April 7, 2025 • 18 mins
The wellness and anti-aging clinic boom promises optimization for active individuals—but could their treatments secretly derail your athletic career? This eye-opening exploration reveals the surprising anti-doping implications of common performance therapies.
When it comes to navigating the world of wellness clinics as an athlete or physically active person, what you don't know can hurt you. We meticulously examine hormone replacement therapies, revealing why substances like testosterone and DHEA are prohibited at all times—regardless of whether they're "bioidentical" or prescribed by a doctor. The misconception that restoring "natural" hormone levels is somehow exempt from anti-doping rules has ended countless athletic careers, and we clarify exactly what you need to know to avoid this fate.
Weight loss treatments offer another minefield of potential violations. While phentermine is only prohibited during competition, HCG is banned for men at all times and lacks FDA approval for weight loss in women. Perhaps most surprising is the strict regulation against IV infusions exceeding 100mL within 12 hours—meaning those trendy vitamin drips and recovery IVs at wellness bars could trigger violations even when their ingredients are perfectly legal. We also untangle the complex rules surrounding newer therapies like ozone treatments (where the method matters more than the substance) and stem cells (permitted for healing but not enhancement).
Your performance goals deserve informed decisions. Before your next wellness clinic appointment, arm yourself with this critical knowledge about supplements (seek NSF Certified for Sport products), compounded medications (beware contamination risks), and homeopathic remedies (none FDA-approved). Remember—the ultimate responsibility for anti-doping compliance rests with you, not your healthcare provider. Check GlobalDRO.com or contact USADA's drug reference line whenever you're unsure about a treatment's status. Your competitive future may depend on it!
Disclaimer:
The information provided in this podcast is for educational purposes only and is not intended as medical advice. Always consult with a qualified healthcare professional before making changes to your supplement regimen or health routine. Individual needs and reactions vary, so it’s important to make informed decisions with the guidance of your physician.
Connect with Us:
If you enjoyed today’s episode, be sure to subscribe, leave us a review, and share it with someone who might benefit. For more insights and updates, visit our website at Lifewellmd.com.
Stay Informed, Stay Healthy:
Remember, informed choices lead to better health. Until next time, be well and take care of yourself.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hey, welcome back to the Deep Dive.
If you're someone who pushesyour limits whether you're
aiming for that new personalbest love, the weekend
competition, or maybe justbelieve in living a really
active life you're probablyalways looking for smart ways to
improve.
The big question is how do youmake sure those methods you're
(00:20):
exploring are not only going toget you results but also keep
you safe and, importantly,within the rules of whatever
game you're playing?
Speaker 2 (00:28):
That's exactly the right starting point, and what's
kind of fascinating right nowis this huge increase in
interest around wellness andanti-aging clinics.
Speaker 1 (00:36):
You see them everywhere.
Speaker 2 (00:37):
You do, and they promise a lot when it comes to
optimizing our health orphysical capabilities, and it's
easy to see the appeal if you'rereally focused on maximizing
performance.
Speaker 1 (00:46):
Absolutely so.
In this deep dive, we're goingto kind of pull back the curtain
on some of the really commontherapies you might run into in
these clinics.
Our goal here is to give you,hopefully, a clear understanding
, especially if you're anathlete or just physically
active, about what's actuallysafe and legal for performance
enhancement and what couldpotentially put you in violation
(01:06):
of anti-doping regulation.
Right, and we're drawingdirectly from information
provided by the US anti-dopingagency, usada, to help navigate
this sometimes confusing terrain.
Speaker 2 (01:16):
And it is a landscape where careful navigation is
really key.
What stands out is that, whileyour personal goals in seeking
these therapies might be allabout health and well-being, the
rules that govern competitivesports are incredibly specific.
They don't always alignperfectly.
Speaker 1 (01:30):
Okay, let's dive right into a topic then that
comes up a lot Hormonereplacement therapies, or HRT,
and also bioidentical hormonereplacement therapies, BHRT.
Can you kind of break down whatthese are all about for us?
Speaker 2 (01:42):
Sure.
So these therapies are oftensuggested to address the natural
hormonal shifts we allexperience as we age, things
like menopause in women or thatnatural decline in testosterone
levels in men.
Right, you might also hearabout hormones, including
steroid hormones, being used tomaybe combat feelings of fatigue
or improve bone density or evenenhance stamina general
(02:04):
wellness stuff often.
Speaker 1 (02:05):
Right, okay, that makes sense as a general
approach.
Speaker 2 (02:07):
Yeah.
Speaker 1 (02:08):
But here's where it gets really interesting when we
look at it from USADA'sperspective.
What are the like criticalthings athletes need to be aware
of regarding HRT and BHRT?
Speaker 2 (02:17):
Okay, the most crucial point to understand
really is that many of thehormones used in these therapies
, specifically things liketestosterone and DHEA, are
included on the WorldAnti-Doping Agency's prohibited
list.
And this isn't just duringcompetition.
This prohibition is in effectat all times, whether you're
actively competing or in youroff-season, and it's important
to emphasize this applies acrossthe board national level
(02:40):
athletes, non-national, junior,recreational masters, everyone.
Speaker 1 (02:44):
So it's definitely not just the elite pros who need
to worry about this.
Speaker 2 (02:47):
Exactly.
The anti-goping rules have areally wide reach and what's
absolutely vital to get is that,whether the testosterone or
DHEA is naturally produced byour body, chemically identical
to what the body produces that'sthe bioidentical part or
synthetically manufactured, itdoesn't change its prohibited
status.
Wow, it's prohibited,regardless of its origin or how
(03:09):
you take it.
Speaker 1 (03:10):
That's a really key distinction, because I can
easily see someone thinking well, I'm just trying to get my
natural hormone levels back towhere they used to be.
That shouldn't be a problem,right.
Speaker 2 (03:18):
That's such a common misconception.
Your healthcare provider mighteven suggest that restoring what
they consider normal levelsisn't performance enhancing.
However, under the anti-dopingregulations, any use of these
prohibited steroid hormoneswithout an approved therapeutic
use exemption a TUE is a directviolation, full stop.
Speaker 1 (03:37):
Me too right.
Speaker 2 (03:38):
The amount you use, the method of administration
tablets, creams, injections itjust doesn't matter.
No TUE, it's a violation.
Speaker 1 (03:45):
And how are these HRT and BHRT substances typically
given?
You mentioned a few.
Speaker 2 (03:50):
Yeah, they can be administered in a whole variety
of ways.
You've got tablets you takeorally, creams or patches you
apply right onto the skininjections, of course or even
these tiny pellets that aresurgically implanted under the
skin for a kind of gradualrelease of the hormone.
Speaker 1 (04:04):
Okay, so for someone who's considering HRT or BHRT,
what's the absolute must-knowtakeaway here?
Like the bottom line.
Speaker 2 (04:12):
The single most important step bar none is to
know with absolute certaintywhat is in the medication you
are being prescribed.
You have a responsibility asthe athlete to verify its status
under anti-doping rules.
Speaker 1 (04:23):
Okay.
Speaker 2 (04:23):
The best way.
Check the globaldrocom website,that's G-L-O-B-A-L-D-R-Ocom, or
you can directly contactUSADA's drug reference line by
sending an email todrugreferenceatusadaorg.
That's your primary safeguard.
Don't just rely on the clinic.
Speaker 1 (04:38):
Gotcha Check globaldro or email USADA Okay,
Let.
Or Yungel, Usada Okay.
Let's pivot now to another areawhere people often seek
guidance from wellness clinicsmedical weight loss.
What are some specific thingsathletes and active folks need
to keep in mind here?
Speaker 2 (04:51):
Yeah, weight loss comes up a lot.
One substance to beparticularly aware of is
phentermine.
It's a stimulant sometimesprescribed to help with weight
loss.
It's specifically prohibited incompetition, so athletes need
to be really careful about thetiming if it's prescribed.
Speaker 1 (05:06):
In competition only for that one.
Speaker 2 (05:07):
OK, ok, but let's focus maybe more specifically on
something called humanchorionic gonadotropin, usually
just called HCG.
Speaker 1 (05:15):
HCG?
Yes, I've definitely heard thatmentioned in weight loss
circles.
What's the deal with that forathletes?
Speaker 2 (05:22):
OK For male athletes, HCG is prohibited at all times.
Simple as that.
Speaker 1 (05:26):
Okay, ban for men.
Speaker 2 (05:28):
Now, while it's not actually on the prohibited list
for women, female athletes stillneed to exercise Pretty
significant caution.
Here's why the Food and DrugAdministration, the FDA, has
approved HCG as a prescriptionmed for specific uses, mainly
treating female infertilityRight, but it has not been
approved by theG as aprescription med for specific
uses mainly treating femaleinfertility Right, but it has
not been approved by the FDA asa safe or effective treatment
(05:50):
for weight loss.
Speaker 1 (05:51):
Ah.
So even if it's not technicallybanned for women in sports,
there are still pretty bigconcerns.
Speaker 2 (05:56):
Precisely.
The FDA itself has stated veryclearly there's basically no
solid scientific evidence tosupport the claim that HCG
actually leads to weight lossbeyond what you'd get from just
cutting calories.
They also point out it doesn'tcause like a better distribution
of fat or reduce the hungerthat comes with dieting.
Furthermore and this iscritical the FDA emphasizes it
(06:19):
is illegal to sell HCG over thecounter as a dietary supplement
or as a homeopathic medicationfor any purpose, including
weight loss.
Speaker 1 (06:27):
Wow, okay, that's a really significant point.
So even if a female athlete isbeing prescribed HCG for weight
loss at, say, a wellness clinic,there are major red flags way
beyond just potentialanti-doping issues.
Speaker 2 (06:39):
Exactly that lack of FDA approval for weight loss is
a crucial considerationregarding its safety and whether
it even works for that purpose,even if it doesn't trigger a
positive test for femaleathletes.
It's a health and efficacyquestion too.
Speaker 1 (06:50):
Okay, super important distinction.
Let's move on to anotherincreasingly popular trend
Intravenous or fine infusions,vitamins, saline you see these
advertised everywhere.
Now, right, dedicated clinics,even mobile services that come
to your house.
Speaker 2 (07:07):
Yep, the IV bars hangover cures.
Speaker 1 (07:10):
Yeah, what's the important info for athletes here
?
It seems harmless enough, maybe.
Speaker 2 (07:14):
Well, this is an area where the anti-doping rules are
actually quite clear and prettystrict.
Any and all IV infusions ofmore than 100 milliliters total
within any 12-hour period areprohibited at all times under
anti-doping regulation.
Speaker 1 (07:27):
Wait.
More than 100 milliliters,that's not very much, is it Like
less than half a cup?
Speaker 2 (07:31):
It's not a large volume, no, and the rule applies
regardless of what's actuallyin the IV bag.
So those popular Myerscocktails or those so-called
hangover cures delivered via IVdrip, they almost certainly fall
under this prohibition becausethey usually involve much more
than 100 milliliters of fluid.
Speaker 1 (07:46):
So, even if it's just like a mix of vitamins and
saline solution, nothingactually banned in the bag.
Speaker 2 (07:51):
Yes, the critical factors here are the volume of
fluid being infused and themethod, the IV administration
itself.
The only specific exceptions tothis rule are if the IV
infusion is legitimatelyreceived during necessary
hospital treatment, as part of asurgical procedure or maybe
during clinical diagnosticinvestigations.
Speaker 1 (08:12):
And I'm guessing wellness or anti-aging clinics
wouldn't typically count ashospital settings for these
specific anti-doping ruleexceptions.
Speaker 2 (08:20):
That's correct.
They generally don't meet thatdefinition.
Therefore, receiving an IVinfusion at a wellness clinic,
even if it seems completelyharmless, could still constitute
a violation of anti-dopingrules simply based on the volume
and method.
Speaker 1 (08:33):
Wow, okay, that's a big one.
A lot of people might notrealize that.
Okay, another type of therapythat's been getting some buzz is
ozone therapy.
What do athletes need tounderstand about this one?
Speaker 2 (08:42):
Ozone therapy basically involves introducing
ozone gas into the bloodstreamthrough various methods, now one
particular method known asauto-hemotherapy.
That's where a quantity of yourblood is drawn out, infused
with ozone gas and thenre-injected back into your body.
That method is prohibited atall times under anti-doping
rules.
Okay, while ozone itself isn'tspecifically on the prohibited
(09:06):
list as a substance, anyprocedure that involves the
manipulation of blood, likeremoving it and then
reintroducing it into thecirculatory system, is
considered a prohibited method.
Speaker 1 (09:18):
Ah, so the procedure itself, the blood manipulation,
that's the issue in thatspecific case, not the ozone.
Speaker 2 (09:23):
Precisely.
However, it's worth notingthere is another method of ozone
therapy called rectalinsufflation, where ozone gas is
introduced into the colon via acatheter.
This particular method, asthings stand, is currently
permitted under anti-dopingrules.
Speaker 1 (09:37):
That's a very specific distinction, but
important to know.
Okay now, many of thesewellness clinics seem to
frequently offer compoundedmedications.
What are the potential risks orpitfalls for athletes who might
be prescribed these types ofcustom-made drugs?
Speaker 2 (09:49):
Yeah, compounded meds are common in this space.
They're essentially custom-madedrugs prepared by specialized
compounding pharmacies, oftenbased on a specific prescription
from a wellness clinic doctor.
The primary concern forathletes here is the
significantly increased risk ofunintentional contamination with
substances that are prohibited.
Speaker 1 (10:08):
Contamination, how so ?
Speaker 2 (10:09):
Well, because these products are often mixed
manually in a pharmacy settingwhere prohibited substances
might also be handled maybethey're making a testosterone
cream one minute and yourmedication the next the
potential forcross-contamination is
inherently higher compared to,say, pre-packaged medications
made by big pharma companiesunder super strict quality
(10:30):
control.
Speaker 1 (10:31):
Okay.
Speaker 2 (10:31):
Plus, compounding pharmacies typically operate
under less stringent regulatoryoversight compared to those
large manufacturers.
Speaker 1 (10:38):
So hang on.
Even if the active ingredientin the compounded medication
itself isn't prohibited, there'sa real risk of inadvertently
getting something else in therethat is banned.
Speaker 2 (10:47):
Exactly right.
Athletes who have prescriptionsfor compounded medications, or
even compounded supplements, forthat matter, need to be
extremely aware of this elevatedrisk.
It's another area where youreally need to exercise extra
caution and do your homework.
Speaker 1 (11:01):
That's a bit scary, actually.
Ok, we've also hearddiscussions around the concept
of adrenal fatigue, which seemsto be diagnosed at some of these
wellness clinics.
What should athletes know about?
Treatments may be offered forthis.
Speaker 2 (11:13):
Right Adrenal fatigue .
It's important to note thatthis isn't really a universally
accepted medical diagnosiswithin the mainstream medical
community, but it is somethingsome wellness clinics address.
The treatments can vary, butone particular treatment to be
very aware of is theprescription of oral cortisone.
Speaker 1 (11:30):
Cortisone, like corticosteroids, aware of is the
prescription of oral cortisone.
Speaker 2 (11:34):
Cortisone like corticosteroids yes, exactly.
Oral cortisone is prohibited incompetition under anti-doping
rules.
So if you happen to receive adiagnosis of adrenal fatigue and
are prescribed any medicationfor it, it is critically
important to verify itsanti-doping status, especially
checking if it's okay duringcompetition periods.
Speaker 1 (11:49):
Got it.
Check anything prescribed foradrenal fatigue, especially
cortisone.
Okay, let's move on to a topicthat affects almost everyone
involved in sports and fitness,dietary supplements.
Wellness clinics oftenrecommend a whole slew of these
products.
What is USADA's sort offundamental stance on
supplements for athletes?
