HFPA - Health and Fitness Professionals Association
     LEADERS IN EDUCATION IN THE HEALTH & FITNESS INDUSTRY SINCE 1979
 

 

SUPPLEMENTATION – Fact File & FAQ’s
   
  Athletes are always looking for ways to improve their performance. The most effective ways to achieve this are through efficient training combined with optimal nutrition. However to get the most out of your training program, it is worth considering supplements. These include pills, powders, drinks, and bars. Such supplements are classed as ergogenic aids, meaning substances that ‘increase work’.
   
  Their purpose is to enhance performance. They claim to increase muscle tissue, increase endurance, promote fat burning and improve strength.
   
  This document will cover the most popular ergogenics, focusing on those which have undergone scientific studies.

 

 
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These include:
Quick Links
Antioxidants
Protein
Branched Chain Amino Acids
Meal Replacement Products
Creatine
Glutamine
HMB
DHEA (dehydroepiandrosterone) and human growth hormone
Pro-Hormones
Ephedrine
Caffeine
antioxidant supplements
protein supplements
branched- chain amino acid (BCAA) supplememts
meal replacement products
creatine
glutamine
HMB
DHEA
pro- hormones
ephedrine
caffeine
 
We will cover what they are, how they work, their possible benefits, suggested doses, possible side effects and whether they are allowed by the IOC.
 
ANTIOXIDANTS
Antioxidant fact file
What are they?
Substances that quench free radicals. They include enzymes, vitamins, minerals, and phytochemicals.
 

What are their benefits?

They help reduce the symptoms and risks associated with high levels of free radicals generated during exercise, protect against age- related diseases, slow down the effects of aging.

 
Who could they benefit?
Anyone involved in regular exercise or sport
 
How much?
Not certain, but levels around 15-25m beta-carotene, up to 1000mg vitamin C, 250-500mg vitamin E and 50-100pg selenium are advised by leading scientists.
 
Any side effects?
No toxic effects form large doses of antioxidant vitamins, but doses of selenium over 900pg can be toxic (cause nausea, vomiting).
 
Are they legal?
Yes
 
What is the evidence for antioxidants?

There is much evidence that antioxidant supplements protect against age-related diseases such as heart disease, some cancers and cataracts.

 
Researchers have also concluded that antioxidant supplementation has a beneficial effect as it reduced post- exercise soreness.
 
How much should you take?
Fruit and vegetables provide a vast array of antioxidants, esp. beta- carotene, vit C and folic acid, as well as protective nutrients called phytochemicals. At least 5 portions of fruit and veg are needed to prevent 20% of all cancers. Try get as many antiox from food as possible.
 
The dept. of health and the World Health Organisation advises a minimum of 400g or 5 portions of fruit and veg daily.
 
Recommended daily amounts for athletes have not been set yet. However, it is doubtful that an athlete’s requirements could be met by food alone. Therefore it makes sense to take a daily antioxidant supplement.
 

ANTIOXIDANT

FOOD SOURCE

Beta- carotene

Carrots, red peppers, spinach, spring greens, mangoes, apricots.

Alpha- and gamma- carotene

Red coloured fruit, red and green coloured vegetables.

Canthaxanthin

Tomatoes, watermelon

Coumaric acid

Green peppers, tomatoes, carrots

Allicin saponins

Onions, garlic, leeks

Glucosinolates

Broccoli, cabbage, cauliflower, brussel sprouts

Sulphoramine

Broccoli

Lycopene

Tomatoes

Lutein

Green vegetables

D- limonene

Pith of citrus fruit

Ellagic acid

Grapes, strawberries, cherries

 
Heart disease protection
.

ANTIOXIDANT

FOOD SOURCE

Folate

Spinach, broccoli, curly kale, green cabbage, and other leafy green vegetables.

Quercetin

Onions, garlic, apples, grapes

Phenols

Grapes

Resveratrol

Grape skins, red wine

 
Are there any side effects?
No toxic effects have been found for the antioxidant vitamins.

Large doses of beta- carotene can turn your skin orange, but it is harmless.

Large doses of vit C can cause diarrhea and flatulence.
Vit E appears to be safe even at levels of 2000mg per day.
However, selenium in high doses can cause nausea, vomiting, hair loss and loss of fingernails. Keep it to under 200pg a day.
The other antioxidant minerals - zinc, magnesium and copper - may produce toxic symptoms in high doses so stick to the upper safety limits.
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PROTEIN
 Protein supplement fact file
What are they?
Powders that mix with milk or water to make a ‘shake’, or protein bars. Most popular brands are based on whey protein (a milk protein). Other protein ingredients include another type of milk protein called casein or soy protein
 
What are the benefits?

