Things you might need to know about sports supplements

Ever since a spate of nandrolone positives at the turn of the century were attributed to contaminated supplements, much has been written about the potential hazards of using sports supplements and the fact that – no matter what the label claims – there is no guarantee that any such product is free from banned substances.

Yet, the use of supplements has skyrocketed!...

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WADA Prohibited List 2017

WADA, the world anti-doping body, has published it's updated prohibited list for 2017, which will come into effect on January 1st. It is available to view here.

They have also, helpfully, produced a document which summaries the changes to the list. That document can be viewed here.

Athletes should remember that they are responsible for whatever substances are found in their bodies, and should stay abreast of changes to the Prohibited List. Any medications that you are taking should be checked on the relevant database (Global DRO if you live/purchased your medication in the UK; Eirpharm if you live/purchased your medication in the Republic of Ireland) on a regular basis as medications that you are taking may change in status.

Those of you who follow the doping news (or sports news in general) will remember the furore earlier this year when a number of top sporting stars failed tests for meldonium, a substance which was added to the 2016 banned list. Some, including Maria Sharapova, claimed that they didn't know the substance was banned, in Sharapova's case because she only knew the substance it only by its trade name Mildronate; others claimed they had stopped taking it before January 1, but that it hadn't cleared the system. Sharapova is currently serving a two year ban, as it was her responsibility to ensure that the drug she was taking wasn't banned.

Sharapova got off lightly - the standard ban for a first time doping offence is four years!

Sharapova, Meldonium, and our anti-doping responsibilities

In light of the recent doping revelations concerning Sharapova and meldonium, there’s no better time to remind athletes and their support staff of some key anti-doping rules and responsibilities in the fight for #cleansport.

Athletes are subject to ‘strict liability’ when it comes to the presence of banned substances in their samples. The athlete, and the athlete alone is responsible for what is found in their bodies. Take responsibility for what you take, and take all the necessary measures to ensure that you are not taking a banned substance.

Just because it’s not yet illegal doesn’t mean that it’s not immoral. We'll cover this point more in future blogs, but probably sums it up quite well (this in relation to Sharapova and Meldonium):

Banned or not, if you're taking stuff designed to treat heart failure, you know you're cheating https://t.co/k75PonDlqx

— David Oliver (@doliversub13) March 7, 2016

Just because it’s not on the banned list now doesn’t mean that it won’t be in the future.

Just because it’s available without prescription doesn’t mean that it doesn’t contain banned substances.

Supplements can inadvertently contain banned substances. They are not subject to the same strict production controls as drugs and medications.

The anti-doping code, including the list of banned substances and methods, changes every 12 months. Changes come into effect on 1st January, but the updated list is generally available from September the previous year. Regularly check all the medication you take.

If you are taking medications or supplements, be sure to list them on your doping control form if/when you are tested.

If you need a medication for known medical condition, ensure that you have followed the correct TUE procedures for the level you are competing at/the medication you are taking.

All the resources and information that you need are available at:

GlobalDro: Database on which you can check whether your medication in permitted or prohibited (for products purchased in Canada, UK, USA or Japan) 

Eirpharm: Similar database to the above, for products purchased in the Republic of Ireland.

UKAD, Sport Ireland, or the national body which oversees antidoping in the country where you are.

WADA, the world anti-doping agency

Supplements and anti-doping

With a few high profile doping cases recently gone through appeals hearings, now is a good time to revisit the area of anti-doping, particularly in relation to adverse findings as the result of contaminated supplements.

Strict Liability

The first point to reiterate is the notion of strict liability.  This means that the athlete alone if responsible for what is found in their bodies.  There have been a number of cases where athletes have failed drug tests without knowingly taking a banned performance enhancing substance.  The consequences in these cases, if a non-specified substance (generally substances which have limited performance enhancing benefits), is, by default, a two year ban, which in some cases gets reduced to 6 months.

Why do Supplements Carry a Risk?

Food supplements are not subject to the very strict monitoring that medical drugs are.  Because of this, they can contain just about anything!

• They can contain substances that are not listed on the label.
• Substances can be named under a very different name to that which appears on the WADA code
• They can be manufactured in the same factories as products which contain banned substances, and become contaminated.
• Products say that they are 'approved' and athletes believe that that makes them ok to take.
• The 'sports nutrition' industry is a lucrative business. They give products to high performance athletes in return for endorsement.  Athletes like getting free stuff, and all of a sudden the perception is that you can't perform without taking a range of products.

