Natural Dietary Supplements

Inner Peace Formula

The formula product of nutrition blends-inner-peace is well known, it is a remedy for plants used for a wide range of problems. In oncology, it is especially recommended as a topical treatment to prevent or treat skin irritations after radiotherapy. The product is a succulent plant with many amazing uses, it is then applied topically to the skin and hair or ingested. The product can also be combined with other natural ingredients to be part of your health or beauty routine. The product is scientifically proven the ingredients used in the Inner Peace formula have been specifically chosen because of scientific studies proving that they have the power to significantly improve the health and well-being of the individual. For decades, the soothing nature of nutrition blends-inner-peace formula has been known and respected by the people who believe in naturopathy. The product has compounds such as ashwagandha, magnolia, hops,l-Theanine, Passion Flower, Panax Ginseng, Hawthorn Berry that are extremely beneficial for human health. It has 18 amino acids that work in association with other compounds of the human body to deliver numerous health benefits. It has been reported extensively that Panax Ginseng supports the immune system by enhancing the body's resistance to illness and microbial attacks. More here...

Inner Peace Formula Summary


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Herbs and Other Dietary Supplements

In 1994, in response to pressure from both consumers and the supplement industry, the U.S. Congress passed the Dietary Supplements Health and Education Act (DSHEA). Under DSHEA, herbs, vitamins, minerals, and other natural health products are regulated differently from pharmaceuticals. After passage of DSHEA, the supplement market boomed, with sales climbing from 8.8 billion in 1994 to 15.7 billion in 2000 (Blendon et al., 2001) and 21 billion in 2008 (Thurston, 2008).

Contamination of nutritional supplements with prohormones

Since 1999, the same time when prohormones were entering the market, nutritional supplements became sporadically contaminated with prohormones. Contamination in this context signifies that a supplement contains substances which are not declared on the label. As the amount of contamination is low, less than 1 per mill of the product, it is assumed that the prohormones are not intentionally added to the supplements but contamination may occur due to poor quality control during the production of nutritional supplements and prohormones. Several athletes have been tested in the past with positive results for norandrosterone (main metabolite of nortestosterone and the main metabolite of the prohormones of nortestos-terone such as norandrost-4-ene-3,17-dione and norandrost-4-ene-36,176-diol), where the use of nutritional supplements which were containing low traces of prohormones led to positive results. In such a case the athlete has not intentionally applied a doping substance but the...

Patient Care and Monitoring

Conduct a medication history (prescription, over-the-counter, and dietary supplements) to determine conditions or causes of hypertension. Does the patient take any medications, supplements, herbal products, or foods that may elevate SBP or DBP Does the patient have drug allergies

Regulatory Issues Whos Minding the Store

When you go to the drug store for aspirin today, you can be reasonably sure that what you're buying is safe and that it contains no more or less than what the package says it contains. It was not always that way with pharmaceuticals, and it still is not that way with most health-food products and dietary supplements sold in health-food stores, supermarkets and pharmacies. Despite continuing concern on the part of the Federal Trade Commission (FTC), Food and Drug Administration (FDA) officials and others who work in the public interest, there are still no across-the-board standards or federal laws governing the quality of food supplements, herbs, and other products marketed with claims for improving health benefits. Caveat emptor let the buyer beware is the only rule governing the purchase of many products used as health foods or dietary supplements. What you think you are buying is not necessarily what you get. The new requirements dealt squarely with the problem that the thalidomide...

The Supplement Shambles

Although the public needed the protection provided by accurate labeling, proof of safety and evidence of benefit, the food supplement industry effectively prevented such legislation from being passed in the U.S. Congress in 1994. It accomplished this with a successful multimillion-dollar campaign urging Americans to Write to Congress today, or kiss your supplements good-bye This false message resulted in the Dietary Supplement and Health Education Act of 1994, which created a protected new category for the estimated 20,000 vitamins, herbs, minerals, and anything else that had been sold as a supplement before October 1994. Top experts in herbal medicine and dietary supplements decried the lack of public protection. The 1994 regulations took good care of the multibillion-dollar supplements industry, but many scientific reviews concluded that they left the public in the lurch. Here's what the November 1995 issue of Consumer Reports said about what that law allowed Products can be sold...

