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Aug. 17, 2001 -- Investigators are trying to determine whether Rashidi Wheeler, the 22-year-old Northwestern University football player who died during a practice earlier this month, had been taking an over-the-counter "performance-enhancing" supplement called Ultimate Orange.
This product contains, among other things, ephedra, which is a stimulant that researchers believe may cause permanent heart damage, stroke, or even death.
The tragic event and its unanswered questions about supplement use have prompted renewed warnings to all consumers about the potential dangers of such products.
"We recommend that everyone, particularly young people, talk to their doctors before taking anything. They can't assume just because it's something that you can buy over-the-counter at a so-called 'health food store' or over the internet that it's good for you," says Iris Shaffer, executive director of the Blue Cross/Blue Shield Association's Healthy Competition Foundation, in an interview with WebMD.
A web site that pitches Ultimate Orange and other supplements presents the product in a matter-of-fact type of challenge: "... some people shouldn't even try the stuff. Let alone use it for workouts. How about you? Can you handle the deep breaths, the mental focus, and the primal urge to lift more weight ... more times ... for greater gains?"
Critics of unregulated sport supplements could add many other things to that "can you handle" list, such as palpitations, high blood pressure, unstable heart rhythms, strokes, breathing problems, and sudden death.
In The New England Journal of Medicine last December, researchers from the University of California, San Francisco released a study of 140 cases where people who had been using ephedra-containing supplements experienced serious side effects. About two-thirds of the cases were found to be definitely, probably, or possibly related to the use of the stimulant. The adverse events included 10 strokes, 7 seizures, 10 deaths, and 13 cases of permanent disability.
What's more, the manufacturer of Ultimate Orange was recently found liable for damages after a 29-year-old man who was longtime user of the supplement suffered a massive disabling stroke.
And ephedra isn't the only culprit; consumer health advocates urge caution in the use of products containing androstenedione, a hormone converted by the body into the male hormone testosterone, and the amino acid compound creatine.
Androstenedione, or "andro," made headlines in 1998 when it was revealed that homerun champ Mark McGwire of the St. Louis Cardinals used it as part of his training and strength-building regimen. But in a study published last November in the journal Archives of Internal Medicine, researchers showed that middle-aged men who took either andro or a similar testosterone precursor called androstenediol did not build muscle any better or faster than men who took a placebo while on the same training program. The researchers did find, however, that men who used the substances were at increased risk for heart disease.
Less is known about creatine, but early evidence suggests that its use is associated with diarrhea, nausea, cramping, muscle strain, dizziness, dehydration, and even liver and kidney damage.
The supplement is not recommended for anyone under age 18, yet as researchers at Weill-Cornell Medical College of Cornell University in New York report this month in the journal Pediatrics, "creatine is being used by middle- and high-school athletes at all grade levels. The prevalence in grades 11 and 12 approaches levels reported among collegiate athletes."
"Student athletes use a lot of things without knowing much about them. They're sold in health food stores and in private gyms all the time," says Linn Goldberg, MD, who's in the division of Health Promotion and Sports Medicine at Oregon Health Sciences University (OHSU) in Portland. "Some coaches unfortunately sell these to the kids. What kid then isn't going to feel pressure to use a product that his coach is selling? Any coach selling any of this stuff should be fired."
Goldberg, who is also a research scientist in OHSU's ATLAS (Athletes Training & Learning to Avoid Steroids) program, tells WebMD that over-the-counter supplements are often gateway substances to more hard-core and even more dangerous performance-enhancing drugs such as anabolic steroids.
To young athletes looking for an endurance boost or performance edge, Goldberg has this recommendation: "Eat food. You really don't know what's in those supplements -- they're not regulated by the FDA."
The Healthy Competition Foundation posts on its web site a brand-name list of sports supplements containing either androstenedione, ephedra, and/or creatine.
This product contains, among other things, ephedra, which is a stimulant that researchers believe may cause permanent heart damage, stroke, or even death.
The tragic event and its unanswered questions about supplement use have prompted renewed warnings to all consumers about the potential dangers of such products.
"We recommend that everyone, particularly young people, talk to their doctors before taking anything. They can't assume just because it's something that you can buy over-the-counter at a so-called 'health food store' or over the internet that it's good for you," says Iris Shaffer, executive director of the Blue Cross/Blue Shield Association's Healthy Competition Foundation, in an interview with WebMD.
A web site that pitches Ultimate Orange and other supplements presents the product in a matter-of-fact type of challenge: "... some people shouldn't even try the stuff. Let alone use it for workouts. How about you? Can you handle the deep breaths, the mental focus, and the primal urge to lift more weight ... more times ... for greater gains?"
Critics of unregulated sport supplements could add many other things to that "can you handle" list, such as palpitations, high blood pressure, unstable heart rhythms, strokes, breathing problems, and sudden death.
In The New England Journal of Medicine last December, researchers from the University of California, San Francisco released a study of 140 cases where people who had been using ephedra-containing supplements experienced serious side effects. About two-thirds of the cases were found to be definitely, probably, or possibly related to the use of the stimulant. The adverse events included 10 strokes, 7 seizures, 10 deaths, and 13 cases of permanent disability.
What's more, the manufacturer of Ultimate Orange was recently found liable for damages after a 29-year-old man who was longtime user of the supplement suffered a massive disabling stroke.
And ephedra isn't the only culprit; consumer health advocates urge caution in the use of products containing androstenedione, a hormone converted by the body into the male hormone testosterone, and the amino acid compound creatine.
Androstenedione, or "andro," made headlines in 1998 when it was revealed that homerun champ Mark McGwire of the St. Louis Cardinals used it as part of his training and strength-building regimen. But in a study published last November in the journal Archives of Internal Medicine, researchers showed that middle-aged men who took either andro or a similar testosterone precursor called androstenediol did not build muscle any better or faster than men who took a placebo while on the same training program. The researchers did find, however, that men who used the substances were at increased risk for heart disease.
Less is known about creatine, but early evidence suggests that its use is associated with diarrhea, nausea, cramping, muscle strain, dizziness, dehydration, and even liver and kidney damage.
The supplement is not recommended for anyone under age 18, yet as researchers at Weill-Cornell Medical College of Cornell University in New York report this month in the journal Pediatrics, "creatine is being used by middle- and high-school athletes at all grade levels. The prevalence in grades 11 and 12 approaches levels reported among collegiate athletes."
"Student athletes use a lot of things without knowing much about them. They're sold in health food stores and in private gyms all the time," says Linn Goldberg, MD, who's in the division of Health Promotion and Sports Medicine at Oregon Health Sciences University (OHSU) in Portland. "Some coaches unfortunately sell these to the kids. What kid then isn't going to feel pressure to use a product that his coach is selling? Any coach selling any of this stuff should be fired."
Goldberg, who is also a research scientist in OHSU's ATLAS (Athletes Training & Learning to Avoid Steroids) program, tells WebMD that over-the-counter supplements are often gateway substances to more hard-core and even more dangerous performance-enhancing drugs such as anabolic steroids.
To young athletes looking for an endurance boost or performance edge, Goldberg has this recommendation: "Eat food. You really don't know what's in those supplements -- they're not regulated by the FDA."
The Healthy Competition Foundation posts on its web site a brand-name list of sports supplements containing either androstenedione, ephedra, and/or creatine.
