Clean or contaminated: the truth about sports supplements

Interview with Dr Naomi Speers, Louise Barker and Alexis Cooper

Tim Gavel: Hello and welcome to On Side I'm Tim Gavel. Supplement use in sport is widespread, with many using supplements in the hope of improving performance. While the sport supplement market might be thriving, the use of supplements can destroy an athlete's career. Supplement manufacturers often use omissions or alternative names to lure buyers in and create the illusion of a clean substance, when in fact many contain substances that are prohibited in sport. 

A recent research collaboration between Sport Integrity Australia (SIA) and Human and Supplement Testing Australia, commonly referred to as HASTA, found that of 200 supplement products tested, 35% contained one or more WADA prohibited substances.

In addition to this, 57% of the products that tested positive did not list the prohibited ingredients on their packaging or website. Today we have a panel of guests to discuss the research results, risks around the use of supplements, and how this can lead to unintentional doping. Welcome to Dr Naomi Speers, Director of Research at Sport Integrity Australia.

Dr Naomi Speers: Hey Tim.

Tim Gavel: Alexis Cooper, Acting Head of Sport Engagement at Sport Integrity Australia. Hello Lex.

Alexis Cooper: Hi Tim.

Tim Gavel: And Louise Barker, Team leader, Sport Supplements at HASTA. Hello Louise.

Louise Barker: Hi Tim.

Tim Gavel: Naomi can I first start with you. Sport Integrity Australia contracted HASTA to purchase and analyse 200 sports supplements products available in the online marketplace in Australia. What prompted this research?

Dr Naomi Speers: The research is prompted by our concern about unintentional doping and really wanting to understand the risks for Australian athletes and hence how we can support Australian athletes to protect themselves. So, we know that supplements are one of the leading causes of unintentional doping internationally, and previously in Australia as well. But we're so proud that recently very few Australian athletes have tested positive due to using supplements, but we weren't really sure what the Australian marketplace was like, so we wanted to take a look at the Australian supplements and understand what the risk currently is for Australian athletes.

Tim Gavel: Were you surprised by the results or is this the trend elsewhere?

Dr Naomi Speers: Yes and no. So no, not surprised that there are contaminated supplements, there have been many studies all over the world that show that. I was surprised by the rate of positives, so 35% of products being positive is higher than I thought. There were other things that were not surprising, so we saw that certain types of products were higher risk. So fat burners, pre workouts, muscle builders, these are all higher risk products, something that surprised me was that the Australian manufactured products were pretty much the same risk as US manufactured products. Whereas previously I would have thought Australian manufactured products were a bit safer.

Tim Gavel: And what is the message out of this, do you think to athletes, support personnel and coaches within Australia within the sport ecosystem here?

Dr Naomi Speers: The message is supplements continue to be a risk, so athletes, support personnel need to continue to be diligent. They need to continue to use the Sport Integrity app to check supplements before they use them.

Tim Gavel: And what do they look for, on the app? Batch tested? Is that what they're looking for?

Dr Naomi Speers: They're looking, that's right, Tim, for a batch tested supplement. So, the company that Lou works for, HASTA, they batch test products, so does another company called Informed Sport and what athletes and support people should be doing is checking in the Sport Integrity Australia app whether their product is listed there and whether the particular batch that they have has been tested.

Tim Gavel: Perfect segway to Louise. And Louise, please can you tell us a little about HASTA and the work you do in sport supplement testing?

Louise Barker: Yeah. So has HASTA is part of Racing Analytical Services Limited, also known as RASL. So RASL is the largest independent drug testing laboratory for racing animals in Australia. So, we test the blood, urine and hair of racehorses and greyhounds, as part of that side of the company we also do human workplace testing. However, we do not test any athletes at all. So due to this, they were like ‘Oh we could start supplement testing’ because there's no conflict of interest, so HASTA was established to focus on supplement testing and then expanding the human portfolio here at RASL because we do not have that conflict of interest.

So, what happens is to ensure athletes are subject to go to doping controls have confidence in their products, supplement manufacturers and brands will come to us and ask to put their product on our certification program and then every batch then is tested and those batches then get uploaded to the SIA app and to our website.

So, for a product to be HASTA certified we review the formulations and the quality systems of the manufacturer, every batch must be tested and that's the most important thing, and it's tested prior to the release of sale so the product should not be sold until they've had a certificate from us. The test batches again are then uploaded to the app and our website and then therefore athletes can then cross check those batch numbers to make sure that the product that they have in their hands has actually been tested. Due to HASTA's certification being a large commitment, we also offer independent batch testing.

So we can do random batch testing of a sports supplement, however this brand cannot claim that the product is HASTA certified, but if they just wanted to supply a certain batch to a sports team or if there is an athlete that wants to take something that's not a certified product, they can send it to us and we will test that specific batch.

Tim Gavel: Can you tell us what you exactly test for and what do you detect?

Louise Barker: Yeah. So, we test for 290 WADA prohibited substances. So, we test for anabolic steroids, beta 2 agonists, beta blockers, stimulants, narcotics, SARMs, peptides, diuretics, corticosteroids, and we test in the parts per billion range. So that's equivalent of one drop in an Olympic size swimming pool, and the instruments that we use are very similar to those instruments that the athlete’s samples will be tested on.

Tim Gavel: Just on a another question, along that I suppose, are you seeing any trends in the supplement testing space? Are you seeing a particular trend in terms of prohibited substances in supplements?

Louise Barker: Well, the majority of our manufacturers want their products to be clean, because they obviously want to sell them to athletes, so when we do get any positives, it's generally naturally occurring compounds. So, things like bitter orange extract contains octopamine, which is a stimulant that's prohibited by WADA. So, when we review ingredients, if something has bitter orange in it, we wouldn't test it and we'd have to tell the client to reformulate it. Same with higenamine. So, higenamine can be found in beetroot powders, so it's in beetroot at really low levels but when it gets concentrated we're then starting to see levels of higenamine come through, so again with beetroot powders, we wouldn't recommend having those tested or certified.

Tim Gavel: What about the collaboration with Sport Integrity Australia on this research program? How important was that?

Louise Barker: It's been really significant. So, in our regular catch ups we would discuss obviously the project findings but also trends that are happening across the human athlete space, the human workplace and the animal sports space. And intelligence sharing within the drug testing community is a really useful resource to see which trends are more prevalent, which drugs are more prevalent at that time and also to discuss emerging drugs which have entered the market.

Tim Gavel: Alright. I'll come back to you in just a moment, Louise. But Naomi just to you before we hear from Lex, what is the process when HASTA detects a prohibited substance? What is done within your team here at Sport Integrity Australia, to ensure the Australian public is cautioned against using supplements containing prohibited substances?

Dr Naomi Speers: So, there's a few things we might do, Tim. One is to look at the substances that have been detected. So, through this study we saw a new substance, halostachine, and so we've been providing information to athletes to make sure that they're aware of that substance.

Secondly, we work with our fellow regulators, so with organisations like TGA or the food standards authorities if there's products that we think they should take action against. And the third is that we do include those products in the Sport Integrity app with a significant warning so that if an athlete searches up that brand name, they will see that we're aware that there's prohibited substances in that product and for them to use it is an extreme risk, they should not absolutely, be using it.

Tim Gavel: Lex I might throw to you now given that we've been talking about the Sport Integrity app, where members of the public can check supplements to see if they have been batch tested. What impact has the app had since its inception?

Alexis Cooper: Yeah, thanks Tim. I think the app has had a huge impact on the Australian sporting sector. So, when we launched it back in 2018, we weren't quite sure how it was going to be received by athletes or coaches or anyone in sport, but since then it's been downloaded by more than 110,000 people.

And just to give you some perspective, we only test around 3000–4000 athletes a year, so what that means is that it's reaching not just those top level athletes who are getting tested, but all the way down into community sport into state level sport, and I take a lot of comfort from that because it means that there are so many athletes who are taking their responsibilities seriously and they're making sure that they're doing the checks, which is brilliant. I think there's something like 7000 checks that are done on supplements every single month, which is incredible.

By working with HASTA and Informed Sport and by also just our work promoting the importance of batch testing, we now have something like more than 12,000 batches of supplements in the app. Again, huge, it means that athletes have so many different options when they want to take something. If it's a protein or a creatine or a fat burner, there's going to be an option that's batch tested for them in the app, which is incredible.

And Naomi, in terms of impacts, Naomi spoke before about the decrease in the number of athletes testing positive, so back before the days of the app, I think we had 16 or 17 athletes, in one year, test positive just to a supplement alone. And in the last couple of years, we've seen a couple of years of zero, couple of years of one and by and large that's down to things like the app. It's things like Cassie Fien, the athlete telling her story, it's things like the work of Naomi and her team in working with the regulators, it's the work of HASTA. It's such a big system and I have to say I'm so proud of Sport Integrity Australia's work to really help athletes in that space.

