Supplements and Inadvertent Doping

Dr Lucienne Attard

Chairperson Medical Commission

 © Copyright 2010 CorbisCorporation

In this issue we shall continue discussing the topic of athletes inadvertently testing positive. We had already emphasized that athletes have to be very careful about any supplements that they take.

Athletes nowadays have ready access to supplements from overseas via mail order or, Internet sales and personal importation. it is important that they have a global understanding of the regulation of supplements. In countries such as the US, there is less regulation of the production and marketing of supplements than under the Australian system. For example, pro-hormones are permitted ingredients in over-the-counter preparations, supplements and sports foods. All forms of food and non-food supplements fall under the jurisdiction of the Food and Drug Administration (FDA). The Dietary Supplement Health and Education Act (DSHEA), passed in 1994, reduced the regulation of dietary supplements and broadened the category to include new ingredients, such as herbal and botanical products. The DSHEA shifted responsibility from the manufacturer to the FDA to enforce guidelines for safety and claims, but the FDA is allowed to investigate a supplement only after a safety problem has been reported. Requirements for good manufacturing practice and accurate labeling are included in the DSHEA, but there has been little enforcement. This means that products advertising the fact that they are FDA approved are not necessarily free from banned drugs.

In the absence of rigorous government evaluation, quality control of supplement manufacturing is trusted to supplement companies. Large companies that produce conventional supplements such as vitamins and minerals, particularly to manufacturing standards used in the preparation of pharmaceutical products, are likely to achieve good quality control. This control includes precision with ingredient levels and labeling, and avoidance of undeclared ingredients or contaminants. However, there is evidence that such control does not occur with all supplement types or manufacturers:

So we where do we go from here? Here are some ideas that might help to reduce the rate of positive doping outcomes:

  • Educate coaches, athletes, trainers and other sports      science/medicine staff. The message: there      will always be a risk that dietary supplements will cause a positive      doping outcome, and that the responsibility lies with the athlete. The      risk is small, but real, and the price is a substantial loss of earnings      and respect.
  • Develop programs that help athletes to distinguish      levels of risk with various supplements. For example, in Australia discussions      are taking place that an accredited assessment/testing program could allow      Australian manufacturers to have their products assigned by brand name      into categories of “low risk”, “unknown risk”,      “restricted” and “banned”. This information could be      circulated like lists of permitted and banned medications. Athletes who      wish to use supplements could be directed to use only those products      designated as low risk.
  • Stop trying to excuse or exonerate athletes who      claim that their positive tests are the result of supplement use. This claim is almost impossible to prove, after the      fact. Even if you could show that a supplement contained banned substances,      how could you prove that it was taken inadvertently by the athlete, or      that the athlete was not also taking other proscribed agents at the same      time. The International      Court of Arbitration for Sport has held that athletes are      liable for drug offences, in that they have a duty to be aware of banned      substances and to know what they are ingesting. Although it is sad to      think that innocent athletes may be punished (e.g., the Romanian gymnast      at the Sydney Olympics), drug education messages are quite clear that      athletes are responsible for their own actions.
  • Apply pressure to supplement companies to produce      only high-quality well-labeled products. Changing government regulations      to set up surveillance of the supplement industry is a desirable but      almost impossibly huge task. Self-regulation might improve if customers      demanded higher standards, or if there were real penalties for providing      contaminated, mislabeled products that failed to deliver the promised      ingredients. The sports supplement industry flourishes because athletes      are prepared to buy anything that claims to improve performance. What      would happen if a few celebrity athletes who have had their careers ruined      because of a positive drug test sued the company that made the supplement      containing an undeclared banned substance? We all might be better off if      athletes undertake complicated legal battles with supplement companies      rather than sporting organizations or drug testing agencies.