Higher biological value (BV) than food sources, whey proteins may stimulate the immune system, high glutamine content spares muscle and prevents immune suppression during heavy training.

 
Who could benefit?
More beneficial to strength and power athletes, athletes on below- maintenance calorie intakes, athletes undergoing very heavy training, possibly vegans, and vegetarians.
 
How much?
One or more servings daily- just enough to make up the shortfall in your diet.
 
Any side- effects?
Excessive intakes of protein from supplements are neither harmful nor beneficial. EXPENSIVE!!
 
Are they legal?
Yes
 
What is the evidence for protein supplements?
Studies show that strength and power athletes have a greater daily requirement for protein than most endurance athletes. Strength athletes need between 1,3-2,0g/kg body weight/day. The harder and more intensely you train the greater your need for dietary protein. Protein supplements allow athletes to make up the shortfall in their diets.
 
Do they have additional benefits?
Yes. Whey protein isolates have immune- enhancing and muscle- sparing properties.. In addition, reputable brands are well- formulated, containing not only high quality protein but other key nutrients (e.g.. vitamins, minerals, selected amino acids, carbohydrates, essential fatty acids).
 
When is the best time to take a protein supplement?

It is best to consume protein in 5-6 divided doses throughout the day. This will ensure a steady supply of amino acids to the tissues and therefore favour the build- up of lean tissue and minimize catabolism. In practice, you should include at least one food source of protein at each meal, and also take a protein supplement in one or two snack meals as necessary.

 
Strength and power athletes would benefit further by including protein in their post-workout meal, or taking a protein supplement together with a high carbohydrate food e.g.. bananas.
 
What type of protein is best?
Protein-based supplements may contain one or more of the 4 types of protein;

  WHEY

  CASEIN
  SOY
  EGG
 
Each type has its own merits. Whey however seems to offer the most advantages and is the main ingredient in most brands of supplements on the market.
 
Are there any side effects?
No. Fears about high intakes causing liver and kidney damage, dehydration or calcium loss have not been proven conclusively.
 
Advantages of whey

These are proteins extracted from curdled milk.

Isolated whey protein has a higher BV (biological value) than any wholefood source. This means that it has an amino acid profile that is better matched to muscle proteins than any other food. It is also extremely easy to digest.

 
It also has an especially high concentration of IAAs about half of which are BCAAs compared with other proteins. This means that whey protein has a ‘muscle-sparing’ effect, which means it minimizes muscle protein breakdown during intense exercise. BCAAS make up a high proportion of muscle tissue and are the first to be broken down for energy during high intensity prolonged exercise. So the more BCAAs you have, the less likely it is that you will breakdown existing muscle tissue.
 
It also has an immune-enhancing ability. Studies show that the amino acid make-up of whey can stimulate the production of glutathione, which is a powerful antioxidant that helps support the immune system. This is particularly useful during times of intense training when the immune system is suppressed.
 
It may also stimulate muscle growth by increasing insulin-like growth factor-1 (IGF-1) production - a powerful anabolic hormone made in the liver that enhances protein manufacture in muscles.
 
Advantages of casein
It has a high BV relative to food sources, which means a relatively high % of the amino acids are utilized for tissue growth.
 
It is especially high in the amino acid glutamine. This can help spare muscle mass during intense exercise and prevent exercise-induced suppression of the immune system.
 
Casein also travels through the gut more slowly than whey protein. This slow transit means that amino acids and peptides could be absorbed more thoroughly and therefore a greater % of the protein could be absorbed.
 
Advantages of soy protein
It has the highest concentration of the key amino acids that are important for muscle growth: BCAAS, glutamine and arginine. These amino acids make up 36% of the soy protein. The glutamine content is similar to that of casein, so it’s a good protein for sparing muscle tissue during intense exercise
 
It is also thought to enhance the production of thyroid hormones. These are important for regulating the metabolic rate.
 
Advantages of egg protein
Egg protein has a BV of 100, higher than any wholefood source and has long been considered the highest quality protein available out of all the wholefood proteins. However, technology has brought us ‘new’ proteins (the whey isolates) that have even higher BVs.
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BRANCHED CHAIN AMINO ACIDS
BCAA Fact File
What are they?
Three IAAs that have branched molecular configurations : valine, leucine, and isoleucine.
 
