Beware of the Super “Natural” Supplement

I wonder what Babe Ruth considered a supplement in his time?

One more serving of pasta? An extra vitamin C tablet? Or perhaps an additional hour of sleep so that he could endure an extra hour of practice? Kind of sounds like eat properly, take your vitamins, sleep well and work hard. When Mark Maguire recently broke Roger Maris’ Major League Home Run Record of 61 home runs in 1961 (The Babe had 60 in an earlier era and Maguire finished with 70 in 1998), the definition of “supplement” took on a new meaning courtesy of the new baseball hero’s use of the Steroid Analogue, Androstenedione.

Do not be mislead, for “ANDRO” is exactly that, a steroid. The only people calling it a supplement are those selling it to you at “natural” food stores, muscle magazines and the internet. Medical literature is full of references to this hormone and its role in the steroid pathway and the function of the human body.

Long before the internet and drug companies, one could read the medical literature about the effect of this steroid in certain medical conditions, such as cases where people lack the enzyme that converts it to other steroids or cases where people have it produced in excess by tumors. Despite the accepted, medical definition based on its steroid structure and physiological effect, a search on the internet showed 1,462 sites discussing Androstenedione as a “natural supplement”. All were trying to sell it to interested net surfers, all claimed to be better, cheaper, safer and more extensively studied than the others, yet all omitted the actual scientific references, which when traced by a Medical Literature search, where done in 1930 & 1960. In fact, the literature search of even remotely reasonable medical studies revealed only 19 studies of this drug. Only 7 of these studies were clinical, none involving sports. Reviewing European research database did reveal some East German Studies from 1963. Very misleading isn’t it?

I’m sure there are ongoing studies that we will soon hear about. I won’t hold my breath. This article isn’t about Androstenedione in particular; rather it is about how such an obvious Steroid can be mislabeled as a supplement. For the record, “The Androstenedione Fact Review” is included below.

What is Androstenedione?
Steroids are important hormones that regulate body function. There are different types of steroid hormones. The mineralocorticoid (“water-pill-like”) hormone pathway controls your body salt balance and your blood pressure. The glucocorticoid (prednisone-like) hormone pathway has important blood sugar, lipid metabolism, and immunological effects. There is also the androgen and estrogen steroid hormone pathway, important in the development of sexual characteristics, and more importantly, the muscle gaining potential that some athletes covet. All of these pathways are interconnected, with precursors of one pathway easily converted or redirected into that of the other.

So what is “ANDRO” and its place in all of this. Androstenedione is the direct precursor to testosterone. One enzymatic effect changes its structure to testosterone, the strength-enhancing hormone that is BANNED beyond what your own body produces “naturally”. Its effect is to allow a more rapid regeneration of the muscle tissue that is injured after working out and thus allow one to train harder and better tolerate the wear and tear of daily vigorous exercise. These type of hormones also affect our mood, often unpredictably, but have commonly been studied for their potential as “mental performance boosters” that might increase training intensity, duration and frequency.

The ANDRO studies that I did find looked at the mental rather than the muscular aspect of sport enhancement. In its oral form, which is the way that it is marketed, its rapid clearance out of the body would make it more likely to be a temporary psychological tool rather than a than physical enhancer. Intra-muscularly or intra-nasally, as shown in some studies, the duration of physical benefits and potential for side effects is larger. Perhaps at the end of a long season, any sporting season, a home runner hitter has more zip and can still swing for the fences or maybe a running back misses fewer games and has more yardage, because of such drugs. Alternatively, he or she may also get caught in a drug test, or worse still, get caught by the nature of their own physiology with the inevitable side effects.

Many drugs, especially precursors, have the potential to convert to other substances. ANDRO in particular, may be “shuttled” to any of the pathways I mentioned above, and thus there is the potential for the side effects of overdosing each pathway, not just testosterone. The possibilities include electrolyte imbalances and blood pressure abnormalities (mineralocorticoids), bruising, blood sugar and cholesterol problems (glucocorticoids) as well as the problems associated with anabolic steroids.

For the record, some steroid side effects are listed:

Blood Pressure:

Increases, which also increases the risk of Heart Disease.

Cosmetic:

Acne, Baldness, and Atypical Facial Hair location.

Chest:

Breast enlargement (gynaecomastia) in men. Deepened Voice in women.

Cholesterol:

Less Good (HDL) & More Bad (LDL).

Liver:

Liver Disease, Jaundice, Tumors and GallStones.

Pancreas:

Blood Sugar & Insulin problems.

Musculoskeletal:

Stunted growth in adolescents.
Muscle > tendon strength = tear at this junction.
Salt & Water Imbalance = cramps, fatigue & injury.

Sexual:

Testicular atrophy, Impotence and Infertility.

Mental:

Aggression which may lead to high risk behaviour; such as being, sexually abusive or acquiring undisciplined penalties. Also, Post-use Depression

With all of the above information, the role of ANDRO or any other steroid precursors (i.e. DHEA) in sport should be clear. The fact that it is not banned in a sport is not an issue. Or is it? Drinking and driving is considered a public health threat, and there are laws in most countries prohibiting it. Is it OK then to drink and drive if one is in a country where there are no such laws? Is it OK to take what is essentially a steroid just because there is no policy in a particular sport?

Studies are looking at truly natural medicines (Elk Antler Fur Oil, Chinese Herb Roots) with “steroid-like” strengthening qualities “without” the steroid side effects. Is this OK? Is it acceptable to send the message that one must take something in order to be a better person, a better athlete? This is the question all sport medicine health care givers face. It is a question that will always be there as long as there are athletes looking for “The Edge” over their competitors. The loophole that allows a home run champion to be adorned while taking a steroid precursor without remorse proves this. Our best chance is to educate athletes about the truths and demystify the myths about drugs and hope that they in turn make sensible decisions for themselves.

There will always be a new precursor, whether to ANDRO, Adrenaline or any other substance that has been banned in sport due unfairness of play or risk to health. By the time I’m looking up and feeling smug about my “Andro-Spiel”, my athletes are kindly making me aware of 20 other drugs of questionable permissibility. They have been told they are “natural”, with “super” qualities that will give them “the edge”, at a “safe” and affordable price. They are the magic words our present society wants to hear and accept unconditionally. But do they really know “the cost”. In order to deal with this, one must arm oneself with a collection of rules and guidelines that can be applied to any substance.

Due to limited space in this issue, I will just list some helpful rules for judging supplements in sport. The details of these rules will be described in the next publication.

  1. SHOULD I TAKE THIS “SUPPLEMENT”?
  2. Is it BANNED in sport?
  3. Is it a PRECURSOR of something banned?
  4. What ELSE is in it? (and is IT banned?)
  5. Is the Advisor, also the Seller that stands to Profit?
  6. When they say, “studies show …” you say, “SHOW ME THE STUDY!”
  7. Does this “supplement” alter its NATURAL BALANCE in my body?
  8. Is the benefit risk and cost worth more to me than a PROPER DIET?