Are Supplements and Ergogenic Aids Worth the Risk?

What are Supplements?

Supplements are a form of ergogenic aid taken because they are believed to improve or increase performance.

What’s the Big Deal About Supplements?

There is a drive for athletes to have every competitive advantage possible.
In 2001 the estimated global market of supplements was $46 billion.1
The US market alone was estimated at $16.7 billion in 2000.1
Supplements may make whatever claims they like as long as the label contains a list of active ingredients4

Some Performance Supplements in Use Today

Supplements to improve strength and power:

amino acids, anabolic steroids, boron, chromium, chrysin, colostrum, creatine, hydroxymethylbutyrate (HMB), omithine alphaketoglutarate, prohormones, protein, tribulus terrestris, vanadium and zinc

Supplements promoting energy supply:

bicarbonate, caffeine, carnitine, creatine, guarana, hornet juice, iron, magnesium, pyruvate and ribose

Supplements used to burn fat

caffeine, carnitine, ephedra

A look at some well known supplements

There are not many pros for many of the supplements, so I have broken this article down into the Facts and the Risks of using each of the following supplements:

  • Anabolic steroids
  • Prohormones
  • Human Growth Hormone
  • Creatine
  • Amino acids
  • Protein
  • Caffeine
  • Antioxidants

Anabolic Steroids

The Facts About Anabolic Steroids:

Defined by the 1990 Anabolic Steroid Control Act as “any drug or hormonal substance chemically and pharmacologically related to testosterone . . . that promotes muscle growth.”2
Developed to promote tissue growth in bed rest patients3
Increased testosterone “shown to increase protein synthesis, muscle strength, and lean body mass.” 2
Requires a prescription to possess

The Risks With Anabolic Steroid:

In males may cause3:

  • Decrease in testicular function
  • Breast development
  • Liver dysfunction
  • Mood and behavioral changes
  • Increased risk of heart disease


The Facts About Prohormones:

Androstenedione (andro), androstenediol, dehydroepiandrosterone (DHEA), norandrostenedione, norandrostenediol
They are only 1 or 2 chemical reactions away from testerone
DHEA, andro and androstenediol do not increase muscular size and strength gained from resistance training1
Norandrostenedione & norandrostenediol do not affect body composition in healthy young men1
Legally sold over the counter in the U.S.

The Risks With Prohormones:

Some increase the risk of cardiovascular disease2
Risk of pancreatic and prostate cancer and behavioral changes from elevated blood concentrations of andro1
Put you at risk for a positive drug test
Banned by the IOC, NCAA and NFL

Recombinant Human Growth Hormone (rhGH)

The Facts About Human Growth Hormone

Increases protein synthesis inside the muscle3
It is mainly connective tissue not contractile tissue that is synthesized3
Acts in an anabolic manner in growing children and adults who lack a normal amount of GH
GH stimulates lypolysis
British Journal of Sports Medicine reported that “no robust, credible study has been able to show clear effects of either medium to long term rhGH administration, alone or in combination with a variety of training protocols or anabolic steroids, on muscle protein synthesis, mass, or strength”5

The Risks With Human Growth Hormone

Chronic use may lead to the following problems3:
Carpal tunnel compression
Muscle disease
Shortened life span
Banned substance
May actually result in a decrease in performance5


The Facts About Creatine:

Not prohibited in most sports
No known harmful side effects6 – yet
Studies have found a positive effect on strength, power and lean body mass1
Particular effects have been seen with repeated short efforts and little recovery time1,6,7
Gains in body mass could be due to water retention

The Risks With Creatine:

Studies have been of short duration with small sample sizes
Effects of long-term usage unknown
Anecdotal reports of muscle cramps (probably unrelated to creatine) and stomach problems
Concerns about effect on kidney function

Amino Acids

The Facts About Amino Acids:

Glutamine, branched chain amino acids, leucine, lysine, arginine, ornithine
Little evidence to support benefit to athletes on a normal diet4
Conflicting evidence on the effect on lean body mass or muscle function from use
Maughan, King & Trevor report there is little supportive evidence

The Risks Associated With Amino Acids:

Studies involving humans have been inconsistent
The safety and efficacy of amino acid use has not been established

Protein Supplementation

The Facts About Protein Supplementation:

The daily protein requirement may be increased in athletes undergoing hard training
It is possible to achieve increased protein intake through diet
Some protein dense foods may also be fat dense
Protein supplementation may help if the athlete is concerned about excess fat in high protein foods


The Facts About Caffeine

It appears to play a role in sparing glycogen by increasing FFAs and increasing fat oxidation1
Exercise time to exhaustion was increased in a group given caffeine over a placebo group1
Under simulated race conditions performance also improved1
There is no apparent effect on maximal oxygen uptake1
Use of 3 mg or less may be all that is needed to achieve the benefits of caffeine1
Possible benefits in performance as short as 1 minute1

The Risks With Using Caffeine:

Some people reported the following side effects1:
Gastrointestinal problems and bleeding
Some concern that high intake may put one at risk of bladder cancer1
Very high doses have caused muscle tremors and impaired coordination in athletes1
Caffeine urine content above a certain level is prohibited by certain organizations like the NCAA


The Facts About Antioxidants:

Vitamins A, C & E, co-enzyme Q10 among others
Some evidence has been reported of a protective effect of using antioxidant supplements1
Reported reduction in signs of muscle damage1

The Risks Associated With Antioxidants:

There has been no reported evidence that they are beneficial to performance
They can also function as pro-oxidants
Athletes who train regularly may have a natural capacity to neutralize free radicals and prevent oxidative damage1
Recent reports have linked vitamin E to possible heart problems

Is Supplementation Worth the Risk?

General Pros and Cons

Pros With Supplementation For Athletes:

Certain ones may improve performance in certain cases
Psychological advantage may be gained

Cons About Supplementation

Most illegal – either by law or stated by international sports governing bodies
Many harmful to health
There are still unknown health risks
Most probably do not help at all
Research is limited – few human studies; small sample sizes; short in duration
They are frequently taken by athletes in quantities that are larger than recommended

NCAA List of Banned Substances

Check out the following website:’ncaa%20banned%20supplements


1. Maughan, R. J., King, D. S., Lea,
T. (Jan 2004). Dietary supplements.

Journal of Sports Sciences, 22, 95-114.  Retrieved March 17 2005 from Student Resource Center database.

2. Powers, M. (July 2002). The safety and efficacy of anabolic steroid precursors: What is the scientific evidence? Journal of Athletic Training, 37, 300-305. Retrieved March 17, 2005 from ProQuest database.

3. Powers, S.K., and Howley, E.T. (2004). Exercise Physiology: theory and application to fitness and performance (5th ed.).  McGraw Hill: Boston

4. Raven, P.B. (2000).

Joint Position Statement:
nutrition and athletic performance.
College of Sports Medicine, American Dietetic Association, and Dietitians
of Canada
.  Medicine
and Science in Sports and Exercise, 2130-2145. Retrieved March 17, 2004

5. Rennie, MJ.  (April 2003). Claims for the anabolic effects of growth hormone: A case of the Emperor’s new clothes?  British Journal of Sports Medicine, 37, 100-101.  Retrieved March 20, 2005 from ProQuest database.

6. Schilling, BK; Stone, MH; Utter, A; et al (2001).

Creatine supplementation
health variables: a
retrospective study
Medicine and Science in Sports and Exercise (Journal) 183-188. Retrieved March 17, 2004 from

7. Terjung, RL; Clarkson, P; Eichner, ER; et al (2000).

American College of Sports
Medicine roundtable. The physiological and health effects of oral creatine
Medicine and Science in Sports and Exercise (Journal) 706-717. Retrieved March 17, 2004 from

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