Effectiveness of Early Detection and Intervention

Hormone replacement therapy does not prevent CHD in postmenopausal women (Anderson et al., 2004 Rossouw et al., 2002), and evidence does not support a benefit from vitamin supplements (Lee et al., 2005). There is good evidence that screening for CAS with an ultrasound leads to important harms, including strokes from confirmatory tests or surgery. For men at increased risk for CHD, aspirin prophylaxis decreases the rate of CHD events and for women at increased risk of strokes, aspirin decreases the rate of strokes (Berger et al., 2006 USPSTF, 2009). The ideal dose is uncertain, but low doses (75 mg) are as effective as high doses

What It Can Do for You

There are important distinctions between dietary supplements in the form of the vitamin pill that many take each morning, and products aimed at treating illness. A daily vitamin tablet is unnecessary if you eat a healthful, balanced diet, but it will help those whose diets do not provide the necessary nutrients or who have special needs, such as calcium with D to protect against osteoporosis.

Fibromyalgia Tired of Being Sick and Tired

Acupuncture, massage, and Chinese herbal medicine are recommended as effective treatments by the Fibromyalgia Network (see Appendix D, State and National Organizations )- The Network is an organization that provides information to patients with this potentially debilitating condition. Moxi-bustion or infrared heat treatments are also useful in driving out the cold. Nutritional supplements such as antioxidants (coenzyme Q10, vitamins E and C) are helpful in managing this condition, as are dietary changes to eliminate dampness and build immunity.

Historical Perspective

Herbal remedies continue to play a significant role in human medicine. Chemical investigations have identified many of the active principles in many commonly used products. These products are often sold as dietary supplements rather than ethical pharmaceutical products. Because these products are complex mixtures of many natural products there is a need to establish criteria for their standardization. This situation is complicated by the natural variation in secondary metabolites produced by closely related species of medicinal plants. Owing to the possibility that variations in the composition of the products will result in unpredictable potency, the herbal products industry has been developing quality control standards. Black cohosh, for example, which is taken for the relief of menopausal symptoms, has a number of signature triterpenoid constituents including, actein, 23-epi-26-deoxyactein, and cimigenol-3-O-arabinoside (Figure 6.2). These compounds can be identified by coupled...

Chronic Exertional Compartment Syndrome

Chronic exertional compartment syndrome (CECS) is another cause of athletic lower leg pain. Patients with CECS complain of cramping, burning, or aching lower leg pain with pain or numbness that may radiate to the foot and ankle. The pain is clearly associated with exertion. Pain onset is characteristically at a fixed point in the patient's activity, with progressively increasing pain if the exercise continues and a dramatic reduction in pain within minutes of rest. The pathophysiology of CECS involves elevated intracom-partmental pressure, which causes relative ischemia of the involved muscles and pressure on neurovascular structures. The diagnosis of CECS can be confirmed by compartment pressure testing after exercise demonstrating increased intra-compartmental pressure correlated with symptom reproduction. Patients with CECS should be questioned about the use of nutritional supplements, such as creatine, that may increase muscle water content and overall muscle mass and contribute...

Clinical Preparation for Radiation Therapy

The nutritional status of the patient will require close attention. Any significant problems such as weight loss, dysphagia, odynophagia, and major trismus must be aggressively addressed. Special dietary supplements and perhaps placement of a percutaneous endoscopic gastrostomy tube may be required.

Additional information

The patient should be maintained at the higher end of its POTZ and humidity must be kept at the animal's normal range. Parenteral vitamin supplements (especially water-soluble ones) have been beneficial in some cases. In severe cases prognosis is guarded and aggressive therapy is recommended

Classifications of Complementary and Alternative Medicine

Fort Iii Osteotomy

Biologically based therapies involve herbs, vitamins, dietary supplements, and foods to treat disease. Around the world, these products are extraordinarily popular, and billions of dollars are spent on them in the United States alone. The assumption is that natural products are healthier and better than synthetic chemicals for treating disease. Dietary supplements are not considered drugs and therefore are not regulated and do not require U.S. Food and Drug Administration approval.

Pregnancy and Migraine

Natural supplements such as magnesium oxide and vitamin B2 have demonstrated benefit in double-blind studies for migraine prophylaxis, and can be used when needed (see Chap. 9). Other non-medication options include biofeedback and other pain and stress management techniques. Yoga may also be of benefit in some women.

Treatment Of Cirrhosis Portal Hypertension And Complications

Portal Hypertension Treatment

Medication use must be monitored carefully for potential hepatotoxicity. Hepatic-ally metabolized medications have the potential to accumulate in patients with liver disease. Little guidance is available on drug dosing in hepatic impairment because these patients have historically been excluded from drug trials. Daily acetaminophen use should not exceed 2 g. Dietary supplements, herbal remedies, and nutraceuticals have not been well studied in hepatic impairment and cannot be recommended.

Refeeding and Nutrition

To effectively minimize such risks, staff need to closely monitor the patient's fluids and electrolytes. A dietician should provide input on the meal content and structure, which are usually divided into three meals and two or three snacks each day. Although the patient's regular food preferences should be considered, meals should be well balanced and varied. Liquid nutritional supplements such as Boost or Ensure can be used if the risk of refeeding syndrome is high. However, because the goal is for the patient to return to normal eating, regular food is preferred. Patients are expected to eat all pre

Preventive Treatment of Episodic Migraine

Abstract Frequent and disabling migraines should be treated with preventive therapies, whether pharmacologic or natural supplements. Many options are available, and treatment should be tailored to consideration of each patient's comorbidities. It is trial and error finding the most effective drug with the least amount of side effects for each patient. Successful treatment will decrease disability and improve quality of life for the patient. This chapter lists the preventive medications with instructions on how to administer them, along with careful consideration of adverse effects.

Frequency of steroid hormone misuse

Since 1999 prohormones of testosterone (Fig. 24.2), dihydrotestosterone (Fig. 24.3), steroids with 5a-androst-1-ene structure (Fig. 24.3), and prohormones of nortes-tosterone (Fig. 24.4) have been marketed in the United States as nutritional supplements. Prohormones are advertised as having effects similar to testosterone, dihydrodestosterone and nortestosterone because of a high conversion rate of prohormones to the physiologically effective steroids in the human body after oral,

Chronic obstructive lung disease

One large well-conducted prospective study demonstrated that short-term low-dose androgen therapy (nandrolone decanoate) augmented the effects of nutritional supplementation in patients with moderate to severe chronic airways disease (Schols et al. 1995). From 233 consecutive patients with stable, moderate to severe and bronchodilator-unresponsive pulmonary disease admitted to an intensive pulmonary rehabilitation program, 217 were randomised into three groups. These were to receive eight weeks of treatment with (a) placebo injections, (b) a nutritional supplement (one high fat, high calorie drink daily) plus placebo injections or (c) a nutritional supplement plus androgen injections (nandrolone decanoate 50 mg men, 25 mg women ) with intramuscular injections given fortnightly. Participants were also stratified according to the degree ofbaseline muscle depletion (body weight

Treatment Desired Outcomes

Maximizing nutritional status through pancreatic enzyme replacement and vitamin and nutritional supplements is necessary for normal growth and development and for maintaining long-term lung function. Reduction of airway inflammation and infection and aggressive preventive therapies minimize acute pulmonary exacerbations and delay pulmonary decline. In pulmonary exacerbations, therapy is directed toward reducing acute airway inflammation and obstruction. This is accomplished through more aggressive airway clearance regimens and antibiotic therapy with a goal of returning lung function to pre-exacerbation levels or greater.

Oxidative Stress and Chronic Bacterial Prostatitis

Shahed and Shoskes 36 showed that sperm OS in symptomatic patients with chronic bacterial prostatitis related to both ROS overproduction (especially with positive cultures) and reduced antioxidant capacity in men with category III prosta-titis. Furthermore, the observed increased levels of OS markers and their decrease after treatment with antimicrobials (category II) or with the antioxidant dietary supplement (category III) suggested that Gram-positive bacteria in the EPS of some men with chronic pelvic pain syndrome may represent true pathogens on the basis of the clinical response to antibiotics. Zhou et al. 37 showed a significant increase of OS markers (plasma nitric oxide and erythrocyte MDA) in patients with chronic bacterial prostatitis compared to healthy normal volunteers, whereas plasma vitamin C, vitamin E, and P-carotene as well as erythrocyte superoxide dismutase, cata-lase, and glutathione peroxidase activities were significantly lower in patients with chronic bacterial...

Biological Cancer Treatments

Moreover, despite proponents' claims of recovery rates as high as 70 to 90 , case reviews by the U.S. National Cancer Institute (NCI) and the New York County Medical Society found no evidence of usefulness for this regimen. An NCI-sponsored study of Gonzalez therapy, which is similar to the Gerson diet and popular today, showed that patients with inoperable pancreatic cancer who underwent standard gemcitabine chemotherapy survived three times longer and had better quality of life than those who chose Gerson-type therapy with pancreatic enzymes, nutritional supplements, detoxification, and an organic diet. This study was reported in the Journal of Clinical Oncology in April 2010.

General Signs and Symptoms

A thorough history is crucial to identify cardiac and noncardiac disorders or behaviors that may lead to or accelerate the development of HF. Past medical history, family history, and social history are important for identifying comorbid illnesses that are risk factors for the development of HF or underlying etiologic factors. A complete medication history (including prescription and nonprescription drugs, herbal therapy, and vitamin supplements) should be obtained each time a patient is seen to evaluate adherence, to assess appropriateness of therapy, to eliminate drugs that may be harmful in HF (Table 6-4), and to determine additional monitoring requirements. For newly diagnosed HF, previous use of chemotherapeutic agents as well as current or past use of alcohol and illicit drugs should be assessed. In addition, for patients with a known history of HF, questions related to symptomatology and exercise tolerance are essential for assessing any changes in clinical status that may...

Proteinenergy Malnutrition

Nutritious food and vitamin supplements generally lead to a complete recovery. Whether PEM results in long-term growth retardation and delayed intellectual development is controversial. y This condition is best prevented by education of affected family members on proper nutrition. In the United States, hospitalized elderly are perhaps at the greatest risk for PEM, and nutritional assessments of all patients at risk should be undertaken at admission to prevent serious malnutrition and to reduce the incidence of morbidity and mortality.

Vitamins and Minerals

Cardiovascular disease, cancer, and osteoporosis and because multivitamins at that dose are safe and inexpensive (Fairfield and Fletcher, 2002a, 2002b). At least 84 of U.S. residents use vitamin supplements regularly, and they probably need them. Only 20 to 30 of the American population met the goal of at least five servings of fruits and vegetables daily (Flood and Schatzkin, 2000).

Consequences to the mother

Home visits also give health workers the chance to educate women about diet and healthy behaviors and to offer women nutritional supplements. This health awareness goes a long way. Antenatal care providers should inform women about the importance of safe delivery with a skilled birth attendant, the warning signs of complications, and how to plan for emergency care. In developing nations such as India, the importance of a hospital delivery, which can provide an environment which is safer for delivery and childbirth, can never be overemphasized (see Chapter 49).

Part Two Overview

Can food be used as medicine Hippocrates thought so. Let food be your medicine, counseled the famed fifth-century B.C. Greek physician. His dictum is followed today, not only by responsible nutrition experts seeking to change the way we eat, but also by exploiters and misguided souls who make outlandish claims for fad diets, massive doses of vitamins, and costly untested supplements. Thus, dietary supplements and food-based cures run the gamut from extremist nutritional cancer cures, such as the grape diet, to healthful living approaches also encouraged by mainstream wellness proponents. Advocates of both vitamins and orthomolecular medicine (the use of extremely high doses of vitamins as therapy) claim that vitamin supplementation enhances health. However, the U.S. Dietary Guidelines Advisory Committee report issued in June, 2010 includes this statement A daily multi-vitamin mineral supplement does not offer health benefits to healthy Americans. Individual mineral vitamin supplements...


Dietary supplements grew in popularity in the late 20th century out of a confluence of various motivations, including nutritional improvement, weight control, and performance enhancement. Many dietary supplements contained ingredients found in other foods and or medications, yet their production alone or in certain combinations placed them outside of both of these wellregulated categories. In 1994, the U.S. Congress passed the Dietary Supplement Health and Education Act, creating separate regulatory control for the multibillion dollar industry of dietary supplement manufacturing. Unfortunately, as evidenced by the 7-year process that culminated in the 2004 ban on products containing ephedra, the Dietary Supplement Health and Education Act lacks effective means for enforcing production standards and protecting consumers' health.70 Nevertheless, dietary supplements remain immensely popular among athletes of all ages and skill levels. Physicians should actively inquire as to the use of...

What It Is

Scientific studies indicate that the necessary nutrients are provided by the average balanced diet, and that only certain groups of people require supplements pregnant women, young children, alcoholics, those with diseases that inhibit absorption of nutrients, postmenopausal women trying to prevent osteoporosis, and people whose diets do not provide the required nutrients. Adults who do not eat healthfully (emphasizing fish, fruit and vegetables and whole grains), and older people who consume fewer calories than needed to meet daily requirements, a general vitamin supplement may help compensate. To the dismay of the related National Institutes of Health (NIH) programs and patient advocacy groups, such as those that seek to protect patients with Alzheimer's disease, mental illness, cancer other diseases, many dietary supplements claim to reduce or cure problems such as depression, sleep disorders, diminishing memory, indigestion, arthritis and cancer. Still others promise to achieve...

Infants and Toddlers

Children with malabsorption or hemolytic anemia can require additional folic acid. Parents who insist on using a vitamin supplement without any obvious deficiency on the part of the child should be counseled to use a preparation that does not exceed the dietary reference intakes (DRIs) established by the Institute of Medicine and the National Academy of Sciences. In particular, vitamins A and D can produce toxicity if given in excessive doses.

Diet and nutrition

Highland people traditionally consume sweet potato as their staple. About 75 of energy intake comes from this source. The protein intake of Highlanders eating a traditional diet is extremely low. Although frank malnutrition is unusual in Highland children, the children are short for their age and have been shown to grow with a dietary supplement containing protein. Stool trypsin levels are low.30


Vitamin Supplementation Epidemiologic studies note that populations who consume diets high in vitamins and minerals have a lower incidence of cancer. Three studies, the Alpha-Tocopherol Beta-Carotene Cancer Prevention Study Group (1994), p-Carotene and Retinol Efficacy Trial (CARET Omenn et al., 1996), and Physicians' Health Study (PHS Hennekens et al., 1996), investigated smokers and asbestos workers to see whether provitamin A and beta carotene supplementation would decrease the incidence of cancer. Those who received supplementation developed cancers earlier than those who did not, and the studies were suspended. The question of whether supplementation with antioxidant vitamins prevents cancer has not been answered, because several other antioxidant vitamins have not been studied. Supplementation has lost its support as a positive intervention, particularly in men who smoke. Foods rich in the antioxidant vitamins (beta carotene, vitamins C and E) and minerals (potassium) are...

Biological Dentistry

This includes the use of nutritional supplements such as magnesium, selenium, vitamins C and E, folic acid, and digestive enzymes. These are used to treat the presumed mercury toxicity, which is believed to be caused by traditional cavity fillings. The supplements are thought to help the body get rid of mercury and to encourage healing of presumably damaged tissues throughout the body.

Metabolic Therapies

Metabolic therapy is based on the theory that disease is caused by accumulations of toxic substances in the body. Accordingly, treatment aims to eliminate the toxins. It is believed that this will enhance immune function, which in turn will assist the body to restore itself to health. Metabolic therapies vary from practitioner to practitioner, but typically include the same basic components a special diet high-dose vitamins, minerals and other dietary supplements and detoxification with coffee enemas or irrigation of the colon (see Chapter 41). Detoxification, another major component of metabolic therapy, consists of coffee enemas every four hours. The enemas are claimed to stimulate the excretion of bile from the liver and rid the body of toxins. Meals with predominantly natural and organically grown foods, plus nutritional supplements, are eaten to strengthen the immune system. Meditation, prayer, and additional alternative therapies such as bioelectric stimulation may be used to...


The most serious problem is that the active ingredient in shark cartilage dietary supplements is too large to be absorbed into the blood stream from the digestive tract, and therefore is excreted from the body before it can actually perform any function. This is what happens to the shark cartilage available in health food stores and promoted for human use.


Nutrition and diet may be strongly predictive of stress fractures. A 1990 study found that dancers with restrictive eating patterns and eating disorders showed a much higher incidence of stress fractures than dancers without 76 . The diet of the dancers who sustained stress fractures was also much lower in fat and higher in the use of low caloric substitutes, such as saccharine, and nutritional supplements, such as vitamins. (Figs 4.6.1 & 4.6.2). Vitamin supplements Vitamin supplements more saccharin and much less fat in their diets than healthy dancers and normal controls, were significantly more likely to supplement their diets with vitamin supplements, and were far more likely to have eating disorders than their stress fracture-free counterparts (Figs 4.6.1 & 4.6.2). Thus, even in two athletes with similar weights and training regimens, it is possible that diet and nutrition are strongly predictive of osteopenia.


Creatine is one of the most common nutritional supplements employed for possible ergogenic benefits. The Metzl et al71 survey of high school students reported use by as many as 44 of high school senior athletes, which parallels estimates of collegiate use. Creatine has become generally accepted to provide benefit in short, maximally anaerobic events, likely through enhancement of adenosine triphosphate regeneration.72 There is also some evidence suggesting a possible direct effect of creatine on muscle development through increased expression of mRNA and growth factors specific to muscle.73 Whether by direct effect or through increased capacity for resistance training, creatine has been linked with increases in muscle mass, including by direct measurements such as ultrasonography.74

Strachans Syndrome

Treatment consists of re-establishing a balanced diet with B complex vitamin and vitamin A supplementation. In the Cuban experience, long-term sequelae were rare, because most had early treatment with nutritional supplements, including B complex and vitamin A. In prisoners of war with longstanding symptoms, persistent ataxia, burning feet, and visual defects often persisted despite adequate supplementation.


Effective treatment of tinnitus is difficult and usually requires various approaches. Finding and eliminating potential causes (especially pharmaceutical) is imperative. Patients should be counseled to avoid caffeine and nicotine. No single medicine has been proved effective in treating tinnitus. Antidepressants have shown promise, especially if depression coexists. Intravenous lidocaine eliminates tinnitus in some patients but is not practical and has obvious potential side effects. Various homeopathic treatments and nutritional supplements are effective in some cases, but most have not been evaluated in controlled studies. Hearing aids are beneficial in masking the tinnitus if hearing loss exists. Tinnitus maskers can be purchased that essentially drown out the tinnitus with various distracting noises. Biofeedback and a technique called tinnitus retraining therapy are helpful for some patients. These techniques can be learned through various publications or at a tinnitus treatment...


Chiropractic is a commonly used alternative therapy in the United States, Canada and Australia. Some chiropractors are called mixers because they combine chiropractic with exercise, nutritional supplements and other therapies. Those who depend only on chiropractic manipulation are identified as straight practitioners. Now in the minority, they emphasize vitalism and spinal adjustments, and consider subluxations to be the leading cause of all disease.


Antioxidants come in a variety of forms, ranging from those generated endog-enously by the body to those acquired exogenously through the consumption of certain foods or dietary supplements. When the natural balance between oxidants and antioxidants within the body is perturbed via antioxidant deficiency or overwhelming ROS production, the subsequent adverse effects have been found to be diminished, and sometimes resolved, through bodily antioxidant defense and supplementation 43 . Since human spermatozoa membranes are rich in unsaturated fatty acids, they are sensitive to oxygen-induced damage mediated by LPO.


Complementary and alternative medicine (CAM) is a term used to encompass a variety of therapies (e.g., acupuncture, chiropractic, botanical and nonbotanical dietary supplements, and homeopathy). Painful conditions are among the most common reasons individuals seek relief from CAM. In a recent survey, neck pain, joint pain, arthritis, and headache were among the top ten reasons for use of CAM, and low back pain ranked the number one reason for CAM therapies. Of the CAM therapies, chiropractic and acupuncture are the most accepted and utilized modalities. A variety of dietary supplements have been suggested for painful conditions such as -adenosylmethion-ine (SAM-e), ginger, fish oil, feverfew, y-linoleic acid, glucosamine, and chondroitin.


For a toddler or older child, determine how many ounces of milk and juice the child drinks. Inquire about the daily consumption of vegetables, fruit, protein, and ''junk foods.'' Does the child take a vitamin supplement It is also valuable to ask about the meal pattern Does he or she eat breakfast, lunch, dinner, and snacks Where does he or she eat With whom Older children and adolescents eat many meals away from home such patients are your best source of information about their eating patterns.


In his review of the literature, Ahrendt82 found no published studies that reported ergogenic benefits of DHEA use. In one study, DHEA did increase androgen levels, but there were no increases in strength or lean body mass measurements following resistance training.83 Similarly, Tokish et al72 reviewed the literature and found no evidence of ergogenic benefits of androstenedione. In fact, there may be an increased risk of cardiovascular disease with androstenedione use due to decreased high-density lipoprotein levels. Other studies have demonstrated no effect of androstenedione on testosterone levels while increasing estrogen levels in males.84,85 Conversely, androstene-dione has also been linked to elevating testosterone levels in females,86 suggesting a gender-specific metabolism of these products. Based on the clear estrogenic and androgenic effects of these products in the absence of any reasonable benefits, the U.S. Food and Drug Administration in 2004 issued a summary of the...


Caffeine is perhaps the most popular stimulant used by the general population. Prior to the U.S. Food and Drug Administration ban on products containing ephedrine, products combining caffeine and ephedrine were among the most purchased dietary supplements and weight-control compounds. Accordingly, much of the research into the ergogenic properties of caffeine actually studies combinations of caffeine and ephedrine. With regard to caffeine alone, caffeine is thought to be most beneficial for performance in endurance events, perhaps to enable the kick at the end of such an event.102 The metaanalysis of Doherty and Smith103 demonstrated caffeine's ergogenic benefits, primarily in studies of endurance exercise and time-to-exhaustion measurements.

Alpha Agonists

Phenylpropanolamine and pseudoephedrine, both alpha agonists, are commonly found in over-the-counter medications and known for their stimulant effects. In fact, since the U.S. Food and Drug Administration banned dietary supplements containing ephedrine, many manufacturers have replaced ephedrine with a variety of alpha agonist compounds. Numerous studies of the effects of phenylpropanolamine and pseudoephedrine on aerobic and anaerobic exercise have failed to show ergogenic benefits, with no significant benefits to power, work, VO2max, or perceived exhaustion.95-100 These studies have tended to demonstrate a relatively safe cardiovascular profile, which would parallel the safety of these compounds in over-the-counter med-ications.96,98 However, one study has suggested increased heart rate at submaximal exercise levels and prolonged time to heart rate recovery with a common nonprescription dose of pseu-doephedrine.100 An older trial also demonstrated an increased incidence of sinus...


A number of terms have been used to refer to supplements that cannot be classified as either herbal remedies or as vitamins or minerals. Often, they are referred to simply as supplements, or they may be categorized as nutritional supplements or as nutraceuticals, as used here.

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