ABSTRACT
Athletes use various pharmacological or nutritional substances in an effort to improve performance and speed recovery from injury. Medications can be over the counter or prescribed. Other substances are sold over the counter as dietary supplements, some of which may be banned by sports governing bodies or be illegal. According to the 1994 Dietary Health and Supplement Health Education Act, substances can be sold without U.S. Food and Drug Administration (FDA) approval as long as the products are labeled and sold as dietary supplements and the label makes no claim as a drug.25 These substances do not require evaluation for safety or ef- cacy and are not held to the same quality control standards
as FDA-approved drugs.12 Because the content and purity of these products are not regulated, the product may contain variable amounts of the ingredients listed. For example, a recent study on vitamin D supplements found potency ranging from 9% to 146% of the labeled amount.41 The authors noted that U.S. Pharmacopeia-veried products are more accurate and less variable (Table 29.1).
