Pubdate: Wed, 27 Jan 1999 Source: Seattle Post-Intelligencer (WA) Contact: http://www.seattle-pi.com/ Copyright: 1999 Seattle Post-Intelligencer. BULK IN A BOTTLE MORE AND YOUNGER ATHLETES TAKING SHORTCUTS, AND A RISK Mark McGwire's record-setting home run race made 1998 a banner year for baseball and sports in general. But it also made it a banner year for an issue far more serious and potentially devastating: athletes using performance-enhancing substances to build bigger and stronger bodies. McGwire's admission that he used two supplements, creatine and androstenedine or "andro," suddenly put new light on a decades-old battle to stem the use of anabolic steroids and other so-called ergogenic aids in athletic competition. With McGwire's admission has come a new set of concerns: That more young athletes will attempt to use supplements as a way of improving performance, fitness and recovery from injuries, instead of building body strength naturally. That the supplements will be lumped together and considered to be medically sound simply because they are available over the counter or via mail order. That policies such as the University of Washington's to administer creatine to athletes might some day create great liability if medical complications are found in the future. That while creatine is currently considered medically safe, andro is considered to be an anabolic steroid that can lead to several potentially life-threatening diseases. Linking the two and using both without proper medical supervision could prove dangerous. While McGwire will go down in the history books as the unqualified home run champion for a single season, other athletes who used similar substances last year faced far different repercussions. Most recently, Petr Korda was forced to forfeit his rankings points and $94,529 in prize money from Wimbledon after the International Tennis Federation found he tested positive for an anabolic steroid. His attempt to defend his 1998 Australian Open title ended over the weekend, but his appearance stirred controversy among his fellow players, who question how Korda could have been allowed to compete. Despite warnings from the medical community and ethical questions about unfair competition, athletes like McGwire and Korda are big- name indicators that supplements have become ingrained at all levels in the world of athletics. "We can easily blame ourselves and society for putting professional and high-level collegiate athletes on such a pedestal that it's going to influence our high school athletes," said Dr. Mark S. Juhn of the University of Washington's Primary Care Center Sports Medicine Clinic. "I think that's a shame, but it's reality." According to the U.S. Department of Health and Human Services, up to 13 percent of all high school athletes use anabolic steroids and 40 percent of those athletes believe the illegal drug is not harmful. Supplement use appears to be starting at younger ages. A study published in May by the journal Pediatrics found that nearly 3 percent of boys and girls at four Massachusetts middle schools were using anabolic steroids to build bigger bodies for sports. "It's ubiquitous, there's no doubt about that," said Charles Yesalis, a Penn State professor of health and human development who has written a book on the subject, "The Steroids Game." McGwire's admitted use makes him "a very poor role model for kids, and he can argue that it's legal to buy in society, but that's merely a loophole in the laws. He can say anything he wants, but it's a drug." Patrick Olsen, president of the Washington Vocational Sports Medicine Association and the head athletic trainer at South Kitsap High School, has seen the problem first-hand and believes McGwire's admission has only clouded the issue. "Anyone who wants to be good at whatever they do has some sort of a hero. And if their hero is using (a performance supplement), then they will be more susceptible to it," Olsen said. "They think, `This can't hurt me because I don't have to have a prescription for it.' They fail to realize that you can buy arsenic too, but you wouldn't want to use it." The issue becomes all the more confusing to the average young athlete because creatine and andro are two entirely different supplements. Creatine is an amino acid powder found naturally in skeletal muscle, heart, brain, testes and other tissues. It is classified as a dietary supplement that enhances muscle growth and weight gain, and not a drug. "Creatine is acceptable, and it does enhance performance," Yesalis said. "Although, if you could get the proper dose of creatine in the food supply, why would anybody pay for it? It will cost you $40 to $50 a month." Andro, on the other hand, is considered an anabolic steroid because taken as a pill it raises the level of the male hormone testosterone, and users claim it builds muscle mass and helps speed recovery from sports-related injuries. Because it is still available at many vitamin stores, mail-order businesses and Internet suppliers, andro is not considered an illegal substance by major league baseball or the NBA, which ban only illegal drugs. Because of the controversy surrounding McGwire's use of andro, baseball commissioner Bud Selig and players union head Donald Fehr have appointed a committee to study whether it should be banned, but the committee has yet to reach a conclusion. Andro, however, already has been banned by the International Olympic Committee, the NCAA and the ATP tennis tour, and the NFL has banned its use since 1996, primarily because it can be classified with other steroids. While the method of taking the steroid is far different from the injections athletes once used, many experts believe the basic health repercussions are the same: excessive acne, shrinkage of the testicles or uterus, and potentially life-threatening ailments such as liver damage, premature heart disease and cancer. While McGwire can set the home run record using andro, other athletes haven't been so lucky. Gold medal shot-putter Randy Barnes, the world-record holder, drew a lifetime ban last year for testing positive for andro. And in September, Pittsburgh Steelers offensive tackle Paul Wiggins was suspended for four games after admitting he used the substance. Use of creatine, however, hasn't yet been banned by any sports organization, although there is plenty of debate about its effects and potential long-term health risks. "Some of our athletes have been using creatine for three years or so," South Kitsap's Olsen said. "It's not something we supply, it's not something we tell our kids they have to be on. They go out to their own people and do their own thing on it." Creatine currently is the supplement of choice for body building, primarily because it is not an anabolic steroid and because so many athletes endorse its use. At the University of Washington, strength and conditioning coach Rick Huegli said creatine has been dispensed to many athletes under his direct supervision, with little or no apparent ill effects. "It enhances the short-term burst energy system," Huegli said, adding that most of the benefit comes during weightlifting training, rather than in on-field performance. Huegli advises athletes to begin a program of better nutrition and training without the use of supplements before trying anything like creatine. But he says athletes will always be tempted to use supplements because it "helps them recover better and train longer and harder." In the past, Huegli said the UW would dispense a one-month supply of creatine to any athlete who wanted to use it, but the school has recently discontinued the practice for fear of liability should an athlete develop a medical problem in the future. Athletes now must buy their own supply. It's not hard to find young athletes who have used creatine. One high school football player, Brian, of Mountlake Terrace, said he began using the supplement last year in an attempt to build more muscle mass and help him during offseason weight training. He learned about creatine from other players who were using it on a regular basis. But after experiencing some weight gain, he soon decided that the expense wasn't worth the results he was seeing. "I just felt that it was better to do it naturally," he said. Another high school football player, a 17-year-old from Edmonds, still uses creatine and says he grew from 167 pounds to 190 pounds in about six months after using the supplement and increasing his workouts. "It doesn't work unless you also work harder, but it helps you work harder," he said. The medical jury still is out on creatine, but it appears to be far safer than an anabolic steroid or a product such as andro. However, there are few studies on its effects on adolescents, and none on long-term effects. "It's very difficult to separate fact from hype when it comes to creatine," said Juhn of UW's sports medicine clinic. "Creatine has some potential, but people have this underlying assumption that it works for everything, but it doesn't." For example, it doesn't help sprinters or distance people in track or swimming, said Juhn, who recently published a study on potential side effects of creatine in the Clinical Journal of Sport Medicine. Juhn says the weight gain associated with creatine is largely due to water storage. "The big issue is, in the long-term, does creatine improve strength? That's up for debate right now," he said. With concern being voiced by doctors such as Juhn, trainers like Olsen are all the more wary of its potential for abuse. "There's no long-term study done on creatine, so you have no information from 10 years out," Olsen said. From the information he has seen, Olsen believes there are several reasons to beware of the supplement: dehydration, possible kidney problems and cost. He reports some young athletes spend hundreds of dollars on the product with minimal results. Compared to andro or other steroids, creatine "is probably the least harmful, but in 10 years you might have some kid who took three or four times the normal dose and find it was overworking the kidneys or something like that," Olsen said. "If you get a symptom such as kidney failure 15 years down the road, how do you relate that back to their creatine use?" There have been some benefits, Olsen said, noting some athletes have gained 10 to 15 pounds in weight and muscle mass. "But once they get off of it, they lose maybe half that weight," he said. "It takes so much water to digest that protein." Juhn notes that creatine is found not only in muscles, but in the brain, the heart, the liver and testicles. "We haven't really studied what taking oral levels of creatine does to creatine levels elsewhere," he said. "I'm saying we don't know. . . . For all we know, creatine might be the safest thing in the world, but we haven't proven that." Olsen says he doesn't know of any of his athletes who are currently taking andro, but he's convinced that many kids are trying it. "I bet if you talk to kids, most would say they're not scared by it," he said. "It's the idea, would you trade a gold medal if you could only live five years? Yeah, give me the gold medal." Yesalis believes there will always be some new product on the market that will attract athletes. One is human growth hormone, which is used as an ergogenic supplement by body builders and has such a short half-life it is nearly impossible to detect by standard drug-testing methods. Yesalis contends that many athletes who use creatine or andro do so to mask their hidden use of human growth hormone to build even bigger bodies. "Some athletes have been using creatine and andro as a smokescreen for their use of other more potent supplements," he said. With so many athletes using such products, there might be no way to turn back the tide short of drug testing at every level of athletics. "I'm disturbed by the emphasis put on supplements when we should be thinking about the most proven method of enhancing athletic performance, which is dedication, perseverance, hard work and practice," Juhn said. "It's really discouraging, what's happening now." The three hottest body-building supplements: CREATINE The substance: A nutritional supplement used to build muscle mass, strength and enhance energy levels for workouts. Taken mostly as a powder. Found naturally in the body and synthesized in the liver and the pancreas by amino acids arginine, glycine and methionine. Also found in red meat and fish. The dangers: Not fully known, although Creatine can lead to muscle tears and cramps and cause dehydration. The rules: Creatine is not banned as are steroids and other ergogenic body building enhancement aids, although many individual teams and trainers disprove of its use. ANDROSTENEDIONE The substance: Essentially an anabolic steroid that acts to elevate testosterone synthesis, which users like baseball's Mark McGwire have claimed gives them more energy for workouts or performance. The dangers: Has been shown to decrease the body's natural production of testosterone. Side effects include higher cholesterol count, acne, baldness and increased risk of cancer. The rules: Non-prescription use of anabolic steroids is against the law, but Andro can be purchased over the counter and by mail order. Banned by the NCAA, the NFL, the ATP tennis tour and the IOC. Allowed by Major League Baseball, which is reviewing its policy. HUMAN GROWTH HORMONE The substance: Synthetically produced hormone used to treat growth deficiencies in children, but also used by athletes to build muscle mass and decrease time for recovery from injury. Stimulates the intracellular breakdown of body fat and can strengthen cartilage, bones, tendons and ligaments. The dangers: Linked to high blood pressure, diabetes, headaches, muscle aches and other ailments. The rules: Banned by the IOC but has a short half-life, which makes it difficult to detect by standard drug-testing procedures. Athletes and performance-enhancing drugs (all cases within the last year) Mark McGwire: Admits using Androstenedione and creatine while setting the single-season home run record. Neither substance is banned by Major League Baseball. Randy Barnes: Gold medal shot putter banned from competition for taking Androstenedione. Dennis Mitchell: Bronze medalist in the 100 meters at the 1992 Olympics, banned after testing positive for high levels of testosterone. Paul Wiggins: Pittsburgh Steeler offensive tackle suspended for four games for taking Androstenedione. Petr Korda: Last year's Australian Open tennis champ forced to forfeit rankings and $94,529 in prize money after testing positive at Wimbledon for nandrolene metabolites, a performance-enhancing anabolic steroid. Team Festina: Tour de France cyclists found to be using EPO, or erythropoietin, a synthetic hormone to boost endurance. Widening drug scandal disrupted cycling's most famous race. - --- MAP posted-by: Rich O'Grady