Speaker 2 (12:10):
The most fundamental thing, the absolute baseline you
need to remember about dietarysupplements is that they are not
subject to pre-market approvalby regulatory agencies like the
FDA.
Speaker 1 (12:20):
Meaning.
Speaker 2 (12:21):
Meaning there's no independent body that verifies
the accuracy of the productlabel or the safety of the
ingredients before thesesupplements hit the shelves and
are available for purchase.
As a direct consequence of thislack of oversight, no dietary
supplement can ever beguaranteed to be completely free
of substances that areprohibited in sport.
There's always a risk.
Speaker 1 (12:40):
So it really is a bit of a buyer beware situation
when it comes to supplements,then To a significant extent.
Speaker 2 (12:45):
yes, if athletes choose to use dietary
supplements despite theseinherent risks and many do USADA
strongly advises using only thesupplements that have undergone
third-party certification by aprogram that specifically tests
for substances prohibited insport.
Speaker 1 (12:59):
Third-party certification.
Yeah, like who.
Speaker 2 (13:01):
Currently, NSF Certified for Sport is widely
recognized as the sort of goldstandard in this area.
They test batch by batch for awide range of banned substances.
Athletes can find much moredetailed information and lists
of certified products on USADA'sNSF Athlete Advisory page on
their website.
Speaker 1 (13:18):
Okay, so look for that NSF Certified for Sport
logo if you're going to usesupplements.
That's really practical,actionable advice.
What about some of the more,let's say, advanced or
cutting-edge therapies sometimesoffered, like stem cell
therapies and orthobiologics,particularly, maybe, for sports
injuries?
Speaker 2 (13:34):
Yeah, these types of treatments are definitely
becoming more prevalent, moretalked about.
According to the WorldAnti-Doping Agency, wada, stem
cell injections are generallypermitted provided that no
prohibited substances are addedto the stem cell material and if
the application is localized,meaning injected right at the
site of the injury with theprimary intention of just
(13:55):
facilitating healing, not withthe aim of enhancing athletic
performance.
Speaker 1 (13:59):
So there are conditions.
Speaker 2 (14:01):
Yes, the crucial aspects here are the nature of
the material being injected.
Are the stem cells themselvesmanipulated?
And the intended use.
If the stem cells are modifiedor manipulated in any way that
could give aperformance-enhancing benefit,
then they would be prohibited.
Speaker 1 (14:18):
So it really comes down to the specific application
and whether any prohibitedsubstances are being introduced
either with the cells or throughmanipulating the cells
themselves.
Speaker 2 (14:26):
Exactly.
The overarching principle is isthis to support recovery and
healing from an injury, or is ittrying to gain an unfair
athletic advantage?
That's the line.
Speaker 1 (14:35):
Okay, that makes sense.
And finally, let's just quicklytouch on homeopathic remedies.
These are also quite commonlyfound and recommended in
wellness circles.
What's the perspective forathletes considering these?
Speaker 2 (14:46):
Right homeopathy.
It's important to understandthat there are currently no
homeopathic remedies that havereceived approval from the FDA
None None.
These products can be marketedand sold without undergoing any
FDA evaluation for either theirsafety or their effectiveness.
In fact, the FDA has actuallyidentified certain homeopathic
products in the past that werefound to contain active
(15:07):
pharmaceutical ingredients.
Things that shouldn't have beenin there were found to contain
active pharmaceuticalingredients, things that
shouldn't have been in there andthere have also been instances
of products that were unsterileor otherwise unsafe.
Speaker 1 (15:18):
So similar to the supplements.
Then there's a significant lackof robust regulatory oversight.
It's kind of the Wild West.
Speaker 2 (15:25):
Precisely Due to this absence of rigorous pre-market
review, USADA simply cannotprovide any guarantee regarding
the accuracy of the ingredientlabels on homeopathic
medications.
They just don't know what'sreally in them for sure.
Speaker 1 (15:36):
Okay.
Speaker 2 (15:37):
And therefore they cannot provide an official
anti-doping status for theseproducts.
Consequently, just like withdietary supplements, athletes
who choose to use homeopathicremedies do so entirely at their
own risk.
Speaker 1 (15:47):
At your own risk, got it.
So, as we kind of bring all ofthis information together, what
is the most importantoverarching message for our
listeners, the athletes, theweekend warriors, the active
individuals who might becontemplating some of these
various wellness clinictherapies?
Speaker 2 (16:11):
anti-aging clinics might present themselves as
offering really attractiveoptions for boosting your
overall health and physicalperformance, you absolutely must
proceed with a significantdegree of caution and you need
to ensure you are extremely wellinformed about the relevant
anti-doping regulations beforeyou start anything.
The mere fact that a particulartreatment or substance is being
offered, or even prescribed toyou, maybe by a doctor, at one
(16:31):
of these clinics does notautomatically mean that it is
either safe from a healthperspective or permissible under
those anti-doping rules.
The two aren't always the same.
Speaker 1 (16:41):
So the ultimate responsibility for that due
diligence it really liessquarely with the athlete
themselves, doesn't it?
Speaker 2 (16:46):
Absolutely 100%.
You must be proactive inverifying the status of any
procedure or medication you areconsidering, even if it comes
highly recommended by a healthcare professional you trust.
Always take the necessary stepsto determine if a therapeutic
use exemption, that TUE, isrequired for your situation
Right.
And when you have any doubts orquestions whatsoever and it's
(17:13):
okay to have doubts the bestcourse of action is to reach out
directly to USADA's drugreference line.
Email them drugreference atUSADAorg or call them 785-2000
and pick option two.
They are there specifically toprovide guidance and help you
navigate these often complexissues safely.
Speaker 1 (17:24):
That's truly invaluable advice.
Use those resources.
So, as we conclude this deepdive, the central message seems
crystal clear Stay informed,exercise caution always double
check the facts and use theresources available.
A huge thank you for providingsuch clarity on this really
vital topic.
Speaker 2 (17:41):
My pleasure.
It's really all aboutsafeguarding fair play and, just
as importantly, protecting thehealth and integrity of athletes
at every single level.
Speaker 1 (17:48):
Absolutely, and that brings us to the end of another
insightful deep dive.
We really hope this informationhas armed you with some clarity
and maybe some actionable stepsyou can take.
Now here's something to mullover how can a deeper
understanding of your own bodyand the specific regulations
that govern athletic performancetruly empower you to achieve
your goals in a way that is bothsafe and ethically sound?
Definitely something worththinking about Until our next
(18:11):
deep dive.
Take care everyone.
Hey, welcome back to the Deep Dive.
If you're someone who pushesyour limits whether you're
aiming for that new personalbest love, the weekend
competition, or maybe justbelieve in living a really
active life you're probablyalways looking for smart ways to
improve.
The big question is how do youmake sure those methods you're
(00:20):
exploring are not only going toget you results but also keep
you safe and, importantly,within the rules of whatever
game you're playing?
Speaker 2 (00:28):
That's exactly the right starting point, and what's
kind of fascinating right nowis this huge increase in
interest around wellness andanti-aging clinics.
Speaker 1 (00:36):
You see them everywhere.
Speaker 2 (00:37):
You do, and they promise a lot when it comes to
optimizing our health orphysical capabilities, and it's
easy to see the appeal if you'rereally focused on maximizing
performance.
Speaker 1 (00:46):
Absolutely so.
In this deep dive, we're goingto kind of pull back the curtain
on some of the really commontherapies you might run into in
these clinics.
Our goal here is to give you,hopefully, a clear understanding
, especially if you're anathlete or just physically
active, about what's actuallysafe and legal for performance
enhancement and what couldpotentially put you in violation
(01:06):
of anti-doping regulation.
Right, and we're drawingdirectly from information
provided by the US anti-dopingagency, usada, to help navigate
this sometimes confusing terrain.
Speaker 2 (01:16):
And it is a landscape where careful navigation is
really key.
What stands out is that, whileyour personal goals in seeking
these therapies might be allabout health and well-being, the
rules that govern competitivesports are incredibly specific.
They don't always alignperfectly.
Speaker 1 (01:30):
Okay, let's dive right into a topic then that
comes up a lot Hormonereplacement therapies, or HRT,
and also bioidentical hormonereplacement therapies, BHRT.
Can you kind of break down whatthese are all about for us?
Speaker 2 (01:42):
Sure.
So these therapies are oftensuggested to address the natural
hormonal shifts we allexperience as we age, things
like menopause in women or thatnatural decline in testosterone
levels in men.
Right, you might also hearabout hormones, including
steroid hormones, being used tomaybe combat feelings of fatigue
or improve bone density or evenenhance stamina general
(02:04):
wellness stuff often.
Speaker 1 (02:05):
Right, okay, that makes sense as a general
approach.
Speaker 2 (02:07):
Yeah.
Speaker 1 (02:08):
But here's where it gets really interesting when we
look at it from USADA'sperspective.
What are the like criticalthings athletes need to be aware
of regarding HRT and BHRT?
Speaker 2 (02:17):
Okay, the most crucial point to understand
really is that many of thehormones used in these therapies
, specifically things liketestosterone and DHEA, are
included on the WorldAnti-Doping Agency's prohibited
list.
And this isn't just duringcompetition.
This prohibition is in effectat all times, whether you're
actively competing or in youroff-season, and it's important
to emphasize this applies acrossthe board national level
(02:40):
athletes, non-national, junior,recreational masters, everyone.
Speaker 1 (02:44):
So it's definitely not just the elite pros who need
to worry about this.
Speaker 2 (02:47):
Exactly.
The anti-goping rules have areally wide reach and what's
absolutely vital to get is that,whether the testosterone or
DHEA is naturally produced byour body, chemically identical
to what the body produces that'sthe bioidentical part or
synthetically manufactured, itdoesn't change its prohibited
status.
Wow, it's prohibited,regardless of its origin or how
(03:09):
you take it.
Speaker 1 (03:10):
That's a really key distinction, because I can
easily see someone thinking well, I'm just trying to get my
natural hormone levels back towhere they used to be.
That shouldn't be a problem,right.
Speaker 2 (03:18):
That's such a common misconception.
Your healthcare provider mighteven suggest that restoring what
they consider normal levelsisn't performance enhancing.
However, under the anti-dopingregulations, any use of these
prohibited steroid hormoneswithout an approved therapeutic
use exemption a TUE is a directviolation, full stop.
Speaker 1 (03:37):
Me too right.
Speaker 2 (03:38):
The amount you use, the method of administration
tablets, creams, injections itjust doesn't matter.
No TUE, it's a violation.
Speaker 1 (03:45):
And how are these HRT and BHRT substances typically
given?
You mentioned a few.
Speaker 2 (03:50):
Yeah, they can be administered in a whole variety
of ways.
