Supplements / Performance Enhancers

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
  • 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. 


  • 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.


  • 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).