10 hangover remedies: What works?

By Anne Harding

 

(Health.com) — Prevention is the best cure for a hangover. The only way to avoid a pounding head and queasiness the morning after is to drink in moderation, or to stay away from alcohol entirely. But with all sorts of seasonal celebrations going on, it’s easy to overindulge.

Alternating your drinks with water or another nonalcoholic beverage can help you slow down and stay hydrated. If you still wind up with a hangover, you may be inclined to try one of the many supposedly tried-and-true remedies that have been passed down through the ages.

Don’t get your hopes up. Traditional hangover remedies are often ineffective, and some of them may actually make you feel worse.

Hair of the dog

Even though the thought of a Bloody Mary may appeal to you, a Virgin Mary is a much better choice the morning after.

“The worst thing to do is to have another drink,” says Charles Cutler, M.D., an internist in Norristown, Pennsylvania, and the chair of the American College of Physician’s board of governors.

The alcohol may temporarily take the edge off your symptoms but could hurt in the long run. Hangovers make you feel horrible because alcohol is toxic, Cutler explains, and you need to give your body a chance to recover. That morning drink could lead to an even worse hangover the following day.

Greasy breakfast

There’s no scientific evidence that a heaping helping of bacon and eggs will ease hangover anguish, although many people swear by it. “Greasy food is just going to give you heartburn,” says Cutler, who recommends sticking with easy-to-digest foods such as toast or cereal. “You want to get calories right back into your system.”

Eat light and stay hydrated, agrees John Brick, Ph.D., an alcohol research scientist and author of “The Doctor’s Hangover Handbook.”

“No specific foods are recommended, although honey sandwiches are helpful to some people,” Brick says. “[They’re] easy to eat and digest.”

Health.com: Surprising heartburn triggers

Alka-Seltzer

Alka-Seltzer turns 80 in 2011, and the famous fizzy medicine has probably been used to treat hangovers for nearly that long. In 2001, the company even introduced a Morning Relief formulation specifically for hangovers.

All Alka-Seltzer varieties contain sodium bicarbonate (also known as baking soda), which will help settle a queasy belly by neutralizing stomach acid. But other ingredients, notably aspirin and citric acid, may irritate your stomach after a night of heavy drinking.

Aspirin or ibuprofen

Over-the-counter painkillers can certainly help ease hangover headaches and the aches and pains you may feel elsewhere in your body after a night of heavy drinking.

But choose carefully. If you’re a regular heavy drinker, you may have done some damage to the lining of your stomach, and taking aspirin or ibuprofen (such as Advil) can worsen this damage and even cause bleeding, Dr. Cutler warns.

Acetaminophen (Tylenol) is also risky for habitual drinkers, due to the potential for liver damage. Check with your doctor about a painkiller that’s right for you.

Health.com: Being choosy about booze helps avoid hangover (to a point)

Hangover pills

There are lots of products out there that claim to prevent or cure hangovers — such as Chaser, PreToxx, and RU 21 — but there is very little scientific evidence that they will make you feel any better.

“Hangover pills that have been studied are not effective, or only help against a few complaints…but not all,” says Joris C. Verster, Ph.D., an assistant professor of psychopharmacology at Utrecht University in the Netherlands, who studies hangovers.

A 2005 review article in the journal “BMJ” identified eight peer-reviewed, placebo-controlled studies of hangover remedies, and concluded that “no compelling evidence exists” to support their use.

“What’s in them either doesn’t work, or if it has any benefit, you could buy it generically for probably a third of the price,” says Cutler.

He suggests taking a multivitamin instead to restore the nutrients your body may have lost during a binge.

Coffee

If you’re a regular coffee drinker, skipping the java when you’re hung over may — or may not be — a good idea, Brick says. You may wind up layering a pounding caffeine-withdrawal headache on top of your hangover woes if you miss your morning fix.

That said, caffeine narrows your blood vessels and boosts blood pressure. “Both of these may make the hangover worse,” Brick says. “If you drink coffee regularly, you might try a very small amount in the morning. Wait 30 to 60 minutes and see how you feel.”

Health.com: Coffee: Is it healthier than you think?

Water and sports drinks

Conventional wisdom holds that the dehydration caused by heavy drinking is what makes you feel so bad the next day.

In fact, experts actually know very little about what causes a hangover. Potential culprits include disrupted biological rhythms or even alcohol withdrawal, and research suggests that congeners — toxic substances found in alcohol, especially dark liquors such as whiskey — may also play a role.

Nevertheless, replacing the fluid you’ve lost will likely help you feel a little less miserable.

“Juice, water, Gatorade, all those things — they’re going to make you feel better,” says Cutler.

Exercise

A gentle workout might help you feel better, if you can manage it. (That’s a big if.)

“Remember: If you’ve been drinking heavily, you could be a little dehydrated, you could be metabolically behind on your nutrition, and exercise is going to require hydration and nutrition,” Cutler says. “Exercise is always the right thing to do, but I don’t think [on] the morning you wake up with a hangover, exercise is what you need.”

What you really need is rest, he adds.

Health.com: Cold or flu? How to know if you’re too sick to work out

Sauna

Think you can “sweat out” the alcohol and other toxins you may have consumed during a night of partying? Think again.

A sauna can cause potentially dangerous blood vessel and blood flow changes in your body. “The last thing you need is to disrupt the normal blood flow patterns by extreme heat,” Cutler says.

If you’re already somewhat dehydrated, excessive sweating can be harmful, and even deadly. Researchers from the Finnish State Alcohol Company’s Research Laboratories in Helsinki warn that sauna bathing while hung over carries “real health risks,” including dangerous drops in blood pressure and abnormal heart rhythms.

Sleep

People sleep poorly after a night of drinking. Alcohol will put you to sleep quickly, but when it begins to wear off several hours later, the withdrawal your body feels can disrupt sleep and jolt you awake. While sleep deprivation won’t by itself cause a hangover, it can definitely make the symptoms worse.

Health.com: 7 tips for the best sleep ever

If you have the luxury of “sleeping it off” the next day, do so. Your foggy brain and achy body will thank you. “The body’s got an amazing capacity to heal on its own,” says Cutler. In the end, the only surefire treatment for a hangover is time.

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Can Regulators Keep Up with the Supplements Industry?

by PRIYANKA BOGHANI

 

Walk down the aisles at your local supermarket or drug store and you can find a veritable alphabet soup of health supplements — from acai to zinc — touting various health benefits.

The supplements industry, which includes everything from vitamins and herbal supplements to weight loss pills, has grown into a more than $30 billion industry.

However, the industry has come under scrutiny in recent years for many of the wrong reasons — allegedly mislabeling their products, not testing them for safety, making unproven health claims and in some instances selling products contaminated with potentially harmful unlisted ingredients. A string of high-profile cases linking certain products to serious health issuessome even leading to liver problems and deaths — has raised questions about how well the industry is regulated.

Unlike prescription drugs that have to go through rounds of rigorous testing and clinical trials before they reach your pharmacy, the current system leaves it up to the manufacturers of supplements to make sure they adhere to guidelines established by the Food and Drug Administration.

It’s a distinction that regulators are concerned consumers may not know about.

“I do think it’s very a important thing to be able to point out to the customer that there is essentially no pre-market review that’s done at the FDA before these products go on the market,” said the agency’s acting commissioner, Dr. Stephen Ostroff, in an interview for the FRONTLINE documentary Supplements and Safety.

In other words, the makers of supplements don’t have to win FDA approval before bringing a product to market, unless it contains a new ingredient that’s never been marketed before. The FDA does oversee labeling, but it usually can’t determine whether a manufacturer is following its guidelines until there’s a problem. Often, the agency only steps in after a product that’s already on the shelves has been misbranded or found to be adulterated.

Once a supplement is on shelves, the FDA relies on inspections of the manufacturer to assess whether the supplement actually contains what it says it does. But as experts point out, the agency only inspects a fraction of companies. Data from the Government Accountability Office, for example, showed that between January and September of 2012, the agency inspected 410 firms – roughly 18 percent of known manufacturers at the time.

“They only inspect a small number of facilities relative to the amount of supplements being sold,” said Laura MacCleery, director of regulatory affairs at the Center for Science in the Public Interest, a consumer advocacy group. “They find significant levels of problems in the few facilities they do inspect.”

When the FDA finds a problem, it can respond in several ways — from issuing warning letters, to pursing civil or criminal charges against a manufacturer. That’s what happened last November when the agency worked with the Department of Justice to bring civil and criminal cases against more than 100 makers and marketers of dietary supplements. The sweep targeted companies across 18 states for allegedly selling products with unlisted ingredients or for making treatment claims that were “unsupported by adequate scientific evidence.”

The FDA also uses so-called “adverse event reports” to monitor whether a supplement might pose a health risk. An “adverse event” might be mild, like a headache or indigestion, or something more serious, resulting in hospitalization, surgical intervention, birth defects or even death. Reports can be sent in from consumers, health care professionals or manufacturers themselves. In fact, in cases of serious adverse reactions, supplement makers are required to submit a report.

