Q: Is there a complete list of banned dietary supplements? A: Unfortunately, there is not a complete list of banned/prohibited supplements due to the ever-changing market.
The NCAA lists banned drugs by class, and any substance that is chemically related to the class is banned (unless specifically exempted.) When the NCAA originally developed the banned drug classes, many examples were listed under each class, though the list was never an exhaustive list of all banned drugs. From the beginning, any stimulant and anabolic steroid was banned, even if it was not named as an example under the banned drug class. THERE HAS NEVER BEEN A COMPLETE LIST OF BANNED DRUGS. This concept is critically important to compliance with NCAA banned drug regulations. In recent years, it has become clear that the list of examples, instead of providing some clarification, have actually created a false sense of security to student-athletes and staff alike, who believe that if the ingredients on a product are not found on “the list” in the same manner the product manufacture names them, they are not banned. And as we explain below, with the many new supplements and designer drugs appearing on the market annually, creating a complete list is impossible.
Some of our professional clients have "list", but that is a case-by-case situation.
Our time is better spent answering incoming questions about dietary supplements, and sending out live updates via twitter @epattrec,facebook, Linkedin, and the REC blog. Using social media, allows us reach thousands in a matter of seconds, and the information is relevant to athletes.
Products labeled as dietary supplements sold over the counter, in print advertisements and through the internet are under-regulated by the U.S. FDA. Whether a product is classified as a dietary supplement, conventional food, or drug is based on its intended use by the manufacturer. Please be aware that some companies manufacturer dietary supplement and conventional food products*. Dietary supplements are at risk of contamination or may include ingredients that are banned under your drug testing policy. Studies have found 12-25% of dietary supplements contain unlisted steroids, stimulants, or trace metals.
Institutional staff should submit each time a student-athlete brings forth a dietary supplement product, as last year’s review may no longer apply to the this year’s newly formulated product by the same name.
You can find your organizations banned/prohibited list under the Drug Program Information section.
Q:I’ve asked about a particular product in the past and believed it was fine, so why is it banned now? A: In 1994, the Dietary Supplement Health and Education Act (DSHEA) was passed and radically changed the dietary supplement marketplace. DSHEA expanded the category of dietary supplements further to include:
DHEA and more
DSHEA removed much of the FDA's control over dietary supplements and as a result created what is considered to be a virtually unregulated industry. Some supplement products change frequently. Oftentimes, they are forced to change because of market recalls driven by adverse health-related reports or the finding of unlisted ingredients in the contents. This uncertainty is why we must continue to check dietary supplement ingredients, because last year’s formula could now be obsolete and the new product could include ingredients banned by your sport governing body.
Q: How do regulations for prescription/over-the-counter drugs differ from dietary supplements? A: Before marketing, drugs must undergo clinical studies to determine their effectiveness, safety, possible interactions with other substances, and appropriate dosages. The FDA then reviews the data and determines whether to allow use of the drugs. Dietary supplements are classified under the general category of food products, not drugs.
In most cases, the FDA does not test dietary supplements or authorize their use prior to these products being marketed. The FDA can order the removal of a dietary supplement from the marketplace, however, if they feel it is unsafe for consumers.
Q: What supplements do you recommend? A: There are dietary supplements on the market that do not contain or list banned/prohibited ingredients. However, even if a product does not list a banned ingredient you should consider a couple of points. When advising Student-Athletes who want to use supplements: Even knowing the stated concerns above, many of our student-athletes insist on using dietary supplements. In most cases, members of the sports medicine staff are assigned the responsibility to educate student-athletes about banned drugs and to advise about and review supplement products that student-athletes intend to use. The burden of this awesome responsibility can be dramatically reduced by establishing an athletics department policy that student-athletes bring all supplement products to the appropriate athletics staff before using, and then checking all supplements through the Resource Exchange Center, REC, staffed by the National Center for Drug Free Sport, the NCAA third party drug testing administrator. The REC is the only authoritative resource for questions related to whether listed ingredients on nutritional supplement product labels or in medications contain NCAA banned substances. Because of the changing nature of the dietary supplement industry and the manner in which manufacturers use proprietary names and rename products to suit their purposes, there is no way to create a reliable database of reviewed products. Institutional staff should submit each time a student-athlete brings forth a dietary supplement product, as last year’s review may no longer apply to the this year’s newly formulated product by the same name.
As sports medicine staff, we must fully understand these concepts, develop an appreciation for the real risks of supplement use, and create a comprehensive policy and educational program that provides clear advice to our student-athletes that promotes safe and healthy approaches to achieve their performance goals.
Q: What warning signs should I lookout for, when thinking about taking a supplement or alternative drug? A: Athletes are presented with a multitude of information about supplements, from the manufacturer, online stores, at the gym, or through friends and family. How do you decide which ones to try? While the REC does not recommend the use of any supplement, we want to provide you some RED FLAG indicators to watch out for if you are considering a supplement. Please know that this is not a complete list and should only be used for reference. If you have questions in regards to a particular product, please consult with the REC. You should avoid any product that list or makes reference to any of the following:
Not for human consumption
Aromaste inhibitor Anti aromatase
Natural testosterone booster
Natural HGH/IGF-1 booster
Stimulant free version
Only FDA approved pro-hormone
Get our product before it is banned
Below: If any one of these ingredients or something similar is present in the supplement, we suggest not purchasing or using. You could have short-term or long-term negative health risks and/or fail a drug test.
