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HPRC Fitness Arena: Dietary Supplements
A new dietary supplement ingredient, dendrobium, is appearing rapidly in dietary supplement products promoted to boost athletic performance. According to the Natural Medicines Comprehensive Database, manufacturers claim that dendrobium is a natural source of the stimulant phenylethylamine, but some researchers say that phenylethylamine doesn’t occur naturally in dendrobium. Phenylethylamine is a stimulant, with effects similar to those of amphetamines. At this time, the safety of dendrobium is unknown, so users should be aware that products containing this ingredient might be unsafe, particularly when used in combination with exercise.
Operation Supplement Safety (OPSS) is about to launch this summer and will answer many of your questions about Dietary Supplements. Watch for HPRC’s announcement coming soon.
Up-to-date information on tainted products marketed as dietary supplements are now provided on HPRC’s Dietary Supplement domain page via a “widget” from the Food and Drug Administration (FDA). Recent product alerts and health information on products marketed for weight loss, sexual enhancement, and bodybuilding are automatically displayed and updated as the FDA adds new notifications. Please see this new feature by visiting HPRC’s Dietary Supplements section.
The latest update of HPRC’s list of DMAA-containing dietary supplement products is now available online. Six more products have apparently been removed from the market; one has been added to the list because the fact that it contains DMAA is stated only on the product label, not on the manufacturer’s website.
Following in the wake of the Food and Drug Administration’s warning letters to manufacturers and distributors of dietary supplements containing DMAA, the Army announced that its own study on the effects of DMAA on soldiers will continue. Read about the announcement and more in the recent Stars and Stripes article. For more information about the FDA’s action, you can read HPRC’s post, which also includes a link to the FDA news release.
The Food and Drug Administration (FDA) sent warning letters to manufacturers and distributors of dietary supplements containing 1,3-dimethylamylamine (DMAA) due to lack of safety evidence provided before marketing. The FDA states that information about the safety of DMAA as a dietary supplement ingredient has not been identified. For more information, see the FDA News Release and HPRC’s latest on Dietary Supplement Products Containing DMAA.
The latest news on DMAA includes the New Zealand government’s ban just placed on DMAA-containing products. DMAA has already been declared a drug in Canada and is banned by the World Anti-Doping Agency, the United States Anti-doping Agency (USADA), collegiate sports teams, and most professional sports teams.
HPRC has again updated its list of DMAA-containing dietary supplements, including a number of additions as well as some products that have been discontinued or reformulated. The additions mostly represent lesser-known products that have been around a while, but surprisingly there are a couple new products too. And we have added two new “aliases” to the list of other names for DMAA. To download the list, click on this link to “Dietary Supplement Products Containing DMAA.”
HPRC has written about energy drinks and their possible adverse health effects; these drinks continue to be in the news following the death of a teenage girl due to caffeine toxicity from drinking two Monster energy drinks. Senator Dick Durbin has now urged the Food and Drug Administration (FDA) to investigate energy drinks, specifically to regulate caffeine in these drinks (caffeine content in colas is already regulated) and determine whether other ingredients contained in them are safe. Read the press release and Senator Durbin’s letter to FDA.
Do you buy dietary supplements when you want to lose weight, improve your performance, or give yourself a boost to get through a long day or hard workout? Then watch for this soon-to-be-released service-wide educational campaign by the Department of Defense in collaboration with the Human Performance Resource Center. Operation Supplement Safety (OPSS) will help Warfighters and their families make informed decisions when choosing dietary supplements. See HPRC’s new OPSS link for an introductory article on supplement safety.
HPRC has received a number of questions about whether dietary supplements—especially those used for bodybuilding and weight loss—could result in a positive result on military drug tests.
