you are considering, using appropriate sources of information
• Understand the proposed benefits, distinguishing between blanket promises and specific supported claims
• Be aware of the possible side effects, keeping in mind that long-term data is scarce
• Follow directions for use and do not exceed the recommended dose; in cases where the label suggests an amount higher than has been safely researched, it is best to err on the side of caution

With our current knowledge, it remains a challenge to determine how valuable each power supplement might actually be. If nothing else, the right information and good sense can maximize safety for those seeking personal experience.