One concern with this system, though, is that “adverse events” are either underreported or never reach the FDA. A 2013 GAO report, for example, found that poison control centers received 1,000+ more reports between 2008 and 2010 of incidents potentially linked to supplements than did the FDA.

Even when they reach the FDA, reports often fail to result in any action because the agency says such reports often lack enough information, and because it can be difficult to establish a link between a particular supplement and the health problem. And under current law, the FDA has to show that a supplement poses a “significant or unreasonable risk of illness” in court before it can remove it from the market. To win criminal charges, the government has to prove that there was intentional wrongdoing. But such lawsuits are rare. From 2002 to 2008, for instance, the government only successfully prosecuted 14 cases.

“They have very strong enforcement tools, but to use them is incredibly difficult,” said Josh Sharfstein, associate dean for public health practice and training at the Johns Hopkins Bloomberg School of Public Health.

Another challenge is finding the resources to keep pace with an industry with an estimated 80,000 to 90,000 products on the market, according to Steve Morris, the GAO’s director of natural resources and environment.  

“Part of it is just the scope of the industry. It’s really large, and the FDA may not have a good sense in terms of the universe of the industry of all the players out there, and the total number of potential adverse effects,” according to Morris. “The resources are limited to some degree, so they can only do so many inspections.”

The FDA gets some assistance in regulating supplements from the Federal Trade Commission, which can take action when companies are found making false or misleading claims about their products. The FTC’s guidelines for supplement marketers say advertising must be truthful and any claims must be substantiated with adequate evidence. For example, if the marketing for a supplement claims that 90 percent of cardiologists recommend it, the claim should be provable. Supplements also have to contain a disclaimer stating that they aren’t intended to “treat,” “cure,” or “prevent” any disease. The FTC can issue warning letters or fines, force marketers to pull or change misleading ads, and can even take them to court over such claims.

Still, many health officials argue that current regulations fail to go far enough. Morris said the FDA can improve its role by offering more guidance to the industry, getting more information about the scope of the problem, and sharing that information with the public. Others have called for dietary supplement makers to register new products with the FDA, arguing that doing so would make it easier to bring enforcement action against rogue products.

In the meantime, officials on the state level have begun to lean in. In February, New York Attorney General Eric Schneiderman sent letters to four of the nation’s largest retailers — GNC, Target, Walmart and Walgreens — calling on them to stop the sale of store-brand herbal supplements after an investigation by his office allegedly showed that just 21 percent of the products tested contained the ingredients listed on their labels.

In an interview with FRONTLINE, Daniel Fabricant, executive director and CEO of the Natural Products Association, a leading industry trade group, said the industry was “working the attorney general’s office so they understand more about the industry and we understand more of their concerns.” But “consumers are going to continue to take supplements,” he said, “because they derive a benefit.  Over half the country every day takes a supplement safely and effectively.”

GNC would later agree to carry out DNA barcoding to authenticate its products. Days later, 14 state attorneys general wrote a letter to lawmakers in Congress urging an inquiry into the herbal supplements industry, and a stronger oversight role for the FDA.

Experts like Sharfstein say that change needs to occur at the national level, given the potential size of the issue.

“Certainly states have done a good job calling attention to the problem,” Sharfstein said. “They can go after very small parts of the problem, but I don’t think states are going to be able to grapple with the whole problem.”

MacCleery, the consumer advocate, believes change is in the industry’s interests as well. “These are products that are widely consumed by the public who assumes that they are better regulated than they are,” she said. “The dietary supplement industry would be smart to decide what kind of additional safety measures are appropriate, because as a whole they’re getting discredited by bad actors that look for spaces where products are under-regulated in order to operate.”

DMT

N,N-Dimethyltryptamine (also known as DMT, N,N-DMT, Dimethyltryptamine, Dmitri, and “The Spirit Molecule”) is an infamous naturally-occurring psychedelic substance of the tryptamine chemical class that produces an unusually intense, short-lived version of what has come to be considered the “classical psychedelic”experience (i.e. those traditionally associated with Mescaline, Psilocybin Mushrooms, DMT, and LSD) when administered.[1]

Depending on the dosage and method of administration, the effects of DMT can range from mild psychedelic states to powerfully immersive life-altering experiences which are often described as the ultimate displacement from ordinary consciousness, in which users are placed in a subjective state where they can experience exploring ineffable spiritual realms or alternate dimensions.[2]

DMT is present in over 65 species of plants and has been identified as being a normal constituent of human metabolism and an endogenous neurotransmitter in certain rodents. Its presence is also known to be widespread throughout the plant kingdom.[3][4] Although various theories have been postulated, the substance’s neurobiological function has yet to be determined.[citation needed]

In modern times, DMT is viewed as an extremely powerful visionary psychedelic entheogen that, when vaporized or smoked, produces short-lived effects with a very rapid onset that are sometimes compared to an “unimaginably high-speed roller-coaster ride.” When ingested in combination with a MAOI or RIMA agent, it becomes active orally and thus significantly longer lasting, immersive, and interactive in nature; this combination is known as ayahuasca.[5] Ayahuasca brews have been used traditionally in South America since at least around the year 1500.[6]

Unlike most highly prohibited substances, DMT is not considered to be physiologically toxic or addictive by the scientific community.[7][8] Nevertheless, unpredictable adverse reactions such as anxiety, paranoia, delusions and psychotic breaks can always still occur, particularly among those predisposed to psychiatric disorders.[9]While these negative reactions or “bad trips” can often be attributed to user inexperience or improper preparation of set and setting, they have been known to happen spontaneously among even the most experienced of users as well.

As a result, it is highly advised to approach this incredibly powerful and unpredictable hallucinogenic substance with proper harm reduction practices if choosing to use it.

DMT Crystals[10]

Chemistry

Substitutive structure of a tryptamine molecule

DMT, or N,N-dimethyltryptamine, is a naturally-occurring indole alkaloid molecule of the tryptamine class. Tryptamines share a core structure comprised of a bicyclic indole heterocycle attached at R3 to an amino group via an ethyl side chain. DMT contains two methyl groups (CH3-) bound to the terminal amine RN at the end of this chain. DMT has many homologs and analogs from base tryptamines like MET and DPT, to four and five position substituted variants such as 4-PO-DMT (Psilocybin), 4-AcO-DMT (Psilacetin), and 5-MeO-DMT.

Pharmacology

Further information: Serotonergic psychedelic

DMT’s psychedelic effects are believed to come from its efficacy at the 5-HT2A receptor as a partial agonist. However, the role of these interactions and how they result in the psychedelic experience continues to remain elusive.

In addition to this, N,N-dimethyltrytamine is believed to be an endogenous ligand for the sigma receptor. However, the significance of the sigma-1 receptor remains the subject of ongoing scientific research.[11]

The compound’s affinities for various receptor sets have been well-studied and are listed in the table below:

Binding Sites Binding Affinity Ki (nM)[citation needed]
5-HT1A >10,000
5-HT1B >10,000
5-HT1D 93
5-HT1E 455.7
5-HT2A 2323
5-HT2B 107.6
5-HT2C 334.6
5-HT5A 611
5-HT6 487.4
5-HT7 87.5
D1 271.1
α1A 1745
α1B 973.7
α2A 1561
α2B 257.7
α2C 258.6
SERT 3742
σ1R 2.23

Subjective effects

The effects listed below are based upon the subjective effects index and personal experiences of PsychonautWiki contributors. The listed effects will rarely (if ever) occur all at once, but heavier doses will increase the chances and are more likely to induce a full range of effects. Likewise, adverse effects become much more likely on higher doses and may include injury or death (via behavorial toxicity).

Physical effects

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Visual effects

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Cognitive effects

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Auditory effects

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Multi-sensory effects

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Transpersonal effects

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Experience reports

Anecdotal reports which describe the effects of this compound within our experience index include:

Additional experience reports can be found here:

Progressive stages

When smoked or vaporized at moderate to heavy dosages, the DMT experience manifests itself in a consistent progressive sequence which is described below.

1. “Breaking Through”

The first step of a DMT trip is the come up that leads onto an experience commonly referred to as “breaking through.”[14] This seems to have at least a few different ways of presenting itself to the user.

The first thing that a person notices is an extremely distinct set of visual enhancements such an increase in visual acuity and colour intensity. This is followed by a sudden onset of high level 3 geometry which increases in its intensity until it envelopes and covers the external environment. These effects are often accompanied by auditory hallucinations such as soft crackling sounds or high pitched extended tones. There is also the possibility of accompanying physical sensations as one “breaks through.” These can include feelings of suddenly being pushed through and onto the other side of a membrane or feelings of shooting through space at high speeds.

