People who received the root extract of ashwagandha had a significant increase in physical endurance after 8 and 12 weeks of treatment compared with the participants receiving a placebo. Another study tested the effects of ashwagandha on the endurance of elite cyclists. After 8 weeks of treatment, the cyclists taking ashwagandha took longer to feel exhausted doing a treadmill test than the cyclists who received a placebo.

Vitamins and supplements can be a safe way for athletes to try to improve their performance, but more research is necessary to determine the effectiveness of some supplements. It is crucial to speak to a doctor before starting to take any new vitamins or other supplements.

These substances can interact with other medications that a person might be taking. Taking too much of some supplements, such as iron, can cause adverse side effects. Also, some vitamins may be ineffective unless a person has an existing deficiency. A doctor can test for vitamin deficiencies and advise on how to correct them if necessary.

People who feel as though they have low energy despite exercising regularly may wish to consider other aspects of their routine before taking supplements. Eating a balanced, nutritious diet and getting enough sleep may also boost athletic performance. Athletes following vegetarian and vegan diets may need to take particular care to ensure that they are obtaining enough of the above nutrients through their diet.

Although a healthful diet and regular exercise can reduce fatigue, some vitamins and supplements can also boost energy. Learn which ones may have….

In this edition of Medical Myths, we tackle some persistent myths about supplements, including multivitamins, probiotics, and antioxidants. Vitamin A supplements come in many different forms, but a person should check with their doctor which form and dosage will best suit them.

Read more…. Vitamin B complex supplements may help to prevent vitamin B deficiency. Learn more here. HUM nutrition offers a range of products to support a person's health. Here is our review for My podcast changed me Can 'biological race' explain disparities in health?

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B vitamins. Share on Pinterest A number of of vitamins and supplements may provide athletes with an added energy boost.

Calcium and vitamin D. Coenzyme Q Further resources For more in-depth resources about vitamins, minerals, and supplements, visit our dedicated hub. How we reviewed this article: Sources. Medical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations.

We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles.

You can learn more about how we ensure our content is accurate and current by reading our editorial policy. Share this article. Latest news Ovarian tissue freezing may help delay, and even prevent menopause. RSV vaccine errors in babies, pregnant people: Should you be worried? As for the other minerals, losses through perspiration can be disregarded for the most part Table 1.

The question of whether mineral losses in urine and feces are increased by physical activity is currently the subject of debate. Such losses may depend on the intensity of exertion and the scope of training. For instance, older studies found significant excretions of magnesium 21 , 54 and zinc However, more recent studies were unable to confirm these findings.

For example, male cyclists were found to have no elevated excretion of magnesium, iron, zinc or copper during high-intensity training Given that the sodium intake of the general population in Germany is far above the reference values 40 , 69 , sport-associated sodium loss may be seen in a positive light in terms of health—as the elimination of an oversupply of sodium.

Therefore, loss of sodium through perspiration should generally not be viewed as problematic. The cause of exercise-associated hyponatremia apart from individual predisposing factors is the combination of increased sodium loss through perspiration and increased intake of low-sodium drinks.

Those affected are predominantly inexperienced participants, athletes performing more than four hours e. marathon, triathlon or ultra-endurance events , women, and athletes with a low body mass index BMI and excessive low-sodium fluid intake 1.

Inexperienced athletes are liable to interpret the initially non-specific symptoms—such as nausea, headache, or reduced performance—as the symptoms of dehydration. Additional consumption of low-sodium drinks can lead to a further reduction in sodium concentration.

In the literature, there are many reports of cases of severe hyponatremia during sports events, some of which have been fatal 1 , Despite the importance of adequate sodium supply in endurance exercise, about one third of marathon runners are unaware of the risks of exercise-associated hyponatremia Organizers of marathons and other endurance events should pay particular attention to the provision of suitable food and drinks e.

provision of bouillon, sodium-rich sports drinks, salty snacks. In the case of adequate fluid intake, the use of sodium-rich drinks or snacks is not necessary because a normal diet usually provides sufficient sodium 40 and an excessive fluid intake is considered a key risk factor for hyponatremia Due to increased energy metabolism, it can be assumed that requirements for certain vitamins increase in line with increasing energy requirements as a result of sporting activities compared to the moderately physically active general population.

Some of the vitamins to which this applies are thiamine vitamin B1 , riboflavin vitamin B2 and niacin Table 2. However, in the case of a diet that covers energy requirements, these increased vitamin requirements are usually covered by the increased intake levels. The D-A-CH reference values for these vitamins are based on the guiding values for energy supply, which means that the relevant reference value for vitamin intake can still be calculated based on these values even in the case of increased energy metabolism as a result of athletic activity Therefore, for athletes, the reference values that should be taken into account are not age and sex-specific reference values, but rather values based on energy metabolism Table 2.

Physical activity is associated with an increased production of reactive oxygen and nitrogen species RONS , also known as free radicals, as a result of various mechanisms 19 , This means that athletes require an adequate supply of nutrients with antioxidant effects e.

vitamin C, vitamin E, beta-carotene. Various studies have demonstrated an increased endogenous antioxidative capacity 17 , 28 and increased antioxidative enzyme activity e.

glutathione peroxidase, superoxide dismutase, catalase 39 , 58 , The significance of reactive species RONS for muscular training adaptation and mitochondrial biogenesis has now been scientifically demonstrated 2 , 53 , 57 , Increased antioxidative defense mechanisms can already be observed after just a few training sessions 62 , 70 and can also be observed in young athletes Some studies have shown that the use of antioxidant supplements alongside training may have a detrimental effect on training adaptation and on increasing performance 31 , 57 , or a detrimental effect on surrogate parameters of health benefits in amateur athletes According to current scientific knowledge therefore, a balanced selection of antioxidant-rich foods is advisable so that the D-A-CH reference values for vitamin C, vitamin E and beta-carotene can be reliably reached.

Athletes who opt for antioxidant supplementation for personal reasons should not exceed the maximum daily doses for food supplements: 30 mg for vitamin E and mg for vitamin C Vitamin D. Both the general population 22 and athletes 34 , 44 , 78 are considered to have a season-dependent insufficient vitamin D supply.

Due to the role that vitamin D plays in bone metabolism 34 and its various other effects for instance in the skeletal muscle , optimal supply of vitamin D is essential for athletes 37 , At present, it is unclear whether administration of vitamin D affects performance, but at a minimum, athletes with a deficiency appear to benefit from vitamin D supplementation during training Currently, there is no scientific consensus regarding this Athletic training, which leads to changes such as increased vascularization formation of new blood vessels increased red blood cell concentration increase in hematocrit and increased hemoglobin concentration in the blood can increase iron requirements 3.

The prevalence of iron deficiency among athletes is comparable to the prevalence in the general population, but there are some increased risks for population groups involved in certain types of sports or who have certain diets These groups include endurance athletes, vegetarians, and athletes with a restrictive energy intake e.

in the case of aesthetic sports. Iron deficiency anemia hematocrit and hemoglobin concentrations that are below the normal values reduces performance by reducing oxygen transport.

It is also possible that iron deficiency without anemia is also associated with detrimental effects on athletic performance The relevant recommendations for an iron-rich diet in the context of sport have been presented elsewhere Iron deficiency in athletes should always be diagnosed and treated by a physician, relevant standards having been published elsewhere, too Due to the health risks of long-term oversupplementation with iron e.

gastrointestinal symptoms, pro-oxidative effects, and the potential risks of cardiovascular diseases and cancer associated with iron overload that are currently the subject of discussion , athletes should be discouraged from independent iron supplementation without medical supervision For diseases of the upper respiratory tract e.

viral infections, the common cold , a J-shaped dose-response relationship has been repeatedly observed between athletic activity and the risk of contracting the relevant illness 50 , Both low and high levels of physical activity in terms of scope and intensity increase the risk of infection.

However, it may be that athletes with less training are more likely to be affected In the case of competitive sport, it is thought that it is mainly a subgroup of susceptible athletes that is contributing to this observed association Vitamin C and zinc are often marketed as effective micronutrients for the prevention and treatment of colds.

A Cochrane analysis shows that a daily intake of mg vitamin C has no effect on the incidence, severity or duration of the illness relative risk [RR]: 0. Under extreme conditions e. Arctic expeditions, marathon running , an appropriate vitamin C intake can help to reduce self-reported symptoms that are typical of infection RR: 0.

However, it remains unclear whether vitamin C actually has a beneficial effect on the course of a viral infection. Nevertheless, the objective of a vitamin C supply that covers requirements for athletes is in line with the results from the relevant EFSA panel, according to which vitamin C can contribute to the maintenance of normal immune defenses However, in the intervention groups zinc intake well above the tolerable intake level , unfavorable effects occurred much more frequently than in the placebo groups.

In addition, the quality of the evidence was assessed by the authors as low to very low The D-A-CH reference values for the aforementioned micronutrients can be achieved through food: for instance with a medium sweet pepper approx.

In general, in the case of a balanced diet that meets energy requirements, nutrient intake increases with increased food and energy intake, which means that athletes are also able to cover their possibly elevated micronutrient needs under these conditions without problems Due to sport-specific, sometimes periodically varying nutrition aims e.

weight reduction, carbohydrate loading or train low techniques , athletes are not always able to meet all of their nutritional needs through their diet. In the case of athletes participating in sports where body weight is crucial e.

endurance, aesthetic, or technical sports , restrictive nutritional behavior with insufficient iron and calcium supply is often observed In addition, the range of foods that athletes consume may be temporarily restricted e.

during training or competition trips, during high altitude training camps, or due to weight reduction or permanently restricted e. g in the case of intolerances, for ethical or religious reasons, or due to avoidance of certain foods for other reasons.

Nutrition counseling from professionals with sport-specific qualifications may be advisable in such cases so that custom solutions can be developed. Vegetarian diets should be viewed as unproblematic even for athletes as long as they are composed of a balanced variety of foods and are combined with regular screening for critical nutrients e.

iron supply It is not currently possible to determine whether a vegan diet increases the risk of nutrient deficiencies or whether it is associated with beneficial or detrimental effects in terms of health and performance due to the low prevalence of competitive athletes who are vegan and due to insufficient evidence from scientific studies.

In principle, it should be assumed that vegan athletes and the general population will derive similar health benefits from sport and will have similar critical nutrients high energy requirements and little time to prepare, ingest and digest sufficient amounts of food prior to training and due to the high volume of food consumed combined with limited tolerability prior to training This may be associated with an inadequate supply of folate for instance, and with low supply of secondary plant compounds 7.

Individual nutrition counselling with regard to suitable alternatives e. integration of vegetable and fruit juices into the meal plan, consumption of vegetable or fruit purees, enrichment of meals with nuts, etc.

is advisable. Based on the D-A-CH reference values i. without taking account of any increased requirements it can be assumed that the micronutrient supply situation among athletes is roughly as good as in the general population 4 , 5 ,

Both forms of the B12 supplement can increase vitamin B12 levels in your blood. Read more about vitamin B Calcium is a nutrient that helps you build and maintain strong bones. Vitamin D is a nutrient that helps your body absorb calcium. Calcium and vitamin D work together to help you maintain healthy bones.

Vitamin D also helps your muscles work properly. Fortified plant-based beverages. Find out more about calcium and vitamin D and how much you need. Antioxidant s help reduce muscle damage and speed up recovery after you play sports.

A well-balanced eating plan with a variety of plant foods will provide you with vitamins A, C and E. The best sources of vitamin C are vegetables and fruit such as oranges, strawberries, bell peppers, tomatoes and broccoli.

Animal foods like milk, salmon and eggs are rich in vitamin A. Dark green and orange vegetables and fruit are rich in carotenoids which can be turned into vitamin A in our bodies. Vitamin E is found in nuts, seeds, avocado, vegetable oils and wheat germ.

Some dark leafy greens and fish are also sources of vitamin E. A dietitian can review what you are currently eating and assess if you are low in any vitamins and minerals.

They will give you suggestions on how to boost the nutritional content of your meals and snacks and let you know if you would benefit from a supplement. A dietitian can also give you personalized advice on when to eat and how much protein, carbohydrates and fat you need when training.

Most employee health benefit plans cover dietitian services. Connect with a dietitian today! Eat a variety of foods rich in iron, B vitamins, calcium, vitamin D and vitamins A, C and E.

Sport nutrition: Facts on sports supplements Sport nutrition: Facts on hydration Sport nutrition: Facts on sports drinks Sport nutrition: Facts on carbohydrate, fat and protein This article was written and reviewed by dietitians from Dietitians of Canada. The advice in this article is intended as general information and should not replace advice given by your dietitian or healthcare provider.

Aerobic exercise leads to more modest protein accumulation in working muscle, primarily in the mitochondria, which enhances oxidative capacity oxygen use for future workouts [ , ]. Athletes must consider both protein quality and quantity to meet their needs for the nutrient.

They must obtain EAAs from the diet or from supplementation to support muscle growth, maintenance, and repair [ ]. The nine EAAs are histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine.

See other sections of this fact sheet for information on the amino acids arginine and glutamine as well as the BCAAs leucine, isoleucine, and valine.

The potential of these amino acids to enhance exercise and athletic performance is not related to their incorporation into proteins. Adequate protein in the diet is required to provide the EAAs necessary for muscle-protein synthesis and to minimize muscle-protein breakdown.

Dietary protein consumption increases the concentration of amino acids in the blood, which muscle cells then take up. Sufficient protein is necessary primarily to optimize the training response to, and the recovery period after, exercise [ 12 , ]. Muscle protein synthesis leading to increases in strength and muscle mass appears to be optimal with the consumption of high-quality protein providing about 10 g EAAs within 0—2 hours after exercise, in the early recovery phase [ 12 ].

However, a meta-analysis of randomized clinical trials found that ingesting protein within an hour before or after exercise does not significantly increase muscle strength or size or facilitate muscle repair or remodeling [ 77 ].