Current Position

Until recently, the advice from UKAD was not to take any supplements.  That made life a lot easier from the perspective of the Anti-doping advisor perspective. You could just tell an athlete that the advice was not to take anything, and then they could choose to heed that advice or not.  Things have changed in recent years, and while UKAD cannot endorse any products, they now give advice based on the likelihood that athletes are going to take supplements anyway, and the current approach is based on risk reduction rather than elimination.  This is fine, and their advice is sound, but in the absence of any information relating to products (or types of products) which carry a high risk, have been linked with positive tests in the past, or which contain banned substances, it's very difficult to hammer home to athletes just how seriously they should be taking the whole matter.  In the ten or so years that I have been involved in advising athletes, the only product I have really seen named is JACK3D, a product which is now banned for sale in the UK and Ireland ...

Positive Moves

... Or at least that was until I saw this recent announcement from the Australian anti-doping body.  In it they name three products which have been shown to contain banned substances, and advise against certain groups of supplements.  They recommend taking special care with weight-loss supplements and with supplements claiming to improve mental performance.  This level of information is very useful when educating athletes.

I have also since noticed that the body responsible for anti-doping in the US (USADA) has a list of high risk supplements - details of supplements which either list banned supplements or have been found to contain banned substances.  Of course this list is by no means complete, but can give some indication to athletes the level of precaution they need to take.  The list includes Ephany D1, the vitamin/mineral/herbal supplement which was blamed for Asafa Powell's failed drug test.

Removing some of the Grey Areas

I find it bizarre why athletes would need to take weight-loss supplements, or to 'get them up' for training or competition.  A wise man - the man who thought me everything I know about athletics - once (or 100 times) told us that if it doesn't work, it's a waste of money and if it does work, it's probably illegal. While this may not be completely true, it's been a good motto to live by.  For me, anti-doping has nothing to do with being caught.  I would hate to look back in a few years and not be able to say that what I achieved in sport, no matter how pitiful, was 100% me.  For me, too many grey areas are created by our fixation on rules and what you can get away with.  Performing clean should be about much more than that.

What Athletes Should Do

Consider the need - Despite the claims, few food supplements actually legally help improve performance, and none make up for poor nutrition.  Consider what changes you can make to your diet, before you resort to any nutritional supplement.  Only take supplements that you actually need.

Consider the risks and the consequences - Some of the risks associated with nutritional supplements are listed above.  From January 2015, first-time doping offences, where there was an intention to cheat, will result in a 4 year ban. The onus will shift to the athlete to prove that there was no intention to cheat.  It is highly likely that more inadvertent doping offences for non-specified substances than before will result in 2 year bans. But think beyond the bans and tangible consequences of inadvertently using a supplement that's found to contain a banned substance.  Consider how you would feel if someone told you that that harmless looking 'endurance enhancer' that you have been using for the last 2 years contains EPO, and that your performances have been artificially enhanced, or that the 'herbal' supplement that you have been using to help shift a few pounds actually contains amphetamines, and has been damaging your health.

Do what you can to reduce the risk - While no anti-doping body can 100% guarantee that a produce does not contain a banned substance, some products sign up to undergo rigorous testing, and those which have not been found to contain substances are listed on sites such as Informed-Sport.  

• Check that any products that you plan on using have undergone this testing.  
• Check what other products are made by the same company/in the same factory - there is an increased risk of contamination if made in the same factory as products which contain banned substances.  
• Do some online research to see if the product has been linked with any doping cases in the past.  
• Check any active ingredients against drug databases (Global Dro in UK; Eirpharm in Ireland).
• Keep all packets and samples of the product, so it can be tested if you have a case to answer.
• If you are chosen for a test, ensure that you list all products that you are taking on the doping declaration form.  It's very difficult to claim that the adverse finding was for a supplement that you hadn't declared you were using.

Dear Asafa, ...

Last week it was announced that Jamaican sprinter and former world record holder Asafa Powell, was banned from competition for 18 months after testing positive for Oxiforan, a banned substance.  Powell claimed that the source of the substance was a nutritional supplement, which was given to him by his trainer, and which did not list Oxiforan as an ingredient.

Powel, his lawyer, and his agent, claim that he is innocent.  In this public letter to Asafa, I point out how he isn’t innocent, irrespective of whether or not he intended to cheat.

Dear Mr Powell,

While I may have been the first to cheer you on at a major championship, and hope that you might finally fulfil the potential that your fast times indicated, I have now lost all admiration for you as both an athlete and a person.  You have clearly broken the rules, so, in the words of Kim Collins, ‘man up’ and accept your punishment. 

As a lesson to you for the future (no doubt you’ll be like all the other cheats and won’t go away), and for other athletes who want to take the ‘I didn’t mean to cheat’ route, I just wanted to point out a few things that you should already have known.

