Dietary Supplements- Are they Safe? The April 7, 2003 issue of Sports Illustrated had an interesting article titled Jolt of Reality. The article explores the increasing trend of teenagers "juicing their workouts with pills and powders -sometimes with tragic results." This is the practice of attempting to enhance workouts with powders or pills that contain ingredients such as ephedra, synephrine, caffeine or creatine to name a few. One such pill, called a Yellow Jacket, was mentioned in the article as containing ephedra and caffeine which speeds up the metabolism. The use of Yellow Jackets was the cause of death for a young man in Illinois named Sean Riggins. Sean believed the pills were okay because they were sold over the counter labeled a dietary supplement. (These supplements are stimulants which increase heart rate). He died because his heart was pumping too fast and gave out. He was only 16 years old. Dr. Arthur Grollman, a professor of pharmacological sciences and medicine at the State University of New York at Tony Brook was quoted saying, "Basically, anyone who uses those products is a human lab rat." This is because these supplements are not federally approved and haven't been subjected to clinical trials. Yet, millions of athletes are taking supplements. "A 2001 survey conducted by Blue Cross Blue Shield's Healthy Competition Foundation indicated that approximately one million kids had used supplements. Other experts wonder if the real number isn't double that." Many times it is athletes who use these supplements in an effort to bench press more weight or run faster so that their chance of a college scholarship increases. Girls as well as boys use the supplements. The appeal for girls is often to increase their aerobics as well as to lose weight. The article goes on to say," even the term dietary supplement can be confusing. It sounds innocuous, even beneficial. What kids-especially those health-conscious and interested in sports - don't want to supplement their diet? But the notion is a joke. No one is going to suffer because of an ephedra or creatine deficiency. We need to call these things what they are: drugs." You may be asking, "why are these supplements legal if they contain potentially harmful stimulants?" The article explains: "Dietary and sports supplements fall under the 1994 Dietary Supplement Health & Education Act (DSHEA), which mandates that products derived from herbs and natural sources be classified as food and not drugs. This has been a boon to supplement manufacturers, which can skip the long and often prohibitively expensive process of seeking FDA approval." However, it was stated that on February 27th the American Medical Association urged the FDA to take dietary supplements containing ephedra off the market. For more details you can read the article in its entirety in the April 7, 2003 issue of Sports Illustrated magazine. By the way, plenty of teens in our area have reported in counseling that they have used "Yellow Jackets" Information on Some of These Products: Ephedra- An extract of the Chinese plant "ma huang" that stimulates cardiovascular and central nervous systems. FOUND IN: Weight-loss energy-boosting and bodybuilding products, including Stacker 2 and Metabolife 356. POTENTIAL RISKS: Can cause elevated blood pressure. When taken in excessive doses or by people with certain medical conditions, can result in cardiac arrhythmia, heart attack seizure or stroke. WHO BANS IT: NFL, NCAA, World Anti-doping Agency (WADA) which oversees Olympic drug testing. Synephrine An extract taken from orange peel and used as a substitute for ephedra; sometimes called bitter orange. FOUND IN Weight-loss, energy-boosting and bodybuilding products marketed as "ephredra free," including Stacker 2 Ephedra Free, Xenadrine EFX Ephedra Free and Metabolife Ephedra Free. POTENTIAL RISKS: Pharmacological and toxic properties similar to ephedra; could cause an athlete to test positive for ephedra, depending on test methodology. WHO BANS IT: NCAA. Androstenedione, Androstenediol Steriod precursors that stimulate the body's production of testosterone. FOUND IN: Supplements such as Andro 100 Poppers; the body converts Andro into testosterone, which is believed to increase lean muscle mass. POTENTIAL RISKS: Have the potential to produce adverse effects linked to anabolic steroids; breast enlargement and testicular atrophy in men; breast shrinkage and deepened voice in women; growth retardation in teens. WHO BANS IT: NBA, NFL, NCAA Creatine Natural compound created from three amino acids; produced by the liver and kidneys and used by muscles and organs as an energy source. FOUND IN: Supplements designed to increase muscle mass and build strength and endurance, such as Simply Creatine and Creatine Candy; also in red meat and some fish. POTENTIAL RISKS: Can cause dehydration, diarrhea, stomach cramps, and muscle and ligament tears. WHO BANS IT: No governing body. Caffeine Stimulant and mild diuretic causes a feeling of heightened alertness. FOUND IN: Coffee, tea, chocolate, colas, energy drinks such as Red Bull and headache tablets; some supplements and drinks such as SoBe Sports System contain extract from guarana, a caffeine-rich plant. POTENTIAL RISKS: Has mildly addictive effect; in large quantities, can cause cardiac arrhythmia. WHO BANS IT: NCAA, WADA (in amounts roughly equivalent to consuming eight cups of coffee in a two-hour period. Note: Red Bull has the caffeine equivalent to 8 cups of coffee and is banned by the NCAA. Final Comments: I hope the preceding information has been helpful in getting you started thinking about this issue of "dietary supplements." One of the reasons I believe this is an important consideration is because people who have drug/alcohol problems are at risk of substituting one drug for another. In other words, if someone quits using their "drug of choice" they may choose a different chemical that they believe is not a "problem" in their life. Another risk is the possibility of relapse to drugs/alcohol because of the physical aspect of brain chemistry, and these products may also interfere with the healing of brain chemistry. Healing and protecting the brain is essential to recovery. This means total abstinence from all drugs including these products. Maintaining balance in life is important. This balance includes plenty of sleep, healthy nutrition with vitamin, mineral and amino acid supplements and exercise. For information on the nutritional aspects to recovery you can read "7 Weeks to Sobriety" by Joan Mathews Larson Ph.D. and "Hidden Addiction and How to Get Free" by Janice Keller Phelps, MD, and Alan E. Nourse, MD.