Sports Performance Supplement

1. See Also
   1. Nutrition for Athletes
2. Epidemiology
   1. U.S. Supplement revenue in 1997: 11.8 Billion
   2. Incidence of supplement use
      1. General population: 50%
      2. College athletes: 76%
      3. Body builders: 100%
3. Efficacy
   1. Supplements listed here are for completeness only
      1. No supplement is endorsed by this resource
      2. Many supplements are dangerous and illegal
   2. Ergogenic Aids generally have poor risk-benefit ratio
      1. Few Ergogenic Aids are beneficial
      2. Many Ergogenic Aids carry significant risks
4. Preparations: Adrenergic Stimulants
   1. Caffeine
      1. Athletes are limited to 12 mcg/ml urine (NCAA) and 15 mcg/ml (IOC)
      2. Performance enhancing in endurance sports
         1. Kovacs (1998) J Appl Physiol 85(2): 709-15
         2. Bruce (2000) Med Sci Sports Exerc 32(11): 1958-63
   2. Cocaine
   3. Phenylpropanolamine
   4. Ephedrine, Ephedra, and Pseudoephedrine
      1. Prohibited by IOC and NCAA
      2. Possibly effective in increasing Exercise performance and strength
      3. However, the potential adverse effects are serious and outweigh any possible benefit
         1. Shekelle (2003) JAMA 289(12): 1537-45
5. Preparations: Anabolic agents (banned by IOC and NCAA)
   1. Insulin
   2. Anabolic Steroids
      1. Androstenedione
      2. Dianabol
      3. Testosterone
      4. Dihydrotestosterone
   3. Human Growth Hormone (banned by IOC and NCAA)
      1. Used to enhance growth in Short Stature
      2. Precursor to testosterone
      3. Produced by recombinant genetics
      4. Very expensive, difficult to detect
      5. No benefit for strength and endurance in athletes
         1. Liu (2008) Ann Intern Med 148(10): 747-58
6. Preparations: Anti-Asthma Medications (for performance enhancement)
   1. Clenbuterol
   2. Albuterol
   3. Salbutamol
   4. Salmeterol
   5. Terbutaline
7. Preparations: Increased Red Blood Cell Mass
   1. Blood Doping
   2. Recombinant Erythropoietin
8. Preparations: Nutritional Supplements
   1. Creatine Monohydrate
   2. Amino Acid Supplement (Arginine Aspartate Supplement)
   3. Chromium Picolinate
      1. Reported cases of liver and renal dysfunction and Rhabdomyolysis
      2. No increase in Exercise performance or strength
         1. Davis (2000) Int J Sport Nutr Exerc Metab 10(4):476-85
         2. Livolsi (2001) J Strength Cond Res 15(2): 161-6
   4. Iron Supplementation
      1. Indicated in iron deficiency (esp. women)
      2. No benefit for athletes with normal iron stores (and risk of Hemochromatosis)
   5. L-Carnitine
   6. L-Tryptophan
   7. Beta-Hydroxy-Beta-Methylbutyrate (HMB)
   8. Dehydroepiandrosterone (DHEA)
9. References
   1. Armsey (1997) Physician Sports Med 25(6):77-92
   2. Eichner (1997) Physician Sports Med 25(4): 70-83
   3. Ahrendt (2001) Am Fam Physician 63(5):913-22
   4. Catlin (1996) JAMA 276(3): 231-7
   5. Jenkinson (2008) Am Fam Physician 78(9):1039-46