You've got tablets you takeorally, creams or patches you
apply right onto the skininjections, of course or even
these tiny pellets that aresurgically implanted under the
skin for a kind of gradualrelease of the hormone.
Speaker 1 (04:04):
Okay, so for someone who's considering HRT or BHRT,
what's the absolute must-knowtakeaway here?
Like the bottom line.
Speaker 2 (04:12):
The single most important step bar none is to
know with absolute certaintywhat is in the medication you
are being prescribed.
You have a responsibility asthe athlete to verify its status
under anti-doping rules.
Speaker 1 (04:23):
Okay.
Speaker 2 (04:23):
The best way.
Check the globaldrocom website,that's G-L-O-B-A-L-D-R-Ocom, or
you can directly contactUSADA's drug reference line by
sending an email todrugreferenceatusadaorg.
That's your primary safeguard.
Don't just rely on the clinic.
Speaker 1 (04:38):
Gotcha Check globaldro or email USADA Okay,
Let.
Or Yungel, Usada Okay.
Let's pivot now to another areawhere people often seek
guidance from wellness clinicsmedical weight loss.
What are some specific thingsathletes and active folks need
to keep in mind here?
Speaker 2 (04:51):
Yeah, weight loss comes up a lot.
One substance to beparticularly aware of is
phentermine.
It's a stimulant sometimesprescribed to help with weight
loss.
It's specifically prohibited incompetition, so athletes need
to be really careful about thetiming if it's prescribed.
Speaker 1 (05:06):
In competition only for that one.
Speaker 2 (05:07):
OK, ok, but let's focus maybe more specifically on
something called humanchorionic gonadotropin, usually
just called HCG.
Speaker 1 (05:15):
HCG?
Yes, I've definitely heard thatmentioned in weight loss
circles.
What's the deal with that forathletes?
Speaker 2 (05:22):
OK For male athletes, HCG is prohibited at all times.
Simple as that.
Speaker 1 (05:26):
Okay, ban for men.
Speaker 2 (05:28):
Now, while it's not actually on the prohibited list
for women, female athletes stillneed to exercise Pretty
significant caution.
Here's why the Food and DrugAdministration, the FDA, has
approved HCG as a prescriptionmed for specific uses, mainly
treating female infertilityRight, but it has not been
approved by theG as aprescription med for specific
uses mainly treating femaleinfertility Right, but it has
not been approved by the FDA asa safe or effective treatment
(05:50):
for weight loss.
Speaker 1 (05:51):
Ah.
So even if it's not technicallybanned for women in sports,
there are still pretty bigconcerns.
Speaker 2 (05:56):
Precisely.
The FDA itself has stated veryclearly there's basically no
solid scientific evidence tosupport the claim that HCG
actually leads to weight lossbeyond what you'd get from just
cutting calories.
They also point out it doesn'tcause like a better distribution
of fat or reduce the hungerthat comes with dieting.
Furthermore and this iscritical the FDA emphasizes it
(06:19):
is illegal to sell HCG over thecounter as a dietary supplement
or as a homeopathic medicationfor any purpose, including
weight loss.
Speaker 1 (06:27):
Wow, okay, that's a really significant point.
So even if a female athlete isbeing prescribed HCG for weight
loss at, say, a wellness clinic,there are major red flags way
beyond just potentialanti-doping issues.
Speaker 2 (06:39):
Exactly that lack of FDA approval for weight loss is
a crucial considerationregarding its safety and whether
it even works for that purpose,even if it doesn't trigger a
positive test for femaleathletes.
It's a health and efficacyquestion too.
Speaker 1 (06:50):
Okay, super important distinction.
Let's move on to anotherincreasingly popular trend
Intravenous or fine infusions,vitamins, saline you see these
advertised everywhere.
Now, right, dedicated clinics,even mobile services that come
to your house.
Speaker 2 (07:07):
Yep, the IV bars hangover cures.
Speaker 1 (07:10):
Yeah, what's the important info for athletes here
?
It seems harmless enough, maybe.
Speaker 2 (07:14):
Well, this is an area where the anti-doping rules are
actually quite clear and prettystrict.
Any and all IV infusions ofmore than 100 milliliters total
within any 12-hour period areprohibited at all times under
anti-doping regulation.
Speaker 1 (07:27):
Wait.
More than 100 milliliters,that's not very much, is it Like
less than half a cup?
Speaker 2 (07:31):
It's not a large volume, no, and the rule applies
regardless of what's actuallyin the IV bag.
So those popular Myerscocktails or those so-called
hangover cures delivered via IVdrip, they almost certainly fall
under this prohibition becausethey usually involve much more
than 100 milliliters of fluid.
Speaker 1 (07:46):
So, even if it's just like a mix of vitamins and
saline solution, nothingactually banned in the bag.
Speaker 2 (07:51):
Yes, the critical factors here are the volume of
fluid being infused and themethod, the IV administration
itself.
The only specific exceptions tothis rule are if the IV
infusion is legitimatelyreceived during necessary
hospital treatment, as part of asurgical procedure or maybe
during clinical diagnosticinvestigations.
Speaker 1 (08:12):
And I'm guessing wellness or anti-aging clinics
wouldn't typically count ashospital settings for these
specific anti-doping ruleexceptions.
Speaker 2 (08:20):
That's correct.
They generally don't meet thatdefinition.
