Beyond Steroids: The Hidden Doping Risks in Athlete Wellness Products

Athletes are increasingly falling foul of anti-doping regulations not just through deliberate steroid use, but also from seemingly innocuous wellness products like dietary supplements, cosmetic treatments, and recovery aids. These substances can lead to costly suspensions, loss of medals, and damage to reputations, sometimes without the athlete even realizing they have crossed a line.

Dr. Mark Kovacs, a performance physiologist who has worked with numerous professional athletes, noted that athletes and their support teams often underestimate the risks associated with wellness products. "The surprise usually comes from the same belief: ‘I bought it legally, so I thought it was safe,’" Kovacs said.

The definition of doping has expanded beyond anabolic steroids to include a wide array of substances and methods, such as anabolic agents, peptide hormones, growth factors, stimulants, and even gene-related methods, according to Kovacs. Athletes are held to a principle of strict liability, meaning they are responsible for everything they ingest, regardless of intent.

David Trosin, senior director of nutrition and wellness at NSF, a nonprofit that tests and certifies products, explained that undeclared or prohibited substances in supplements have led to violations even when an athlete had no intention of cheating. Former NFL offensive tackle Taylor Lewan experienced this firsthand in 2019 when he tested positive for ostarine, a substance similar to anabolic steroids banned by the World Anti-Doping Agency (WADA) and the NFL. Lewan claimed he ingested it accidentally through a supplement recommended for brain health, even passing a polygraph test to support his assertion, but still faced a four-game suspension.

Supplements pose risks in several ways: they may contain prohibited ingredients listed under different names, have inaccurate or incomplete labels, or become contaminated during manufacturing, storage, or distribution. Studies indicate a significant problem, with one analysis of over 3,000 dietary supplements finding that 28% contained undeclared substances. Another study revealed that nearly 90% of sports supplements were inaccurately labeled, with many spiked with illicit ingredients.

The US Anti-Doping Agency (USADA) has identified muscle-building, weight-loss, and energy products as particularly risky. "Pre-workouts and weight-loss products are especially concerning because even when caffeine itself is not prohibited under WADA, those products may contain other stimulants or contaminants that are prohibited," Kovacs stated.

Paralympic track and field athlete Desmond Jackson received a 14-month suspension in 2021 after testing positive for dehydroepiandrosterone (DHEA), a banned drug, from an over-the-counter energy pill. Similarly, Olympic gold medalist sprinter LaShawn Merritt received a 21-month ban in 2010 after failing three doping tests due to DHEA found in an over-the-counter sexual-enhancement product.

Even products seemingly unrelated to performance enhancement can cause issues. In 2006, US skeleton racer Zach Lund was disqualified from the Winter Olympics and suspended for taking finasteride, a prescription hair-loss medication that WADA then classified as a steroid-masking agent. More recently, Athletic Club player Yeray Álvarez received a 10-month ban for a prohibited substance linked to medication he took to prevent hair loss following testicular cancer treatment.

IV therapy has also emerged as a significant concern. WADA rules prohibit IV infusions or injections exceeding 100 mL in a 12-hour period unless medically necessary, as they can potentially mask prohibited substances by diluting blood or urine. Olympic swimmer Ryan Lochte received a 14-month suspension in 2018 following a social media post of him receiving an IV infusion. Track and field athlete Aleia Hobbs accepted a six-month ineligibility earlier this year after exceeding the infusion limit while treating flu-like symptoms.

Med spa services also carry risks. While traditional cosmetic procedures may be safe, many spas now offer services involving peptides, growth factors, and recovery products that can be problematic. Sprinter Tyson Gay received a one-year suspension in 2014 after testing positive for a steroid believed to have come from a cream supplied by an anti-aging specialist.

Experimental peptides, often lacking human research and FDA approval, are another growing concern. Triathlete Anthony McCauley accepted a four-year ban last year for using banned substances, including the peptides BPC-157 and TB-500, sometimes referred to as the "wolverine stack."

To mitigate these risks, Kovacs advises athletes to prioritize whole foods, address medical needs directly, and only use supplements when necessary and with extreme caution. This involves verifying ingredients, using third-party certified products, and meticulously documenting everything. Programs like NSF Certified for Sport screen supplements, personal care products, and functional foods for banned substances and verify label accuracy, earning recognition from major sports organizations.