Anyone working with teen or preteen athletes will be asked a question about getting “bigger, thinner, faster, stronger.”

Despite long hours at practice, teens in sports are constantly being pressured by coaches, peers and sometimes parents to be better. Looking for fast and effective results, various supplements can seem to offer a quick fix.

What are supplements? They can be a wide variety of products designed to enhance athletic performance. They are used by both sexes to gain an edge in their sport. The athletes are likely to be younger rather than older and increasingly female.

They are more likely to be relatively uneducated in nutrition and highly influenced by their teammates. They may be looking to gain weight or perhaps to lose (or cut) weight. They often want bigger and stronger muscles. Whatever the need, nearly all teen athletes are aware that there are products out there that may provide a quick fix for their particular concern.

I’d like to review some of the more common supplements that I hear about in my practice that are readily available in our community for a high school athlete.

Creatine: Creatine is a substance produced naturally by the body and taken in as a part of a normal diet. It is metabolically used to aid the process of providing quick energy to muscles during high intensity activity. It has been shown to increase the performance of elite, international athletes in sports demanding rapid energy expenditure such as sprinting and weight lifting.

It is a popular supplement used in sports such as football. It affects fluid balance and will cause apparent weight gain even in lesser athletes, but this does not translate into increased performance . Appropriate dosing is quite expensive and there is definite risk of hydration problems in warmer weather. There are no studies of how creatinine affects a growing body and is not recommended to be used by adolescents.

Protein Supplements: Protein Supplements are widely available from pharmacies, sports stores, heatlh clubs and the internet. All claim rapid results in building muscles, strength and the body you’ve always wanted. This can be attractive to a 14-year-old freshman competing for a spot on the football team with much more mature seniors. These products are unregulated by the FDA as they are marketed as dietary supplements.

Although they may simply be powdered whey protein, they may also contain unlabeled additives such as anabolic steroids that may be harmful. All are expensive. If additional protein is needed, it is far more effective to add it through a healthy diet.

Chromium Picolinate: Chromium Picolinate is a substance marketed to “burn fat” and increase muscle mass. Trace amounts of chromium aids in glucose metabolism and amino acid uptake. Studies have shown, however, that it does not increase muscle mass or eliminate fat. It has been associated with kidney failure and anemia.

Androstenedione and DHEA: Androstenedione and DHEA are both popular nutritional supplements. They are “prohormones” that can be broken down into testosterone. Taken in large amounts, they may have a similar effect to anabolic (body-building) steroids.

Although most teens are somewhat aware of the dangers of anabolic steroids, these are marketed as “safe, natural steroids, without the risk.” It is known that they have most of the side effects of androgenic steroids including testicular cancer, heart disease, infertility, breast development, testicular atrophy and stroke.

Interestingly, in a very recent Pediatrics journal article, teen girls have been found to be increasingly common users of anabolic steroids.

There are a wide variety of more sophisticated sports supplements that haven’t been mentioned in this article such as EPO, blood doping, designer anabolic steroids, human growth hormone and others. These are usually associated with higher levels of competition. The products mentioned are commonly used in our community.

It is far more important that younger athletes and their parents be aware that simple things like enough sleep, a balanced diet, proper training with good coaches and avoiding harmful substances are much
more effective in achieving results in sports.

—Gary Nichols, MD