What are the benefits?
They may decrease protein breakdown during intense exercise but may not offer any advantage over carbohydrate supplementation.
 
Who could they benefit?
Athletes on a fat loss program who are consuming inadequate carbohydrates.
 
How much?
4g taken during and after exercise
 
Any side effects?
BCAAs are relatively safe as they are normally found in protein in the diet. Excessive intakes may reduce the absorption of other amino acids in the body.
 
Are they legal?
Yes
 
What are they?
The BCAAs include the 3 IAAs with a branched molecular structure ; leucine, valine and isoleucine. They make up one third of muscle protein.
 
What do they do?
They are thought to prevent the break down of muscle tissue during exercise. They can also be used directly by the muscles as fuel, esp. when glycogen is depleted, studies confirm that under conditions of stress, injury, or exercise, the body uses a disproportionately high amount of the BCAAs for energy.
 
What is the evidence?
Studies show that taking 4g BCAA during and after exercise can reduce muscle breakdown. They seem to be effective in preserving muscle in athletes on a low carb diet.
 
However it is unclear if they have any benefits on performance.
 
Who could benefit from BCAAs?
Athletes, esp. body builders, report muscle strength and growth benefits from BCAA supplementation. However, they are not just for power athletes. Endurance athletes can also benefit from supplementation with them
 
They are usually an ingredient of most protein and meal replacement products, so it is probably not worth taking them if you are already taking such a supplement.
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MEAL REPLACEMENT PRODUCTS (MRPs)
MRP fact file
What are they?
Multinutrient supplements designed to a provide near- perfect balance of nutrients, and possibly other ergogenic aids, in a drink.
 
What are their benefits?
It takes the guesswork out of meal planning, highly convenient, good way of combining nutrients and supplements. Best used as ‘snacks’ rather than meal substitutes.
 
Who could they benefit?
Any athletes with high nutritional needs.
 
How much?
One or more servings per day, just enough to make up the shortfall in the diet.
 
Any side effects?
High intakes are unlikely to be harmful, although they will provide no further benefit either. They may also lead to weight gain if they cause you to consume more calories than you burn.
 
Are they legal?
Yes. However, you must check the ingredients for banned substances such as caffeine or ephedrine.
 
What are MRPs
They are multinutrient powders which mix with water or milk to make a ‘shake’. They are designed to provide as complete a nutritional package as possible, comprising of carefully calculated quantities of protein powder (usually whey and/or casein and/or other  milk proteins), carbohydrate (usually maltodextrin and/or various sugars), vitamins and minerals.
 
Some MRPs have extra ergogenic nutrients such as creatine and glutamine to combine all the benefits of all the ingredients.
 
Why take MRPs instead of food?
They should be seen as supplement rather than substitute meals. Their 2 biggest advantages over food are convenience and ‘completeness’. They usually have a good nutritional profile and are low in calories and fat. They are quick and easy to prepare, and easy to carry with you. They will not have a significant effect on your performance, strength or stamina, but they will help you meet your nutritional needs and take the guesswork out of meal and snack planning.
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CREATINE
Creatine fact file
What is it?
It is made naturally from 3 amino acids in the body, stored mostly as phosphocreatine (PC) in the muscles. PC generates energy during high intensity activity. When you have a quick-energy need, your anaerobic system breaks down PC to resupply ATP to your muscles. This system delivers a great boost if you have a high-intensity short-term need, but the ATP supplied from it is depleted rapidly. Creatine products are designed to boost the body’s reserve of useable PC for energy.
 
What are the benefits?
Prolongs maximal power output, speeds recovery between high-intensity ‘sets’, increases lean and total body mass, and buffers lactic acid build-up in muscles.
 
Who would benefit?
Athletes involved in high-intensity and anaerobic-based sports, interval training and possibly aerobic sports that include some anaerobic bouts.
 
How much?
Either a loading dose of 20g (4x5g) per day for 5 days followed by 2g a day maintenance; or a daily 3-6g divided dose for 30 days. Reload after 8-12 weeks.
 
Side effects?
The only proven side effect is the weight gain as water and/or lean muscle mass.
 
Is it legal?
Yes
 
What does creatine supplementation do?
Increasing the muscle stores of PC through creatine supplementation would theoretically increase the ability to maintain power output during intense exercise and promote recovery between short bursts of exercise. This would result in more effective training gains and give the athlete the competitive edge.
 