Tim Gavel: And you've moved to a higher level too, because you're also on the World Anti-Doping Agency's Taskforce for Unintentional Doping. That's a very important taskforce too, isn't it? Because it's not just work we're doing here in Australia, but it's work globally to prevent athletes from taking supplements and testing positive.

Alexis Cooper: Yeah, absolutely. So the taskforce is new and I think it's kind of the first time that we might have collectively as a system gone like 'There is a problem of unintentional doping, where athletes are being caught out in this system, when they had no intent or no deliberate means to cheat', and that goes against everything that the code is set up to do.

Like it's there to protect clean athletes, not to accidentally catch them out through a supplement or something like that. So, the task force will be huge in terms of collecting all the views from across the world and then figuring out what we can change in the system internationally to try to protect all athletes from unintentional doping.

Tim Gavel: Because there is a call for contributions too, isn't there?

Alexis Cooper: There is! So, at the moment anyone in the world can go through and submit their answers to I think it's like a 15-question survey and the questions that we're asking are we want to understand the size of the problem. So, at the moment I can't tell you that 10% of all anti-doping cases are unintentional, for example. Is it 20%? Is it 30? Is it 50? We're not sure.

So, what we want to try to understand is are there any measurements out there or is there a new one that we need to build so that we can actually monitor? Because over time obviously you would like to see, let's say it's 10% of all cases internationally are unintentional, we'd love to see that getting close to 0, but we can't tell that story yet because we don't know the figures.

The other thing that we want to do, because it's not just for people like Naomi and I to fill in the survey, we actually want coaches, we want athletes, we want administrators to fill it out and the survey for athletes specifically asks about their fear and their anxiety when it comes to accidentally getting caught out in the system. I think there's a previous podcast where Lauren Jackson talks about her fear of accidentally testing positive, and we know that that's a big thing, but we need those stories from people so then we can influence WADA, we can influence governments, we can influence sports to actually try to change the system.

Tim Gavel: Because that is a real fear, isn't it? That's a real story in that athletes are worried about testing positive. We've seen stories coming out of tennis players for instance, in the wake of the Jannick Sinner case where players are actually expressing their concern, afraid to drink water, afraid to eat meat, etcetera.

Alexis Cooper: Absolutely.

Tim Gavel: So there needs to be clarity.

Alexis Cooper: One hundred percent and I can understand their fear, I guess, because we see cases not just in Australia where people might test positive to a supplement, but there's also been cases where athletes share a blender with their housemate and their housemate might be using a SARM or something, and they can test positive through that. We've seen cases where athletes are giving their pets medication, but the medication contains a banned ingredient and it touches their fingers, and then they test positive. Like, I can appreciate the concern of athletes, and I'm sure Naomi is probably the same in that regard as well.

Dr Naomi Speers: Yeah, absolutely. And I think the unknowns about unintentional doping, I imagine that makes it even harder for an athlete. You're fearful that you might test positive and it's not yet clear how you might protect yourself against that.

Tim Gavel: Yes well, how do you protect yourself? Is it greater awareness, greater education, or is it just being extra cautious? How do athletes approach a situation like this?

Dr Naomi Speers: Look, I think the work that Lex's taskforce, or the taskforce that Lex is on, is doing, is really important to understand what is the occurrence of unintentional doping, how do those matters occur, once we have that understanding, then our role is to educate athletes about those and to work together with sports and athletes and support people to put in place protections, and that's what we see has happened with supplements in terms of having the app and enabling athletes to use supplements but with a much lower risk.

And I think in terms of other unintentional doping, we're not as far along the journey yet, and so it's really at this point about understanding what's happening and then there's a potential suite of strategies that could be used to mitigate that.

Tim Gavel: Because Lex, it's really important to get an athlete's perspective on this, isn't it? To understand exactly what goes through the mind of an athlete and the anxiety, as you've mentioned, but also the checks and balances that they've got to go through before they eat or consume anything, I guess it's really important for your taskforce to understand what goes through the mind of an athlete.

Alexis Cooper: One hundred percent. I don't think we can ever have a system that's designed to protect athletes that hasn't been informed by them and their experience. So until we know what their level of fear and anxiety is, what they're already doing to try to prevent this from happening to them. You do hear stories about people not wanting to kiss strangers that they don't know, for example, like, what measures are they already taking and then what do we, as an organisation that's meant to help them, have to put in place to help that.

Tim Gavel: Naomi, just another question on athletes and their liability, et cetera, and their responsibilities. Should athletes record what they're taking and keep a record of exactly what they've bought and purchased and consumed?