2. “The Waiting Room”

Almost immediately after a person has inhaled enough DMT to have “broken through”, they often find themselves spending a brief amount of time in what is sometimes described as a psychedelic “waiting room” or “loading screen.” The appearance of this space can assume a seemingly infinite variety of forms but generally appears in the shape of an enveloping tunnel comprised of rapidly shifting, interlocking geometry. This lasts approximately 10 – 20 seconds and feels qualitatively different from other stages of the experience.

3. “The Other Side”

Once the waiting period is over, the user will feel that they have “broken through” onto the other side. It is here where users experience intense level 7 geometry and level 3 – 4 internal hallucinations. It is worth noting that although experiences vary between individuals, DMT trips often follow common archetypes, scenarios, content, and plots. These scenarios generally consist of visiting what appears to be an alternate reality that is often described to contain autonomous entities, settings, sceneries, and landscapes as well as themes of a cosmic, transcendental, or transpersonal nature.

4. “Drifting Down”

The final stage is experienced as the sensation of being pulled further and further away from the scenario until it is no longer visible and one finds themselves back in reality. This is typically accompanied by level 3 – 4 geometry as well as a sense of general exhilaration and awe. The moderate to mild geometry stays for a further 10 – 15 minutes before disappearing completely, sometimes leaving a noticeable “body high” that lingers for up to an hour.

Natural plant sources

Main article: DMT-containing plants

Mimosa hostilis root bark

Further information: Mimosa tenuiflora (botany)

Mimosa hostilis root bark.

Mimosa hostilis (also known as Mimosa tenuiflora, Jurema and Tepezcohuite) is a perennial tree or shrub native to the northeastern region of Brazil and is found as far north as southern Mexico. Around 1% of the dried weight is DMT. It is legal to purchase online in many parts of the world and a commonly used source for performing DMT extractions or brewing into ayahuasca.

Acacia confusa root bark.

Acacia confusa root bark

Further information: Psychoactive acacias

Acacia confusa (also known as Acacia Petit Feuille, Small Philippine Acacia, Formosa Acacia (Taiwan Acacia) and Formosan Koa) is a perennial tree native to South-East Asia. It is legal to purchase online and easily accessible in many parts of the world. The plant matter itself contains the following chemicals:[15]

  • N-Methyltryptamine: 1.43% (not psychoactive without MAOI)
  • DMT/N,N-Dimethyltryptamine: 1.15%

Preparation methods

Preparation methods for this compound within our tutorial index include:

Toxicity and harm potential

DMT is considered to be non-addictive, is not associated with any form of neurotoxicity, and has an extremely low toxicity relative to dose. As with other psychedelic substances, there are relatively few physical side effects associated with acute DMT exposure. Various studies have shown that in reasonable doses in a careful context, it has little to no negative cognitive, psychiatric or physical consequences.[13]

However, as with psychedelics generally, DMT is thought to be able to act as a potential trigger for those with underlying psychiatric conditions.[citation needed] Those with a personal or family history of mental illness are advised not to use this substance unless under medical supervision.

Despite the lack of physical risks, it is highly advised to approach this substance with extreme caution and harm reduction practices due to the lasting mental imprint it can leave on the user.

Lethal dosage

The median lethal dose (LD50) of DMT in humans has never been reached in any setting, nor is this expected to change due to its pharmacological properties.[citation needed]

Tolerance and addiction potential

DMT is not habit-forming and the desire to use it can actually decrease with use.[13] As with most psychedelics, it is generally considered to have a built-in, self-regulating aspect. This can either occur subconsciously or even during the experience itself in which an autonomous entity will seemingly warn the user to discontinue their usage.[citation needed]

Tolerance to the effects of DMT does not occur. DMT presents cross-tolerance with no other psychedelics, meaning that after the consumption of DMT psychedelics will not have a reduced effect.

Dangerous interactions

Although many psychoactive substances are safe on their own, they can become dangerous and even life-threatening when combined with other substances. The list below contains some common potentially dangerous combinations, but may not include all of them. Certain combinations may be safe in low doses of each but still increase the potential risk of death. Independent research should always be done to ensure that a combination of two or more substances is safe before consumption.

Legal status

  • International: DMT is classified as a Schedule I drug under the United Nations 1971 Convention on Psychotropic Substances, meaning that international trade in DMT is supposed to be closely monitored and its use is supposed to be restricted to scientific research and medical use. Natural materials containing DMT, including ayahuasca, are not regulated under the 1971 Psychotropic Convention.[17][18]
  • Australia: Between 2011 and 2012, the Australian government was considering changes to the Australian Criminal Code that would classify any plants containing any amount of DMT as “controlled plants”.[19]
  • Brazil – Possession, production and sale is illegal as it is listed on Portaria SVS/MS nº 344.[20] Rules are relaxed regarding religious use.[citation needed]
  • Canada: DMT is a Schedule III drug.[21]
  • Estonia: DMT is a Schedule I drug.[citation needed]
  • Germany: The production, distribution, or possession of DMT is illegal.[citation needed]
  • Latvia: DMT is a Schedule I drug.[22]
  • New Zealand: DMT is classified in New Zealand as a Class A drug under the Misuse of Drugs Act 1975.[23]
  • Norway: DMT is a Schedule I drug.[citation needed]
  • Russia: The production, distribution, or possession of DMT is illegal.[citation needed]
  • United Kingdom: DMT is a Class A drug.[24]
  • United States: DMT is a Schedule I drug.[citation needed] Rules are relaxed regarding religious use, however. In the US, dried root bark of Mimosa hostilis had been considered a “grey area” item for a long time. However, recent efforts by the DEA appear to be focusing on eliminating internet sales of the bark, citing 21 USC § 841, which states that “(IV) any compound, mixture, or preparation which contains any quantity of any of the substances referred to in subclauses (I) through (III)” is also considered an illegal substance. Many USA based vendors have since been stocking Acacia Confusa bark as a result due to its very similar alkaloid content.[citation needed]

What is DMAA?? Check those Preworkouts!!😜😰

What is DMAA?
DMAA (1,3-dimethylamylamine) is an amphetamine derivative that has been widely used in sports supplements sold in the United States. Also known as methylhexanamine or geranium extract, DMAA is often touted as a “natural” stimulant, with many claimed functional uses including a body-building aid, an athletic performance enhancer, and a weight-loss aid. Although DMAA at one time was approved as a drug for nasal decongestion, no medical use of DMAA is recognized today. FDA is not aware of any reliable science indicating that DMAA exists naturally in plants.

DMAA-containing dietary supplements are illegal and their marketing violates the law. Based on the scientific information reviewed by FDA, DMAA is not a dietary ingredient.

Is it safe to consume DMAA?
No, FDA does not have any information to demonstrate that consuming DMAA is safe. FDA is very concerned about DMAA and we advise consumers not to purchase or use any dietary supplement containing DMAA. This substance narrows blood vessels and arteries, which can elevate blood pressure, and may lead to cardiovascular problems such as shortness of breath, arrhythmias, tightening in the chest, and heart attack, as well as seizures and other neurological and psychological conditions. FDA has received 86 reports of adverse events involving products containing DMAA. These events include psychiatric disorders, heart problems, nervous system disorders, and death.

How does FDA regulate ingredients in dietary supplements like DMAA?
The law requires companies to notify FDA when they intend to market a dietary supplement containing a New Dietary Ingredient (NDI) in the United States, if the NDI has not been used in the food supply in the same chemical form.  An NDI is a dietary ingredient that was not marketed in a dietary supplement prior to October 15, 1994. Unlike drugs, dietary supplements do not have pre-market approval for safety or effectiveness. If a safety issue arises post-market, FDA can investigate and take steps to remove products that may be unsafe from the market. However, in order for FDA to ban a compound in a dietary supplement, FDA is required under the statute to undertake a series of lengthy scientific and legal steps. In the interim, FDA can take direct action by issuing warning letters to industry to obtain removal of ingredients in dietary supplements and protect the public from potentially harmful products. FDA can also bring a seizure action to remove products from the market or obtain an injunction against a company to prevent it from manufacturing and distributing illegal products.

What is FDA doing to remove DMAA-containing dietary supplements from the market?
As of April 30, 2013, FDA has sent warning letters to a total of 11 companies advising them that DMAA-containing products marketed as dietary supplements are illegal and must be taken off the market. These 11 companies account for most of the DMAA products sold in the United States. This action was taken to protect consumers and get these products off the shelves as quickly as possible. Ten companies agreed to stop marketing products with DMAA. One company, USPlabs, responded to FDA’s warning by submitting published studies that purport to challenge FDA’s conclusions. After reviewing the studies provided by USPlabs, FDA found the information insufficient to defend the use of DMAA as an ingredient in dietary supplements. On April 10, 2013, FDA notified the company it still needed to take corrective action to remove its products containing DMAA from the market, and that a formal letter would be issued shortly. On April 16, 2013, USPlabs announced its plans to phase out its products containing DMAA. FDA issued its formal response letter on April 18, 2013. In addition, FDA is sending its investigators to the companies that agreed to reformulate or remove DMAA to verify that they have taken the appropriate action. Seven companies have been visited so far and all had either stopped producing products containing DMAA or agreed to recall their product after discussions with FDA.

back to top

Why hasn’t the FDA banned this ingredient, especially after the U.S. military took it off their shelves?
The U.S. military initiated a temporary hold on the sale of DMAA-containing products in military exchanges. The law requires FDA to follow certain lengthy steps before the agency can ban dietary supplements containing DMAA. FDA has been working to remove dietary supplements containing DMAA from the marketplace and we believe this goal will be achieved soon, as the agency has contacted all DMAA supplement manufacturers and distributors of which we are aware, and all of them have taken their DMAA products off the market or have agreed to do so.