The period after exercise when protein intake reduces muscle protein breakdown, builds muscle, and increases mitochondrial proteins to enhance oxygen use by working muscles the so-called window of anabolic opportunity can last for up to 24 hours [ 79 ].

Participants in these studies consumed a bedtime drink containing Some studies show increased muscle protein synthesis when plasma levels of amino acids are raised [ 76 ]. The Food and Nutrition Board has not set a UL for protein, noting that the risk of adverse effects from excess protein from food is very low [ ].

However, it advises caution for those obtaining high protein intakes from foods and supplements because of the limited data on their potential adverse effects. High-protein diets e. Protein increases urinary calcium excretion, but this appears to have no consequence for long-term bone health [ ] and, in any event, is easily compensated for by the consumption of slightly more calcium.

Many foods—including meats, poultry, seafood, eggs, dairy products, beans, and nuts—contain protein. Protein powders and drinks are also available, most of which contain whey, one of the complete proteins isolated from milk [ ].

Digestion of casein, the main complete protein in milk, is slower than that of whey, so the release of amino acids from casein into the blood is slower [ 72 ]. Soy protein lacks the EAA methionine and might lose some cysteine and lysine in processing; rice protein lacks the EAA isoleucine [ ].

Many protein supplements consist of a combination of these protein sources. All EAAs are necessary to stimulate muscle protein synthesis, so users should select singular or complementary protein sources accordingly.

To maximize muscle adaptations to training, the AND, DoC, and ACSM recommend that athletes consume 0. Since the Food and Nutrition Board developed the RDA for protein, more recent data have suggested that athletes require a daily protein intake of 1.

Athletes might benefit from even greater amounts for short periods of intense training or when they reduce their energy intake to improve physique or achieve a competition weight [ 12 ]. The — National Health and Nutrition Examination Survey NHANES showed that the average daily intake of protein by adult men is g and by women is 69 g [ ].

Athletes who require additional protein can obtain it by consuming more protein-containing foods and, if needed, protein supplements and protein-fortified food and beverage products. Quercetin is a polyphenolic flavonol that is naturally present in a variety of fruits such as apples , vegetables such as onions , and beverages such as wine and, especially, tea.

The mechanisms by which quercetin might enhance exercise and athletic performance when taken in much larger amounts are not known, but many have been hypothesized.

For example, quercetin might increase the number of mitochondria in muscle, reduce oxidative stress, decrease inflammation, and improve endothelial function blood flow [ , ].

Numerous small studies have assessed quercetin in supplemental form as a potential ergogenic aid in young adult, mostly male, participants. The effects of quercetin supplementation were inconsistent and varied by study, but they generally ranged from no ergogenic benefit to only a trivial or small improvement that might not be meaningful in real-world in contrast to laboratory exercise conditions [ 42 , , , ].

The safety of longer term use of that amount of quercetin or more has not been studied. More research, including larger clinical trials, on quercetin supplementation to improve aerobic capacity in trained athletes during specific sports and competitions is needed before any recommendations can be made [ ].

Ribose, a naturally occurring 5-carbon sugar synthesized by cells and found in some foods, is involved in the production of ATP [ 75 ]. The amount of ATP in muscle is limited, and it must continually be resynthesized. Therefore, theoretically, the more ribose in the body, the more potential ATP production [ ].

The authors of the short-term studies investigating ribose as a potential ergogenic aid have not reported any safety concerns. No studies have assessed the safety of long-term ribose use as a dietary supplement.

Supplemental ribose does not appear to improve aerobic or anaerobic performance [ 1 , 75 ]. Sodium bicarbonate is commonly known as baking soda. The consumption of several teaspoons of sodium bicarbonate over a short time temporarily increases blood pH by acting as a buffering agent.

The precise mechanism by which this induced alkalosis leads to an ergogenic response to exercise is unclear. It is thought that bicarbonate loading enhances disposal of hydrogen ions that accumulate and efflux from working muscles as they generate energy in the form of ATP via anaerobic glycolysis from high-intensity exercise, thereby reducing the metabolic acidosis that contributes to fatigue [ , ].

As a result, supplementation with sodium bicarbonate might improve performance in short-term, intense exercises e.

Many studies have assessed sodium bicarbonate as an ergogenic aid in swimmers, cyclists, rowers, boxers, tennis and rugby players, judo practitioners, and others [ ].

These studies usually included a small number of participants who underwent one or more trials in a laboratory over several days. Because the research results are conflicting, the activities and individuals most likely to benefit from sodium bicarbonate supplementation in real-world conditions is not clear.

However, individuals have varied responses to bicarbonate loading; the practice does not benefit some users, and it can worsen rather than enhance performance in others. Recreationally active individuals, in particular, might find the supplements to be ergogenic for one exercise session but not another.

