Performance-enhancing, or ergogenic, substances (PES) include a broad range of products – from anabolic steroids and growth hormone to caffeine and creatine. The two main types of PES are hormones (and hormone mimetic drugs) and dietary supplements. There are known and suspected risks of steroid use, and the benefits are not well-defined. Reliance on ergogenic substances may distract athletes from appropriate training techniques and produce side effects that impede athletic performance. Anabolic steroids are prohibited by most athletic organizations, with the risk of sanctions against the athlete and possibly against the athlete’s team or school. It is illegal to possess steroids for uses other than medicinal.
Anabolic steroids increase lean body mass and weight. They can be administered orally or by injection, depending on the preparation. There are many different anabolic steroids used by athletes, and primary among them is testosterone. Despite the benefit of increased lean muscle mass, there is no definitive evidence that anabolic steroids enhance athletic performance. Health and performance risks have been associated with anabolic steroids, including increased aggressiveness (which can emerge as recklessness and loss of judgment), adverse effects on lipid levels, liver tumors, and temporary infertility.
Growth hormone is secreted from the pituitary gland, and stimulates physical growth of the body. Although growth hormone is effectively used as replacement therapy for individuals with growth hormone deficiency, there is no evidence that supplemental growth hormone enhances athletic performance in normal men and women.
There is a long history of clinical use of hormones for treatment of medical conditions, providing substantial data on effects and health risks. The data on benefits to athletic performance are fewer and inconclusive. There is virtually no information regarding the safety and effectiveness of dietary supplements such as “steroid replacers” and “growth hormone replacers.”
Dietary supplements may be useful to athletes who have specific nutritional deficiencies or nutritional “gaps” in their normal diets. Unfortunately, dietary supplements (and their claims) are poorly legislated, and there are few safeguards to ensure that these products are safe and effective.
Data suggest that vitamins are important in disease prevention, especially at higher-than-normal levels of intake. There is no basis for the use of vitamins as performance enhancers in athletes who are not vitamin deficient. Excess vitamin use can even cause health problems, especially overuse of vitamins B6, A, and D (although dosage levels would have to exceed 10 times the RDA). Vitamins C and E are antioxidants, which reduce tissue damage caused by oxidative stress.
Caffeine and creatine are two of the few dietary supplements that are known to be effective in enhancing specific types of athletic performance for some individuals. The ergogenic potential of caffeine has been demonstrated in several studies, benefitting strength, power, and endurance athletes.
Accurate information from Strength and Conditioning professionals and coaches can have a significant impact on athletes’ perception of performing-enhancing substances. This information should include the risks and benefits of these products, and ethical issues regarding their use.
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