Athletes hoping to boost their performance by consuming androstenedione - an over-the-counter dietary supplement known as "andro" - may actually increase their risk of testing positive for a steroid banned by sports organizations.
Andro can contain a contaminant that produces a urine byproduct linked to the use of nandrolone - an anabolic steroid, reports a UCLA study in the Nov. 22-29 issue of The Journal of the American Medical Association.
"Our findings question the purity of over-the-counter steroids," said Dr. Don Catlin, principal investigator and director of the UCLA Olympic Analytical Laboratory. "What you buy isn't always what you get."
Researchers from UCLA and Massachusetts General Hospital divided 37 healthy men aged 20 to 44 into three groups to test how their bodies metabolized andro. The first group took 100 milligrams of andro a day for a week, and the second group took 300 milligrams a day for a week. A control group consumed no andro at all.
At the end of the study, the research team tested the men's urine. The 13 men who did not take the supplement showed no positive results. But surprisingly, the urine of all 24 of the men who consumed andro contained 19-norandrosterone, a metabolic byproduct of the steroid nandrolone. Twenty of the men's samples contained enough 19-norandrosterone to test positive for banned steroid use at the Olympics.
"We wondered where the 19-norandrosterone came from," said Catlin, a UCLA professor of pharmacology, "because it's not likely to be a metabolic byproduct of andro."
Catlin and his colleagues decided to analyze the content of the andro capsules. What they discovered alarmed them: each capsule contained a trace contaminant of 19-norandrostenedione - enough to produce a positive urine test for steroid use.
To confirm this, Catlin's team administered a 19-norandrostenedione dose of 10 micrograms (one-ten thousandth of a milligram), which was the average amount they found in the andro capsules. They dosed four men, then analyzed their urine. Each participant tested positive for steroid use under Olympic guidelines.
"The andro manufacturer is not to blame," Catlin said. "The amount of 19-norandrostenedione we detected lies far below the purity level required by the U.S. Food and Drug Administration for regulated pharmaceutical drugs," he said.
Disturbed by their findings, Catlin's team purchased nine different brands of andro and examined their contents in the laboratory. Though each brand advertised its dosage as 100 milligrams, the actual amount in each andro dose varied from zero to 103 milligrams. In addition, some of the capsules' contents did not match what their labels listed.
"Some of the andro brands contained testosterone - which is illegal," Catlin said. "What dietary-supplement customers are buying isn't always what they're getting. This is a case where the buyer must beware."
Catlin acknowledged that his team tested only one batch of andro and cannot claim that all andro is contaminated. Still, he said, "The only way to protect yourself from testing positive for steroid use is to not take drugs or health supplements at all."
Alleged to increase muscle size and strength, andro made headlines in 1998 when baseball icon Mark McGuire admitted using it and hit a record 70 home runs that season. This year, a number of Olympic athletes lost their medals after their urine samples tested positive for 19-norandrosterone. The Olympic Games ban both nandrolone and andro.
"Olympic athletes sometimes take andro, even though it's banned, because the International Olympic Committee has not yet approved a urine test for andro," Catlin said. "We've seen a large rash of athletes testing positive for 19-norandrosterone in the last few years. Many claimed they didn't take anything, but later admitted that they'd used andro or something similar."
The National Collegiate Athletic Association, National Football League, National Gym Association, North American Boxing Federation and professional tennis have banned the supplement.
Experts debate the competitive benefits of andro, some citing that there are none and that usage may actually cause health risks. Despite the controversy, the FDA allows andro and related products to be sold over the counter at health-food stores, gyms and grocery stores.
The National Institutes of Health, National Football League, National Collegiate Athletic Association, U.S. Olympic Committee, Major League Baseball and Major League Baseball Players Association supported the UCLA study. Funding organizations did not participate in the design, conduct, interpretation or analysis of the findings.
Elaine Schmidt
elaines@support.ucla.edu
310-794-2272
Journal
JAMA