There have been many recent cases of athletes failing drug tests and blaming contaminated dietary supplements. This includes athletes from the recently concluded 2002 Winter Olympics, as well as NCAA athletes. Gold medals have been lost because of supplements, and the NCAA gives a one-year ban for a positive test. Much of this has been fueled by the $20 billion-per-year dietary supplement industry that is not subject to typical Food and Drug Administration (FDA) safety regulations

A recent study analyzed over-the-counter dietary supplements and found that 11 of 12 brands did not contain what was stated on the label. The findings, which were reported in the November issue of the Clinical Journal of Sports Medicine, revealed that supplements either did not contain the amount of drug on the label, had missing ingredients, substituted other ingredients or contained more than what was written on the label. All of the supplements tested were supposed to contain over-the-counter steroids, such as androstenedione, androstenediol, 19-norandrostenediol, etc. In one case, a supplement actually contained testosterone -- a prescription drug.

The conclusion of the study is that mislabeling frequently occurs. In this case, all of the supplements tested contained NCAA-banned substances. However, other studies have been published in which supplements containing ephedrine, ginseng, echinacea and St. John's Wort all have been found to have major discrepancies between the labels and the actual pill content.

Athletes frequently have claimed (although not always documented) that they have tested positive as a result of contaminated substances. Buying a supplement is truly a case of "buyer beware." Although there are some reputable supplement companies, it is almost impossible to determine which ones follow good manufacturing standards.

Athletes often fail to understand that dietary supplements are not subject to the same rigorous standards as prescription drugs, nor are they strictly regulated by the FDA for quality and purity. Athletes should ask themselves, "Do I really want to take a product that has not been proven to be effective, may not contain what is on the label and may cause a positive drug test?"

It also is important to know that sports organizations like the NCAA and the United States Olympic Committee do not usually accept ignorance or contamination as a defense in a positive drug test. Athletes are responsible for their own tests and need to consult with their athletic trainer or team physician before taking any supplement.

If you are unsure or don't have the resources at your school, you can contact the Resource Exchange Center at 816/474-7321 or through the Internet at www.drugfreesport.com/rec to ask questions about supplements. The Resource Exchange Center is supported by the NCAA to provide accurate information about supplements so that student-athletes don't test positive and lose a year of eligibility.

Gary Green is a doctor in the UCLA division of sports medicine and chairs the drug-education and drug-testing subcommittee of the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports.