Athletes Face Extra Risks When Taking Dietary Supplements

In recent months, numerous athletes representing a variety of sports have faced allegations of doping after testing positive for a substance known as Ostarine, which has been banned by the World Anti-Doping Agency (WADA) for more than a decade. Many of them claimed that the chemical—an unapproved drug that can build muscle mass—had contaminated supplements they used and believed to be harmless to their health and careers.

One such athlete is Taylor Lewan, offensive tackle for the Tennessee Titans, who began the last season with a four-game suspension after traces of Ostarine were found in his system. “I didn’t take anything knowingly,” Lewan said last summer. “I’ve never done anything knowingly that would cheat the game.”

Lewan’s case appears to demonstrate the widespread problem of supplement contamination. The U.S. Anti-Doping Agency (USADA) has long warned athletes of the dangers of certain dietary supplements, commonly marketed for athletic performance or weight loss and too often laced with illegal ingredients or those banned by a sport’s governing body.

These supplements not only pose serious risks to athletes’ careers—for example, when tainted products cause them to fail drug tests—but also their health. Collegiate, Olympic, and professional sports organizations have worked to protect their competitors through educational campaigns, policies, and even product testing programs. All these initiatives face challenges, however, because of the limited oversight of dietary supplements by the Food and Drug Administration (FDA).

This issue is not unique to athletes because millions of Americans take a wide range of supplements every year. The problem stems in part from FDA’s lack of basic information about dietary supplement products, which manufacturers can put on the market without the agency’s review. The result is that, although FDA is responsible for oversight of supplement safety, the agency cannot sufficiently protect consumers from harmful products or ingredients.

Indeed, FDA continues to find illegal substances or prescription drugs hidden in supplements. Between 2007 and 2016, the agency found that 776 dietary supplements from more than 145 companies were  contaminated with drugs, including prescription medicines, banned and unapproved chemicals, and steroids or steroid-like ingredients such as Ostarine.

For athletes, like Lewan, these supplements can stymie or ruin careers. In 2012, American swimmer Jessica Hardy was kicked off the U.S. Olympic team for taking a nutritional supplement that contained clenbuterol, which can increase muscle growth. Similarly, in 2009, Brazilian-American cyclist Flavia Oliveira was suspended for 18 months after testing positive for oxilofrine, a hidden ingredient in the weight loss supplement she acknowledged using.

In addition, numerous college student-athletes have appealed positive drug tests to the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports, arguing that they had taken legal dietary supplements and tested positive for performance-enhancing drugs.

Addressing the problem

Athletes and other supplement users often assume that because a product is legal and on the market, it must be safe. Given these challenges, sports leagues, as well as the USADA, have worked to ensure that players do not consume unsafe supplements. The NCAA, for instance, requires all member institutions to educate student-athletes about banned drugs and the products that may contain them.

USADA, as well as leagues such as Major League Baseball (MLB), advise their players to consume only supplements that have been approved under third-party certification programs, such as NSF International’s Certified for Sport program, which certifies that the ingredients listed on supplement containers are accurate and that the product is safe.

Third-party certification programs are an important means of vetting supplements, but there is room for improvement. In a recent statement, representatives of the USADA, MLB, the Major League Baseball Players Association, Ultimate Fighting Championship, and the Consortium for Health and Military Performance at Uniformed Services University urged third-party certification programs to do more to ensure “supplement companies are in good standing with the U.S. FDA and do not have a history of unresolved warning letters or other noncompliance issues.”

They added that the programs play an important role in bringing noncompliant companies into legal compliance and that they “hope to see more surveillance of supplement companies to fully comply with all U.S. regulations.” 

The statement includes several recommendations to bolster the certification process, including steps to ensure that the combination and level of ingredients are safe and unlikely to cause toxicological concern. Supplement companies, the authors state, should be truthful in their advertising, particularly when labeling their products with messages such as “FDA-approved” or “WADA-approved.” Neither WADA nor FDA approve, endorse, or recommend any dietary supplement.  

Changes should also be made at the federal level. Legislation has been proposed to ban performance-enhancing drugs similar to androgenic steroids known as SARMs. But addressing individual ingredients through Congressional action is cumbersome and could undermine FDA’s role as the key regulatory authority.

Lawmakers have tasked the agency with ensuring the safety of dietary supplements, yet FDA lacks the authority to require supplement manufacturers to provide a list of all the supplements they make and their ingredients. Congress can pass legislation to equip FDA with the funding, resources, and basic product data needed to effectively detect and respond to potentially harmful supplements.

Athletes’ careers, health, and lives may be on the line because of poor scrutiny of supplements. Seemingly safe products often contain hidden ingredients that are either banned by athletic organizations or are outright illegal. Meanwhile, consumers—both athletes and the general public—are in the dark, unsure of whether these products could harm them. By providing FDA with the tools to better monitor supplements, Americans can have greater assurance that the products they take are safe.

Liz Richardson directs The Pew Charitable Trusts’ health care products project.