Many study findings suggest that supplementation with sodium bicarbonate is most likely to improve the performance of trained athletes [ , ]. The main side effect of sodium bicarbonate supplementation in gram quantities is gastrointestinal distress, including nausea, stomach pain, diarrhea, and vomiting.

Supplement users can reduce or minimize this distress by consuming the total dose in smaller amounts multiple times over an hour with fluid and a snack of carbohydrate-rich food [ , ]. Sodium bicarbonate is Such a large intake of sodium with fluid can lead to temporary hyperhydration, which could be useful in activities where large sweat losses might otherwise lead to significant fluid deficits.

However, the slight increase in body weight from fluid retention might hinder performance in other sports [ ]. Studies have not evaluated the safety and effectiveness of long-term use of sodium bicarbonate as an ergogenic aid over months or longer.

Many athletes find this amount of sodium bicarbonate powder dissolved in fluid to be unpalatably salty [ ]. The Australian Institute of Sport supports the use of bicarbonate for improving sports performance in suitable athletic competitions under the direction of an expert in sports medicine, but it notes that more research might be required to understand how the supplement should be used for best results [ 29 ].

The Montmorency variety of tart or sour cherry Prunus cerasus contains anthocyanins and other polyphenolic phytochemicals, such as quercetin. Researchers hypothesize that these compounds have anti-inflammatory and antioxidant effects that might facilitate exercise recovery by reducing pain and inflammation, strength loss and muscle damage from intense activity, and hyperventilation trauma from endurance activities [ ].

The labels on tart-cherry juice and concentrate products do not usually indicate that they are dietary supplements, although the labels on products containing encapsulated tart-cherry powder do. Much of the limited research on use of tart cherry to enhance exercise and athletic performance involves short-term use of a tart-cherry product or placebo by young resistance-trained men for about a week before a test of strength such as single-leg extensions or back squats ; participants continue taking the supplements for about 2 days after the test.

None of the participants who drank the juice experienced airway inflammation causing upper respiratory tract symptoms after the marathon a common complaint in many marathon runners , but half of those drinking the placebo did. Another study compared a supplement containing mg freeze-dried Montmorency tart-cherry-skin powder CherryPURE with a placebo in 18 male and 9 female endurance-trained runners and triathletes age range 18—26 years [ ].

Participants took the supplements once a day for 10 days, including the day they ran a half-marathon, then for 2 days after the run. Further research is needed to determine the value of tart-cherry products for enhancing performance and recovery from intense exercise or participation in sports—especially when used on a regular basis—and the amounts of supplement, juice, or concentrate needed to provide any benefits.

Studies have not identified any side effects of the fresh tart-cherry juice or concentrate or of supplements of dried tart-cherry-skin powder. However, they have not adequately assessed the safety of tart-cherry dietary supplements.

There is no expert consensus on the value of taking tart-cherry products to enhance exercise and athletic performance. Tribulus terrestris common names include bindii, goat's-head, bullhead, and tackweed , is a fruit-bearing plant that is most common in Africa, Asia, Australia, and Europe.

It has been used since ancient times in Greece, China, and Asia to treat low libido and infertility [ ]. Tribulus terrestris extracts contain many compounds, including steroidal saponins [ ].

Some marketers claim that Tribulus terrestris enhances exercise and athletic performance by increasing serum concentrations of testosterone and luteinizing hormone, but studies have not adequately determined its potential mechanisms of action [ ].

Only a few small, short-term clinical trials have investigated Tribulus terrestris as an ergogenic aid [ ], and none since A study in 15 resistance-trained men found no differences among those taking 3.

In 22 elite male rugby players age The only toxicity studies of Tribulus terrestris were conducted in animals, where unspecified high intakes led to severe heart, liver, and kidney damage [ ]. The clinical studies described above found no side effects of Tribulus terrestris.

Subsequent tests indicated hepatotoxicity, nephrotoxicity, and neurotoxicity. The man's condition improved after he discontinued the water, but the water was not tested to determine the presence or amount of Tribulus terrestris or any other potential toxin or contaminant.

The Australian Institute of Sport advises against the use of Tribulus terrestris by athletes, noting that this supplement and other claimed testosterone boosters are banned from athletic competitions or have a high risk of being contaminated with substances that, if ingested, could lead to positive drug-screening results [ ].

The published biomedical literature provides no support for the efficacy and insufficient support for the safety of Tribulus terrestris for enhancing exercise performance [ ]. This section provides examples of ingredients that FDA currently prohibits in dietary supplements and that some consumers have used in the past as ergogenic aids, despite the lack of evidence supporting their use.

