Think you only have to worry about steroids when it comes to athlete misconduct? That’s a misconception.
In reality, athletes can get into serious trouble with anti-doping authorities over a range of products, not just steroids. Dietary supplements, cosmetic treatments, and recovery aids are all culprits that have led to suspensions and damaged reputations — often without the athletes even being aware of any wrongdoing.
Dr. Mark Kovacs, a performance physiologist and coach, shared with The Post that there’s a significant underestimation of risks associated with wellness products. He explains this misunderstanding stems from a common belief: “I bought it legally, so I thought it was safe.”
Kovacs also emphasized that doping isn’t strictly about illicit drug use or intentional cheating as many might think. The spectrum is, in fact, broader.
“It includes anabolic agents, peptide hormones, growth factors, beta-2 agonists, hormone and metabolic modulators, masking agents, stimulants, certain narcotics, cannabinoids, glucocorticoids in specific contexts, IV methods, blood manipulation, and even gene or cell-related methods,” he noted.
What’s important to understand here is that ignorance won’t exonerate an athlete. Even if a violation is accidental, it often leads to penalties.
David Trosin, who is with NSF, a nonprofit that independently tests and certifies products, pointed out that athletes are placed under a principle of strict liability. That means they’re ultimately responsible for everything they consume, regardless of intent.
There have been numerous instances where athletes were caught out by hidden or undeclared substances in supplements, even when they had no intention of using something prohibited.
Take former NFL player Taylor Lewan, for example.
In 2019, he tested positive for ostarine, a substance banned by WADA and other sports leagues, including the NFL. He claimed that he unknowingly ingested it from a supplement recommended for brain health by his medical team.
“I’ve never knowingly done anything that would cheat the game,” he stated during a press conference. Lewan even went as far as to take a polygraph test, which he reportedly passed, to support his claim. However, he still faced a four-game suspension.
What might be in your supplements?
Kovacs explained that supplements can expose athletes to risks in three main ways. First, a product might contain banned ingredients listed under different names. Second, the labeling can be inaccurate or incomplete. And third, contamination during manufacturing, storage, or distribution can occur.
The statistics are alarming. A study involving over 3,000 dietary supplements found that about 28% contained undeclared banned substances. Another study highlighted that nearly 90% of sports supplements were mislabeled, often containing illegal ingredients.
This is significant, especially since a large number of elite athletes consume dietary supplements. The US Anti-Doping Agency has specifically pointed out that muscle-building, weight-loss, and energy products are especially risky.
“Pre-workouts and weight-loss products are particularly concerning because, even if they don’t contain prohibited caffeine, they may have other banned stimulants or contaminants,” Kovacs warned.
Paralympic track athlete Desmond Jackson faced this reality personally in 2021.
After testing positive for DHEA, a banned substance, he was given a 14-month suspension. Jackson, who was just 22 at the time, accepted an over-the-counter pill given to him by his coach, believing it would enhance his energy — without questioning its contents.
Kovacs highlighted that sexual-enhancement products also pose significant risks.
Take Olympic gold medalist LaShawn Merritt, who learned this lesson in 2010. He received a 21-month suspension after failing several drug tests, claiming the positive results were due to ExtenZe, a sexual-enhancement pill he bought at a convenience store, which had undeclared DHEA. Merritt later described his decision as “foolish and immature.”
A messy situation
Interestingly, even seemingly innocuous products can cause trouble. In 2006, US skeleton racer Zach Lund tested positive for finasteride, a hair-loss medication. Although he disclosed this medication, WADA had classified it as a steroid-masking agent, leading to his suspension and removal from the Olympics.
In a twist of fate, he eventually became bald — and finasteride is no longer banned. Yet athletes still face hurdles with hair-loss treatments. Last year, Yeray Álvarez of Athletic Club received a 10-month suspension after testing positive for a substance linked to canrenone, which he took to prevent hair loss caused by cancer treatment.
Risks at the medical spa
Kovacs has flagged IV therapy as another significant area of concern. What was once limited to specialized clinics for hydration and nutrient delivery has now made its way into med spas.
Athletes often think that IVs containing legal vitamins or fluids won’t create issues, but that’s not the case. According to WADA rules, infusions exceeding 100 mL in a 12-hour period are prohibited unless there’s a specific medical exception because they can mask the presence of banned substances.
Ryan Lochte faced consequences in 2018 after posting a photo of his IV infusion, resulting in a 14-month suspension. And just recently, athlete Aleia Hobbs accepted a six-month period of ineligibility after receiving a saline infusion to combat flu-like symptoms, which exceeded the allowed limit.
Med spa services can be misleading, and Kovacs warns that while traditional cosmetic treatments may not be issues on their own, many now promote overlapping services involving anti-aging, hormone optimization, peptides, growth factors, and recovery products.
Tyson Gay’s experience in 2014 is a case in point. He accepted a one-year suspension after testing positive for a steroid traced back to a cream provided by an anti-aging specialist, leading him to relinquish his Olympic silver medal.
The peptide conundrum
Experimental peptides also raise concerns as many lack proper research or FDA approval but are widely available. Last year, triathlete Anthony McCauley accepted a four-year suspension after using banned substances, including BPC-157 and TB-500, which are claimed to expedite recovery.
McCauley faced scrutiny not just for his usage but also for promoting these restricted products to followers, some of whom were held under the World Anti-Doping Code.
What athletes can do to stay compliant
Kovacs advises that elite athletes should adhere to this principle: focus on nutrition first, medical needs second, and use supplements only with clear justification and a thorough risk-reduction process.
It’s crucial to check every ingredient, utilize reputable third-party certified products when supplementation is warranted, save batch numbers, and document recommendations alongside checking WADA and USADA resources.
NSF leads the charge in this space, operating its Certified for Sport program to screen dietary supplements and personal care products, ensuring they are clear of banned substances. This program is the only independent, third-party certification recognized by various sports organizations, including the USADA, MLB, and NHL.
The certification extends to some products in high-risk categories. Ultimately, athletes must extend their diligence: they should ask what goes into their bodies and what treatments they’re receiving from practitioners.
“That is the level of diligence required in modern sport,” Kovacs concluded.