How do consumers know if a dietary supplement contains DMAA?
Consumers should look for DMAA listed on the product label. It may also be listed as:

  • 1,3-DMAA
  • 1,3-Dimethylamylamine
  • 1,3-Dimethylpentylamine
  • 2-Amino-4-methylhexane
  • 2-Hexanamine, 4-methyl- (9CI)
  • 4-Methyl-2-hexanamine
  • 4-Methyl-2-hexylamine
  • Dimethylamylamine
  • Geranamine
  • Methylhexanamine
  • Methylhexanenamine
  • InChIKey=YAHRDLICUYEDAU-UHFFFAOYSA-N

Some products also will list Pelargonium graveolens extract or Geranium extract, which may indicate that the product contains DMAA.

What should consumers do if they believe they’ve been harmed by consuming DMAA?
Consumers should contact their health care practitioner if they have suffered or are still being affected by an adverse event. Consumers can report incidents directly to FDA, see Dietary Supplements – Adverse Event Reporting. In addition, consumers can also report these adverse events to the company whose name and contact information is on the product label.

Warning Letters Issued by FDA

Banned Supps (WADA) 😜

This guide is intended to provide practical guidance on how the World Anti-Doping Agency (WADA) Prohibited List may affect an athlete. This guide is not intended to be exhaustive, and should be read in conjunction with the Prohibited List. Ultimately, the athlete is solely responsible for the substances in his or her body. Further information on the topics contained in this guide can be obtained by consulting the references and resources below.

  • The 2017 Prohibited List can be downloaded.
  • Global DRO (GlobalDRO.com) is a searchable online database of medications that details the status of medications available in Australia, Canada, Japan, Switzerland, the United Kingdom, and the United States.
  • Contact USADA’s Drug Reference Department for questions on Therapeutic Use Exemptions or the status of medications via email at AthleteExpress@USADA.org.
  • Determine if you need a TUE

Note: USADA does not provide medical advice or recommendations. An athlete should make all treatment-related decisions with his/her physician, in conjunction with the Prohibited List.

 

Substances Prohibited at All Times (Both In- and Out-of Competition)

 

The first section of the Prohibited List discusses substances and methods that are prohibited at all times, both in-competition and out-of-competition. Any athlete, including elite (Registered Testing Pool) or non-national level (e.g. Masters, juniors, recreational) athletes, can be tested for these substances at any time:

 

S0. Non-Approved Substances

This “open” section addresses the abuse of pharmacological substances for performance enhancement that are not included in other sections of the Prohibited List. It includes substances that are not approved by any governmental regulatory health authority for human therapeutic use (e.g. drugs in pre-clinical or clinical trials, under development, discontinued, or designer drugs, and veterinary drugs). These substances are prohibited at all times (in- and out-of-competition).

 

Advisory:

  • An athlete who wants to participate in drug research trials for drugs that are not yet approved for human use by the FDA should contact AthleteExpress@USADA.org.
  • An athlete participating in research projects (academic or otherwise) involving prohibited substances or methods must contact USADA before participation to determine TUE requirements.

 

S1. Anabolic Agents

This category includes the use of prescription testosterone topical products (such as Androgel) or injections, and the use of any other anabolic substances (such as DHEA) in any form, including dietary supplements. The list of anabolic agents is extensive and even if one is not specifically listed, it is still prohibited if it is a metabolite or has “a similar chemical structure or similar biological effect(s)” to anabolic agent.

Advisory:

  • Clenbuterol is sometimes prescribed outside of the U.S. to treat asthma, and may be used in other countries to “bulk up” livestock. There is no threshold limit for clenbuterol, meaning the detection of any amount of clenbuterol in the sample is a positive test.
  • Clenbuterol may also be found in some products marketed as dietary supplements, and may be marketed as a weight loss drug.
  • SARMS (selective androgen receptor modulators), such as andarine and ostarine, are prohibited under this category.

 

There have been many instances of products marketed as dietary supplements that contain one or more anabolic agents. For a few examples, see the High Risk List on Supplement411.org. The use of any supplement is at an athlete’s own risk.

 

S2. Peptide Hormones, Growth Factors, Related Substances, and Mimetics

This section includes erythropoietin-receptor agonists and anything that stimulates erythropoiesis (the production of red blood cells). Also prohibited are hypoxia-inducible factor (HIF) stabilizers and HIF activators, pituitary gland hormones, and many growth hormones and releasing factors. The list of S2 agents is long and even if a substance is not specifically listed, it is still prohibited if it has “a similar chemical structure or similar biological effect(s).”

Growth hormone (HGH), growth-hormone releasing-hormone, releasing factors, and analogues are prohibited, including insulin-like growth factor-1 (IGF-1), corticotrophins, and a number of other growth factors are all prohibited. The WADA definition of growth factors includes “any other growth factor affecting muscle, tendon, or ligament protein synthesis/degradation, vascularization, energy utilization, regenerative capacity or fiber type switching.”

Chorionic gonadotropin (hCG), luteinizing hormone (LH), and their releasing factors are prohibited for use by men, only. Women prescribed these medications when trying to conceive a child do not need to submit a TUE.

Advisory:

  • All Hypoxia-inducible factor (HIF) stabilizers (e.g. Cobalt, molidustat, roxadustat) and HIF activators (e.g., Argon, Xenon) are prohibited.
  • Vitamin B-12, which contains trace amounts of cobalt, is not prohibited.
  • Non-erythropoietic EPO-receptor agonists are prohibited, and in 2017 Erythropoietic Stimulating Agents were expanded to include GATA Inhibitors (e.g. K-11706) and Transforming Growth Factor-b Inhibitor (e.g. sotatercept, luspatercept).
  • Some products marketed as dietary supplements claim to contain these substances or boost the release of EPO, IGF-1, and other growth hormones. Peptide hormones, their releasing factors, AND other substances with similar chemical structure or biological effect(s) are prohibited. If such products actually contain what they claim, they are prohibited.[1]

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  • Human chorionic gonadotrophin (HCG) is prohibited in sport at all times for males, but is a Food and Drug Administration (FDA) approved prescription medication for the treatment of female infertility. It is not approved as a weight loss drug. The FDA warns consumers to avoid “homeopathic” HCG weight-loss products because they are illegal. These are sold in the form of oral drops, pellets, and sprays and can be found online and in some retail stores.
  • Even though Platelet Rich Plasma (PRP) contains some growth factors, WADA has clarified that PRP is not prohibited. Be aware, though, that individual growth factors are still prohibited when given separately as purified substances as described in S.2.5.
  • Stem cell injections may or may not be prohibited, which depends on how the product is manipulated or modified for use. Contact AthleteExpress@USADA.org for specific guidance.
  • According to a WADA statement, colostrum is not prohibited, per se; however, it contains certain quantities of IGF-1 and other growth factors which are prohibited and can influence the outcome of anti-doping tests. Therefore, WADA recommends against the ingestion of such products.

 

S3. Beta-2 Agonists

All beta-2 agonists are prohibited at all times by any route of administration (oral, inhaled, injected), except for:

  • Inhaled Albuterol (also called salbutamol) in dosages under 1600 micrograms (mcg) in any 24-hour period (not to exceed 800 mcg in 12 hours)
  • Inhaled Formoterol in dosages less than 54 mcg in any 24-hour period
  • Inhaled Salmeterol in dosages not to exceed 200 mcg in any 24-hour period

If you use more than these amounts of albuterol, formoterol, or salmeterol, are taking a diuretic medication in conjunction with these inhalers, or using an inhaler with another beta-2 agonist (like pirbuterol, indacaterol, procaterol, reproterol, terbutaline, fenoterol, olodaterol, vilanterol or any other beta-2 agonist), you are required to submit a TUE for use. The table below is a guide to determine the dosage of albuterol, formoterol and salmeterol inhaled beta-agonists that may be used in sport without a TUE. However, an athlete should examine his/her inhaler closely to determine the exact dose delivered.