1. Strict Liability – An athlete, and only an athlete is responsible for what is found in his or her body.  If you’re going through airport security and a gun is found in your bag, blaming someone else isn’t going to do you much good.  Similarly, you should be vigilant about what is going into your body, and don’t go blaming coaches, trainers, parents, agents, doctors, dogs or baby sitters when a banned substance is found in your body.
2. Nutrition supplements aren’t regulated, and the ingredient list should be taken with a pinch of salt.  The nandrolone scandal, now almost 20 years old, should have been a lesson to athletes that they can’t trust nutrition supplement producers.  We get that you don’t work in a supplement factory (I’m don’t know of any top level athlete that does), but surely you’ve heard other athletes blame positive tests on supplements they were taking?
3. If a supplement claims to be ‘mind-bending’, as Epiphany D1 does, it’s probably not something you should be taking.  Having said that, if the supplement is called Epiphany D1, it’s probably not something you take to make up for not eating your greens.  Other things which the supplement claims to do include enhancing focus, attentiveness, short term and long term memory and vision, speeding up auditory and spatial thought processing, and optimising motor coordination.  On reading these benefits, would the word ‘stimulant’ not immediately pop into your head?  Think again about what the supplement claims to do – surely this is performance enhancement that if not illegal, is immoral.
4. You benefited from a banned substance – there’s no denying that.  You should have to serve some punishment one those grounds alone.
5. Nutritional supplements are generally a waste of money, and if not, they probably contain banned substances that they don’t list.  Try eating a balanced diet, and stop trying to get an unfair advantage.
6. Next time you’re tested, try listing all the supplements and medications you’re taking on the doping form.  If there’s too many to remember, consider point 5 again.
7. Jamaican charm may get you a long way with the ladies, but it won’t get you out of sticky doping situations, nor will pretending to be stupid.

For me, only one question remains: was 18 months long enough?

That is all.

Elizabeth Egan

(for drug free sport)

p.s. This advice is free.  No need to thank me.  Similar advice is available on the WADA website.

Was Jenny Jones really GB’S first Winter Olympic Medallist on snow?

Snowboarder Jenny Jones at this year’s Winter Olympics in Sochi won Great Britain’s first Olympic medal on snow (rather than ice) when she took bronze in the Snowboard Slopestyle.

However, 12-years ago in Salt Lake City Alain Baxter became the first British athlete to win a medal on snow.  The medal was later taken away and awarded to Austria’s Benjamin Raich after Baxter failed a post-race drugs test.  A minute quantity (20 millionths of a gram) of the banned substance methamphetamine was found in the athlete’s urine sample which he claimed was from an over the counter Vicks nasal inhaler.

He was supported by the BOC to appeal the decision to the Court of Arbitration for Sport (CAS) and though CAS agreed with his argument the IOC’s decision was upheld because of the strict liability rule.

Alain Baxter’s error was buying an American version of a nasal inhaler to clear his sinuses.  It had different ingredients to the British version he had used for years, which had been cleared for use by his doctor.  The American version was not checked and contained traces of the banned substance levometamphetamine.

Since the games Alain has told the BBC that it was quite hard to take in when they were saying about it being a historic medal for Britain and he had some explaining to do when the archive pictures of him were shown on television news after Jenny Jones won her medal in Sochi.

“Kerr [my son] saw the pictures of me from Salt Lake City and drugs were mentioned. He started asking me about it and I thought ‘heregoes’.  He knows I won a medal but I nolonger have that medal, and it’s hard to explain why to a seven year old”

Baxter did return to ski racing after serving a ban, and competed at the 2006 Games in Turin where he finished 16^th; he has since retired from competitive racing in 2009. 

So what can athletes learn from this mistake?

What is the Strict Liability Rule?

This is where athletes are 100% responsible for what is ingested into their bodies whether or not the athlete intentionally or unintentionally used a prohibited substance or was otherwise negligent or at fault.

Medication

At some point, an athlete is likely to require medication for an illness or infection to allow them to train or compete and many athletes receive information on what to do through the 100% programme run by UK Anti- Doping (UKAD).

But here are a few pointers:-

1.   Check with your doctor that the medication does not contain a banned substance and that you are able to compete; if it does contain a banned substance is there an alternative medication?
2. Even over the counter medications can contain banned substances so should always be checked
3. Athletes in the UK can check their medication on the Global Drug Reference Online (Global DRO) which provides athletes and support personnel with information about their prohibited status of specific substances-  http://www.globaldro.com
4. Athletes in Ireland can check their medication on- http://www.eirpharm.com/sports/search which provides athletes and support personnel with information about their prohibited status of specific substance.
5. Some medications are banned just in competition, so be specific when you come to check

What happens if you train or compete abroad?