Therefore, receiving an IVinfusion at a wellness clinic,
even if it seems completelyharmless, could still constitute
a violation of anti-dopingrules simply based on the volume
and method.
Speaker 1 (08:33):
Wow, okay, that's a big one.
A lot of people might notrealize that.
Okay, another type of therapythat's been getting some buzz is
ozone therapy.
What do athletes need tounderstand about this one?
Speaker 2 (08:42):
Ozone therapy basically involves introducing
ozone gas into the bloodstreamthrough various methods, now one
particular method known asauto-hemotherapy.
That's where a quantity of yourblood is drawn out, infused
with ozone gas and thenre-injected back into your body.
That method is prohibited atall times under anti-doping
rules.
Okay, while ozone itself isn'tspecifically on the prohibited
(09:06):
list as a substance, anyprocedure that involves the
manipulation of blood, likeremoving it and then
reintroducing it into thecirculatory system, is
considered a prohibited method.
Speaker 1 (09:18):
Ah, so the procedure itself, the blood manipulation,
that's the issue in thatspecific case, not the ozone.
Speaker 2 (09:23):
Precisely.
However, it's worth notingthere is another method of ozone
therapy called rectalinsufflation, where ozone gas is
introduced into the colon via acatheter.
This particular method, asthings stand, is currently
permitted under anti-dopingrules.
Speaker 1 (09:37):
That's a very specific distinction, but
important to know.
Okay now, many of thesewellness clinics seem to
frequently offer compoundedmedications.
What are the potential risks orpitfalls for athletes who might
be prescribed these types ofcustom-made drugs?
Speaker 2 (09:49):
Yeah, compounded meds are common in this space.
They're essentially custom-madedrugs prepared by specialized
compounding pharmacies, oftenbased on a specific prescription
from a wellness clinic doctor.
The primary concern forathletes here is the
significantly increased risk ofunintentional contamination with
substances that are prohibited.
Speaker 1 (10:08):
Contamination, how so ?
Speaker 2 (10:09):
Well, because these products are often mixed
manually in a pharmacy settingwhere prohibited substances
might also be handled maybethey're making a testosterone
cream one minute and yourmedication the next the
potential forcross-contamination is
inherently higher compared to,say, pre-packaged medications
made by big pharma companiesunder super strict quality
(10:30):
control.
Speaker 1 (10:31):
Okay.
Speaker 2 (10:31):
Plus, compounding pharmacies typically operate
under less stringent regulatoryoversight compared to those
large manufacturers.
Speaker 1 (10:38):
So hang on.
Even if the active ingredientin the compounded medication
itself isn't prohibited, there'sa real risk of inadvertently
getting something else in therethat is banned.
Speaker 2 (10:47):
Exactly right.
Athletes who have prescriptionsfor compounded medications, or
even compounded supplements, forthat matter, need to be
extremely aware of this elevatedrisk.
It's another area where youreally need to exercise extra
caution and do your homework.
Speaker 1 (11:01):
That's a bit scary, actually.
Ok, we've also hearddiscussions around the concept
of adrenal fatigue, which seemsto be diagnosed at some of these
wellness clinics.
What should athletes know about?
Treatments may be offered forthis.
Speaker 2 (11:13):
Right Adrenal fatigue .
It's important to note thatthis isn't really a universally
accepted medical diagnosiswithin the mainstream medical
community, but it is somethingsome wellness clinics address.
The treatments can vary, butone particular treatment to be
very aware of is theprescription of oral cortisone.
Speaker 1 (11:30):
Cortisone, like corticosteroids, aware of is the
prescription of oral cortisone.
Speaker 2 (11:34):
Cortisone like corticosteroids yes, exactly.
Oral cortisone is prohibited incompetition under anti-doping
rules.
So if you happen to receive adiagnosis of adrenal fatigue and
are prescribed any medicationfor it, it is critically
important to verify itsanti-doping status, especially
checking if it's okay duringcompetition periods.
Speaker 1 (11:49):
Got it.
Check anything prescribed foradrenal fatigue, especially
cortisone.
Okay, let's move on to a topicthat affects almost everyone
involved in sports and fitness,dietary supplements.
Wellness clinics oftenrecommend a whole slew of these
products.
What is USADA's sort offundamental stance on
supplements for athletes?
Speaker 2 (12:10):
The most fundamental thing, the absolute baseline you
need to remember about dietarysupplements is that they are not
subject to pre-market approvalby regulatory agencies like the
FDA.
Speaker 1 (12:20):
Meaning.
Speaker 2 (12:21):
Meaning there's no independent body that verifies
the accuracy of the productlabel or the safety of the
ingredients before thesesupplements hit the shelves and
are available for purchase.
As a direct consequence of thislack of oversight, no dietary
supplement can ever beguaranteed to be completely free
of substances that areprohibited in sport.
There's always a risk.
Speaker 1 (12:40):
So it really is a bit of a buyer beware situation
when it comes to supplements,then To a significant extent.
Speaker 2 (12:45):
yes, if athletes choose to use dietary
supplements despite theseinherent risks and many do USADA
strongly advises using only thesupplements that have undergone
third-party certification by aprogram that specifically tests
for substances prohibited insport.
Speaker 1 (12:59):
Third-party certification.
Yeah, like who.
Speaker 2 (13:01):
Currently, NSF Certified for Sport is widely
recognized as the sort of goldstandard in this area.
They test batch by batch for awide range of banned substances.
