Potential Dangers and Guidance Regarding Dietary Supplements and Performance Enhancing Aids

Soldier health and physical fitness are top priorities for the army. Therefore, Soldiers need to make informed decisions about the appropriate use of dietary supplements. Dietary supplements include herbal preparations, vitamin and mineral supplements, amino acids, protein powders, and various animal products (e.g., gland and tissue extracts, bee products).

Be advised that many dietary supplements touted as performance enhancing or weight loss aids provide little, if any, benefit beyond that attainable with a safe, effective physical training program and a healthy eating lifestyle. Although products marketed as dietary supplements may be sold legally in the united states, this does not imply that they are effective as claimed or that they are without negative side effects. Just because a product is "natural" does not mean it is "safe". Many natural substances can cause harm. Soldiers must approach these products with a healthy skepticism and extreme caution.

Some dietary supplements may provide a health benefit to Soldiers, but many have dangerous side effects. Of considerable concern are products containing ephedrine alkaloids such as ephedra (ma-huang), epitonin, and sida cordifolia. These botanical ingredients may be associated with adverse side effects including rapid heart rate, increased blood pressure, and increased risk of heat injury, depression, agitation, muscle breakdown, heart attack, stroke, memory loss, convulsions, and death. Furthermore, exercise, dehydration, caffeine, and some medications (to include over-the-counter medications) used in conjunction with ephedrine-containing products will increase the risk of these adverse side effects as well as their severity. Due to life threatening safety issues, the food and drug administration recently banned the sale and use of ephedrine alkaloids in dietary supplements in the us. However, certain products containing ephedrine alkaloids may be available internationally. Soldiers and their Family members should never use products that contain ephedra.

Many products are now labeled as "ephedra free," but contain ingredients that mimic the action of ephedra such as synephrine (also called citrus aurantium, bitter orange or zhi shi), octpamine, yohimbe, yohimbine, hordenine, and high doses of caffeine. These products may have stimulant effects similar to ephedra in some individuals and should be avoided. Soldiers and their Family members who are taking a blood pressure, cholesterol, or decongestant medication, or consuming high doses of caffeine, should never take ephedra-free supplements.

Soldiers and Family members are encouraged to consult with a health care provider prior to purchasing or using any dietary supplement or other self-care products. If you or a Family member experience an adverse side effect with one of these products, you are encouraged to report this information immediately to a health care provider, who will document the incident into your medical record and report the necessary information to the food and drug administration (fda). You may also report adverse events directly to the fda by completing the on-line reporting form at www.fda.gov/medwatch/how.htm or by calling the fda office of emergency operations at (301) 443-1240.

Reliable sources of information on dietary supplements include:

1. Medical treatment facility personnel with expertise in dietary supplements include dietitians, pharmacists, and other health care providers.
2. These web sites:
   • U. S. Army Center for Health Promotion and Preventive Medicine
   • Office of Dietary Supplements, National Institutes of Health
   • Food and Drug Administration

Also see: Dietary Supplements

Source: POTENTIAL DANGERS AND GUIDANCE REGARDING DIETARY SUPPLEMENTS AND PERFORMANCE ENHANCING AIDS (MS Word) - US Army Center for Health Promotion and Preventive Medicine.