Knowledge Level: Beginner
Supplement products can pose a significant risk to riders in terms of inadvertent doping that may lead to them being found guilty of an Anti-doping Rule Violation. Riders and support personnel should be fully aware of what supplements are, what the risks associated with them are and how they can reduce those risks. Caution should be exercised at all times.
What are supplements?
Riders and support staff should be clear on the types of products that are regarded as ‘supplements’ so they can apply the appropriate amount of caution to the use of those products. Although there is no clear definition, supplements might be regarded as products used alongside diet to enhance general health and wellbeing or sporting performance. The claimed effects of supplement use may include building muscle, increasing endurance, weight gain or loss, increasing suppleness, rehydrating, aiding recovery or overcoming a mineral deficiency. Dietary supplements can be found in a range of forms including pills (possibly named as tablets or capsules), powder or liquid. The following generic types of supplements are just some examples of products that have been identified in the past as potentially containing prohibited substances:
• Testosterone boosters
• Weight loss products
• Muscle building products (including creatine)
• Vitamins and minerals
• Energy gels
• Recovery drinks.
What are the risks associated with using supplements?
There are supplements on the market that explicitly declare that they contain banned substances and declare that on the label. Others have no prohibited substances listed as ingredients, but do contain them. Some may have been accidentally or intentionally contaminated with prohibited substances (the reasons for this are explained further below) or may be incorrectly labelled. As the supplements industry is not governed by the same regulatory requirements as the pharmaceutical industry, they do not have to be as stringent in listing every ingredient on the label.
Some products may list ingredients under other names than those that appear on the Prohibited List. For example, some supplements list geranium or geranium oil but in fact they contain methylhexaneamine.
A study in 2001 by the International Olympic Committee analysed 634 nutritional supplements from 215 companies located in 13 different countries, for anabolic steroids. It found that 14.8 per cent of them contained prohibited substances, predominantly testosterone and nandrolone, that were not declared on the label. Around 20 per cent of those incorrectly labelled were purchased in the UK. A more recent study in 2008 by HFL Sports Science, an independent drug surveillance laboratory, found that 10 per cent of tested supplements and weight loss products purchased in the UK were contaminated with steroids and/or stimulants at levels that could have caused riders to test positive.
The above video gives the story of Adam Dean, a rugby player who tested positive for a banned steroid contained in a supplement.
How does contamination occur?
In many cases the presence of a prohibited substance in a supplement arises from inadvertent contamination. Such contamination can come from a number of sources within the manufacturing process, such as when equipment isn't cleaned thoroughly between batches or a product containing a prohibited substance is being manufactured alongside a supplement. Some manufacturers produce products on behalf of many companies, so there may be a huge array of substances being used under one roof, and potentially a lack of control from the lead company on manufacturing process. Contamination within raw ingredients is also possible.
Deliberate contamination could also be undertaken by a ‘rogue trader’ to give the user a particular benefit and boost reputation and sales.
Assess the need
UK Anti-Doping’s core message on supplements is that diet, lifestyle and training should all be optimised before considering the use of supplements. Riders should assess the need for supplements by always consulting an accredited sports dietician, a registered nutritionist with expertise in sports nutrition, or a sport and exercise medical doctor before taking supplements.
Riders are advised to be vigilant in their decision to use any supplement. No guarantee can be given that any particular supplement is free from prohibited substances. Riders should keep in mind the important principle of strict liability: Riders are ultimately responsible for any prohibited substances found in their system. If riders don’t feel confident that they know what they are putting into their body, they are safer to avoid using it. The appropriate sanctions will be imposed on any rider who tests positive for a prohibited substance via a supplement product.
Assess the risk
If a rider makes the decision to use supplements they should assess the associated risks and make informed decisions about the products they opt to use. Supplements may claim to be drug-free or safe for drug-tested riders. However, it is not possible to guarantee that specific supplements are free of prohibited substances; it is only possible to reduce the risk of inadvertent doping by making informed decisions.
In the UK, HFL Sports Science has created a risk minimisation scheme called Informed-Sport to support riders in assessing the risks associated with using supplements. Informed-Sport is a supplement testing and certification programme which aims to assure riders that products carrying this mark have been regularly tested for prohibited substances in sport and manufactured to strict standards.
Samples of a product are drawn from a number of batches, to explore inter- and intra-batch (in other words between different batches and within a given batch) variations and are tested for a determined list of prohibited substances (found on the Informed-Sport website). A number of products will also be purchased directly from retail outlets and tested. Should the product meet all the programme criteria, it will be registered on the Informed-Sport web directory and will be entitled to display the Informed-Sport logo. Further information on the Informed-Sport programme can be found on the website, along with a list of tested batch numbers so riders should attempt to buy from those specific batches.
It is very important that users understand that companies register specific products with Informed-Sport and not entire brands, and the licence is required to be renewed annually.
Limitations of the Informed-Sport programme
Informed-Sport is a risk-minimisation programme; it does not remove risk entirely. If a rider has made a decision to use a supplement, they can reduce the risk by taking a supplement that has been subjected to credible testing and appropriate manufacturing controls, rather than none at all.
As part of the Informed-Sport programme HFL do not test for all substances on the Prohibited List. As an example, when methylhexaneamine was added to the Prohibited List in 2010 there was a time delay before it was added to the list of substances that HFL tests for. Riders need to keep in mind that the status of substances could change between the batch going through the Informed-Sport programme and them purchasing and consuming it.
If riders opt to purchase from a tested batch they should remember that analysis can only indicate that no contamination could be found within the sample of the product that was analysed, and for defined substances, at defined limits of detection. In batch testing the amount of product actually analysed is a tiny proportion of the whole batch that is manufactured, and it is possible to get variation in levels of contamination both between separate manufacturing batches, and even within a batch itself if the product blending is inadequate. This is particularly relevant for solid product (powders, capsules, tablets, bars etc.) where the mixing of raw materials is likely to be variable. Batch testing should be taken to be an assessment of the likelihood of contamination in the entire batch. Just because a sample does not test positive for a prohibited sample there is no guarantee that the entire product is ‘clean’.
Riders should be aware that vitamins, minerals and herbal remedies are also supplements and can pose the same risks to riders.
There is no guarantee a supplement is free of prohibited substances regardless of the manufacturer or product- supplements are still the biggest cause of inadvertent doping in the UK. This poses a significant risk which could catch a rider out and lead to an anti-doping rule violation. Riders who fall foul of an anti-doping rule violation through the use of a supplement could face a two year suspension. Always remember the principle of strict liability- riders have a responsibly to ensure that they undertake thorough research (for example in-depth internet searches, nutritionist consultation) of all products they are intending to take, prior to use. Doing so may lead to a reduction in any suspension imposed.
For further information visit www.ukad.org.uk