Military drug testing begins with urine, which is first screened and then followed by additional tests depending on the outcome of the screen. You can get extensive information about DoD’s drug policy and drug testing from the Drug Demand Reduction Program (DDRP), including military testing. And for answers about the potential effects of specific dietary supplements on drug screening tests, you can contact your service’s military drug-testing laboratory by phone or email at:
- U.S. Army, Fort Meade, MD – (301)-677-7085 or USArmy.Meade.Medcomfirstname.lastname@example.org
- U.S. Army, Tripler AMC, HI – (808)-433-5176 or email@example.com
- U.S. Navy, Great Lakes, IL – 847-688-2045, press 2 or ext 113, or NDSLGLfirstname.lastname@example.org
- U.S. Navy, San Diego, CA – 619-532-5180 or NDSLSDemail@example.com
- U.S. Navy, Jacksonville, FL – 904-542-7755, press 2 or ext 104, or DLJAX@med.navy.mil
- U.S. Air Force, Lackland AFB, TX – (210) 292-3089 or firstname.lastname@example.org or 210-292-3101 or email@example.com
Positive urinalysis results due to dietary supplement use can occur because products on the market may contain undeclared drug ingredients—that is, controlled substances that are not stated/listed on the product label. More information can be found in the FDA Consumer Update There you will also find information about how to get updates about products FDA has identified as tainted. There is no way to know if a particular supplement contains an undeclared drug without laboratory testing, but FDA does keep track of such products once identified through its MedWatch program.
The Department of Defense (DoD) currently has no formal policy on the use of dietary supplements and no list of either banned or safe supplements. For more on this topic, see Operation Supplement Safety’s (OPSS) FAQ “Is there an all-encompassing list of dietary supplements that are banned or illegal for use by military personnel?”
Lately, HPRC has been receiving a lot of questions about banned supplements in the military, but the fact is, there isn’t a list of banned dietary supplements currently available. It isn’t always easy to determine whether a dietary supplement product is safe or not, so the Department of Defense (DoD) is working on an educational campaign to inform Warfighters and their families about potential health risks involved with taking dietary supplements and steps to take before choosing/using a dietary supplement. And although DoD currently has no formal policy on the use of dietary supplements, a committee is working to establish such a policy.
Some dietary supplements, including ones sold on military installations, may contain potentially harmful and problematic ingredients. HPRC has put together the resource Red Flags: What You Need to Know to Stay Safe and Avoid Fraud. Of particular note are problematic, potentially dangerous ingredients that could be red flags, including approved prescription drug ingredients and their analogs, drugs banned by the FDA for safety reasons, controlled substances (such as anabolic steroids), and untested/unstudied new active drug ingredients.
You can also learn more on how to make informed decisions about dietary supplements and natural products from the Natural Medicines Comprehensive Database (NMCD). HPRC has made this available to all active-duty personnel; a “.mil” email address is required to create an account. We encourage consumers of dietary supplements to consider only using products rated eight or above on their rating scale. These are in the green area of the scale and have evidence of safety. Items in the yellow range mean data are lacking, and the red area indicates well-known safety concerns and/or proven ineffectiveness. HPRC makes this user-friendly database readily available through links on its website for both Warfighters and healthcare professionals. Choose the appropriate version and follow the instructions to create an account.
Generally, if a supplement is not banned or recalled by the FDA, FTC, or DEA, then it is not banned by DoD. One way to ensure that a dietary supplement product is safe is to see if it is third-party verified. Third-party certification organizations have developed criteria for evaluating and authenticating the quality of a supplement—the ingredients, the dosage levels, the level of contaminants, the label claims, and whether the manufacturing facilities follow Good Manufacturing Practices (GMP). Currently, United States Pharmacopeia (USP) and NSF International conduct safety reviews, and NSF screens for substances banned by the World Anti-Doping Agency (WADA) or United States Anti-Doping Agency (USADA). Multiple professional sport/athletic organizations—including MLB, NHL, NBA, NFL, and NCAA—currently have policies requesting the use of NSF-certified products only. Shop for products with seals from USP and NSF International.
We encourage you to talk with your healthcare provider or dietitian before using dietary supplements to avoid potential problems. Also, see FDA’s list of tainted body building products, which includes important public notifications.