Creatine supplementation raises PC stores by 10-40%. Elevates creatine levels would allow athletes to maintain greater training volumes, particularly if involved in short bursts of activity (eg. Weight training, sprinting, football, rugby). Creatine supplementation may help athletes by one or more of the following mechanisms:
 
  Boosts the short-term energy stores of PC so the duration of maximal exercise can be increased
  Speeds the recovery between ‘sets’ so it is beneficial for high-intensity bursts
  Promotes protein manufacture and muscle hypertrophy (by drawing water into the cells), increasing lean body mass
  Reduces muscle acidity (it buffers excess hydrogen ions), thus allowing more lactic acid to be produces before fatigue sets in
 
What is the evidence for creatine?
Anaerobic performance
Of all the studies done, creatine supplementation has proved to be beneficial in over half of the cases.
Aerobic performance

There is less evidence that it is beneficial in aerobic-based sports. This is probably because the PC energy system is less important during endurance activities. It may however increase an athletes’ lactate threshold and provide some benefit.

Body mass and composition
Studies show that short term creatine supplementation increases body mass. This effect occurs in males, females, trained and sedentary people, elite and non-elite athletes. Well-trained athletes show considerable increases in lean body mass.
 
The observed gains in weight are due partly to and increase in cell volume and partly to muscle synthesis.
 
 1.  It is an osmotically active substance, ie. it causes water to be move across cell membranes. When muscle cell creatine concentration increases, water is drawn into the cell. It is thought that the raised cell volume caused by creatine supplementation acts as an anabolic signal and can stimulate protein synthesis and reduce protein breakdown. The result is increased lean tissue.
 
 2.  Creatine may have a direct effect on protein synthesis.
 
 3.  If creatine improves the quality of resistance training over time, this would lead to faster gains in mass, strength and power.
 
Who could benefit from creatine supplementation?
Athletes in sports that involve high-intensity bursts of activity benefit the most. It may benefit aerobic athletes too if bursts of high intensity effort are needed.
 
Does it work for everyone?
No. Not everyone responds well to creatine. In some people, creatine concentrations rise very slightly. It may be due to differences in muscle fibre types. Fast-twitch fibres (FT) tend to build up higher concentrations of creatine than slow-twitch (ST). This means that athletes with naturally low FT fibre compositions may experience smaller gains from creatine supplementation. Taking creatine with a carbohydrate may help solve the problem as carbohydrate raises insulin, which, in turn, helps creatine uptake by muscle cells.
 
What is the best form of creatine?
Creatine monohydrate is the most widely available form of creatine. It looks like a white powder, dissolves readily in water and is virtually tasteless. It is simply a molecule of creatine with a molecule of water attached to it so that it is more stable. It is the most concentrated form and is the least expensive.
 
You can also get creatine monohydrate attached to carbohydrate, taurine, glutamine, and amino acid, all of which claim to make it more effective.
 
Studies have shown that insulin can stimulate creatine transport into the cells and so some manufacturers have added a carbohydrate to the creatine dose. This high GI carb causes an increase in insulin which, in turn, drives the creatine into the muscle cells. However, by taking creatine monohydrate with a food or drink containing carbohydrate works just as well and is much cheaper
 
How much should you take?
The key to efficient creatine supplementation is to take small quantities at a time- to slow the absorption from the gut. Roger Harris (1998) recommends taking only 0,5-1g at a time with a daily dose of 6g and sprinkling it on your food so that it reduces your absorption rate. Over a 5- or 6-day period that will produce results equivalent to taking 20g per day. After that, a maintenance dose of 2g a day will keep creatine muscle levels high enough. The loading strategy can be repeated in8-12 weeks.
 
Alternatively, you can load up with 3g a day for 30 days. This technique produces the least water retention.
 
Muscle has a maximal creatine storage capacity of 150-160mmol/kg, which makes supplementation over the recommended quantities a waste of time and money.
 
