Do's And Don'ts of Supplements for Young Athletes

By Dev K. Mishra, M.D.

Last week I wrote about painkillers and how to use them occasionally, as well as some cautions. This weekI’d like to follow that up with a brief discussion about supplements commonly used by young athletes.

Supplement use is incredibly common in teenage athletes, especially males. In myinformal survey of the high school athletes I work with, I’d say that half of the male athletes are using protein and/or creatine supplements.

Let’s start with some definitions.Supplements are products such as protein powders, creatine, amino acids, high-dose vitamins, weight-loss products, energy boosters, and more. Specific examples include protein powders, creatineproducts, and “energy drinks” like Monster.

Some supplements are legal, but aim for ‘food first’

Protein powders, creatine, and caffeine (up to somelimits) are generally legal for high school and college sports. Whenever possible though, aim to get your “supplements” through real food. For example, excellent sources of supplementalprotein would include lean meats and tofu. Creatine is found in meats and poultry. Caffeine would be in some soft drinks, energy drinks, tea, and coffee.

If you choose to use supplements suchas creatine or protein powder please be absolutely certain you are purchasing from a highly reputable manufacturer (see below) and be on the lookout for common side effects. For example, you need toreally focus on hydration with creatine and protein powder to reduce side effects of muscle cramps and stomach cramps.

The problem with supplements: inadvertently consuming banned ordangerous substances

In the United States there is an organization called the Food and Drug Administration (aka “FDA”) whose job is to ensure as best as possible the safety ofdrugs used to treat medical conditions. One of the big issues with common supplements is that their production is not regulated by the FDA. This means that there are no assurances about what isactually in the supplement you are consuming.

Although manufacturers are required to list all ingredients on the label, a dietary supplement may contain a banned substance, even if not listed,due to contamination or poor manufacturing practices. There might also be outright deception or fraud from the manufacturer.

For example:

• The product may not contain what islisted on the label (Example: a multivitamin could actually just be sugar or fillers).
• The product may contain different amounts of the substances than listed on the label (Example: aproduct that states it has 60 mg of caffeine may actually contain 120 mg).
• The product may contain (sometimes illegal) compounds that are not listed on the label (Example: a product thatclaims to be creatine could be laced with steroids, steroid precursors, or ephedrine).

Do: if you buy, do so from a highly reputable manufacturer

Even though the FDA does notregulate the supplement industry, some companies do a much better job of ensuring safety and purity of their products than others. For example, one company I really like is EAS, a company with astrong reputation that publishes its “100% Certified and Safe” pledge. And for disclosure, I have no relationship with the company, nor does Sideline Sports Doc. I just think they do itright. There are other companies that also do a great job.

Avoid anything that acts like a hormone, or gives outrageous performance claims

Absolutely avoid products that claimthey alter the effects of hormones like testosterone, estrogen, and progesterone. Also beware of products that make extreme claims (example: “Build 25 pounds of muscle and lose fat in twoweeks!”). If it sounds too good to be true, then it probably is. Exaggerated claims related to energy metabolism, body fat loss and muscle mass gain are especially high risk for containing anundisclosed banned substance.

Here are some Red Flag phrases to look out for. Avoid any products that have these in their advertising:

• Energizer
• Fat Burner
• Metabolic Booster
• Proprietary Ingredients
• Testosterone Booster

Bottom line: get your “supplements” from food first. And if you really feel the needto add supplements follow some of the cautions above. Don’t risk your health or your eligibility to compete!

Key Points:
• Supplement usein high school-aged athletes is very common, especially amongst male athletes.
• Whenever possible get your “supplement” from food first, for example, lean meats and tofu areexcellent natural sources.
• If you do buy, get your supplements from a highly reputable manufacturer to avoid the chance that you are inadvertently consuming something that is banned ordangerous.

(Dr. Dev K. Mishra, a Clinical Assistant Professor of orthopedicsurgery at Stanford University, is the creator of the SidelineSportsDoc.com online injury-management course, now arequirement for US Club Soccer coaches and staff members. Mishra writes about injury management at SidelineSportsDoc.com Blog, where this article first appeared.)