Athletes can find much moredetailed information and lists
of certified products on USADA'sNSF Athlete Advisory page on
their website.
Speaker 1 (13:18):
Okay, so look for that NSF Certified for Sport
logo if you're going to usesupplements.
That's really practical,actionable advice.
What about some of the more,let's say, advanced or
cutting-edge therapies sometimesoffered, like stem cell
therapies and orthobiologics,particularly, maybe, for sports
injuries?
Speaker 2 (13:34):
Yeah, these types of treatments are definitely
becoming more prevalent, moretalked about.
According to the WorldAnti-Doping Agency, wada, stem
cell injections are generallypermitted provided that no
prohibited substances are addedto the stem cell material and if
the application is localized,meaning injected right at the
site of the injury with theprimary intention of just
(13:55):
facilitating healing, not withthe aim of enhancing athletic
performance.
Speaker 1 (13:59):
So there are conditions.
Speaker 2 (14:01):
Yes, the crucial aspects here are the nature of
the material being injected.
Are the stem cells themselvesmanipulated?
And the intended use.
If the stem cells are modifiedor manipulated in any way that
could give aperformance-enhancing benefit,
then they would be prohibited.
Speaker 1 (14:18):
So it really comes down to the specific application
and whether any prohibitedsubstances are being introduced
either with the cells or throughmanipulating the cells
themselves.
Speaker 2 (14:26):
Exactly.
The overarching principle is isthis to support recovery and
healing from an injury, or is ittrying to gain an unfair
athletic advantage?
That's the line.
Speaker 1 (14:35):
Okay, that makes sense.
And finally, let's just quicklytouch on homeopathic remedies.
These are also quite commonlyfound and recommended in
wellness circles.
What's the perspective forathletes considering these?
Speaker 2 (14:46):
Right homeopathy.
It's important to understandthat there are currently no
homeopathic remedies that havereceived approval from the FDA
None None.
These products can be marketedand sold without undergoing any
FDA evaluation for either theirsafety or their effectiveness.
In fact, the FDA has actuallyidentified certain homeopathic
products in the past that werefound to contain active
(15:07):
pharmaceutical ingredients.
Things that shouldn't have beenin there were found to contain
active pharmaceuticalingredients, things that
shouldn't have been in there andthere have also been instances
of products that were unsterileor otherwise unsafe.
Speaker 1 (15:18):
So similar to the supplements.
Then there's a significant lackof robust regulatory oversight.
It's kind of the Wild West.
Speaker 2 (15:25):
Precisely Due to this absence of rigorous pre-market
review, USADA simply cannotprovide any guarantee regarding
the accuracy of the ingredientlabels on homeopathic
medications.
They just don't know what'sreally in them for sure.
Speaker 1 (15:36):
Okay.
Speaker 2 (15:37):
And therefore they cannot provide an official
anti-doping status for theseproducts.
Consequently, just like withdietary supplements, athletes
who choose to use homeopathicremedies do so entirely at their
own risk.
Speaker 1 (15:47):
At your own risk, got it.
So, as we kind of bring all ofthis information together, what
is the most importantoverarching message for our
listeners, the athletes, theweekend warriors, the active
individuals who might becontemplating some of these
various wellness clinictherapies?
Speaker 2 (16:11):
anti-aging clinics might present themselves as
offering really attractiveoptions for boosting your
overall health and physicalperformance, you absolutely must
proceed with a significantdegree of caution and you need
to ensure you are extremely wellinformed about the relevant
anti-doping regulations beforeyou start anything.
The mere fact that a particulartreatment or substance is being
offered, or even prescribed toyou, maybe by a doctor, at one
(16:31):
of these clinics does notautomatically mean that it is
either safe from a healthperspective or permissible under
those anti-doping rules.
The two aren't always the same.
Speaker 1 (16:41):
So the ultimate responsibility for that due
diligence it really liessquarely with the athlete
themselves, doesn't it?
Speaker 2 (16:46):
Absolutely 100%.
You must be proactive inverifying the status of any
procedure or medication you areconsidering, even if it comes
highly recommended by a healthcare professional you trust.
Always take the necessary stepsto determine if a therapeutic
use exemption, that TUE, isrequired for your situation
Right.
And when you have any doubts orquestions whatsoever and it's
(17:13):
okay to have doubts the bestcourse of action is to reach out
directly to USADA's drugreference line.
Email them drugreference atUSADAorg or call them 785-2000
and pick option two.
They are there specifically toprovide guidance and help you
navigate these often complexissues safely.
Speaker 1 (17:24):
That's truly invaluable advice.
Use those resources.
So, as we conclude this deepdive, the central message seems
crystal clear Stay informed,exercise caution always double
check the facts and use theresources available.
A huge thank you for providingsuch clarity on this really
vital topic.
Speaker 2 (17:41):
My pleasure.
It's really all aboutsafeguarding fair play and, just
as importantly, protecting thehealth and integrity of athletes
at every single level.
Speaker 1 (17:48):
Absolutely, and that brings us to the end of another
insightful deep dive.
We really hope this informationhas armed you with some clarity
and maybe some actionable stepsyou can take.
Now here's something to mullover how can a deeper
understanding of your own bodyand the specific regulations
that govern athletic performancetruly empower you to achieve
your goals in a way that is bothsafe and ethically sound?
Definitely something worththinking about Until our next
(18:11):
deep dive.
Take care everyone.
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