Guidelines when using creatine
 1. Take it 60mins before your training session so that it is in your bloodstream during the workout. Take it with a high GI carb as carbs seem to help transport the creatine to the muscles and boost the amount they retain significantly.
 2. When the week-long loading period is over, stop the loading and move to a maintenance dosage. Once you achieve muscle saturation, anything above a maintenance dose is a waste of money.
 3. Creatine loading can dehydrate you. Drink a lot of extra water during the program.
 4. Studies show that caffeine cancels creatine’s performance benefit. Don’t waste your creatine by washing it down with a caffeinated drink.
 5. Some people experience bloating, gas, cramping, diarrhea, or a combination of these symptoms when they load. Try increasing your fluid intake to alleviate these symptoms. If that doesn’t help, reduce your dose.
 6. Experiment with loading during a hard training period. Don’t initiate the practice just before a competition.
 
Are there any side effects?
The only proven side effect is weight gain. All the studies conducted indicate that there are no health risks associated with creatine supplementation.
 
When would  it be a disadvantage?
The body weight gain would be a disadvantage in athletes who need to be light, for example, long distance running, swimming and cycling. The extra weight will slow them down. It’s a matter of weighing up the potential advantage of increased maximal power and/or lean muscle mass against the possible disadvantage of increased weight.
 
What happens when I stop taking it?
When you stop supplementing, elevated creatine levels will droop very slowly to normal levels over a period of 4 weeks. During supplementation the body’s own synthesis of creatine is depressed but this is reversible.
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GLUTAMINE
Glutamine fact file
What is it?
Dispensable amino acid (DAA) found in muscle cells, the major fuel of the immune system.
 
What are the benefits?
Helps prevent muscle breakdown and suppresses exercise-induced immune depression.
 
Who could it benefit?
Any athlete during periods of intense training or immediately after prolonged intense exercise (eg. Major competition)
 
How much?
100mg/kg body weight during 2-hour post-exercise period.
 
Any side effects?
No
 
Is it legal?
It is labeled as ‘nonpermissible’ by the NCAA (national college athletic association).
 
What is it?
Glutamine is a DAA. It can be made in the muscle cells from other amino acids (glutamic acid, valine, and isoleucine) and is the most abundant free amino acid in muscle cells. It is essential for cell growth and is a critical source of energy for immune system cells called lymphocytes.
 
What does glutamine supplementation do?
It indirectly promotes muscle growth by increasing cell hydration. When cells are swollen with water the breakdown of protein and glycogen is inhibited while the synthesis of protein and glycogen is promoted. This is a favourable state for athletes.
 
The idea behind glutamine supplementation is that when taken during stressful catabolic periods (e.g. intense training), it should help prevent muscle breakdown and boost the immune system.
 
During training, stress, illness or trauma, cell hydration takes a back seat to more important survival processes. So, muscle and blood levels of glutamine drop as demand exceeds supply. This causes a domino effect on the immune system and cell volume. Without adequate fuel (glutamine) immune cell activity is impaired. As a result, athletes are more susceptible to minor infections and illness, and as cell volume decreases the muscles become catabolic and there is a net breakdown in muscle tissue.
 
Every cell in your body uses glutamine, and maintaining an ample supply- which is crucial for supporting your immune and CV systems, building muscles, replenishing glycogen stores after exercise, protecting you brain from ammonia toxicity, and much more- can take special dietary efforts. If you don’t have enough of it, your muscles will begin to atrophy, and you may even get sick.
 
What is the evidence?
Studies show that glutamine taken immediately after intense prolonged exercise and again 2 hours later, boosted immune cell activity and lowered the risk of illness in professional athletes. Studies have also shown that it may promote muscle growth and/or prevent upper respiratory tract infections among athletes.
 
How much?
No ideal dose has been determined. Usually around 100mg/ kg body weight in the 2 hours following strenuous exercise has been suggested. You can take it before and after workouts, but taking it afterwards is the most important.
 
What is the best form?
You can get it from a protein supplement fortified with glutamine or as a separate supplement. Both provide adequate amounts. But the supplement should be taken straight after training.
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HMB
HMB fact file
What is it?
A metabolite of the amino acid leucine.
 
What are the benefits?
Reduces muscle damage, repairs and builds muscle after exercise, increases muscle strength, reduces body fat.
 
Who could benefit?
Strength and power athletes, athletes wishing to gain lean muscle mass, possibly endurance athletes.
 
How much?
38,1mg/kg body weight/day – approx 3g (men) or 2g (women) 
 
Any side effects?
No. Excess is excreted in the urine.
 
Is it legal?
Yes
 
What is HMB?
HMB (beta-hydroxy beta-methylbutyrate) is made in the body from the BCAA, leucine. You can also obtain it from a few foods such as grapefruit, alfalfa and catfish.
 
What does it do?
It assists the immune system, builds muscle, decreases body fat and lowers blood cholesterol. It is involved in cellular repair. It protects muscle protein from excessive breakdown and accelerates repair. Thus it helps build muscle and repair tissue more rapidly after exercise.
 
What is the evidence?
Studies show it reduces muscle damage and produces greater strength gains. It works equally as well in men and women, trained and untrained individuals.
 
It may also reduce body fat, probably due to the increase in muscle. Since muscle burns more calories during rest and exercise, the more muscle you have, the more calories you expend.
 
Who could benefit?
Endurance and strength athletes. It minimizes muscle damage and promotes faster recovery.
 
How much?
A daily dose of 3g for men and 2g for women is recommended.
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DHEA (dehydroepiandrosterone) and human growth hormone
DHEA Fact File
What is it?
An adrenal steroid hormone.
 
What are the benefits?
No proven benefit. Theoretically, it increases testosterone levels and may reduce body fat.
 
Who could benefit?
Insufficient evidence to recommend its use to anyone. Definitely should not be used by anyone in drug-tested sports.
 
How much?
Doses of 50-100mg have been used in studies.
 
Side effects?
No major effects, except for excess facial hair in women. Higher doses may result in liver toxicity and prostate cancer in men.
 
Is it legal?
Legal to buy but prohibited by the International Olympic Committee (IOC)
 
What is DHEA?
It is the most abundant steroid produced by the adrenal glands. It plays a central role in the production of other hormones.
 
What does it do?
It is converted to the more powerful androgenic and anabolic hormones: oestrogen, testosterone, and dihydrotestosterone. Lowered DHEA is associated with increased abdominal fat storage, loss of muscle mass, fatigue and decreased sex drive. The theory is that because DHEA is a precursor of testosterone, supplementation should increase testosterone. This is a powerful anabolic hormone that increases muscle mass and decreases body fat.
 
What is the evidence?
Despite it’s widespread use, no studies have shown conclusively that it has any effect on body composition in trained athletes. However, studies in older and sedentary people, obese people and animals, suggest that it may be effective in reducing body fat.
 
Is it legal?
Yes
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PRO-HORMONES
Pro-hormone fact file
What are they?
Inactive substances which are converted to active hormones in the body. The ‘andro’ compounds are precursors to testosterone. The ‘nor’ compounds are precursors tonandrolone.
 
What are the benefits?
Theoretically, they increase testosterone production, strength and muscle mass. In practice, there is no scientific proof for their purported effects.
 
Who could they benefit?
According to their marketing claims, strength and power athletes should benefit.
 
How much?
Manufacturers recommend daily doses between 50 and 100mg.
 

Any side effects?

May raise oestrogen levels and decrease HDL. May raise nandrolone levels, therefore banned in drug-tested sports.
 
Are they legal?
Legal to buy, but may result in illegal levels of testosterone or nandrolone.
 
What are prohormones?

They are steroid compounds that can be converted by the body into potently active steroid hormones such as testosterone. The pro-hormones possess only very weak anabolic properties, but when converted to hormones, they have a powerful anabolic effect, increasing muscle mass and strength.

 
Androstenedione is produced naturally in the body from DHEA and is then converted into testosterone. There are a number of ‘andro’ derivatives on the market that are then converted by the body into testosterone.
 
Another pro-hormone, 19-norandrostenedione, does not convert to testosterone, but to a less androgenic compound called nandrolone which also causes increased muscle mass and strength.
 
What do pro-hormones do?
The theory behind “andro’ supplements is that they increase the body’s production of testosterone, which in turn helps build muscle and gain strength. The norcompounds are claimed to be converted into nandrolone, a potent androgenic hormone that increases muscle mass and size and speeds up recovery.
 
What is the evidence?
It has been suggested that under-the-tongue forms of pro-hormone work more effectively than oral pro-hormone supplements.
 
Are there side effects?
The ‘andros’ may increase oestrogen and decrease HDL levels. This can lead to gynecomastia and lowered libido in men. Reduced HDL increases your risk for heart disease. Another possible side effect is reduced prostate function which can result in lowered sperm count. It can also cause “roid rage”. They can cause radical, violent behavior.
 
Are they legal?
They are not permitted by the IOC.
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EPHEDRINE
Ephedrine fact file
What is it?
A stimulant substance derived from the ephedra or mahuang plant.
 
