Are Supplements Good or Bad?

A review of the 3 most common supplements my clients use.

The honest answer is that it is very unclear whether supplements are safe and effective. There is limited research on performance supplements and it is important to remember that these products are not tested and approved by the FDA. The FDA does monitor these products and if they find one that is unsafe or is advertising false information they can take action but they do not go through the same process as pharmaceutical drugs. This is why performing your own research is extremely important when it comes to performance supplements. In this article we’ll discuss some of the more common supplements and some recommendations for how to go about navigating this market safely. 

First off I want to say that I am not a nutritionist and I am not giving professional medical advice here. I am going to provide you with some information to help you make an informed and educated decision about what is best for you. That being said, you should always discuss adding a new supplement to your diet with your healthcare provider. Everyone is different and, as we’ll discuss in more detail, these supplements can affect different conditions in different ways and interact with different medications in different ways. Okay, so let’s get started!

Pre-Workout:

This is the supplement I hear my clients talk about the most. Pre workout can contain a number of different things but two of the most common are beta-alanine and caffeine. 

• Beta-alanine is an amino acid that has been shown to decrease muscle pH levels and decrease overall fatigue:
  • There is mixed evidence and opinions by sports medicine experts that beta-alanine actually does anything but there has been some limited research that showed benefits for exercise that requires high intensity efforts over a short period of time._{(1, 4)}
  • Limited evidence to support that it is beneficial for endurance workouts. 
  • According to the International Society of Sports Nutrition, beta-alanine is relatively safe at recommended doses (4 to 6 grams per day). ₍₄₎
  • An adverse effect of beta-alanine can be moderate to severe paresthesias (tingling). People usually notice tingling in their hands, face and neck. It is usually not harmful but if you are feeling this you may want to decrease your dosage. _{(1, 4)}
  • There is also little research on how this supplement can affect you when taking it daily for longer than several months so it is not something that you want to be taking daily for an extended period of time. 
  • ALWAYS discuss with your doctor before adding a new supplement to your diet, especially if you have other medical factors to consider. 
• Caffeine is another common addition to pre-workout supplements. It is believed that caffeine increases release of endorphins and improves neuromuscular function meaning improved reaction time and muscular coordination.₍₁₎ 
  • Caffeine has been shown to have benefits for strength, endurance and power in athletics, as well as decrease feelings of fatigue. Basically it allows you to exercise at a higher intensity level for a longer period of time. _{(1, 4)}
  • Recommended doses for high performance athletes are around 3-6mg/kg of bodyweight, according to the International Olympic Committee.₍₁₎
  • Increased doses did not necessarily have increased benefits and can actually cause adverse effects such as sleep disturbances, irritability, anxiety and decreased performance.₍₄₎
  • 10,000mgs or more in a single dose can be fatal. ₍₄₎
  • It is estimated that 400-500mg/day of caffeine in adults is safe, but teenagers should limit caffeine intake to 100mg/day.₍₄₎
  • It is important to always check the labels and make sure that the amount of caffeine added to the pre-workout you want to take is a safe amount and appropriate for you. Some brands have higher amounts than the recommended doses, which can increase risk of adverse effects.

Creatine:

In addition to pre-workout, I hear my clients talking about creatine all the time. Your body manufactures its own creatine in small amounts (~1g/day) and you can get some creatine from red meats and seafood. Creatine is involved in the process of creating ATP which is where your muscles get their energy from. The exact mechanism of how creatine works is unknown, however it is believed that supplementing creatine into your diet can increase muscle stores of the compound which can improve your ability to exercise at higher intensities.₍₁₎ 