Q: Can I take a product that makes claims to increase testosterone, if there is nothing listed on the ingredients list that is banned/prohibited? A: A product that increases testosterone could lead to a positive drug test. If a product claims to increase testosterone, we recommend that you not use it. If the product works and increases your testosterone levels, the use of the product could lead to a positive drug test. If the product does not work, you will have wasted your money and time.
Q: What Over-The-Counter cold medications can I take? A: There are many OTC medications that are not banned/prohibited by your respected organization. Some of the more common ingredients found in cold medications that aren’t banned are pseudoephedrine* (ephedrine is banned by NCAA, MLB, NFL, PGA TOUR and all other National Governing Bodies), phenylephrine, chlorpheniramine and guaifenesin. There are many more that aren’t banned. If you have a question about a specific product or ingredient, please submit an inquiry to the REC.
If you are an athlete associated with a professional sport organization please go to the Drug Program Information section to find examples of approved Over-The-Counter medications to take.
*Pseudoephedrine is prohibited by the NFL except as properly prescribed by Club medical personnel.
Q: What is the NCAA stance on dietary supplements and illegal substances?
Q: If my doctor prescribes a medication that is banned, can I take it? A: NCAA: The NCAA does recognize a legitimate medical need for certain banned substances and has an exceptions procedure. Keep in mind that a prescription is not a guarantee that a banned substance is ok to use.
Professional Sports Organizations: If you are an athlete associated with a professional sport organization please go to the Drug Program Information section to find examples of approved drugs to take. Please submit your prescription for review if it is not listed as an example.
High School Student-Athletes: Please visit the Drug Program Information section of your REC website for instructions or submit an REC inquiry.
Q: How long does a banned drug stay in my system? A: The amount of time it takes for a substance to clear one's system is dependent upon many factors. The drug that was taken, amount used, duration the product was used, body composition, and metabolic rate to name a few. Unfortunately we cannot give you a specific time frame on this question.
Q: How do I log into the Resource Exchange Center (REC)? A: Consult with your athletic trainer and/or staff to obtain information on log-in and password information. If you are an individual or organization that would like to subscribe to the REC please contact us at firstname.lastname@example.org or 816/474/8655 Ext. 129.
Q: How do I find out information on getting my product tested for banned ingredients? A: The labs that we do work with do not conduct product testing because of the possible conflict of interest. The conflict that we speak of here is the lab doing both the test to prove that the product is free and clear of banned ingredients, and the drug test to screen for banned substances.
Q: Why is caffeine banned by the NCAA? A: The NCAA bans caffeine because it is found to be a performance enhancer. The 15 micrograms/mL cut-off is designed to eliminate individuals from testing positive for caffeine because of the “normal” amounts consumed from average dietary intake. The cut-off is not designed to identify the most caffeine one can consume and still avoid testing positive (e.g.; using a supplement for performance gains). Unfortunately, there is not a formula to calculate how much caffeine consumed would result in a urinary concentration greater than 15 micrograms/mL. Varying metabolic rates and time of consumption prior to urine collection are contributing factors.
Q: I’ve heard the terms ‘false positive’ and ‘false negative’ used relating to drug testing. What do they mean? A: The term false positive is frequently misused. The term false positive is often used when a person has a positive drug test, but didn’t knowingly take a banned substance or “illegal” substance. A true false positive would be an instance where a substance is identified incorrectly.
The use of a product that is contaminated with a banned substance and leads to a positive drug test is NOT a false positive. The banned substance was ingested and was correctly identified by the laboratory; such a finding is a positive drug test. For example, the use of a dietary supplement that contains 19-norandrostenedione could lead to a positive drug test for the metabolites of the anabolic steroid Nandrolone. In addition, the use of a medication that is banned and leads to a positive drug test is a positive drug test. Such a finding is a positive drug test - not a false positive.
Conversely, a term that is not used very often is false negative. A false negative is what a cheater is hoping for. A false negative is a drug test that is incorrectly reported negative. This means a banned substance was present in the urine but was not identified by the laboratory.
Drug Free Sport and the organizations it works with have taken many steps to ensure there are no false positives. One measure that is standard is using a split sample. By splitting the sample into ‘A’ and ‘B’ vials at a collection site, one specimen can be tested and confirmed twice. If the A sample is screened and confirmed positive for a banned substance, the B sample is tested. If the B sample also is found to be positive, the athlete who provided the specimen is declared positive.
The second measure that can be taken in relation to anabolic steroids is to use only World Anti-Doping Agency (WADA)-certified laboratories for specimen analysis. Drug Free Sport only uses WADA-certified laboratories for steroid testing.
Truth be known, there are no false positives in sport when the correct measures are taken to ensure such.