What are the benefits?
Increases alertness, arousal, and motivation to train; increases thermogenesis and helps fat loss.
 
Who could it benefit?
Not recommended to anyone in drug-tested sports. In practice it is taken by endurance and strength athletes to increase workout intensity and duration and to aid weight loss.
 
How much?
Up to 25mg in one dose is considered safe in cold and flu remedies, higher doses around 150mg would be needed to produce a stimulant effect.
 
Any side effects?
Anxiety, heart palpitations, hypertension, insomnia, and if taken in high enough doses it can be fatal.
 
Is it legal?
Legal to buy but banned by the IOC.
 
What is ephedrine? 
It is a drug rather than a supplement. It is a common ingredient in ‘energy boosters’ and ‘fat burners’ and weight loss supplements.
 
It is also used in low concentrations in cold and flu remedies and in cough syrup. It comes from the dried young branches of the Ephedra sinica plant, and asian shrub commonly known as ephedra or mahuang.
 
What does ephedrine do?
It is chemically similar to amphetamines which act on the brain and central nervous system. Athletes use it because it increases arousal, physical activity and the potential for neuromuscular performance. It is often combined with caffeine which roughly doubles the effect of the ephedrine.
 
What is the evidence?
It is a proven stimulant. However, it has little effect on strength and endurance. They are used because they have a ‘speed-like’ effect and make you feel more alert, awake, motivated to train hard and more confident.
 
There is also some evidence that it helps fat loss: partly due to and increase in thermogenesis and partly because it suppresses the appetite  and partly because it makes you more active.
 
When taken as a ‘caffeine-ephedrine stack’ or as a ‘caffeine-ephedrine-aspirin stack,’ it is thought that it has a greater effect on thermogenesis and weight loss.  The caffeine also stimulates the beta-2 agonist receptors on muscle cells, which could increase the force of muscle contractions.
 
Are there any side effects?
It is safe in doses of 18-25mg, the amount used in medications. Too much can cause increased heart rate, increased blood pressure, palpitations, anxiety, nervousness, insomnia, nausea, vomiting and dizziness. Very high doses (around 3000mg) can be fatal.
 
Caffeine-ephedrine stacks produce adverse effects at even lower doses.
 
Is it legal?
It is classified as a banned substance by the IOC.
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CAFFEINE
Caffeine fact file
What is it?
A stimulant.
 
What are the benefits?
Increases alertness, concentration and endurance.
 
Who could it benefit?
Athletes involved in both high-intensity short-term activities and endurance athletes. Not recommended to athletes in drug-tested sports.
 
How much?
Doses between 210 and 1050mg will have no ergogenic effect. However this varies between individuals.
 
Any side effects?
It varies, but it may exacerbate anxiety and sleeplessness. Diuretic action may cause dehydration if extra fluids are not consumed.
 
Is it legal?
Legal to buy but banned by the IOC at levels above 12pg/ml in the urine.
 
What is caffeine?
It is a drug not a nutritional supplement. It is found in drinks such as coffee (50-100mg/cup), tea (30-60mg/cup), cola (50mg/330ml can), herbs such as guarana and chocolate. It is also added to a number of energy and sport drinks and to meal replacement powders.
 
What does it do?
It acts on the central nervous system increasing alertness and concentration. It also stimulates adrenaline release and mobilizes fatty acid release. This means that more fatty acids are used for energy and glycogen is spared. This would be advantageous in many sports as this glycogen-sparing property would increase endurance. Caffeine can also affect muscle contraction positively by releasing calcium from its storage sites in muscle cells. This would be advantageous in both aerobic and anaerobic activities
 
What is the evidence?
There is a huge amount of research evidence that shows that caffeine improves performance. It has proved beneficial in both short-term high-intensity activities, such as 100m sprint runs or swims, as well as aerobic activities, such as long distance swimming and running. Positive effects have even been demonstrated within the legal limits.
 
Any side effects?
Its side effects include sleeplessness, trembling and anxiety. Some people are more susceptible than others to its effects. It is also a diuretic, so it causes a net excretion of fluid from the body. So you must make sure that you are adequately hydrated, and consume extra fluid during exercise to offset the diuretic effect.
 
Is caffeine legal?
The IOC classifies it as a stimulant, but as a constituent of drinks, it is permitted in doses that produce a urine level of less than 12pg/ml. On average the amount needed to reach this level is equivalent to 8 cups of coffee or 16 cans of cola.
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