Adulterated products masked as dietary supplements continue to be a concern for professional athletes and weekend warriors alike. Nutritional Outlook caught up with two experts on the topic of adulterated sports supplements.
John Travis is a senior scientist at NSF International (Ann Arbor, MI). Travis has more than 20 years of experience as an analytical chemist specializing in the analysis of dietary supplements. As senior research scientist at global public health organization NSF International, Travis analyzes hundreds of dietary supplement products each year for various contaminants, emerging drugs, and harmful compounds. He has written articles for Nutritional Outlook on emerging adulterants in sports supplements and the tools used to detect them.
Amy Eichner, PhD, is a special advisor, drug reference and supplements, for the U.S. Anti-Doping Agency (USADA; Colorado Springs, CO). Eichner has worked with USADA in its Drug Reference Department since 2009 on initiatives such as USADA’s Drug Reference Hotline, the Global Drug Reference Online database, USADA’s Therapeutic Use Exemptions, and Supplement411.org.
Overall, how has the problem of sports-supplement adulteration improved since the passage of the Designer Anabolic Steroid Control Act of 2014 (DASCA)? What are some of the biggest problem areas that remain?
John Travis: NSF International has seen improvement in the issue of adulterated sport supplements since the passage of DASCA, which has definitely had a huge impact on this problem. Before DASCA, supplements containing steroids either directly by name or hidden on the label masquerading as another ingredient were marketed through blogs and forums. This type of distribution has pretty much disappeared. While there are still some companies out there selling steroids masquerading as supplements, many of the companies engaged in that practice have exited the marketplace. Hopefully, we do not witness a re-emergence.
Amy Eichner: The 2014 amendment to the Controlled Substances Act specifically named many anabolic agents that are considered “controlled,” which provided much needed clarity to enforcement agencies and manufacturers. Since then, we’ve seen a movement toward the sale of selective androgen receptor modulators (SARMs) and other experimental drugs, including Enobosarm, various peptide hormones, and other metabolic agents, that are not specifically named in any regulation. While USADA is not aware of any basis upon which companies can claim such substances are dietary ingredients, this doesn’t stop companies from advertising them as such. Consequently, athletes continue to be exposed to and test positive from illegal ingredients that can be dangerous and are prohibited in sport.
What are some of the most concerning adulterants now appearing in products marketed as dietary supplements for athletes? Why do you find these ingredients to be so troubling?
Eichner: Of greatest concern are the experimental drugs currently undergoing clinical trials, such as Enobosarm (also known as ostarine), ibutamoren, and others. These substances are investigational new drugs that act on the hormone systems in the body and have nothing to do with nutrition. The FDA has clarified that such products are not legitimate dietary ingredients, but they continue to pop up in dietary supplements. Such ingredients in products marketed as dietary supplements pose a serious threat to athletes and all consumers.
Other ingredients that we see a lot and are concerned about include higenamine, methylsynephrine (oxilofrine), B-methylphenethylamine, and dimethylbutylamine (DMBA). We still even see methylhexaneamine (DMAA) included in products, even though the FDA clarified years ago that methylhexaneamine does not meet the definition of a dietary ingredient.
Travis: There are a set of concerning ingredients that are appearing in products which produce effects similar to the anabolic steroid products that we have seen in the past. Manufacturers of these products are targeting athletes and image-conscious people. The ingredients SARMs and GHRPs (growth hormone releasing peptides) have become more popular after the passage of DASCA.
SARMs and GHRPs are actually pharmaceuticals masquerading as supplements. Both SARMs and GHRPs have been on the World Anti-Doping Agency (WADA) prohibited list for some time. Researchers are investigating the clinical use of SARMs in hospitals for patients who lose muscle mass due to bed confinement for extended periods and the use of GHRPs in children with growth hormone deficiency. SARMs target the androgen receptor similar to anabolic steroids, while GHRPs target the ghrelin receptor, causing the cascade of events which stimulates the body to release more growth hormone. They have different, perhaps complementary, mechanisms of action within the body.
These are not legal dietary supplement ingredients. We are concerned that the side effects of supplements containing SARMs and GHRPs are unknown and that their use in healthy individuals has not been clinically investigated. During the clinical trial phase of many pharmaceuticals, the drug has been discontinued due to unacceptable side effects. It would be unfortunate to have an outbreak of serious adverse side effects due to the use of SARMs and GHRPs in dietary supplements.