Risk of contamination in over the counter supplements

N.B. - This article was originally written with combat sport as its focus but the message is relevant to ALL sports, especially strength sports where supplement use is prevalent if not normal.

With an estimated global worth of over $30 billion, and a with a 2012 projected value of over $90 billion, the explosion of the sports supplement industry over the last couple of decades can only be described as thermonuclear. One just has to do a quick Google search, venture into any high street ‘sports nutrition’ retailer or investigate many of the advertisements placed in magazines such as this to grasp the sheer size of the business and the quite mind boggling variety of supplements available.

If you’re someone that engages solely in physical training for your own, personal reasons and have no want to compete in any form of organised sport then this article may be of general, passing interest to you and may contain certain implications to personal health. If, however, you are a competitive athlete in a drug tested sport then the information herewith could potentially have a direct impact upon your career and whether it continues.

It is easy to understand how driven, competitive combat athletes have the will to do all they can to be as successful as possible in their chosen fighting art, as long as their efforts are within the rules of their sport and basically safe to their own health. Thus the widespread use of sports nutrition supplements in competitive athletes, research by the European Specialist Sports Nutrition Alliance suggests that in 2008 over 90% of Olympic athletes were using supplements, is easy to understand. The athlete walks into a reputable, high street retailer and sees a product which claims to enhance some aspect of performance and, according to the ingredients, does not contain one substance which is on the WADA (World Anti-Doping Association) banned list; who could blame them for buying it? Imagine, then, how that athlete would feel if at their next random or post-fight drug test they tested positive for a prohibited substance and received a two year ban from sport, leaving their career and reputation in tatters. They rack their brains as to how this could possibly have happened and after many sleepless nights come to the conclusion that the only thing that was different in their diet was the consumption of that quite innocuous supplement. To many this would seem to be an unlikely chain of events yet numerous high profile athletes have blamed their own positive tests on consumption of such supplements which had been contaminated with illegal performance enhancers. One could quite understandably, and possibly correctly, suggest that this type of claim, made by such athletes as tennis player Greg Rusedski, hurdler Fani Halkier, swimmer Jessica Hardy and MMA fighters Pawel Nastula, Sean Sherk and Vitor Belfort, is nothing more than a smokescreen. Much evidence does, however, exist to suggest that there may indeed be veracity to their claims. Advertent or inadvertent, the fact remains that WADA specifically state “Remember, under the strict liability principle, it does not matter how or why a prohibited substance entered an athlete's body. Athletes are responsible for everything that goes into their body.”

The first real evidence of supplement contamination was a 2000 research paper carried out in Cologne by Hans Geyer and colleagues which was published in the German Journal of Sports Medicine. They tested a number of brand supplements which should not have brought about a positive test for any banned substance according to their ingredients and found that in fact a significant number of these supplements resulted in positive tests for the steroid nandrolone. The Cologne laboratory would follow this study up with a far larger one in 2002. In this study they tested a total of 634 supposedly legal supplements which were obtained from 13 countries and 215 different suppliers. Their findings were of great concern; a total of 94 products (14.8%) contained traces of banned anabolic steroids with 45 samples containing more than one steroid and 8 containing 5 or more! The worst offending countries, in terms of company origin, were Holland (25.8% of the positive tests), Austria (22.7%), the UK (18.8%) and the USA (18.8%). Another interesting finding was that from companies who produce prohormones (e.g. DHEA, Androstenedione etc) 21.1% of their products tested proved to be contaminated whereas this number was 9.6% for companies without such products in their greater range. Many different supplement exhibited evidence of contamination including creatine, HMB, vitamins and minerals, protein powders and herbal extracts.

Also of note was that contamination levels varied greatly from batch to batch but also within a batch, an observation which raises great concerns over product quality control in the sector. With many supplement companies not actually producing the raw ingredients of their products but simply combining them it is arguably very difficult to 100% ensure the receipt of wholly uncontaminated product; after all even the NHS have been duped by counterfeit syringes (BBC, 2010). Many supplement companies now claim to test a sample of each batch for contamination yet even this approach may not be foolproof. Fighting Fit’s own Brian Hamill, one of the UK’s most respected experts in the field of athletic strength and power development, expresses great concern over these efforts. He observes, “I spent much of my working life as an executive in the frozen foods sector and filling machine contamination was impossible to avoid. It’s all well and good taking a sample for analysis from the middle of a production run but that does not address the potential contamination which may occur as lines move from preparation or packaging of one product to another. In layman’s terms, you’ll always get some peas in your diced carrots.”

Vienna’s IOC accredited lab would go on to run a similar study with supplements purchased in Austria with basically the same end result, 22% of supplements were contaminated.

Whilst unintentional contamination will likely be responsible for much of what has been discussed here there have been examples of supplements found to contain such high doses of steroids which should never have been near the supplement’s production run (Geyer, 2000; Geyer et al, 2002) that some have alleged intentional ‘spiking’ to increase efficacy. Hopefully this is the exception and not the rule, yet Professor Ron Maughan of Loughborough University, arguably the World’s leading expert in the field of sports supplementation, recently wrote, “Most of the herbal compounds sold as stimulants are almost totally ineffective. Add something that makes them feel good and they will not only buy more but will also tell their friends about this great product.”

