Sports Medicine: Just the Facts

CHAPTER 70 • MEDICATIONS AND ERGOGENICS 423

DEHYDROEPIANDROSTERONE

EFFICACY

• Dehydroepiandrosterone (DHEA) is a hormone
  secreted by the adrenal gland that is a precursor to both
  androgens and estrogens.
  •Although the FDA banned the manufacture of DHEA
  as a drug due to insufficient evidence of efficacy and
  safety, it continues to be available as a nutritional sup-
  plement (Sturmi and Diorio, 1998).


• DHEA levels peak at puberty and young adulthood
  and gradually fade as aging progresses.


• Studies showed that physiologic doses (50 mg/day)
  and supraphysiologic doses (1600 mg/day) of DHEA
  increased circulating androgen levels in older women
  but not in older men (Stricker, 1998).


• DHEA increased androstenedione levels but not testos-
  terone levels and had a small, not statistically significant
  increase in lean body mass when given at supraphysio-
  logic doses to five young males (Stricker, 1998).


• DHEA did not appear to effect energy or protein
  metabolism in young males (Welle, Jozefowicz, and
  Statt, 1990).


• In summary, DHEA does not appear to increase
  testosterone in young healthy males, and it does not
  appear to have an ergogenic effect.

SAFETY

• Short-term use of DHEA has been associated with few
  side effects, but long-term use risks are unknown.
  There is a theoretical risk of prostate and endometrial
  cancer as well as gynecomastia. DHEA effects on lipids
  are unknown (Corrigan, 1999).

LEGAL

• DHEA is currently banned by both the NCAA and
  IOC and is available only as a nutritional supplement
  in the United States (American College of Sports
  Medicine, 1987; U.S. Antidoping Agency, 2003).

EPHEDRINE (MA HUANG) AND
RELATED SYMPATHOMIMETICS

EFFICACY

• Ephedrine is a sympathomimetic drug that is the
  active ingredient in the Chinese herbal medicine Ma
  huang.
  
  
  • Ephedrine and other sympathomimetics like pseu-
    doephedrine are commonly found in over the counter
    cold medicines. It acts physiologically to increase heart
    rate and blood pressure. When used with caffeine,
    ephedrine has been shown to improve time to exhaus-
    tion during exercise tests. When used with caffeine, it
    also seems to be effective in producing weight loss.
    Low dose (24 mg) ephedrine did not show an improve-
    ment in performance (Sidney and Lefcoe, 1977).
    •Pseudoephedrine has not been shown to improve aero-
    bic performance in controlled trials (Swain et al, 1997).
    •More research would be needed to find a therapeutic
    nontoxic dose of ephedrine.
  
  
  
  

SAFETY

• Higher dose ephedrine has been associated with hem-
  orrhagic stroke.


• Other serious side effects have been reported includ-
  ing nephrolithiasis and, rarely, hepatitis.


• Common side effects include tachycardia, hyperten-
  sion, anxiety, and arrhythmias.


• Ephedrine has caused fatalities even at recommended
  over-the-counter doses, prompting the FDA to issue a
  warning against its consumption in 1996 (U.S.
  Department of Health and Human Services, 1996).
  Ephedra’s inclusion in over-the-counter products was
  officially banned by the FDA in 2003.

LEGAL

• Ephedrine and related compounds are banned by the
  NCAA and IOC (American College of Sports
  Medicine, 1987; U.S. Antidoping Agency, 2003).

GINSENG

EFFICACY

• Ginseng is a shrub of which there are four varieties
  whose root is often used as a ergogenic aid. The
  saponin extracts or glycosides from the root are con-
  sidered to provide most of the biological activity, but
  there is a marked lack of quality control and standard-
  ization in the amount of saponins available in the prod-
  ucts.


• There have been conflicting reports on efficacy, with a
  few placebo controlled studies showing improvement
  in maximum aerobic capacity while others did not.


• Recent well designed placebo-controlled, double-blind
  studies have failed to demonstrate any improvement in