SII Focus 15th September 2021

Two cases underline dangers of supplement contamination

When the International Olympic Committee (IOC) dropped its case against Brenton Rickard last month, the swimmer warned that testing mechanisms have surpassed contamination protocols in pharmaceutical manufacturing. This should serve as a huge red flag for athletes. Two recent cases involving prohibited supplements that were not listed on a supplement label have further underlined the dangers that they present to athletes.

South African sprinter Carina Horn was provisionally suspended almost exactly two years ago, after a 20 August 2019 sample returned an adverse analytical finding (AAF – or ‘positive test’) for Ibutamoren and LGD-4033. On 10 September this year, the Athletics Integrity Unit (AIU) of World Athletics sanctioned her with a two year ban.

Larissa Cunha was provisionally suspended on 27 July, after a sample she gave on 14 July returned an AAF for a substance prohibited due to the CrossFit Drug Testing Policy. In an Instagram post, the Brazilian athlete revealed that the substance involved was Ostarine, which has been involved in a number of contamination cases. She has yet to be sanctioned.

The similarity between both cases? Both athletes were able to prove that supplements were at least partly – if not fully – to blame. 

Mutant Madness

Mutant Madness ingredient list (click to open)…

South Africa’s Bloemfontein Laboratory analysed four supplements provided by Horn. On 29 October, it confirmed that it had detected LGD-4033 in both an un-sealed and sealed bottle of Mutant Madness provided by Horn, with the Lot Number #50381. Horn provided a sworn statement that ‘coffeine [sic.]’ declared on her doping control form referred to the Mutant Madness supplement, as she understood caffeine to be its main ingredient (see right for list of ingredients).

The AIU contacted FitFoods, the manufacturer, to see if it had any remaining Lot #50381 of Mutant Madness. It didn’t, but had two lots of blend powders it claimed had been used to make Lot #50381 of Mutant Madness. The Montreal Laboratory analysed these, and confirmed that neither contained Ibutamoren or LGD-4033.

The Lausanne Laboratory’s analysis results from ten supplements Horn claimed to have been taking (click to open)…

Horn then purchased sealed batches of six other supplements she claimed to have been taking at the time of her AAF. Both the original four supplements and the six additional supplements were analysed by the Lausanne Laboratory (see right). This confirmed that Mutant Madness contained LGD-4033 and Amplify Whey contained Ibutamoren. 

‘The AIU has concluded that the Athlete’s evidence is (by the very narrowest of margins) sufficient to demonstrate, on the balance of probabilities, the source of the LGD-4033 and Ibutamoren in the Sample’, reads the Decision. ‘In particular, although the analysis by the Montreal Laboratory of the Retained Blend Powders used to create lot number #50381 of Mutant Madness did not reveal the presence of LGD-4033, the Athlete’s evidence is that the Mutant Madness supplement that she ingested, and a further sealed container of the same Mutant Madness supplement with the same batch number (Lot number #50381), were sent to two different WADA-accredited laboratories for analysis and both detected the presence of LGD-4033 in the unsealed and sealed containers. In addition, the Athlete provided a sealed container of Amplify Whey that was purchased from the same store where she made her original purchase of Amplify Whey and which, when analysed by the Lausanne Laboratory, revealed the presence of Ibutamoren.’

Horn’s two year ban will be backdated to 13 September 2019. This means that she is free to compete again.

Two supplements contain Ostarine

CrossFit specifically warns athletes about supplements (click to open)…

CrossFit is not a signatory to the World Anti-Doping Code. However, its Drug Testing Program outlines that samples are analysed under World Anti-Doping Agency (WADA) Guidelines. It specifically warns athletes about the dangers of supplements, which may contain prohibited substances not listed on the label (see right). It mentions Ostarine as prohibited.

Larissa Cunha arrived in Madison, Wisconsin, to compete in the 2021 CrossFit Games, which took place from 26 July to 1 August. On 27 July, CrossFit announced that she had returned an AAF, and was therefore ineligible for the CrossFit Games. 

Cunha confirmed that the substance involved was Ostarine in an Instagram video (below), also posted on 27 July. A day later, she revealed that analysis of her B sample had confirmed the result from analysis of the A sample. 

In a 13 September video (below), Cunha states that analysis of two supplements she had used revealed the presence of Ostarine, despite it not being listed on the label. CrossFit has yet to comment on what will happen next.

Past history suggests that CrossFit may not be kind to Cunha. In 2019, Katie Trombetta was sanctioned with a four year ban after returning an AAF for GW1516 and Ostarine at that year’s CrossFit Games. She also blamed supplements. 

Eat, drink, train, sleep, repeat…

In an ideal anti-doping world, this is what athletes would do. However, in what is perhaps symptomatic of our ‘short cut’ society, most elite athletes use some form of supplementation. Everybody needs an edge, so advertisers lead us to believe…

Whether this should extend to ten supplements, one of which is named Mutant Madness, is perhaps debatable. Especially as the manufacturer’s website features advertising depicting swollen muscles and veins. But the key point is that neither Horn, nor Cunha, intended to take prohibited substances in order to cheat at sport.

Yesterday the AIU announced that CJ Ujah’s B sample had confirmed his AAF for Ostarine (S-22) and S-23. Both Selective Androgen Receptor Modulators (SARMs) are investigational drugs not yet approved for use in humans, and both were developed by pharmaceutical company GTx Incorporated. 

The US Anti-Doping Agency’s (USADA) Supplement 411 resource lists over 200 supplements that contain SARMs; 98 that specifically contain Ostarine; and nine that specifically contain S-23. In 2017, USADA issued a warning about Ostarine in supplements that it updated in 2019. This specified that there are 72 products on USADA’s High Risk List that contain Ostarine, including 19 where it isn’t declared on the label. 

UK Anti-Doping’s (UKAD) Guidance Page on Ostarine mentions 178 positive tests between 2015 and 2019. In 2017, USADA released a video claiming that ostarine was being intentionally put into supplements.

Analysis of supplements for the IOC (click to open)…

In a Study produced for the International Olympic Committee (IOC) in 2001, analysis of 634 supplements found almost 15% of those to contain prohibited substances that are not listed on the label. In the US, this reached 19% and in some countries, it topped 20% (see right).

What this means for athletes is that if you take a supplement that doesn’t list any prohibited substances, there is a 15%-20% chance that you will return an AAF. As these two cases and anti-doping rules emphasise, athletes are ultimately responsible for what they put into their body. 

The only way to protect yourself against the risk of contamination – and not just from supplements – is to keep samples of everything you consume. In an extreme case, Rob Font’s retention of samples of all cosmetic products – as well as supplements – he had used allowed the UFC fighter to prove that cosmetic products were responsible for his AAF.

Is any ‘edge’ that supplements provide worth a 15%-20% chance of a four year ban from competition? Perhaps it is worth considering educating athletes and their coaches that it simply isn’t worth the risk.

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