Inadvertent Doping: The Dangers of Dietary Supplements in the USA

November 11, 2015


By Emma Harvey – Thompson Rivers University 3L JD Student

Ben Johnson, Alex Rodriguez, and Lance Armstrong are household names known for their athletic accomplishments as well as their notorious doping scandals. Their use of banned performance-enhancing drugs in sports has placed a spotlight on the perils of anabolic steroids, hormones, and stimulants. With that said there is still an aspect of doping that hasn’t garnered much attention, that is, the inadvertent doping through the use of dietary supplements.

Dietary supplements as the name would suggest are a dietary ingredient (i.e. vitamins, amino acids, minerals, herbs, etc.) intended to supplement one’s diet. They are sold online and in nutrition stores. Currently there is very limited evidence to suggest that supplements are at all beneficial, yet many athletes use them consistently as an integral part of their training program. Where there is hard evidence is in the fact that dietary supplements can and have led to both positive anti-doping tests and serious health issues.

The dangers of dietary supplements start with the fact that many dietary supplements aren’t technically dietary supplements, even though they may be labelled as such. So-called dietary supplements have been found to contain pharmaceutical drugs, stimulants, anabolic steroids, and other hormones. A recent study overseen by the non-profit coalition of dietary supplements, Informed-Choice, found that 25% of all supplements studied were tainted with a banned substance. Another study ran by the International Olympic Committee found that of the 240 American supplements tested, 18.8% contained steroids.

Most recently the attorney general of Oregon filed a lawsuit against GNC, which is one of the world’s largest retailers of all-natural dietary supplements, accusing GNC of selling adulterated and unlawful supplements. As for the harmful health effects, a 2015 study by the New England Journal of Medicine reported that dietary supplements send 23,000 Americans to the emergency department every year, with 10% of those cases requiring further hospitalization. Liver injury, kidney failure, strokes, heart attacks, psychiatric disorders, lung blockages, and death are only a few of a long list of potential health hazards.

Dietary supplements are a very lucrative business, with sales totalling $36.7 billion in 2014. The Nutritional Business Journal predicts that the industry will reach $60 billion sales in 2021. Companies are marketing their products with a view for profits and a disregard for the health and safety of the consumers.

There are two explanations as to why a dietary supplement may contain a banned product. The first is by accidental contamination through poor manufacturing practices; the second is by intentional practice. I contend most fall within the second category. When companies sell pharmaceutical agents as dietary supplements they evade US Food and Drug Administration (FDA) scrutiny, testing, and regulations while maximizing their profits. Many companies market their dietary supplement product through misleading packaging. Guarantees are made to look like the product is certified and safe, when really they are just a decorative decal. Proprietary blends are used to avoid quantifying the individual ingredients, listing only the total blend amount and leaving the consumer unsure as to how much or little of an ingredient may actually be in the product. Lastly, a lengthy health warning in fine print may be included on the packaging to protect companies from liability.

Enabling the problem is the fact that there’s no organisation in place that can guarantee the safety, effectiveness, or quality of the dietary supplements. Congress defined the term dietary supplements in the Dietary Supplement Health and Education Act (DSHEA), categorizing it as a “food”. The “food” classification implies that the FDA cannot regulate the dietary supplement through a pre-market approval process like it can with drugs. If the FDA test a supplement and find a banned ingredient in it, the FDA can issue a letter of warning notifying the company that the supplement contains an illegal product and that it must be taken off the market. If companies fail to do so, the FDA has no mandatory recall authority, and may only initiate a seizure application for the dietary supplement. Though all too often companies’ responses are to fold the brand, make the dietary supplement disappear, then have it resurface with the same product formula under a new brand name. For an athletes’ personal reference, the United States Anti-Doping Agency (USADA) maintains a “high risk list” of supplement products flagged by the FDA.

Ultimately, athletes who choose to take dietary supplements do so at the risk of their athletic career as well as their health. There’s no denying the sizable need for the FDA to better regulate the dietary supplement industry, though this won’t occur without some sort of congressional action. For now, all an athlete can do to reduce risk is research the dietary supplements to become an informed consumer. With that said there’s still a chance an athlete may test positive for a prohibitive substance or become ill. The only sure way an athlete can eliminate the risk, is by eliminating the use of dietary supplements all together: eat clean; play clean.

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