The role of banned substance residue analysis in the control of dietary supplement contamination / Catherine Judkins, Philip Teale and David J. Hall . – In: Drug testing and analysis 2 (2010) vol. 9 (September), p. 417–420

The potential for contaminated dietary supplements to result in a failed doping test remains a concern for athletes, trainers, and sporting authorities despite improvements to regulatory guidelines. Previous surveys of readily available supplements confirm that many are contaminated with steroids and stimulants prohibited for use in elite sport. Suggested responses to this issue include the complete avoidance of all supplements. Many athletes, however, use nutritional supplements to achieve effective training and also to ensure that daily nutritional requirements are met (e.g. recommended levels of vitamins and minerals). This ensures that the use of supplements is and will remain the norm for a range of sports. As a result, an alternative approach of rigorous testing of materials destined for use by elite athletes has been introduced in several countries. While the testing of final product for banned substances may help mitigate the problem, it will not help to remove the underlying issue of contamination. In this article we describe an alternative approach that uses appropriate quality assurance procedures backed up by testing to remove sources of contamination. The decrease in the incidence of contamination amongst supplement companies adopting such a system is explained, and contrasted with the relatively high incidences of contamination found in products that are not part of a quality system. These findings are of key importance to both supplement manufacturers and those involved in advising athletes about supplement use.

ANP Persberichten Archief over dopingonderwerpen

Period: 2005 - present

Location: http://www.dopingautoriteit.nl/nieuws/anp/archief

Supplements and Inadvertent Doping – How Big Is the Risk to Athletes? / Catherine Judkins and Peter Prock . – In: Medicine and Sport Science. Basel, Karger, 2013, vol. 59, pp 143–152 (Lamprecht M (ed): Acute Topics in Sport Nutrition)

Despite ongoing improvements to regulatory and manufacturing guidelines, the potential for contaminated nutritional supplements to cause a failed doping test for an athlete remains a concern. Several surveys of supplements available through the internet and at retail have confirmed that many are contaminated with steroids and stimulants that are prohibited for use in elite sport. Suggested responses to this issue include the complete avoidance of all supplements. However, this approach seems to be unrealistic as many athletes use nutritional supplements for very different reasons. In addition, the number of publications describing trials that demonstrate the benefit of certain nutritional products has also increased over the last decade or so. This ensures that for many sports the use of supplements will remain a common practice. In response to the issue of contamination in nutritional supplements, many reputable manufacturers have their products rigorously tested by sports anti-doping laboratories to help ensure as far as possible that the risks to an athlete remain minimal. In this chapter we review the issue of supplements and contamination, and look at how this might be addressed through effective quality control procedures at the manufacturing facility and through the highly sensitive testing of finished products using appropriately accredited tests.

Analysis of Non-Hormonal Nutritional Supplements for Anabolic-Androgenic Steroids Results of an International Study / H. Geyer, M. K. Parr, U. Mareck, U. Reinhart, Y. Schrader and W. Schänzer. (International Journal of Sports Medicine 25 (2004) 2(February); p. 124–129)

Several recent studies have shown evidence of some nutritional supplements containing prohibited anabolic androgenic steroids, so-called prohormones, which were not declared on the label. Therefore, a broad-based investigation of the international nutritional supplement market was initiated to clarify the extent of this problem. From October 2000 until November 2001, 634 non-hormonal nutritional supplements were purchased in 13 countries from 215 different suppliers. Most supplements were bought in shops in the respective countries (578 samples = 91.2%) and on the internet (52 samples = 8.2%). 289 supplements were from prohormone-selling companies and 345 supplements came from companies which do not offer prohormones. After isolation from the supplement matrix 11 different anabolic androgenic steroids, mainly prohormones of testosterone and nandrolone, were analysed by gas-chromatography/mass spectrometry. Out of the 634 samples analysed 94 (14.8%) contained anabolic androgenic steroids not declared on the label ("positive supplements"). We could not obtain reliable data for 66 samples (10.4%) due to matrix effects. In relation to the total number of products purchased per country, most of the positive supplements were bought in the Netherlands (25.8%), in Austria (22.7%), in the UK (18.8%) and the USA (18.8%). According to the label, all positive supplements were from companies located in only five countries: the USA, the Netherlands, the UK, Italy and Germany. 21.1% of the nutritional supplements from prohormone-selling companies contained anabolic androgenic steroids, whereas 9.6% of the supplements from companies not selling prohormones were positive. The positive supplements showed anabolic androgenic steroid concentrations of 0.01 g/g up to 190 g/g. The administration of supplements containing nandrolone prohormones adding up to a total uptake of more than 1 g resulted in positive doping results for norandrosterone for several hours.