• There is some evidence to show that creatine can help with short burst, high intensity exercises such as weight lifting and sprints, however there is minimal evidence to show that it helps with endurance training. Supplementing creatine appears to help improve athletic performance and increase lean muscle mass. ₍₄₎
• A recommended protocol from the International Society of Sports Nutrition was 5g four times daily for 5-7 days to increase muscle stores initially. Then after the 5-7 days, maintain these levels with 3-5g once daily.₍₁₎
• They also suggested a second protocol in which you take 3g daily for 28 days to improve creatine levels in the muscles.₍₁₎
• The recommended protocols appear to be safe for healthy adults but you should always confirm with your doctor before adding any supplement into your diet. People with kidney disease or bipolar disorder should be cautious about adding creatine to their diet. _{(1, 3, 4)}
• There is limited evidence regarding the use of creatine in youth and adolescent athletes despite increasing numbers of teenagers reporting using it, therefore use of this supplement should be discussed with a pediatrician first in these populations.₍₂₎ 

Protein

This is another supplement my clients use very often. Protein is made up of Amino Acids, some of which your body is able to produce on its own, others (known as EAAs or essential amino acids) you need to get from outside sources such as meat, fish, eggs and some plant foods.  Protein is helpful for muscle growth and recovery. 

• The amount of protein you need in your diet depends highly on the type of exercise or athletic event you’re participating in. 
  • There is little evidence to suggest increasing your protein intake helps with endurance based exercises.₍₁₎
  • There is some evidence to suggest that supplementing your diet with protein can reduce muscle damage and decrease post exercise soreness.₍₁₎
  • Supplementing protein into your diet may also be necessary if you are a bodybuilder or a wrestler trying to make weight or increase lean muscle by decreasing your food intake. 
• The International Society of Sports Nutrition recommends an overall protein intake of 1.4-2.0 g/kg of bodyweight for people who are trying to build and/or maintain muscle mass. This works out to approximately 95g-136g of protein a day for someone weighing 150lbs.₍₁₎
• There appears to be minimal risks to increasing protein intakes and even consuming high amounts of protein appears to be safe although there is no apparent benefit to taking more than the recommended doses.₍₃₎ 

In conclusion, there is some evidence to support that supplements like creatine and protein can be beneficial for people training at higher levels looking to increase muscle mass and performance. Pre-workout seems to help combat fatigue and increase energy levels which can help improve exercise intensity. But there is little evidence to support that these supplements have a direct effect on strength or endurance. It is also important to know the recommended doses and to be aware of what supplements you are taking and what is actually in them. Check the nutrition facts before buying new supplements and make sure you are using a reputable company. Some companies add additional things to their supplements that are not necessarily approved or safe for consumption so it is important to know what you’re getting. Also, it is also important to discuss addition of new supplements with your healthcare provider to avoid potential adverse reactions. 

I hope this article gave you some helpful information and if you have questions about any other supplements or anything else feel free to comment, email or DM me on Instagram. Thanks for listening!

Disclaimer: this article is not meant to present professional medical advice. This article is for educational purposes only and should not be used to substitute, discredit or in any way negate the advice of your personal healthcare provider. Always discuss your personal health questions and concerns with your designated healthcare provider. 

References

1. Harvard University School of Public Health. (2022, April 27). Workout supplements. The Nutrition Source. Retrieved January 29, 2023, from https://www.hsph.harvard.edu/nutritionsource/workout-supplements/

2. Jagim, A. R., Stecker, R. A., Harty, P. S., Erickson, J. L., & Kerksick, C. M. (2018). Safety of creatine supplementation in active adolescents and youth: A brief review. Frontiers in Nutrition, 5. https://doi.org/10.3389/fnut.2018.00115

3. U.S. Department of Health and Human Services. (2021, January). Bodybuilding and performance enhancement supplements: What you need to Know. National Center for Complementary and Integrative Health. Retrieved January 29, 2023, from https://www.nccih.nih.gov/health/bodybuilding-and-performance-enhancement-supplements
4. U.S. Department of Health and Human Services. (2021, March 22). Office of dietary supplements - dietary supplements for exercise and athletic performance. NIH Office of Dietary Supplements. Retrieved January 29, 2023, from https://ods.od.nih.gov/factsheets/ExerciseAndAthleticPerformance-Consumer/