Androstenedione is an anabolic steroid precursor, or prohormone, that the body converts to testosterone which induces muscle growth and estrogen [ ]. Major League Baseball slugger Mark McGwire popularized androstenedione as an ergogenic aid in [ ].

However, two randomized clinical trials found no performance benefits from androstenedione supplements. In one study, 10 healthy young men age 19—29 years took a single mg dose of androstenedione.

The short-term or longer term use of the supplement did not affect serum testosterone concentrations, nor did it produce any significantly greater gains in resistance-training performance, muscle strength, or lean body mass.

However, participants who took androstenedione for the 6 weeks experienced significant declines in their high-density lipoprotein HDL cholesterol levels and significant increases in serum estrogens. The supplements did not improve participants' muscular strength or lean body mass compared with placebo, but they significantly decreased HDL cholesterol levels and raised levels of serum estrogens.

In March , FDA warned companies to cease distributing androstenedione-containing dietary supplements. The rationale was the lack of sufficient information to establish that such products could reasonably be expected to be safe and that FDA had never approved androstenedione as a new dietary ingredient permitted in supplements [ ].

Department of Justice classified androstenedione as a Schedule III controlled substance defined as a drug with a moderate to low potential for physical and psychological dependence in [ ]. The National Collegiate Athletic Association, International Olympic Committee, and World Anti-Doping Agency ban the use of androstenedione [ , ].

Dimethylamylamine DMAA is a stimulant formerly included in some preworkout and other dietary supplements claimed to enhance exercise performance and build muscle. Studies have not evaluated DMAA in humans as a potential ergogenic aid.

In , FDA declared products containing this ingredient to be illegal after it received 86 reports of deaths and illnesses associated with dietary supplements containing DMAA. These reports described heart problems as well as nervous system and psychiatric disorders [ ].

Furthermore, FDA had never approved DMAA as a new dietary ingredient that would reasonably be expected to be safe [ ]. Although products marketed as dietary supplements containing DMAA are illegal in the United States, discontinued, reformulated, or even new products containing DMAA might still be found in the U.

The Department of Defense's Human Performance Resource Center maintains a list of currently available products that contain DMAA or are labeled as containing DMAA, dimethylamylamine, or an equivalent chemical or marketing name e.

FDA also determined that dietary supplements containing 1,3-dimethybutylamine DMBA , a stimulant chemically related to DMAA, are adulterated. As with DMAA, FDA had never approved this stimulant as a new dietary ingredient. The agency contended that there is no history of use or data offering sufficient assurance that this compound is not associated with a significant or unreasonable risk of illness or injury [ , ].

Ephedra also known as ma huang , a plant native to China, contains ephedrine alkaloids, which are stimulant compounds; the primary alkaloid is ephedrine [ ].

In the s, ephedra—frequently combined with caffeine—was a popular ingredient in dietary supplements sold to enhance exercise and athletic performance and to promote weight loss.

No studies have evaluated the use of ephedra dietary supplements, with or without caffeine, as ergogenic aids. Instead, available studies have used the related synthetic compound ephedrine together with caffeine and typically measured the effects 1—2 hours after a single dose [ , ]. No data show any sustained improvement in athletic performance over time with continued dosing of ephedrine with caffeine [ ].

Ephedra use has been associated with death and serious adverse effects, including nausea, vomiting, psychiatric symptoms such as anxiety and mood change , hypertension, palpitations, stroke, seizures, and heart attack [ , ]. In , FDA banned the sale of dietary supplements containing ephedrine alkaloids in the United States because they are associated with an unreasonable risk of illness or injury [ ].

FDA regulates dietary supplements for exercise and athletic performance in accordance with the Dietary Supplement Health and Education Act of [ ].

Like other dietary supplements, exercise- and athletic-performance supplements differ from over-the-counter or prescription medications in that they do not require premarket review or approval by FDA. Supplement manufacturers are responsible for determining that their products are safe and their label claims are truthful and not misleading, although they are not required to provide this evidence to FDA before marketing their products.

If FDA finds a supplement to be unsafe, it may remove the product from the market or ask the manufacturer to voluntarily recall the product. FDA and the Federal Trade Commission FTC may also take regulatory actions against manufacturers that make unsubstantiated physical-performance or other claims about their products.

FDA permits dietary supplements to contain only dietary ingredients, such as vitamins, minerals, amino acids, herbs, and other botanicals.

It does not permit these products to contain pharmaceutical ingredients, and manufacturers may not promote them to diagnose, treat, cure, or prevent any disease [ ]. For more information about dietary supplement regulation, see the ODS publication, Dietary Supplements: What You Need to Know.

Like all dietary supplements, supplements used to enhance exercise and athletic performance can have side effects and might interact with prescription and over-the-counter medications. In some cases, the active constituents of botanical or other ingredients promoted as ergogenic aids are unknown or uncharacterized.