Dr Naomi Speers: I think having a record is really important for athletes. Particularly when we're talking about unintentional doping, having that information about where you've been, like have you been in a country where the meat is more likely to be contaminated, the products that you've consumed, means that if you do need to go back and try to identify what a source is, then you've got a much stronger base to do that.

So, I would be recommending to athletes to keep a record of the products that they're using and their travels to support them in the future.

Tim Gavel: And that includes seemingly innocuous products bought at a chemist, which are everyday use for future testing possibly, as we've seen with the Olympic movement 10 years after the Olympics, people returning a positive test with no records.

Dr Naomi Speers: Absolutely. Like, innocuous products can be a risk, and I personally before I started here, I would have thought supplements in the supermarket were innocuous, but this study shows that they're not and that there is a real risk to athletes from those products as well.

Tim Gavel: And Louise, HASTA plays a very important role in Australian sport in terms of checking supplements to make sure that they're OK for athletes to use. You've got an enormous responsibility.

Louise Barker: Yeah, we have. So, you know, there's always a food first approach. But at the same time, you know, some athletes require supplements for their dietary needs. So like bars, gels and gummies are really convenient after exercise. Like they're just there, you don't have to prepare anything, you can just take it.

We have found greens powders, a lot of athletes when they're competing in countries where the fruit and vege isn't recommended to take, they often ask us about any greens powders that would be suitable for them to use. And yeah, most things, is all about convenience. So having a tested product means that they're less likely to take something that's got a prohibited substance in it.

Tim Gavel: I guess though when you are in another country and there may be contamination risks there, athletes say, listen, we're afraid to eat the meat or we don't want to drink the water, etcetera. That's sort of out of your bounds. I guess that is the reason why people do take supplements, because they feel afraid to consume outside what happens in Australia sometimes.

Louise Barker: Exactly that.

Tim Gavel: And just on your role, obviously batch testing's very important, have you been surprised by some of the substances that are put into regular supplements?

Louise Barker: Yeah. So, the naturally occurring things are quite common. We see and we know about them, they're not illegal to use, they're just banned in sport. However, part of this study we did find substances that are man-made stimulants, some of them are prescription only medications and they should not be in there.

Again, these were the products that come out of America, and they're available online in Australia, so you know, there's just that, you just need to be cautious of what products you're getting and where it's made.

Tim Gavel: Just on the survey itself, and I'll ask all three, have you been surprised by the coverage that this survey has received? Because it's gone global and a lot of people I know are contacting Sport Integrity Australia for further details about it, but it is becoming quite a significant document in terms of what is happening elsewhere. Have you been surprised by just the global coverage that it's received?

Louise Barker: Yeah, I actually had an e-mail from a guy at Japanese Triathlon asking me about the survey, and about some of the products, which I couldn't tell him for legal reasons, and just said just make sure that anything you take is batch tested.

Tim Gavel: Well I guess it's surprising that there aren't other organisations doing what HASTA is doing, but it has received fair coverage, hasn't it? Firstly, to you, Lex.

Alexis Cooper: Yeah, I think everyone around the world who works in protecting athletes is interested in this research, especially when you consider Australia is by and large regarded a bit of a success story when it comes to supplements in terms of having so few cases these days, to look at it and go 'Oh gosh, it's still such a big problem in Australia. The risk is still so high.' I think that's really of interest to people, not just here in Australia but abroad.

Tim Gavel: Naomi?

Dr Naomi Speers: Yeah definitely, it did really surprise me. So it was published in a scientific journal and talking to our lovely Comms team, they said ‘we should probably put something out’ and I said 'Yeah, no one will read the journal so we've got a couple of weeks’, but straight away people were really interested in those findings and absolutely agree with Lex, like, internationally people are watching Australia to see what's happening here and what they can learn from our system. And so being aware that that risk exists still here is really important, for our athletes, but also a real interest overseas.

Tim Gavel: Thank you very much, Naomi, Dr Naomi Speers and Lex Cooper, from Sport Integrity Australia, and Louise Barker from HASTA. Thanks very much for joining us today on On Side.

Dr Naomi Speers: Thanks Tim.

Alexis Cooper: Thanks Tim.

Louise Barker: Thank you.

Tim Gavel: And we'll be back with more On Side shortly.

Narrator:  You've been listening to On Side the official podcast of Sport Integrity Australia. 

Send in your podcast questions or suggestions to: media@sportintegrity.gov.au.

For more information on Sport Integrity Australia, please visit our website: sportintegrity.gov.au or check out
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