Credit to Steven Lelham

Supplement411 High Risk List

Risk Assessment Materials and High Risk List

An excellent site with resources for pharmacists to access for free and use with their patients. The US AntiDoping Agency designed a simple to follow risk assessment system to get your patient-athletes started. Realize | Recognize | Reduce.

Before an athlete uses any dietary supplements, ensure they have reviewed the High Risk List for both the product and the manufacturer and distributors. And remind them that companies change the names of the products, the ingredient list and even the name of their own company with very little enforcement/regulation.

This reduces risk (it will not eliminate the risk for athletes), and use of these loosely regulated products should be a topic of discussion at each meeting with your patient-athletes.

NSF Certified

National Science Foundation Product and Ingredient Certification and NSF International Certified for Sport® (nsfsport.com)

For your general consumer and the elite athlete alike, providing counseling on the lack of quality of control over dietary supplements should be a common warning your provide. Finding an independent third party that provides testing of the products is vital, especially for your athletes that are strictly liable for everything they put in their bodies. NFS provides an online search engine of the general products they have tested, found here.

Be aware that NSF Certified for Sport requires the athlete look up the Lot Number! Not every batch is tested! Please read what “certified” means on their website. This reduces risk (it will not eliminate the risk for athletes, and use of these loosely regulated products should be a topic of discussion at each meeting with your patient-athletes).

To help with precision of identification, NSF International has a great Certified for Sport® App which allows the athlete to scan the barcode of the product they are considering purchasing.

Banned Substance Control Group

BSCG – The gold standard in dietary supplement certification is another highly credible and reliable source of information on dietary supplements for athletes (and sports pharmacists!). The BSCG Certified Drug Free – Supplements, Ingredients, Facilities offers a search engine that ISPN recommends you have the athlete check prior to using any supplements.

This may offer the most comprehensive testing panel, in comparing the independent testing companies for supplements. No app or barcode scanning option was located, but this may exist for this company as well.

This reduces risk (it will not eliminate the risk for athletes), and use of these loosely regulated products should be a topic of discussion at each meeting with your patient-athletes.

In addition to providing testing of products, BSCG also remains on the frontlines with substance identification for novel chemical structures that may be banned for your patient-athlete (that catch-all phrase of  “and other substances with similar chemical structure or similar biological effect(s)”).

Operation Supplement Safety

Operation Supplement Safety | OPSS is the Department of Defense dietary supplement resource designed for for the military community and healthcare providers. Another site with a wealth of information, as you work with your patient-athlete (even if they are civilians with no military connections), this resource is one pharmacists should also highly encourage as a resource.

A feature unique to OPSS is the specified list of supplements that are prohibited! Dietary Supplement Ingredients Prohibited by DoD

OPSS also has a searchable database of the OPSS High-risk list, Check Supplements and an A-Z list of ingredient examples.

Again, sports pharmacists, reassess at each visit the intent of the dietary supplement use by the patient-athlete. Does benefit outweigh the risk? Take one additional step to ask, does the benefit outweigh the unknowns of use? Not only the lack of regulation but the lack of safety and efficacy studies should be approached in conversation with your patients.

Informed Sport

Informed Sport Sports Supplements Certification | Informed Sport (wetestyoutrust.com) offers testing of every batch, for less confusion among your patient-athletes in trying to understand or locate specific lot numbers. Have your patient-athlete type any keyword in the search at the top of the page. This credible and reliable, independent third party testing company also offers an Mobile App | Informed Sport (wetestyoutrust.com) for the patient to download and scan the product barcode.

One point for your to recognize and make your patient-athlete aware, is the difference between Informed Sport(R) which is intended as a higher standard for risk reduction for the elite athletes, then the similarly names Informed Choice(R) products.

This reduces risk (it will not eliminate the risk for athletes), and use of these loosely regulated products should be a topic of discussion at each meeting with your patient-athletes.

Consumer Labs

Consumer Lab offers independent testing of products, including vitamins, minerals and dietary supplements, but they do not specialize in testing for banned substances. While this offers a level of comfort in comparing some products, for athletes to consider, the company has limited information on sports products.

Sports Performance Supplements Reviewed by ConsumerLab.com

This may reduce risk (it will not eliminate the risk for athletes), and use of these loosely regulated products should be a topic of discussion at each meeting with your patient-athletes.

ASADA Supplement Checker

Even though these are not products in the US (and the brand names and ingredients are likely different — be warned!), ASADA provides a really nice reference on their app via Sport Integrity Australia and HASTA.

The lack of regulation on dietary supplements, or lack of enforcement of regulations on the market tends to be nearly a worldwide issue for athletes and the general health consumers. View their medical professionals video on supplement regulations in Australia.