Bigger, stronger, faster -- over the counter

Anabolic steroids get the bulk of attention.

Yet, the main focus of a new state drug testing program for high school athletes won't be illegal steroids, but the shakes, powders and pills available at drug stores, nutrition retailers and gyms across the suburbs -- and for purchase by any teen with cash.

"It's difficult for high school kids to get their hands on anabolic steroids," said Marty Hickman, executive director of the Illinois High School Association. "The over-the-counter substances are really the main concern."

Dietary supplements -- which include vitamins, minerals, herbs, amino acids, enzymes and organ tissues -- are legal, largely unregulated, and highly alluring to teens looking to boost athletic performance.

Best-selling supplements advertise themselves as "legally insane." They promise to "immediately flood muscles with pump-inducing vascular expanders," stimulate "chilling gains in muscle size and strength" and induce "an anabolic insulin spike." One label lists "internal combustion" as an ingredient.

"They're wowing people with words. You need a dictionary to find out what they're saying," said David Buchanan of ProSport Training and Rehab in Rolling Meadows. "You have someone in the vitamin world telling kids, 'You need to take this, you need to take that. This is the sports nutrition drink of the day.' … It's a marketing plan."

High school coaches and athletic directors say they know their students buy into the hype.

"We're always talking about it," Lake Zurich High School Athletic Director Rolly Vazquez said. "You see kids doing protein shakes and such, all the stuff sold over-the-counters these days. Bigger, faster, stronger -- that's what the kids want to be."

But bigger, faster, stronger comes at a financial price -- and sometimes a physical one.

"They think this bar or supplement is going to help, but a really high percentage don't help at all, and the rest are really dangerous," said Don Beebe, football coach at Aurora Christian High School and founder of the House of Speed training centers.

Beebe, who played professional football and has coached more than 40,000 athletes through his training centers and camps, estimated half of the high school athletes he works with use some type of supplement.

"The kids don't know better. The parents don't know better," Beebe said. "A very high percentage just don't have the knowledge."

Evan Page, a Jacobs High School football standout who played the past two seasons for Harper College, estimated about half of his high school teammates used over-the-counter supplements. Some spent as much as $1,000 a year on the performance-enhancers, he said.

"We just assumed if it was at a store, it couldn't hurt," Page said. "It wasn't until I was older that I learned most of it wasn't FDA-approved."

Safety

The Food and Drug Administration uses a different, less stringent set of regulations for supplements than for conventional food and drugs.

Supplements can go to market without FDA approval and without registering with the agency. The FDA is responsible for taking action against unsafe products -- but only after they're on the shelf.

This safe-until-proven-unsafe approach raises a number of concerns, particularly for teens, industry observers say.

"They're expensive and most of them don't work," said Frank Uryasz, the president of the Center for Drug Free Sport, which administers drug-testing programs for the NBA, the NCAA and minor league baseball.

"Then there are those things that are harmful or potentially harmful, and we just don't have any research on them … . And even if products are tested, they wouldn't be tested on young people," Uryasz said.

An industry representative said there are a handful of unscrupulous companies, but the vast majority hold themselves to high standards.

Protein powders, Creatine and amino acids -- which many teens take to build muscle mass -- are widely used and almost certainly safe, said Andrew Shao, vice president of scientific and regulatory affairs at the Council for Responsible Nutrition, a trade association.

"There's no reason to believe that these mainstream types of products are any dangers to teens, any more so than drinking a Venti coffee from Starbucks," Shao said.

Other products, though, raise red flags because of the stimulants they contain. Many, for example, have large amounts of caffeine. A single dose of one popular supplement contains the caffeine equivalent of three cups of coffee.

"Stimulants plus exercise plus heat and humidity, that's our concern," Uryasz said, speaking to the dangers of heat stroke. "If a product purports to increase metabolism, burn calories or burn fat, there's a real good chance it contains a stimulant.

"We also tell them, if it increases testosterone levels, or uses a word that sounds like steroid or hormone, you need to stay away from it."

A whole class of supplements claim to increase testosterone, but Uryasz said if there were any proof that any of these products actually did so, they would be banned. Anabolic steroids are a synthetic version of testosterone.

A number of trainers pointed out that if any of these products worked as well as advertised, everyone would know about it.

"I know every week, there's the latest and greatest that … nutritional stores may be advertising," said Ted Hirschfeld, head athletic trainer at Hinsdale Central High School and a board member for the Illinois Athletic Trainers Association. "But I haven't read anything in the health lit I'm reading … and through the grapevine, I haven't heard of anything that's supposed to work."

Self-regulation

Supplement manufacturers and retailers label some products as dangerous for people younger than 18. Still, because the labeling is voluntary, teens can buy the products without showing identification.

"This is where some responsibility lies with the consumer," Shao said. "We fight for open access to dietary supplements, and with that comes a lot of responsibility."

But even for consumers willing to do their homework, it can be tough to pinpoint what, precisely, they're consuming.

Uryasz's Center for Drug Free Sport offers a hotline --to which the NCAA and other organizations subscribe -- for athletes who want to know whether their supplement contains banned or dangerous substances.

Staying abreast of all the new products on the market is extremely challenging, Uryasz said.

"Often, we don't know about a product until someone writes, and then we have to do research," he said. "Sometimes we have to come back and say, 'This is not a real compound; this isn't a real word. We don't know what this is. Our best advice is to stay away from it.' "

Illinois high school athletes now must take similar precautions, or risk penalties under the new drug-testing program.

The IHSA hasn't yet revealed the full extent of the testing program, but the association has adopted the same list of banned substances as the NCAA.

Some products at local nutrition stores contain NCAA-banned substances, such as DHEA, a steroid precursor.

"There is a risk, and our recommendation for our athletes is, avoid use of dietary supplements," Uryasz, said.

What most teens forget, trainers say, is that a good diet and training regimen is far more effective than anything you can buy over the counter.

"It always goes back to eating well, and if you eat well, you don't need the other stuff," said Nancy Clark, a registered dietitian with the American College of Sports Medicine. "Supplements are a huge business, and everybody looks for the shortcut. They look for the magic pill rather than just being responsible."

In 2007, the IHSA banned high school coaches, administrators, employees and boosters from selling, distributing, or promoting the use of performance-enhancing supplements to students.

Beebe said coaches should not just refrain from promoting supplement use, but they should be actively discouraging it.

"It needs to be talked about, and we need to find ways to council them," Beebe said. "To say it's not a problem, and fluff it off, I've got a problem with that."

Web links

For more information about dietary supplements for athletes:

• U.S. Food and Drug Administration has data about dietary supplements, including warnings and safety information at www.cfsan.fda.gov/~dms/supplmnt.html#info

• National Federation of State High School Associations has information on drug testing and the risks of a variety of supplements at www.nfhs.org

• The NCAA list of banned substances is at www.ncaa.org