 

Examples of Inhaler Brands and Strengths

Recommended Dosing by Manufacturer

WADA MAXIMUM doses per 24 hours

Advair Diskus 100/50, 250/50, or 500/50
Each has salmeterol 50mcg per puff

1 puff twice each day
(=100 mcg salmeterol)

Do not take more than Salmeterol 200 mcg in 24 hours

Advair HFA 45/21, 115/21, or 230/21
Each has salmeterol 21 mcg per puff

2 puffs twice each day
(=84 mcg salmeterol)

Do not take more than Salmeterol 200 mcg in 24 hours

Albuterol 108 mcg per puff
(dosing 90 mcg of salbutamol)
ProAir, Proventil, Ventolin

1-2 puffs every 4 hours as needed for wheezing

Do not take more than 8 puffs in 12 hours

Bevespi Aerosphere 4.8/9

2 puffs twice each day
(=9.2 mcg formoterol)
Do not take more than 11 puffs a day

Dulera 100/5 or 200/5
Each has formoterol 5 mcg per puff

2 puffs twice each day
(=20 mcg formoterol)

Do not take more than 10 puffs a day

Foradil Aerolizer 12 mcg per puff

1 capsule inhaled every 12 hours
(=24 mcg formoterol)

Do not take more than 4 puffs a day

Serevent Diskus 50 mcg per puff

1 puff twice each day
(=100 mcg salmeterol)

 Do not take more than Salmeterol 200 mcg in 24 hours

Symbicort 80 /4.5 or 160 /4.5
Each has formoterol 4.5 mcg per puff
2 puffs twice each day
(=18 mcg formoterol)
Do not take more than 12 puffs a day

Advisory:

  • Use of oral beta-2 agonists are prohibited even if the athlete has a TUE for the same inhaled beta-2 agonist. If the athlete’s doctor prescribes an oral beta-2 agonist, the athlete should submit an application for a TUE.
  • Prohibited Inhalers require a TUE, such as Anoro Ellipta, Breo Ellipta, Stiolto Respimat, Utibron, indacaterol, olodaterol, procaterol, reproterol, terbutaline, vilanterol
  • Use of multiple inhaled beta-agonists is not prohibited, but was added to the Monitoring List.
  • Some dietary supplements claim to contain ingredients that have beta-2 agonist activity such as higenamine (also known as norcoclaurine). Higenamine is prohibited at all times as a beta-2 agonist.higenamine-supp-label

 

  • If you use a beta-2 agonist inhaler and a diuretic, you need a TUE for BOTH medications, even if you are using a permitted inhaled beta-2 agonist under the WADA threshold.
  • The presence in urine of salbutamol in excess of 1000 ng/mL or formoterol in excess of 40 ng/mL is presumed not to be an intended therapeutic use of the substance and will be considered as an Adverse Analytical Finding (AAF).
  • Some inhalers have more than one active ingredient. Make sure to check all active ingredients on GlobalDRO.com.

 

S4. Hormone and Metabolic Modulators

Hormones and metabolic modulators are a group of substances that are not hormones themselves. Instead they modify how hormones work either by blocking the action a hormone or by increasing the activity of a hormone.  There are many substances that fall into the category of “Hormone or Metabolic Modulator”. Some of these substances are discussed here.

Aromatase inhibitors are hormone modulators that bind to aromatase and stop it from working. The aromatase enzyme is responsible for synthesizing estrogen in the body by turning testosterone and other androgens into estrogen. Aromatase inhibitors like exemestane, anastrozole and letrozole are FDA-approved drugs that are used to treat some kinds of breast cancer. Some cancers grow faster in the presence of estrogen. By blocking the synthesis of estrogen there is less estrogen circulating in the body. Likewise, selective estrogen receptor modulators (SERMs) (like tamoxifen and raloxifene) bind to estrogen receptors in breast tissue and therefore block the effect of estrogen. Athletes in strength sports, or athletes who are trying to prevent the effects of estrogen on their bodies might abuse aromatase inhibitors or SERMs.

Another group of metabolic modulators are agents that affect myostatin.  Myostatin is a growth factor that controls and limits the amount of muscle a person makes. Myostatin inhibitors (substances that block the action of myostatin) can cause an increase in muscle mass.  There are animals that have a genetic mutation where they do not produce very much myostatin. To see images of these animals and the effect of reduced myostatin, search for “Belgian Blue Cattle” and “Myostatin”. A number of experimental compounds that modify myostatin are being evaluated to treat muscle wasting diseases.  There are currently no FDA approved medications that modulate myostatin.

Other metabolic modulators include substances that affect how the body processes energy. For example, substance that mimic the effects of insulin can change how the body processes sugar, causing you to burn more or less.  Insulin is also anabolic (muscle building) so substances that mimic the effects of insulin could build muscle.

Substance that activate AMP-activated protein kinases, for example AICAR, show promise in protecting cells against oxidative damage during stroke or in certain diseases like diabetes. Similarly, substances that activate peroxisome proliferator activated receptor modulators (PPARs) like GW1516, GW0742, L1655041 are experimental drugs under study to treat diabetes, lipid disorders and metabolic syndrome. AMP-activated protein kinases and PPARs are experimental drugs with no approved medical use at this time. However, these substances are synthesized by clandestine laboratories around the world and are readily available on the internet.

Meldonium, which was added to the prohibited list in 2016, is a drug registered for use in some Baltic countries and is readily available on the internet.  It is not approved for use in the US, Canada, or Western Europe.  There are not many clinical studies available in peer reviewed journals to really understand the action of meldonium although it appears to have a protective effect on heart cells, especially when compromised with low oxygen conditions, such as the medical condition of angina. Meldonium has non-linear pharmacokinetics so it is especially difficult to estimate clearance times for this substance.

All of the substances discussed in this section are prohibited in sport at all times.

In short, the following are prohibited:

  • Aromatase inhibitors
  • Selective estrogen receptor modulators (SERMs) and other substances that block estrogen effects (anti-estrogens)
  • Agents modifying myostatin function(s)
  • Metabolic modulators, including insulin and insulin-mimetics
  • Activators of the AMP-activated protein kinase, Meldonium (Mildronate)
  • Trimetazidine

Please consult the Prohibited List for examples of substances in each of the above classes.

Advisory:

  • An athlete diagnosed with insulin-dependent diabetes is required to submit a TUE for use of insulin.
  • Telmisartan has been added to the WADA Monitoring Program, but is not prohibited.

 

 

S5. Diuretics and Masking Agents

Masking agents are prohibited, including diuretics (water pills) and plasma expanders, which increase blood volume.

Advisory:

  • WADA has clarified that drospirenone, pamabram, carbonic anhydrase inhibitors used as eye drops (dorzolamide and brinzolamide), and the local administration of Felypressin for dental anesthesia are permitted.
  • The use of any amount of a threshold substance (i.e., albuterol, formoterol, cathine, ephedrine, methylephedrine and pseudoephedrine) at the same time as a diuretic or other masking agent requires a TUE for the threshold substance AND the diuretic/masking agent. This means two TUEs are needed. If there is any reason you need to be on a diuretic and asthma medication at the same time, for instance, please email AthleteExpress@usada.org.
  • Some dietary supplements that claim to be “natural” water pills may contain prescription diuretics not listed on the label. The use of any dietary supplement is at the athlete’s own risk. For a few examples, see the High Risk List on Supplement411.org.
  • Glycerol is prohibited as a plasma expander which requires the ingestion of quantities far beyond those commonly found in foodstuffs and toiletries. Standard daily use of toiletries and processed foods will not cause a competitor to test positive for this prohibited substance.

 

Methods Prohibited At All Times (Both In- and Out-of- Competition)

M1. Manipulation of Blood and Blood Components

Blood doping, the use of red blood cells from any source, or otherwise artificially enhancing the uptake, transport, or delivery of oxygen, is prohibited. Any type of intravenous (IV) manipulation of the blood or blood components by physical or chemical means is prohibited.

 

Advisory:

  • Supplemental oxygen (e.g. breathing an oxygen rich air mixture temporarily, such as on the side-lines) administered by inhalation is not prohibited.
  • Use of hyperbaric or hypobaric tents is permitted. Similarly, training or sleeping/living at high altitudes is permitted.
  • Hemodialysis is prohibited under M1.1, as blood is taken out from the patient (in a closed circuit) and reintroduced into the circulatory system. An athlete needing this treatment requires a TUE.
  • Whole blood donation, when no blood is returned to the donor, is not prohibited.
  • Donating plasma or plasmapheresis (when the rest of the blood components are reinjected into the donor) is prohibited for the donor because the donor’s own red blood cells and other blood components are being reintroduced into the circulatory system after the plasma has been separated. Please see the WADA FAQ.
  • Intravenous laser therapy, such as ozone and/or ultraviolet light therapies which includes the removal, treatment, and manipulation of blood or blood components are prohibited.

 

M2. Chemical and Physical Manipulation

Tampering or attempting to tamper with a collected sample in order to affect its integrity or validity is prohibited. This includes providing synthetic urine or urine that is not the athlete’s own, or any modification of the urine sample, such as addition of proteases.

