More than half of all high school students play on sports teams. In a quest to enhance their sports performance, teen athletes may turn to ergogenic drugs, which range from illegal substances such as anabolic steroids to supplements available over the counter, such as creatine. What types of ergogenic drugs are teens using, and what's the effect on their health?
Researchers from the Brown University School of Medicine identified the types and risks of several types of ergogenic drugs used by teen athletes, such as:
- Anabolic-androgenic steroids. These steroids are synthetic versions of the hormone testosterone, which allows users to build and preserve muscle mass. But about 1 in 3 steroid users develops side effects, such as male breast tissue development, acne, early pubertal development, high blood pressure, and high cholesterol. Teens who use steroids may also be prone to aggression and high-risk activities, such as driving under the influence of drugs, carrying weapons, and practicing unsafe sex. Steroids have been banned from all major sporting leagues and are illegal; nevertheless, it's estimated that between 4% and 11% of high school boys and up to about 3% of high school girls use these drugs. Even teens not involved in athletics use these illegal supplements: One study indicated that nearly one third of teen steroid users do not play school sports. Teen or college athletes may use steroids to recover from injuries or improve performance, and they may start young: 42% of young steroid users first tried these drugs in high school, and 15% began using steroids in junior high or earlier.
- Androstenedione (andro) and dehydroepiandrosterone (DHEA). When a person takes these drugs, it's thought that the body converts them into testosterone or other hormones that aid in muscle development. However, studies have not proven these drugs are effective at increasing muscle mass. Andro and DHEA are banned from sporting leagues, including college sports, and they may cause negative side effects including male breast development, heart problems, and hormonal changes in both men and women. Studies suggest that 4% to 5% of teen athletes admit to using andro or DHEA within the past year.
- Growth hormone. Growth hormone is a substance prescribed by doctors to help children with growth deficiency and certain other medical conditions attain more height. Athletes may combine this expensive drug (a 1-month supply can cost several thousand dollars) with steroids with the expectation that the drugs will decrease their body fat and improve athletic performance. But growth hormone hasn't been shown to improve sports ability, and taking it may actually weaken a person's muscles. A person taking this may be at risk for hepatitis and HIV, since these drugs are injected with needles. One survey of 10th-grade boys showed that nearly 5% reported using growth hormone for improving sports performance, and one study showed almost 4% of college athletes reported using it within the last year.
- Nutritional supplements. Health food stores and vitamin suppliers sell (and teen athletes may easily purchase) nutritional supplements, such as herbs, amino acids, protein powders, and metabolism boosters. Nutritional supplements aren't regulated by the U.S. Food and Drug Administration (FDA), so their labels may suggest dosages or ingredients not appropriate for teens to use. Some brands may actually contain illegal hormones such as testosterone; ingesting these supplements could lead teens to fail drug tests if unnamed ingredients are included in the supplement.
- Creatine. Creatine, which helps muscles use energy and recover more quickly, is naturally produced by the body and found in foods such as meat and fish. Creatine is also available as a legal, over-the-counter supplement, and it has been found in studies to increase strength during intense, short-duration physical activities. However, organizations such as the American College of Sports Medicine recommend that people under 18 avoid these supplements because the effects of creatine on minors have not been adequately studied. Despite these warnings, one study found that more than 8% of 14- to 18-year-olds used the supplement. Currently, about 25% to 78% of college athletes use creatine.
- Ephedrine. This amphetamine-like substance stimulates the central nervous system and is used by some athletes to provide quick energy and aid in fat loss, but studies have failed to show significant improvement in physical performance with the drug. When combined with caffeine, ephedrine causes dangerous side effects such as high blood pressure, irregular heartbeat, insomnia, stroke, and even death. The FDA has removed ephedrine sports supplements from the market but many teens may be using it in cold medicines to boost performance.
What This Means to You. This overview of teen use of ergogenic drugs highlights that a significant number of adolescent athletes may rely on sports supplements to improve their athletic performance — at the risk of their health. Encourage your young athlete to use healthy ways to improve strength and muscle development, such as proper exercise and nutrition, and discuss the dangerous side effects of these drugs that could permanently sideline your child's athletic career. If you suspect that your child is using these drugs or your child shows signs of steroid use, such as mood swings, worsening acne, or sudden increases in muscle development, you should call your child's doctor.
Source: Ryan Calfee, MD; Paul Fadale, MD; Pediatrics, March 2006.
Reviewed by: Steven Dowshen, MD
Date reviewed: April 2006