1. Take enough of the prescription with you so you don’t need to buy any abroad
2. If you are in the UK, Canada, United States and Japan check- http://www.globaldro.com
3. If you are in Ireland check- http://www.eirpharm.com/sports/search
4.   If you are in any other country outside of those listed you can check the ingredients listed in the medication

Hay Fever and Sport

With hay fever season well and truly here, I thought it appropriate to share some advice on the illness.  I, like many others it seems this year, am relatively new to the illness, and am beginning to realise that summer time is not all sunshine so to speak!

Firstly, all high performance athletes who suffer from hay fever, should check that any medication that they take complies with anti-doping regulations.  While there are many over-the-counter and prescription treatments which are permitted, some are not, especially intra-muscular injections with are sometimes prescribed to treat the condition, and products containing pseudoephedrine which is prohibited in competition (e.g. Zirtex Plus Decongestant Prolonged Release Tablets).  Athletes should check the status of any medication (intra-muscular, oral, nasal or otherwise) that they take on their national drug database - www.globaldro.com for medications purchased in UK, including Northern Ireland, USA and Canada and www.eirpharm.com for products purchased in the Republic of Ireland.

Any athlete who is prescribed a prohibited cortiosteriod intra-muscular injection will need to take additional measures, including obtaining documentation to show that such a treatment was necessary, over and above the permitted medications available.  Athletes who are part of their national testing pool (i.e. subject to out-of-competition testing) will need to obtain a Therapeutic Use Exemption (TUE) prior to use, and other high performance athletes will need to obtain and provide TUE permission after testing.

Further information can be obtained here (for athletes in the UK) and here  (for athletes in Ireland).

As well as the potential of failing a drug test, taking hay fever medication can result in drowsiness; not ideal when you're trying to compete at the top of your game!  Any steps that you can take to avoid the symptoms may be better than taking medication.  Simple things like wearing wrap-around sunglasses can help prevent pollen getting the eyes, and can therefor reduce at least one of the symptoms of hay fever.

This article provides useful basic information on hay fever.  Remember though you should always seek medical advice for any condition that you suffer from, and check all medications, even if they have been prescribed by a doctor.

Drug use versus training methods: EPO as an example

For some athletes, there is a fine line between modern training methods and the use of banned substances.  For me the difference is clear as day.  Below is my slightly tongue-in-cheek take on the differences between EPO use and altitude training which I wrote earlier this week for another blog.  I use it as an example of how training methods and drug use differ, and hope that it will have athletes confused by the differences between the two.   

In the interest of keeping things simple, when I refer to a drug’s secretion naturally in the body I give it it’s full name (e.g. erythropoietin), and when I’m referring to the drug in it’s synthetic, exogenous or administered form, I refer to it in abbreviations (e.g. EPO).

‘Legalise EPO’ they say, ‘because you can’t ban altitude training, and they’re essentially the same thing’.  ‘The only difference between EPO use and altitude training is that one is banned in sport and that the other isn’t’, I’ve recently heard people argue.  ‘They both increase red blood cells, so they must be the same thing’; a simplistic, and ignorant, statement which not only misinterprets how EPO and altitude training work, but completely ignores the ethos behind drug-free sport.

People’s arguments suggest that if there were different legislators in sport, altitude training might find itself on WADA’s prohibited list, or that one day we might see EPO legalised in sport.  As somebody who has strong anti-doping convictions, but has benefited from altitude training, for me, EPO use, and altitude training are worlds apart. 

To argue that EPO use and altitude training are the same thing because they have similar effects would be the same as saying that steroid use and weight training are similar (they both increase muscle size), and that taking an afternoon nap following training would be just as unethical as injecting HGH, as to do so would cause an increase in human growth hormone secretion and expose the body to it’s benefits.  In fact, hill training, endurance training, recovery runs, fartlek training, plyometrics, good nutrition, heat acclimatisation… and pretty much every other form of training, increases the body’s ability to perform through increased hormone secretion, increased tissue growth and/or increased neural adaptation, and it would be ridiculous to suggest that any of these are on the same moral footing as using banned performance-enhancing drugs.  Training is very much allowed!

The drug EPO is not only banned in sport, but it is a prescription-only drug, designed to help keep individuals with an inability to produce it naturally healthy.  It is not (or at least should not be) available for healthy individuals to purchase and use without medical reason.  Conversely, individuals around the world have the right to be born or live at any altitude at which human life is possible.