You may expect that with this information coming to light supplement companies would have resolved these issues of contamination yet subsequent research papers would suggest this was not the case. A 2005 study published in the Scandinavian Journal of Medicine and Science in Sports analysed 103 supplements and found approximately one-fifth contained either steroids or banned stimulants. A further study in the UK (Judkins, 2007) tested 58 products, 25% of which showed contamination with steroids and 11% with stimulants such as ephedrine.

As previously observed, many of the leading supplement companies have put batch testing in place and it is certainly a commendable endeavour. The difficulty is that regardless of the efforts made, no system in infallible. Brian Hamill’s comments illustrate a key issue, mid batch sampling will not always highlight contamination. Furthermore, if a supplement company were to dishonestly make such claims about their efforts or these efforts fell short, it would be too late for the athlete’s career once this had been uncovered. In all truth, making the supplement company fully accountable for a positive test would only be possible if a sealed product could be tested but given that intra-batch differences have been highlighted in the research this would prove little to nothing. Basically you would have to keep the product you’d taken unopened, which is clearly impossible. It certainly leaves the athlete in a quandary.

We approached thirteen of the leading supplement producers and posed the following questions:

- In which countries are your products produced?

- Are any of your supplements, or raw components which comprise them, produced in factories where anabolic steroids or other banned substances are produced?

- Does your company produce any supplements which would lead an athlete to fail an IOC/WADA test and can you confirm that these are not produced in the same factories as your other, non-prohibited products?

- What specific effort does your company make to ensure that contamination does not occur?

- If you perform batch testing, are the tests carried out in WADA/IOC approved labs?

What is interesting to note is that the only company which opted to provide a response was EAS (Energy, Athletics, Strength). To EAS’ credit, Nigel Perkins (Regional Manager & Performance Nutritionist, EAS UK) provided very full and frank answers to our questions. These responses are as follows:

1.  In which countries are your products produced?

EAS® products are produced at multiple third party manufacturers across Europe in the UK , Netherlands , Germany , Belgium , and Italy .  All manufacturing sites have been reviewed by Abbott’s quality organization and agreements are in place to ensure that EAS products meet both European Union as well as country specific standards.

2.  Are any of your supplements produced in factories where anabolic steroids or other banned substances are produced?

No.  EAS products are produced in facilities that are free of banned substances.

3.  Does your company produce any supplements which would lead an athlete to fail an IOC/WADA test and can you confirm that these are not produced in the same factories as other, non-prohibited products?

EAS products are tested by an independent agency for WADA banned substance testing.  Additionally, our products are manufactured in facilities that are free of banned substances.

EAS is committed to offering athletes the very best in safe, high-quality nutrition to help them achieve their performance, endurance and other fitness goals.  Many elite athletes in the UK rely on EAS for their nutritional needs because they know our products are tested to ensure there is no contamination of doping substances.  

4.  What specific effort does your company make to ensure that contamination does not occur?

Abbott's EAS® products are subjected to a rigorous quality assurance and testing process in accordance with World Anti-Doping Agency guidelines.  Athletes trust our products because they have the assurance that every batch of EAS product is tested to ensure there are no banned substances.

5.  If you perform batch testing, are the tests carried out in WADA/IOC approved labs?

Abbott’s testing methods are accredited by the United Kingdom Accreditation Service (UKAS) under ISO 17025 - an internationally recognised quality standard for analytical testing.   The HFL laboratory is also accredited by WADA (the World Anti Doping Agency), which also oversees Olympic doping tests.

EAS also have a very interesting website (www.doping-free.com) specifically addressing these areas which is well worth a look. It is vital to note that Fighting Fit has no affiliation with EAS whatsoever; they were simply the only company that opted to provide us with a response. In the interests of fairness it is important to observe that other companies do provide some information on their websites; this, for example, can be found on the website of Kerry Kayes’ supplement company, CNP:

“To provide assurance to these athletes, CNP’s products are independently tested on a regular basis for banned substances listed by WADA (World Anti-Doping Agency). These tests are conducted by HFL Sport Science, a world class sports doping control laboratory.

Products undergo rigorous testing using an ISO 17025 accredited method. This testing provides assurance to the athlete that tested products are safer to use than non-tested products.”

In a sense it is to CNP’s credit that they only state that this testing process makes their products safer than non-tested supplements, not totally risk free.

Can any athlete be 100% confident that their supplements are contamination free? In truth, probably not. It would seem to appear than some companies are, however, making commendable efforts to address this issue and dramatically reduce the risk of contamination. The advice to any athlete must simply reflect the statement from WADA that “Athletes are responsible for everything that goes into their body” and as such any sensible, diligent athlete should make every possible effort to investigate where there supplements are coming from and what their manufacturers are doing to prevent substances being in there which should not be.