Some dietary supplements can give you a ‘positive’ experience
By Monique Ryan
Beginning two years ago there was a sudden increase in elite athletes testing positive for metabolites of the steroid nandrolone. Many of these positive tests have occurred in Great Britain, where in 1999 alone there were 17. Several athletes, including U.S. Postal Service rider Benoit Joachim, have claimed these positive doping tests occurred inadvertently through the use of dietary supplements.
Experts continue to speculate over the recent increase in nandrolone positives. Is such a sudden increase in intentional nandrolone use likely? Testing techniques allowing the period of nandrolone detection to be increased by several months have been in place since 1996 and this drug can be stored in the body for up to one year. Increasingly, it does seem possible that athletes are ingesting products called prohormones, intentionally or not, which are precursors to nandrolone and testosterone.
Prohormones are easily purchased in the U.S., due to the passing of the Dietary Supplement Health and Education Act in 1994. Often found in supplements geared toward muscle building, recovery and maintaining hormone levels, these products may or may not be appropriately labeled. Many athletes have claimed inadvertent use of these products – some have been cleared, some have not. According to chemist Larry Bowers, Ph.D. of U.S. Antidoping, “Athletes will be held responsible for whatever they put in their body.” The message is clear: buyer beware.
Nandrolone itself is not a dietary supplement, but what are legally sold are two main classes of prohormone products, which include the “andro” and the “nor” prohormone products. Androgenic products, namely androstenedione, are testosterone precursors, and transform to this hormone in the body. Other androgenic products include androstenediol and dehydroepiandrosterone (DHEA). Nor products are precursors to the steroid nortestosterone (nandrolone), which is structurally similar to testosterone. Available nor-prohormones are 19-norandrostenediol and 19-norandrostenedione. These nor-prohormones break down to the urinary metabolites norandrosterone and noretiocholanolone, which are the same metabolites used to detect nandrolone usage. According to the Olympic Movement Anti-doping code, all of these prohormone products and “related substances” are banned. Athletes who take these substances will be deemed to have doped and carry the risk of a positive urine test. Andro prohormones including DHEA, may lead to an elevated testosterone/epitestosterone ratio, and the nor-prohormones may result in a positive test for nandrolone metabolites.
Athletes should read labels carefully and avoid these banned products, but it is becoming clear that this may not be enough. A recent study conducted at the UCLA Olympic Analytical Laboratory checked urine tests after supplementation with androstenedione and 19-norandrostenedione. Not surprisingly, the 10 micrograms of the 19-nor supplement given four subjects produced nandrolone metabolites in their urine two to four hours later, in amounts exceeding IOC limits.
But more concerning were the urine results from androstenedione supplementation. For this component of the study, 37 men were randomly assigned a placebo, or 100 or 300 milligrams of androstenedione daily. The metabolite 19-norandrosterone was found in the urine sample of all supplemented subjects. Of the 24 positive urine samples, 20 exceeded the IOC cutoff for men of two nanograms per milliliter. Based on this finding, researchers re-tested the andro supplement provided the subjects, using more sensitive testing for impurities (tested at 0.001 percent rather than 0.1 percent). Seven of the eight tested capsules contained anywhere from 0.004 to 0.18 percent 19-norandrostenedione. The authors concluded that the 19-norandrosterone detected in the urine was most likely due to contaminated androstenedione.
Other brands of andro were analyzed at a less stringent level of impurity. One brand actually contained no steroids, while another contained 10 mg of testosterone. Brands labeled as providing 100 mg of androstenedione, provided from 85 to 103 mg. Overall, researchers categorized six of the nine andro products as misbranded.
While andro is clearly a banned product, and avoiding it is the athlete’s responsibility, the issue of cross-contamination could be disastrous. “The problem that is coming to light is that there are traces of nor-prohormone products finding their way into some non-prohormone nutritional products,” says Patrick Arnold, who is involved in the bulk manufacture of prohormones. “This is due to cross-contamination in some stage of the manufacture. Many companies use the same equipment to blend, encapsulate, and bottle both prohormone and non-prohormone products.”
Quality control is now entrusted to supplement companies. It is estimated that 30 percent of companies that sell supplements achieve the same standards that must be met by pharmaceutical companies that manufacture drugs regulated by the FDA.
Other than inadvertently testing positive, ingestion of these prohormones may carry some unwanted side effects. Two studies were conducted at the University of Iowa in Ames. In the first, 20 men took either a placebo or 300 mg of androstenedione, and performed eight weeks of resistance training. While this andro dose did not significantly increase serum testosterone levels or produce a greater increase in muscle strength than the placebo group, other parameters were measured. There were increases in blood levels of the estrogens, estradiol and estrone, and a reduction of the protective HDL cholesterol. Researchers speculated that andro supplementation could have potential serious side effects in regards to certain cancers and heart disease.
In the second study, a combination of androgen precursors and herbal extracts was tested. The herbal extracts are claimed to enhance testosterone formation while reducing product conversion to estrogen. Again, there were not significant increases in serum testosterone in the supplemented groups, or greater gains in muscle strength with resistance training. But most importantly, the estrogenic profile was not reduced from the herbal extracts. Higher supplement doses than used in both studies could potentially cause even greater estrogen increases.
What does all this mean? First of all, prohormone supplements are illegal. Second, read labels carefully and don’t accidentally take these products. Even if a mislabeled supplement is proven to contain banned substances, it’s hard to prove after-the-fact that ingestion was accidental, or did not coincide with ingestion of some other banned agent. Clearly, the current message is that athletes are responsible for what they ingest.
In addition to that, cross-contamination is a real concern. Consumers should demand that supplement companies produce only quality-controlled and well-labeled products. Perhaps the debate should not be left to the sporting and testing organizations, but with the supplements companies themselves so that appropriate pharmaceutical standards are met.
Monique Ryan, RD, LD is a nutritionist in private practice in Evanston, IL. She is the author of “Complete Guide to Sport Nutrition,” and “The Complete Meal Planning Guide For Sports Nutrition.”