Intravenous infusions and intravenous injections of any substance containing more than 50 milliliters given in less than a six-hour period are prohibited, unless it is administered legitimately during the course of hospital admissions, surgical procedures, or clinical investigations.

 

Advisory:

  • Even if the substance delivered by intravenous infusion is permitted (e.g., iron), the method is prohibited if given outside of a hospital/surgery/ admission/surgery/clinical investigation because it is diluted in more than 50 milliliters of fluid. Intravenous injections of less than 50mL are only prohibited if the substance is included on the prohibited list.
  • In an emergency, an athlete should always receive appropriate medical care. If the emergency medical providers need to insert an intravenous line or provide medications as a life-saving procedure, request copies of all the clinical documentation for the diagnosis, decision to start the IV, and the amount of fluid administered. Once the emergency is over, the athlete should contact USADA to determine if a TUE is required.
  • The use of IV infusions in place of or in addition to oral fluid intake, such as to relieve severe dehydration caused by gastrointestinal distress during travel, without hospitalization, is prohibited and requires a TUE. Also, WADA clarified “the use of IV fluid replacement following exercise to correct mild re-hydration is not clinically indicated nor substantiated by the medical literature.”

 

M3. Gene Doping

The transfer of polymers of nucleic acids or nucleic acid analogues, or the use of normal or genetically-modified cells is prohibited.

Substances and Methods Prohibited In-Competition Only

This section focuses on substances that are prohibited in-competition, only. These substances are not tested for out-of-competition.

It is very important to understand the definition of “in-competition.” Knowing how the sporting event defines the “in-competition” period is the athlete’s responsibility. Each International Federation (IF) may have a different definition and it may vary by event. For some events, this period may be defined as 12 hours before the start of the competition and different rules may apply to multi-day events (e.g, the Olympic Games).

An athlete must ensure that all substances prohibited in-competition have been completely cleared from his/her body before an event period. This means the substances are not detectable in the athlete’s sample. It is not possible for USADA to list specific stop times for substances prohibited in-competition. If the on-going or daily use of a substance is needed, or the medication cannot be stopped before an event long enough to allow it to clear from the body, an application for a Therapeutic Use Exemption (TUE) should be submitted.

 

S6. Stimulants

All stimulants and their optical isomers are prohibited, except for clonidine, imidazole derivatives for topical/ophthalmic use, and stimulants on the 2017 Monitoring Program (i.e., buproprion, caffeine, nicotine, phenylephrine, phenylpropanolamine, pipradrol, and synephrine).

 

Advisory:

  • WADA has clarified that clonidine is not prohibited.
  • An athlete who has been diagnosed with Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD) and is taking stimulants should apply for a TUE for their medication. All elite-level athletes as defined on the “Determine if you need a TUE” page, should apply for a TUE. An athlete who is not competing does not need to obtain a TUE in order to use these medications.
  • An athlete should obtain a TUE if diagnosed with Parkinson’s Disease and taking selegiline, or diagnosed with narcolepsy and taking modafinil or armodafinil.
  • Nicotine and caffeine are permitted, but they are part of the WADA monitoring program.
  • Pseudoephedrine is an ingredient in many cold and flu medications.
    • WADA advises athletes to discontinue taking pseudoephedrine AT LEAST 24 HOURS prior to the time defined as “in-competition” when taking a dose of 240mg or less per day. Be advised, in some cases this may not be enough time for the medication to clear the body, such as a slow-metabolizer or because of drug interactions. USADA recommends avoiding pseudoephedrine-containing cold and flu products for several days in advance of competition.
  • If you need to be on a diuretic for any reason, and you also need to use a medication that has pseudoephedrine in it, you need a Therapeutic Use Exemption for BOTH the diuretic and pseudoephedrine.
  • Levmetamfetamine (nasal inhaler) and racepinephrine (nebulizer) are prohibited in-competition but are also found in some cold and flu products. Read the label of your cold and flu, or allergy product, carefully and check the active ingredients on GlobalDRO.com.

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  • Common cough, cold and flu active ingredients are in the label below.

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S7. Narcotics

Certain narcotics are prohibited in-competition: buprenorphine, dextromoramide, diamorphine (heroin), fentanyl and its derivatives, hydromorphone, methadone, morphine, nicomorphine, oxycodone, oxymorphone, pentazocine, and pethidine (meperidine). Use of these narcotics in-competition requires an approved TUE.

 

Advisory:

  • Opium, the latex extract of the poppy plant, contains morphine and therefore it is also prohibited. Poppy seeds can contain trace amounts of opium.
  • Mitrgynine (Kratom) and tramadol are in the Monitoring Program. They are not prohibited.
  • Codeine is not prohibited but has been added to the 2017 Monitoring Program.

 

S8. Cannabinoids

Natural or synthetic tetrahydrocannabinol (THC) and THC-like cannabinoids or cannabimimetics (e.g. hashish, marijuana, Spice, JWH018, HU-210) are prohibited.

 

Advisory:

  • An athlete should be aware that cannabinoids may be retained in fat tissue following frequent, repeated use and may be detected weeks after use. Also, significant weight loss over a short-period of time has caused cannabinoid metabolites stored in fat to be released in detectable levels, even if not used recently. USADA strongly advises athletes not to use cannabinoids at any time.
  • An athlete who chooses to consume hemp products may be at risk for a positive anti-doping test, even though many of these products claim not to contain THC.
  • While the use of medical marijuana may be decriminalized in some states, it is still illegal under federal law. Currently, USADA will only consider TUE applications for legal, FDA-approved uses of THC, with prescription products (e.g. Dronabinol, Marinol).
  • Cannabidiol, or CBD oil, is prohibited as a cannabinoid.

 

S9. Glucocorticoids

The systemic use of glucocorticoids (often called “steroids” by prescribers) is prohibited in-competition. WADA defines systematic routes as oral intake (taken by mouth and swallowed, e.g. Medrol Dose Pak), a systemic injection into the vein (IV) or muscle (IM), or rectal use (e.g. suppositories or creams).

 

Advisory:

  • An athlete who is prescribed oral, rectal, IV, or IM glucocorticoids may take these medications out-of-competition without submitting a TUE, as long as the prohibited substance has cleared their system prior to the time defined as “in-competition.” If an athlete needs to use these routes of administration shortly before or during competition, he or she must obtain a TUE.
  • The time it takes for glucocorticoids to clear from an athlete’s body depends on many variables and cannot be predicted by USADA. An athlete’s doctor or pharmacist can help determine the medication’s clearance time. Read the Clearance Time FAQ on the TUE page.
  • Injections of glucocorticoids around tendons, into joints, and epidural spaces (into the spine) are not prohibited, but an injection into a muscle is prohibited.
  • Inhalation of glucocorticoids (e.g. for asthma) is permitted.
  • Topical use of glucocorticoids (e.g., anti-rash cream, hemorrhoid creams used on the surface, etc.) are not prohibited. Be aware, however, that some hemorrhoid suppositories or inserted rectal creams contain glucocorticoids and are prohibited in-competition.

Substances Prohibited in Particular Sports

Some sports have additional rules about the use of substances such as alcohol or beta-blockers. If you participate in any of the following sports please consult the current WADA Prohibited List or Global Drug Reference Online (GlobalDRO.com) before using alcohol or beta-blockers.

P1. Alcohol

Alcohol is prohibited In-competition only at a blood alcohol level over 0.1 g/L for the following sports: Air Sports, Archery, Automobile, Powerboating

In 2016, WADA removed motorcycling (FIM) from the list. WADA understands that FIM will address the use of alcohol using their own regulations.

P2. Beta-Blockers

Beta-blockers (e.g. atenolol, bisoprolol, carvedilol, esmolol, labetolol, metoprolol, propranolol, sotalol, and timolol) are prohibited for the following sports:

  • Prohibited at all times (In-competition and Out-of-Competition): Archery, Shooting
  • Prohibited In-Competition only: Automobile, Billards, Darts, Gold, Skiing/Snowboarding in ski jumping, freestyle aerials/halfpipe and snowboard halfpipe/big air, and Underwater Sports as specified.

 

[1] Many products marketed as dietary supplements make false, misleading, or deceptive claims about what they actually do. Thus, such products may not actually boost EPO or IGF-1 or growth hormone at all; if they do, they are prohibited. USADA considers such products to be high risk for causing positive anti-doping tests or health problems. The use of any dietary supplement is at an athlete’s own risk.

Have to Read This One…🤔😷

A man from China had nearly 30 pounds of feces removed from his body after it became impacted in his colon and made it difficult for him to breath. The severe abdominal pain and colon problems were the result of a condition known as Hirschsprung’s disease.

Zhou Hai, 22, had a section of his colon weighing 28.6 pounds and measuring 30 inches removed, AsiaOnereported. Hai went to the hospital complaining of abdominal pain so bad that it made it difficult to breath. A CT scan revealed that his colon had become distended and was storing an amount of feces so large that it “looked like [it] could explode at any time,” explained Dr. Yin Lu, who operated on the young man, The Mirrorreported. The three-hour operation took place at the 10th People’s Hospital of Shanghai in eastern China.

Read: British Bodybuilder’s Colostomy Bag Brings Him No Shame

According to the Mayo Clinic, Hirschsprung’s disease is a condition that affects the large intestines and makes it difficult for the individual to have a bowel movement. The condition is a result of missing nerve cells in the muscles of the colon. Without these cells, it is extremely difficult to push waste through the intestines. The condition is present from birth and usually noticed soon after a child is born. However, if left untreated, as in Hai’s cause, it can cause a megacolon, or abnormal dilation of the colon.

The signs and symptoms of Hirschsprung’s disease include a swollen belly, vomiting, constipation or gas, and diarrhea, The Mayo Clinic reported. The true cause of the condition is not clear, although it seems to be hereditary and in some cases may be due to a genetic mutation. The condition is also more common in males, and in those with other inherited conditions such as Down’s syndrome and congenital heart disease.

The condition is usually treated with surgery early in life to bypass the part of the colon that has no nerve cells. The abnormal part of the colon is removed and the healthy part is attached to an opening the doctors will make in the child’s abdomen, called a stoma. This is usually temporary, and allows time for the lower colon to heal before it is reconnected.

AsiaOne reported that Hai’s condition went untreated for the majority of his life. He reportedly relied on laxatives to help him use the bathroom, but still a large amount of feces built up in his intestines over the course of many years. This is extremely dangerous, as feces is made up of poisons and toxins meant to be eliminated from your body.

 

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Benefits of Taurine..

By Ian Macleavy

The Japanese have a life expectancy that is among the highest in the world. In fact, Okinawa, Japan’s famous “Island of Longevity,” likely has the world’s highest percentage of people over 100 years old.1

Undoubtedly, there are many factors that play into the life spans of the longest-living populations, but evidence shows that they all have one thing in common: high dietary intake of an amino acid called taurine.2

The connection between taurine and a long life is so strong that researchers have dubbed taurine, “The nutritional factor for the longevity of the Japanese.”3

Taurine promotes cardiovascular health, insulin sensitivity, electrolyte balance, hearing function, and immune modulation. In animal research, taurine protected against heart failure, reducing mortality by nearly 80%.4

Its benefits are so broad and extensive that scientists have described taurine as “a wonder molecule.”5

Taurine is found abundantly in healthy bodies.6 However, certain diets, particularly vegetarian or vegan diets, lack adequate amounts of taurine.7,8 Disease states—including liver, kidney, or heart failure, diabetes, and cancer—can all cause a deficiency in taurine.9-11 And aging bodies often cannot internally produce an optimal amount of taurine, making supplementation vital.12

That’s why those interested in longevity should consider this vital and super low-cost nutrient. In this article, you’ll learn how boosting taurine levels can contribute to better cardiovascular, metabolic, and neurologic health.

Why We Need Supplemental Taurine

In the enthusiasm to investigate new longevity compounds, sometimes the importance of venerable ones that have been around for decades is forgotten. Such is the case of taurine. Foundation members used to get taurine as part of multi-nutrient formula, but this product is not as popular as it once was.

A study released in November 2012 made the bold statement that taurine is one of the most essential substances in the body. The authors wrote:8 “Considering its broad distribution, its many cytoprotective attributes, and its functional significance in cell development, nutrition, and survival, taurine is undoubtedly one of the most essential substances in the body.”

Although it’s possible for your body to produce taurine on its own, you still need to obtain taurine through diet and supplementation in order to achieve optimal amounts of this essential nutrient.8,11,13

Because of taurine’s essential role in the body, supplementing with taurine can provide numerous health benefits, including restoring insulin sensitivity, mitigating diabetic complications, reversing cardiovascular disease factors, preventing and treating fatty liver disease, alleviating seizures, reversing tinnitus, and more.

Taurine Prevents Obesity

Taurine Prevents Obesity

One of the ways taurine can help improve overall health is by fighting obesity. Obesity impacts every area of the body, especially because of the inflammation-generating abdominal fat stores. Human studies show that 3 grams per day of taurine for 7 weeks reduced body weight significantly in a group of overweight or obese (but not-yet-diabetic) adults.14 Subjects saw significant declines in their serum triglycerides and “atherogenic index,” a ratio of multiple cholesterol components that predicts atherosclerosis risk.

Various animal studies support the anti-obesity and lipid-lowering capabilities of taurine, both alone and combined with other natural products.15,16 These studies highlight taurine’s ability to improve glucose tolerance in obese animals, an important benefit given how many overweight people go on to develop diabetes.17,18

Perhaps most alarming, animal research reveals that obesity itself causes a decline in plasma taurine levels, which, in a vicious cycle, further promotes obesity.19 The observed decline in taurine levels was seen in mouse models of both genetic obesity and diet-induced obesity. Fortunately, in the same study, taurine supplementation interrupted the cycle, helping to prevent obesity and its consequences.19

Taurine Promotes Glucose Control—and Treats Diabetes

It is a known fact that taurine concentrations are lower among diabetics than they are in healthy individuals.20 Given the above information about low taurine levels promoting obesity, it is clear that the low levels of taurine only serve to promote the interdependence of diabetes and obesity.20 Fortunately, human studies have shown that supplementing with just 1.5 grams of taurine a day can restore taurine levels to those in healthy control subjects, and additional animal research has shown that taurine supplementation can help prevent the onset of type II diabetes.20,21

Normal taurine concentrations are essential in controlling diabetes and the impact of its consequences. Animal studies have found that having adequate taurine concentrations helps control diabetes by reducing blood glucose and restoring insulin sensitivity.22 But it doesn’t stop there. Taurine helps prevent—and even reverse—many of the consequences associated with the disease.

For example, in adult diabetics, supplementation with 1.5 grams of taurine daily for just 14 days can reverse diabetes-induced abnormalities in arterial stiffness and in the ability of the vasculature to respond to changes in blood flow or pressure.23 This can be critical to the longevity of diabetics, since these types of abnormalities are to blame for diabetics’ increased risk of dying from cardiovascular disease. In addition, studies in diabetic rats show that taurine helps protect heart function and helps prevent heart muscle damage, due in part to the ability of taurine to increase glucose transport from blood into energy-hungry heart muscle cells.24,25 In the process of increasing glucose transport into energy producing cells, blood glucose levels are lowered.

Additional animal and cell culture studies have revealed that taurine supplementation is effective against diabetic complications as well. Taurine supports nerve fiber integrity, potentially slowing or reversing painful diabetic neuropathy.26-29 And in the retina, another target of destructive elevated blood glucose, taurine fights glucose-induced oxidant stress and preserves the health of light-sensing cells in diabetic retinopathy.30-32 Kidney damage, another consequence of diabetes, can be minimized with taurine supplementation in diabetic animals.33

WHAT YOU NEED TO KNOW
Taurine: Bountiful Benefits

Taurine: Bountiful Benefits

  • Taurine is the most abundant amino acid you’ve never heard of; it is found throughout the body, but especially in tissues containing excitable cells, like nerves and heart muscle.
  • Strong epidemiological evidence suggests that certain groups with the longest life spans consume higher amounts of taurine than those of us in the rest of the world.
  • Taurine supplementation can prevent diabetes and obesity in animal models, and can mitigate the effects of both conditions in humans.
  • Taurine supplementation strengthens heart muscle cells, extends their life spans, and protects them from damage, while reducing many of the factors that produce atherosclerosis and its deadly consequences.
  • Taurine protects retinal and inner ear cells from damage, normalizing the flow of calcium ions they require for proper function.
  • Evidence is growing for taurine’s role in preventing epileptic seizures and liver disease, two conditions that can be attributed to toxic effects on delicate tissue.
  • If you are interested in a longer, healthier, and more active life, consider supplementing with taurine.

Taurine Reverses Cardiovascular Disease Factors

Taurine has powerful effects on the heart and blood vessels. People with higher levels of taurine have significantly lower rates of dying from coronary heart disease.1,34 Additionally, they have lower body mass index, lower blood pressure, and lower levels of dangerous lipids. Many different mechanisms account for these powerful effects on the heart and blood vessels.

In animal models of hypertension, taurine supplementation lowers blood pressure by reducing the resistance to blood flow in the blood vessel walls and by minimizing nerve impulses in the brain that drive blood pressure up.35,36Oral taurine supplementation has been found to reduce the arterial thickening and stiffness characteristic of atherosclerosis, to restore arteries’ responses to beneficial endothelial nitric oxide, and to reduce inflammation (a direct contributor to cardiovascular disease).34,35

A study of patients needing coronary bypass surgery showed that consuming a liquid drink containing 3 grams of taurine, combined with 3 grams carnitine, 150 mg CoQ10, and basic multivitamin nutrients, reduced left-sided ventricular volume during the heart’s resting phase (diastole).37 This is important since an increased left-ventricular diastolic volume is the single greatest predictor of death in patients requiring bypass or stent placements. This makes taurine a vital component of such patients’ diets.

ENHANCE YOUR EXERCISE PERFORMANCE
Enhance Your Exercise Performance

Want a better workout? Try taking taurine supplements! Trained athletes who supplement with taurine experience better exercise performance, and cyclists ride longer distances with less fatigue.38,39

There’s good reason for these positive effects: Taurine helps muscles work harder, longer, and safer.

Harder. Taurine increases muscle contractility (the force with which muscle cells pull together) in both skeletal and cardiac muscle.40,41 That means more powerful workouts as muscle works harder.

Longer. Taurine helps exercising muscle rid itself of lactic acid.42,43 Lactic acid is what causes the feelings of pain and soreness and is what limits how much a muscle can continue to work. By cleaning up lactic acid, taurine helps muscles work longer.38,43

Safer. Working muscles generate oxidant stress and damage DNA, leading to the potential for muscle damage and poorer performance. Taurine protects muscles from such damage, so muscle works more safely.38,44

Taurine Provides Potent Retina Protection

Taurine is especially vital when it comes to eye health. Adequate levels can help prevent age-related vision loss; conversely, a deficiency can lead to troubling vision problems. Age-related vision loss has many different causes, but near the top is the impact of oxidative stress on light-sensing cells in the retina. Such damage leads to age-related macular degeneration and other forms of retinal disease.45

While taurine is found in very high concentrations in the retina, it declines significantly with age.46-48 Additionally, the taurine found in the retina fights oxidative stress, especially in diabetes, and helps restore deficient levels of nerve growth factor, required for maintaining retinal health.46,30,31

When taurine levels are deficient, a variety of vision problems can occur including retinal ganglion cell degeneration,49 and in children, retinal dysfunction;7 taurine supplementation has been shown to ameliorate diabetic retinopathy.30 Evidence is strong that taurine is vital in maintaining optimal retinal function.50

Certain drugs deplete the body of taurine, which can induce retinal damage.48,49,51 These include frequently used chemotherapy drugs such as cyclophosphamide (Cytoxan®) and busultan (Bulsufex®) as well as the anti-epileptic drug vigabatrin (Sabril®). Radiation therapy has also been shown to deplete the body of taurine.51 Fortunately, supplementation can restore taurine levels to normal and protect the retina in such cases.32,46,47,52

Taurine Helps Reverse Tinnitus

Taurine plays a vital role in hearing. In fact, studies have found that in some cases, taurine can reverse the biochemical processes behind hearing loss.53,54 Other studies have demonstrated that taurine can almost completely eliminate the ringing in the ears associated with tinnitus.55

Much of the damage to hearing occurs not in the mechanical parts of the ear, but rather in the nerve cells that convert sound waves into the electrical energy that is perceived in our brains. Like other nerve cells, these so-called “hair cells” depend on the flow of calcium ions into and out of the cell. Taurine helps restore and control normal calcium ion flow in auditory cells.53,56

Taurine improves the hearing ability in animals exposed to drugs like the antibiotic gentamicin, which is notoriously toxic to hearing.54 And in a boon for the 17% of us troubled by chronic tinnitus (ringing in the ears), taurine may be helpful in quieting the noise.57 Animal studies using human equivalent doses of 700 mg to 3.2 grams per day of taurine over the course of several weeks demonstrate near-complete resolution of tinnitus with taurine supplementation (the animals had been trained in tasks that are sensitive to distraction by tinnitus).55 And a human pilot study has shown encouraging results, with 12% of people responding to taurine supplementation.58

Solution for Seizures

While there are many types and many causes of epilepsy (seizures), a disruption in the function of excitable brain tissue underlies all of them. One of taurine’s major roles in mammalian biology is the regulation of such excitable tissues, making taurine of natural interest to scientists and clinicians who study epilepsy.59

Animal studies reveal that taurine depletion makes seizures more likely, while supplementation with taurine is capable of preventing seizures induced by a number of drugs and chemical toxins.59-61 Taurine appears to work by increasing the levels of glutamic acid decarboxylase (GAD), the enzyme responsible for the production of the neurotransmitter GABA, as well as by binding to so-called GABA receptors in brain cells, calming them and reducing their likelihood of participating in the random, uncoordinated electrical firing that produces an epileptic seizure.59,61

TAURINE AND ENERGY DRINKS
Taurine and Energy Drinks

Energy drinks such as Red Bull, Monster, and others have been getting a lot of press recently, most of it unfavorable. There’s concern that the drink’s biggest consumers, adolescents and young adults, are at risk for sudden death and seizures following high consumption.

Because taurine is a major ingredient in these drinks, some readers may be concerned that taurine might be contributing to these ill effects.

The good news (for taurine) is that there’s no evidence at all for taurine’s involvement in any adverse outcome of consuming energy drinks. It has been well-established that the high caffeine content in energy drinks (ranging from 80 milligrams, the amount in a strong cup of coffee, to 300 milligrams per serving) is to blame for the health problems associated with the drink. Side effects of energy drinks are the same as those of caffeine intoxication, and include nervousness, jitteriness, seizures, cardiac arrhythmias, and (rarely) death.66

It’s probably best to avoid energy drinks entirely and instead focus on getting your energy from safe, natural sources. Taurine alone offers many of the advantages attributed to energy drinks, such as improved exercise performance.

Taurine Prevents and Treats Liver Disease

Increasing evidence suggests that taurine may help treat the most common cause of liver disease in the US, non-alcoholic fatty liver disease (or NAFLD). Non-alcoholic fatty liver disease occurs when too much fat accumulates in the liver, and it can be caused by insulin resistance and metabolic syndrome. Over time, the end result is the loss of liver function, leading to liver cirrhosis.

The human liver is our master detoxifying organ, screening our blood flow many times over each day for substances that can damage our bodies. Taurine is an integral part of the liver’s self-protective mechanisms.

Studies show that taurine defends liver cells against free radicals and toxins, helping to reduce the severity of oxidative stress-induced liver injury.62 This is vitally important in alcoholic and non-alcoholic fatty liver diseases, both of which can progress to cirrhosis and liver failure.63,64

Human studies reveal the impact of taurine on liver disease. When 24 patients with chronic hepatitis took 2 grams of taurine 3 times daily for 3 months, serum markers of liver damage, as well as markers of oxidative stress, decreased significantly, as did their elevated levels of cholesterol and triglycerides.65

DIETARY SOURCES OF TAURINE
Dietary Sources of Taurine

Taurine occurs naturally in food, especially in seafood and meat.76 The amount consumed in most societies, however, is quite low. The mean daily intake from omnivore diets was determined to be around 58 mg (range of 9 to 372 mg).77 In another study, taurine intake was estimated to be generally less than 200 mg a day, even in individuals eating a high-meat diet.78 According to another study, taurine consumption was estimated to vary between 40 and 400 mg a day.77

Successful clinical studies with taurine have used daily doses of 1,500 to 3,000mg.14,20,23,37,65 It is challenging to obtain this amount of taurine from traditional dietary sources.

Taurine is made by the body from the metabolism of the amino acid cysteine.9,10 Aging can reduce the amount of taurine made from cysteine, thus making taurine supplementation desirable in maturing individuals.12,51,79

Taurine is not abundant in most plant foods.7 On average, non-vegetarians typically eat around 43-76 mg of taurine per day.77 Vegans have been shown to have lower blood levels of taurine.80

Summary

Taurine is the most abundant amino acid you’ve never heard of. Strong evidence suggests that groups with the longest life spans consume higher amounts of taurine than those of us in the rest of the world. High intakes of taurine could be the underlying factor in the world’s longest-living populations—and for good reason.

Taurine supplementation can mitigate the damaging effects of fat, glucose, and excess insulin. Taurine strengthens and protects heart muscle cells and the system of blood vessels that supplies blood throughout the body, helping to protect against atherosclerosis, heart attacks, and strokes.

And taurine protects vision and hearing. It can prevent and alleviate seizures, and it has been shown to treat the most common cause of liver disease in the United States.

With epidemiological evidence that it contributes to the longevity of famously long-lived groups, taurine belongs on the short-list of supplements necessary for maintaining optimal health in the face of aging.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.

TAURINE: ONE OF THE MOST ESSENTIAL SUBSTANCES IN THE BODY!
  • It increases the action of insulin, improving glucose tolerance, and acting as an antioxidant.67
  • It is vital for the proper function of the minerals potassium, calcium, magnesium, and sodium.68
  • Taurine regulates heart rhythm, cardiac contraction, blood pressure, and platelet aggregation,69,70 and regulates the excitability of neurons.69
  • It detoxifies liver cells of various toxins.71-74
  • It helps form bile acids and maintains cell membrane stability.9
  • It reduces the synthesis of lipids and cholesterol that are associated with atherosclerosis.75