The use of EPO is extremely dangerous.  Prolonged or excessive use can have at least two fatal consequences in humans.  EPO increases red blood cell production, and the more red blood cells you have, the thicker your blood becomes.  Blood can in fact become so thick that your heart is no longer able to pump blood around the body.  If that happens, you die.  Additionally, EPO use can affect your body’s natural ability to produce erythropoietin.  Without erythropoietin you can’t produce red blood cells, and without red blood cells you can’t transport oxygen around the body.  Oxygen, I hear, is fundamental for human life (and not just in life involving sport), so that’s pretty crap.  Of course you don’t have to die, but you do become dependant on EPO.  Altitude exposure at or below 3,000m, even over a prolonged period of time, though not without it’s side effects (crazy dreams for example), is unlikely to kill you!

And now to the scientific bit, and the crux of my argument. Just because two things have the same end product, doesn’t mean that they are the same thing, physically, morally or legally.  We’ve already agreed (unless you’re the real argumentative type), that training in sport is allowed, and indeed encouraged if you want to be any good at sport, and call me an idealist, but I feel that injecting ourselves with any substance (when not medically required) to take a short-cut to enhanced performance is not in line with drug-free sport, irrespective of whether that substance is banned or not.

Now, I will agree that a large portion of the response to EPO use, and to altitude training, is the same, but there are some fundamental differences.  As we mentioned before, EPO use increases red blood cell production; increased red blood cells carry more oxygen around the body; and a greater oxygen carrying capacity increases endurance performance.  The main way in which altitude training is proposed to work is that the reduced atmospheric oxygen stimulates the body to increase erythropoietin synthesis, which in turn increases red blood cell production, increased red blood cells carry more oxygen around the body; and a greater oxygen carrying capacity increases endurance performance.  Taking EPO makes training easier.  It allows the body to recover quicker (because the body is not the one synthesising the EPO, which believe you me is stressful business for the body), and allows you to train hard day after day.  Altitude training on the other hand is a nightmare!  It’s impossible to breathe, you sleep 14 hours a day, simple tasks like walking to the shops can tire you out, you can’t run as hard or as long as you can at sea level, and think again if you think you’re going to do session after session after session.  Like lots of other beneficial training methods (e.g. weight training, hill reps), you need to recover.  Increased EPO increases red blood cell production.  More EPO creates more red blood cell production.  Altitude exposure increases erythropoietin, and subsequently red blood cell production, to respond to the reduced oxygen in the air, but once it’s adapted, it doesn’t keep on producing erythropoietin.  More altitude exposure doesn’t mean more erythropoietin.  And the real catch is that some people’s bodies are so against the whole erythropoietin synthesis lark that they don’t bother.  Yes, not everyone responds to altitude.  The good news though is that these people are usually the freaks that find altitude training easy.

For me altitude training and EPO use are as different from each other as helping old ladies cross the road and sticking needles in little babies’ eyes.  Other methods of increasing endurance such as altitude tents, altitude masks, iron injections, blood transfusions and blood doping may fall various degrees closer to the proverbial fine line, but training your ass off in difficult environments is not the same as injecting yourself with a drug, which you’ve acquired illegally, to make the route to the top easier for yourself.

Now, I don’t’ know if all of you, or in fact any of you, have managed to read through my waffle, but I have sure as hell enjoyed putting up my side of the argument.  If you’d like to agree or disagree, then please leave your comments below.

 

I've been Elizabeth Egan, and I'm for Drug-free sport (and for afternoon naps!).  Thanks for reading.

The Risks of Medication and Nutritional Supplements

Below is a link to an article in The Mail online, about the risks of using nutritional supplements and over the counter medications.  Not only is your chances of competing in major championships jupordised by inadvertant doping offences, but your reputation is forever tarnished, even if you didn't intend to cheat.  Always check your medications (even if they are bought over the counter), and remember that there are alternatives to food supplements (like a healthy nutritions diet).

http://www.dailymail.co.uk/sport/olympics/article-2034360/London-2012-Athletes-told-jeopardise-Olympic-chances-taking-drugs-risk.html

Doping News

Athletes that are subject to WADA's anti-doping rules, should be very careful not only about the medications and supplements that they take, but also about the source of their food.  Recently positive tests for clenbuterol as a result of eating contaminated meat products have been reported (most notable in the case of 3-times Tour de France winner Alberto Contador).  This recent article highlights the risk:

Contaminated meat products in China?

Be very careful!  Contador may be cleared to compete, but his reputation will forever be tarnished.  UK sprint hurdler Callum Priestley wasn't so lucky.

We will include further articles on doping in sport and precautions to take to avoid unintentional doping violations.  In the meantime, check out the UK Anti-doping (UKAD) website for further information.

Athlete Life Development are committed to drug-free sport.