Furthermore, many such products contain multiple ingredients that have not been adequately tested in combination with one another. People interested in taking dietary supplements to enhance their exercise and athletic performance should talk with their health care providers about the use of these products.

The Uniformed Services University and the U. Anti-Doping Agency maintain a list of products marketed as dietary supplements that contain stimulants, steroids, hormone-like ingredients, controlled substances, or unapproved drugs and that can have health risks for warfighters and others who take them for bodybuilding or other forms of physical performance [ ].

FDA requires the manufacture of dietary supplements to comply with quality standards that ensure that these products contain only the labeled ingredients and amounts and are free of undeclared substances and unsafe levels of contaminants [ ].

However, FDA notes that products marketed as dietary supplements for bodybuilding are among those most often adulterated with undeclared or deceptively labeled ingredients, such as synthetic anabolic steroids or prescription medications [ ].

As one example, some products sold for bodybuilding are adulterated with selective androgen receptor modulators; these synthetic drugs are designed to mimic the effects of testosterone [ ].

Using such tainted products can cause health problems and lead to disqualification of athletes from competition if a drug test shows that they have consumed prohibited substances, even if they have done so unknowingly. FDA has warned against the use of any body-building products that claim to contain steroids or steroid-like substances [ ].

It recommends that a user contact their health care provider if they experience symptoms possibly related to these products, especially nausea, weakness, fatigue, fever, abdominal pain, chest pain, shortness of breath, jaundice yellowing of skin or whites of eyes , or brown or discolored urine.

Some dietary-supplement firms have hired third-party certification companies to verify the identity and content of their supplements to enhance exercise and athletic performance, thus providing some extra, independent assurance that the products contain the labeled amounts of ingredients and are free of many banned substances and drugs.

The major companies providing this certification service are NSF nsf. org through its Certified for Sport program, Informed-Choice informed-choice.

org , and the Banned Substances Control Group bscg. Some ingredients in dietary supplements used to enhance exercise and athletic performance can interact with certain medications. For example, intakes of large doses of antioxidant supplements, such as vitamins C and E, during cancer chemotherapy or radiotherapy could reduce the effectiveness of these therapies by inhibiting cellular oxidative damage in cancerous cells [ ].

Ginseng can reduce the anticoagulant effects of the blood thinner warfarin Coumadin or Jantoven [ ]. Iron supplements can reduce the bioavailability of levodopa used to treat Parkinson's disease and levothyroxine Levothyroid, Levoxyl, Synthroid, and others, for hypothyroidism and goiter , so users should take iron supplements at a different time of the day than these two drugs [ , ].

Cimetidine Tagamet HB, used to treat duodenal ulcers can slow the rate of caffeine clearance from the body and thereby increase the risk of adverse effects from caffeine consumption [ ]. Individuals taking dietary supplements and medications on a regular basis should discuss the use of these products with their health care providers.

According to the AND, DoC, and ACSM, sound science supports the use of only a few dietary supplements whose labels claim ergogenic benefits [ 12 ].

These organizations add that the best way to use supplements is as additions to a carefully chosen diet, that dietary supplements rarely have ergogenic benefits when not used in these conditions, and that there is no justification for their use by young athletes.

The National Federation of State High School Associations also expresses strong opposition to the use of supplements to enhance athletic performance by high school students [ 15 ].

The American Academy of Pediatrics adds that performance-enhancing substances do not result in significant improvements in most teenage athletes beyond those that can result from proper nutrition and training basics [ 7 ].

Elite and recreational athletes perform at their best and recover most quickly when they consume a nutritionally adequate diet with sufficient fluids and when they have appropriate physical conditioning and proper training. For more information about building a healthy dietary pattern, refer to the Dietary Guidelines for Americans [ 10 ] and the U.

Department of Agriculture's MyPlate [ 11 ]. The Dietary Guidelines for Americans describes a healthy dietary pattern as one that:. This fact sheet by the National Institutes of Health NIH Office of Dietary Supplements ODS provides information that should not take the place of medical advice.

We encourage you to talk to your health care providers doctor, registered dietitian, pharmacist, etc. about your interest in, questions about, or use of dietary supplements and what may be best for your overall health. Any mention in this publication of a specific product or service, or recommendation from an organization or professional society, does not represent an endorsement by ODS of that product, service, or expert advice.

Updated: June 2, History of changes to this fact sheet. Dietary Supplements for Exercise and Athletic Performance Fact Sheet for Health Professionals. Consumer Datos en español Health Professional Other Resources. Table of Contents Introduction Selected Ingredients in Dietary Supplements for Exercise and Athletic Performance Ingredients Banned from Dietary Supplements Regulation of Dietary Supplements to Enhance Exercise and Athletic Performance Safety Considerations Choosing a Sensible Approach to Enhance Exercise and Athletic Performance References Disclaimer.