Is the breast cancer drug tamoxifen being sold as a bodybuilding dietary supplement? / Michael Evans-Brown, Andreas Kimergård, Jim McVeigh, Martin Chandler and Simon D Brandt. - (British Medical Journal, 6 (2014), vol. 348 (10-16 February), g1476

Bodybuilders often take tamoxifen to prevent and treat gynaecomastia (breast cancer) caused by use of anabolic steroids. Forums lead to naming a dietary supplement containing tamoxifen. In three of the four selected supplements for analysis confirmed the presence of this substance. Supplements are used for various reasons not always with mentioning the ingredients. This leads to users unaware of what they are taking. Healthcare professionals should have a role in reporting this.

Would you dope? A general population test of the Goldman dilemma / James Connor and Jason Mazanov. - (British Journal of Sports Medicine 11 (2009) 43 (October), p. 871-872)

• Doi: 10.1136/bjsm.2009.057596

Abstract

OBJECTIVE:
To test Goldman's dilemma on a general population sample by asking whether they would take the Faustian bargain of a drug that guaranteed sporting success but would result in their death in 5 years' time. Between 1982 and 1995 a bi-annual survey using this dilemma suggested half of all elite athletes would take the drug.

DESIGN:
A random telephone survey of 250 members of the Australian general public, with counterbalanced presentation of success and death.

MAIN OUTCOME MEASURES:
Respondents gave age, gender, sports engagement and response to the dilemma (yes/no).

RESULTS:
Only two of a sample of 250 reported they would take the bargain offered by the dilemma.

CONCLUSIONS:
Athletes differ markedly from the general population in response to the dilemma. This raises significant practical and ethical dilemmas for athlete support personnel. The psychometry of the dilemma needs to be established more comprehensively for general and athlete populations.

Would they dope? Revisiting the Goldman dilemma / James Connor, Jules Woolf, Jason Mazanov. - (British Journal of Sports Medicine 47 (2013) 11 (July); p. 697-700)

• DOI: 10.1136/bjsports-2012-091826

Abstract

BACKGROUND/AIM:
Discussions of doping often report Goldman's sensational results that half of the elite athletes asked would take a drug that guaranteed sporting success which would also result in their death in 5 years' time. There has never been any effort to assess the properties of the 'Goldman dilemma' or replicate the results in the post World Anti-Doping Agency context. This research evaluated the dilemma with contemporary elite athletes.

METHODS:
Participants at an elite-level track and field meet in North America were segregated into an interview or online response. After basic demographics, participants were presented with three variant 'Goldman' dilemmas counter-balanced for presentation order.

RESULTS:
Only 2 out of 212 samples (119 men, 93 women, mean age 20.89) reported that they would take the Faustian bargain offered by the original Goldman dilemma. However, if there were no consequences to the (illegal) drug use, then 25/212 indicated that they would take the substance (no death condition). Legality also changes the acceptance rate to 13/212 even with death as a consequence. Regression modelling showed that no other variable was significant (gender, competitive level, type of sport) and there was no statistical difference between the interview and online collection method.

CONCLUSIONS:
Goldman's results do not match our sample. A subset of athletes is willing to dope and another subset is willing to sacrifice their life to achieve success, although to a much lesser degree than that observed by Goldman. A larger scale online survey is now viable to answer important questions such as variation across sports.

Reticulocytes in Sports Medicine / Giuseppe Banfi. - (British Journal of Sports Medicine 38 (2008) 3 (May); p. 187-211)

• PMID: 18278982
• DOI: 10.2165/00007256-200838030-00002

Abstract

Reticulocytes are the transitional cells from erythroblasts to mature erythrocytes. Reticulocytes are present in blood for a period of 1-4 days and can be recognized by staining with supravital dyes, such as new methylene blue, or fluorescent markers, which couple residual nucleic acid molecules, a hallmark of the immature forms of erythrocytes. Although reticulocytes could be counted through a microscope (there is a standard of International Committee for Standardisation in Haematology for manual counting), this method is reported to be time consuming, inaccurate and imprecise. The integration of the reticulocyte count in automated haematology systems allowed the widespread use of these parameters, although the lack of calibration material and different markers, technologies and software used in automated systems could engender discrepancies among data obtained from different analytical systems.The importance of reticulocytes in sports medicine derives from their sensitivity, the highest among haematology parameters, in identifying the bone marrow stimulation, especially when recombinant human erythropoietin is fraudulently used. Automated systems are also able to supply information on volume, density and the haemoglobin content of reticulocytes. Some of the related parameters are also used in algorithms for identifying abnormal stimulation of bone marrow as reticulocytes haematocrit. The pre-analytical variability of reticulocytes (transportation, storage, biological variability) should be taken into account in sports medicine also. Reticulocytes remain stable for almost 24 hours at 4 degrees C from blood drawing, they are affected by transportation, and biological variability is not high in general. It could be remarked, however, that the intra-individual variability is high when compared with other haematological parameters such as haemoglobin and haematocrit. The intervals of data reported in athletes are very similar to reference intervals characterizing the general population.The reticulocyte count shows some modifications after training and during the competition season. The variability induced by exercise cannot be overlooked since the so-called haematological passport, a personal athlete's document in which haemoglobin and other parameters are registered, may be introduced by sports federations. Exposure to naturally high altitude and 'living high-training low' programmes determined contentious results on reticulocytes. Simulated high altitude induced by intermittent hypobaric hypoxia does not modify reticulocytes, despite an increase in erythropoietin serum concentration. The variability among athletes competing in different sport disciplines is apparently limited. The knowledge of the behaviour of reticulocytes in training and competitions is crucial for defining their role in an antidoping control context. It is important for sport physicians and clinical pathologists to know the reticulocyte variability in the general population and in athletes, the pre-analytical warnings, the different methodologies for counting reticulocytes and the derived parameters automatically available, and, finally, the possible influence of training, competitions, type of sport and altitude.

Confounding factors and genetic polymorphism in the evaluation of individual steroid profiling / Tiia Kuuranne, Martial Saugy and Norbert Baume. – In: British Journal of Sports Medicine, 10 (2014), Vol. 48 (May), p. 848–855

In the fight against doping, steroid profiling is a powerful tool to detect drug misuse with endogenous anabolic androgenic steroids. To establish sensitive and reliable models, the factors influencing profiling should be recognised. We performed an extensive literature review of the multiple factors that could influence the quantitative levels and ratios of endogenous steroids in urine matrix. For a comprehensive and scientific evaluation of the urinary steroid profile, it is necessary to
define the target analytes as well as testosterone metabolism. The two main confounding factors, that is, endogenous and exogenous factors, are detailed to show the complex process of quantifying the steroid profile within WADA-accredited laboratories. Technical aspects are also discussed as they could have a significant impact on the steroid profile, and thus the steroid module of the athlete biological passport (ABP). The different factors impacting the major components of the steroid profile must be understood to ensure scientifically sound interpretation through the Bayesian model of the ABP. Not only should the statistical data be considered but also the experts in the field must be consulted for successful implementation of the steroidal module.

Supplements and Sports / David M. Jenkinson and Allison J. Harbert. – In: American Family Physician, 9 (2008), Vol. 78 (November), p. 1039-1046

Use of performance-enhancing supplements occurs at all levels of sports, from professional athletes to junior high school students. Although some supplements do enhance athletic performance, many have no proven benefits and have serious adverse effects. Anabolic steroids and ephedrine have life-threatening adverse effects and are prohibited by the International Olympic Committee and the National Collegiate Athletic Association for use in competition. Blood transfusions, androstenedione, and dehydroepiandrosterone are also prohibited in competition. Caffeine, creatine, and sodium bicarbonate have been shown to enhance performance in certain contexts and have few adverse effects. No performance benefit has been shown with amino acids, beta-hydroxy-beta-methylbutyrate, chromium, human growth hormone, and iron. Carbohydrate-electrolyte beverages have no serious adverse effects and can aid performance when used for fluid replacement. Given the widespread use of performance-enhancing supplements, physicians should be prepared to counsel athletes of all ages about their effectiveness, safety, and legality.