You are here

Supplements / Performance Enhancers

Calcium  
Creatine Steriods

Glucosamine sulfate

Vitamin D

Ginko Biloba Prevention resourches

synonyms: Performance-enhancing drugs, PEDs

Banned Substances

  • Amphetamine and its analogs
  • Ephedrine and its analogs
  • Human Growht hormone (HGH)
  • Insulin-like growth factors
  • Erythropoietin
  • Diuretics
  • Masking agents: epitestosterone, probenecid, plasma expanders
  • Steriods
  • see www.wada.org for banned substance lists or http://www.wada-ama.org. 
Caffeine
  • stimulates the central nervous system, has ergogenic effects 
  • theorized to decrease the perception of effor
  • on the World Anti- Doping Agency monitoring program
  • NCAA will ban any athlete with a caffeine level in urine higher than 15 μg/mL. 

Creatine

  • Acts as a substrate for ATP. At standard dosage increases muscle creatine by 20%.
  • Protein synthesized in the liver and kidney.
  • Associated with increased muscle mass, short-term improvement in sprinting, may increase anaerobic resistance performance. Improves short duration, high intensity activities.
  • Common side effects: diarrhea, cramping, water retention, weight gain, nausea, abdominal cramping. Increases urine and serum creatine.
  • (Branch JD, INt J Sport Nutr Exerc Metab 2003 Jun;13:198)

Glucosamine sulfate / Chondroitin Sulfate

  • Glucosamine: monosaccharide precursor to gycosaminoglycans.
  • Chondroitin: repeating units of galactosamine sulfate and glucouronic acid; predominant glycosaminoglycan in articular cartilage.
  • Several placebo-controlled studies document substantial functional improvement. Largest randomized limited controlled study showed no benefit (Clegg DO, N Engl J Med 2006:354:795).
  • Glucosamine/Chondroitin should be discontinue 2 weeks prior to surgery. Concern is that glucosamine inhibits platelet activation. Guinea pigs receiving 400 mg of glucosamine had suppressed platelet activation by 51% (Lu-Suguro JF, Inflamm Res. 2005;54:493).
  • Recommended dose: Glucosamine 1,500mg PO daily, Chondroitin 1,200 mg PO daily.
  • Side effects: hypersensitivity in patients allergic to shellfish, GI discomfort, skin reactions.

Calcium

  • Imported in: muscle contraction, coagulaiton, intracellular signal transactions, controlling cell membrance potentials, bone
  • Normal level: 8.5-10mg/dL. Serum calcium is 50% free ionized and 50% protein bone (mainly albumin).
  • Factors decreaing Ca Resorption: increased Ca intake, increased Na intake, metabolic acidosis, phosphate depletion, glucocorticoids, furosemides
  • Factors Increased Ca Resorption: PTH, PTH-related protein, 1,25-dihydroxyvitamin D, Calcitonin, increased phosphate intake, chronic thiazide diuretics.
  • Daily Recommended intake: 0-6months=210mg/dL, 6m-1y=270mg/dL, 1-3yr=500mg/dL, 4-8yrs=800mg/dL, 9-18yrs=1,300mg/dL, 19-50yrs=1,000md/dL, >51y/o=1,200mg/dL. Pregnant/lactacting=1,300mg/dL. Should be taken in devided doses not to exceed 500mg/dL to aid in resorption. Do not take at the same time as antibiotics or iron.
  • Options: Calcium carbonate, calcium citrate.

Vitamin D

  • fat-soluble steriod derived from cholesterol.
  • Produced in the skin during direct sunlight exposure or absorbed from dietary intake.
  • Causasions need 15 minutes of direct bright sunlight exposure to hands and face per day. Longer for dark skinned individuals. Sunscreen limits Vit. D production.
  • Only natural dietary sources are salmon, mackerel, sardines and other oily fish.
  • Daily Recommended intake: 400-800 IU in individuals who lack adequate sunlight exposure.

Prevention Resourches

Ginko Biloba

  • Poplular for patietns with early dementia, peripheral vascular disease, vertigo and tinnitus
  • Inmproves mental alertness and cognitive deficiency.
  • Antiplatelet effects
  • Has been associated with spontaneous biilateal subdural hematomas, subarachnoid hemorrhage and postoperative bleeding. (Bebbingtion A, J Arthroplasty 2005;20:125).

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer