Why is Medicine so reticent towards Sport Supplementation?
Let’s discuss why your doctor may be against taking supplements.
- 1. An uncomfortable situation with your doctor
- 2. Personal View
- 3. Lack of knowledge and misinformation
- 4. The commercial regulation of supplements is less strict than that of medicines
- 5. False associations with “underground bodybuilding” and doping
- 6. Cross-contamination with other substances
- 7. Connection between protein and chronic renal disease
- 8. Lack of empathy with athletes and their objectives
- 9. Analytic alterations of athletes interpreted as pathological
- 10. Then, are supplements bad?
- 11. Conclusions
- 12. Bibliography
- 13. Related Entries
An uncomfortable situation with your doctor
You go inside the room to see your primary care physician.
First, you sit down. Everything seems to be fine. You just caught a simple cold. Nothing serious. Then, he asks you a couple of questions, examines you and prescribed an antipyretic every 8 hours. No problem…
The blood test results arrived and the creatinine and transaminase levels are higher than usual.
The physician starts to wonder why, since there is no “normality pattern”
- – Do you use a supplement and you have not told me?
- – Yes, I take whey protein after the workout (…you start feeling like you have done something wrong…)
- – What?
- – Yes, I do
The situation becomes a little tense. You are told not to take “gym” supplements by any means.
Has this ever happened to you?
In 2018, this situation kept happening in different primary care centers and hospitals. In fact, I get messages almost every day from boys and girls, usually young athletes, who have experienced this situation.
Today, we are going to analyze why this happens with as much empathy as possible.
Before anything, I have to say I experienced a very similar situation in my teenage years. This made me think a lot, do tons of research and until today, share all I have learned.
Today, we are going to try to put ourselves in the shoes of medicine professionals to try to understand their advice.
Lack of knowledge and misinformation
Sometimes, it may be hard to accept, but we cannot know everything.
The ego of doctors, which tends to be bigger than what it should, does not let them see what is evident: they do not know about sport, training, physical activity, sport planning, nutrition and, therefore, sport supplementation.
This could be fixed by adding a subject to the Medicine Degree, it does not have to be compulsory. But that is not the case.
Consequently, we have hundreds of doctors that know the most complex metabolic pathways, the rarest diseases and the most novel treatments. However, they do not know BASIC physical exercise guidelines to their patients.
It is hard to understand why this happens, specially knowing that physical exercise can prevent up to 26 pathologies1
So, if your doctor frowns when you talk about protein or creatine, think that it is something unknown for him. In fact, he does not control the recommended “posology”.
The commercial regulation of supplements is less strict than that of medicines
When it comes to the commercial regulation regarding the safety and quality of the products, the supplement industry is QUITE unsatisfactory.
We have seen everything up until now, from protein and other supplements combined with other doping substances. Moreover, there are labels that do not meet the average % of protein, “lowering” the amount of protein per scoop unethically, and even commercial substances that are barely legal. In fact, many have been removed from the market due to important side effects.
Yes, this also happens in the field of medicine and many had to be removed as well. But the difference is that doctors have a perfectly structured system that is becoming more and more regulated. Therefore, what is sold is safe for the patient.
So, when your doctor tries to discourage you from taking this type of substances, his intention is no other than protecting you against the “side effects” of said substances.
False associations with “underground bodybuilding” and doping
In Medicine, the world of supplements and “muscles” is directly associated with notorious underground subcultures.
Bodybuilding has never had good press in the world of medicine
Above all, this is partly due to the abusive and insane practices performed by this collective: implicit doping, eating disorders, taking medicines without control, weights and volumes that increase the risk of injury and many more.
To be honest, bodybuilding and related sports have given more than enough reasons to be frowned upon.
What is clear is that the muscle is a source of health and we need to protect it as much as we can. In fact, a strength workout routine is vital to improve and preserve our health.
Cross-contamination with other substances
It will not be the first nor the last time you watch the news to see that “X supplement has been removed because it has traces of Y, a doping substance”. Unfortunately, this happens.
There are adulterated supplements partly due to the bad regulation by the supplement industry.
As you may understand, physicians worry about this issue
Connection between protein and chronic renal disease
It seems that we are not capable of getting rid of this stereotype once and for all. Even today, most physicians still believe that an excess of protein can trigger chronic renal disease.
The problem is that said “excess” is not so well defined, so most believe that clearly insufficient amounts of 0.8g/kg of body weight
Recently, another meta-analysis reached the same conclusion: high protein diets for healthy people without pre-existing renal pathologies DO NOT deteriorate the renal function2.
However, things change if you have an altered renal function, a single kidney or a family history of renal disease
Lack of empathy with athletes and their objectives
The general population is sedentary and not active at all.
7 out of 10 adults are sedentary
Surprisingly, most physicians are sedentary, smoke, eat poorly and suffer chronic stress. This is partially justified due to the harsh working conditions they have to undergo.
But I strongly believe that a professional cannot attend a patient with a can of coca-cola on top of the table (I have seen this personally).
If there is a strategy that gives a 5% of advantage, an athlete will use it. Quite frequently, this is something that is hard to understand for those who are on the other side of the spectrum.
Why do you want to take protein? Why do you want to work out 3 hours a day? Is it really necessary to take 180g of protein every day?
We should try to be more understanding about the choices others make regarding their lifestyle. For instance, we can understand how a professional singer goes on tour and sacrifices spending time with their family; or the risk of a formula 1 pilot runs in each race.
This is even more important when we see how most active people worry a lot more about their health than the average citizen.
Therefore, we should start dropping the prejudice and see how better decisions can improve our lifestyle.
Analytic alterations of athletes interpreted as pathological
Physical exercise, specially at a high intensity and volume, produces a series of analytic alterations that could be defined “athlete analytics”.
To sum up, there are different enzymes like CK or transaminases that could increase in response to an intense workout. However, this is not a symptom of a disease, as long as said increase is reasonable.
Creatinine and urea are directly related to the muscle mass and protein intake. That is why their levels can be higher than normal for athletes.
This tends to occur with men who do strength/power sports.
When it comes to resistance, bilirubin can also exceed the standard levels due to the repeated micro-traumas caused by a long distance race.
As soon as your doctor notices these alterations, he or she will probably panic…
Then, are supplements bad?
Supplements are just supplements, they are neither good nor bad.
They are tools that, if used properly, can be beneficial in terms of health, performance or physique.
Example: Whey Protein
Most athletes used this product when it is hard to meet your daily protein requirements with conventional food. Moreover, it can help you gain muscle mass or losing weight.
The intake tends to go from 1 to 2g/kg of body weight depending on the volume, intensity, type of workout, fat percentage…
The day will come, when Medicine regards sport supplementation as standard supplementation that we use every day with our patients. For example, iron, folic acid, vitamin D, omega-3, nutritional formulas, to name a few.
It is just a matter of time
Let’s keep empowering!
- Fiuza-Luces C, Garatachea N, Berger NA, Lucia A. Exercise is the Real Polypill. Physiology. 2013;28(5).
- Devries MC, Sithamparapillai A, Brimble KS, Banfield L, Morton RW, Phillips SM. Changes in Kidney Function Do Not Differ between Healthy Adults Consuming Higher- Compared with Lower- or Normal-Protein Diets: A Systematic Review and Meta-Analysis. J Nutr [Internet]. 2018 Nov 1 [cited 2018 Nov 26];148(11):1760–75. Available from: https://academic.oup.com/jn/article/148/11/1760/5153345
- Laine MK, Eriksson JG, Kujala UM, Kaprio J, Loo B-M, Sundvall J, et al. Former male elite athletes have better metabolic health in late life than their controls. Scand J Med Sci Sports [Internet]. 2016 Mar [cited 2018 Nov 26];26(3):284–90. Available from: http://doi.wiley.com/10.1111/sms.12442
- Marshall K. Therapeutic applications of whey protein. Alternative Medicine Review. 2004.
- Luhovyy BL, Akhavan T, Anderson GH. Whey Proteins in the Regulation of Food Intake and Satiety. J Am Coll Nutr. 2007;
- Volek JS, Volk BM, Gómez AL, Kunces LJ, Kupchak BR, Freidenreich DJ, et al. Whey Protein Supplementation During Resistance Training Augments Lean Body Mass. J Am Coll Nutr. 2013;
- Tang JE, Manolakos JJ, Kujbida GW, Lysecki PJ, Moore DR, Phillips SM. Minimal whey protein with carbohydrate stimulates muscle protein synthesis following resistance exercise in trained young men. Appl Physiol Nutr Metab. 2007;
- Devries MC, Phillips SM. Supplemental protein in support of muscle mass and health: Advantage whey. J Food Sci. 2015;
- Altered Analytics in Athletes
- Protein Analysis: Methods, Reliability and Quality
- High Protein Diet, what are its effects?
- Sedentarism Kills