Antioxidants vitamin C, vitamin E, and coenzyme Q 10 [CoQ 10 ]. Minimize free-radical damage to skeletal muscle, thereby reducing muscle fatigue, inflammation, and soreness. Several small clinical trials Research findings : Do not directly improve performance; appear to hinder some physiological and physical exercise-induced adaptations.

Increases blood flow and delivery of oxygen and nutrients to skeletal muscle; serves as a substrate for creatine production; increases secretion of human growth hormone to stimulate muscle growth. Limited clinical trials with conflicting results Research findings : Little to no effect on vasodilation, blood flow, or exercise metabolites; little evidence of increases in muscle creatine content.

Dilates blood vessels in exercising muscle, reduces oxygen use, and improves energy production. Limited clinical trials with conflicting results Research findings : Might improve performance and endurance to some degree in time trials and time-to-exhaustion tests among runners, swimmers, rowers, and cyclists; appears to be most effective in recreationally active nonathletes.

No safety concerns reported for short-term use at commonly recommended amounts approximately 2 cups Reported adverse effects : None known. Increases synthesis of carnosine, a dipeptide that buffers changes in muscle pH, thereby reducing muscle fatigue and loss of force production; considerable individual variation in associated muscle carnosine synthesis.

Numerous clinical trials with conflicting results Research findings : Inconsistent effects on performance in competitive events requiring high-intensity effort over a short period, such as team sports; little or no performance benefit in activities lasting more than 10 minutes.

No safety concerns reported for use of 1. Helps stressed and damaged skeletal muscle cells restore their structure and function. Numerous clinical trials with conflicting results Research findings : Might help speed up recovery from exercise of sufficient amount and intensity to induce skeletal muscle damage.

Might increase creatine production, blood nitric oxide levels, or water retention in cells. Limited clinical trials in men with conflicting results Research findings : Potential but modest strength and power-based performance improvements in bodybuilders and cyclists.

Branched-chain amino acids leucine, isoleucine, and valine. Can be metabolized by mitochondria in skeletal muscle to provide energy during exercise. It's important that athletes make sure their nutrient intake is tailored towards their needs - after all nutrition is key when it comes to reaching those fitness goals.

Check out our selection of fitness supplements and sports nutrition today. To help get the most out of your sport and reach peak potential, we've compiled our top 7 impactful supplements, vitamins and minerals for sports performance that have been proven time and time again by athletes around the world!

Discover some of the highest quality nutritional solutions below that'll help power up your workouts and push yourself even further. Protein powder is arguably the best supplement for sports performance due to its ability to support muscle building and recovery.

Depending on the type of protein powder chosen, it can be a great source of essential amino acids that not only help repair broken down muscles during exercise but also help them grow bigger and stronger over time.

Protein powder is also convenient, allowing athletes or regular people to meet their daily protein needs quickly, regardless of what diet they follow. Studies have even indicated that adding extra protein to your diet can lead to improved muscular strength, endurance and reduced body fat levels over time.

All in all, protein powder is definitely worth considering for anyone wanting to improve their sports performance. Browse our protein powders collection now.

The Garden Of Life Organic protein is a superior quality protein powder that is perfect for muscle growth and recovery. Creatine is a naturally occurring compound found in small quantities in various foods, but it's also commonly taken as a supplement to enhance sports performance.

This powerhouse supplement is renowned for its ability to rapidly produce energy during high-intensity exercise, making it a staple for athletes looking to improve strength, power, and muscle mass. By increasing the body's stores of phosphocreatine, creatine supplementation aids in the regeneration of adenosine triphosphate ATP , the primary energy currency of cells, leading to improved performance during short bursts of intense activity such as weightlifting or sprinting.

Moreover, creatine has been shown to reduce muscle fatigue, allowing athletes to push themselves harder and longer during training sessions.

For individuals seeking to maximize their fitness gains, investing in premium quality creatine powder such as Do Not Age Creatine is essential. Discover the entire range of Do Not Age at Oceans Alive Health. With its potent formula and proven efficacy, Do Not Age Creatine ensures that athletes have the necessary support to achieve their fitness goals and excel in their chosen sports.

B vitamins, such as B6 and B12, are essential for optimal sports performance. This is due to the fact they provide important energy-producing molecules and support the body's metabolism. In addition, they help the body break down and transport carbohydrates, fats, and proteins more efficiently during physical activity.

B vitamins also assist with red blood cell production which can help to transport oxygen throughout our bodies, making them a powerful tool for athletes in any sport or exercise.