Despite potential health risks, young athletes and dieting teenagers increasingly turn to supplements as a legal way to enhance performance or drop weight, coaches say.

Among the most popular products are ephedrine, an herbal stimulant that raises metabolism, and androstenedione, or "andro," a muscle-building substance made famous in 1998 by baseball slugger Mark McGwire. A third product, creatine, is used to boost strength and endurance.

All three are sold legally and allowed in California high school athletics. But growing concerns about associated side effects have prompted state legislation aimed at preventing minors from using them.

Sen. Jackie Speier, D-Hillsborough, has proposed SB 1750, which would ban the sale of creatine, androstenedione and ephedrine to minors and require detailed labeling on packages.

A separate measure, SB 1964 by Sen. Deirdre Alpert, D-Coronado, would prohibit the sale to minors of any product banned in collegiate sports competition. Another Speier bill, SB 1562, would require the California Interscholastic Federation, which sets rules for high school sports, to compile its own list of banned substances.

The dietary supplement industry has been unregulated in the wake of a 1994 federal law that exempted products containing vitamins, minerals and herbs from a requirement that drugs have to be found safe and effective by the U.S. Food and Drug Administration before they can be sold.

"The frightening thing about it is that most consumers believe supplements are subject to FDA review, and they presume it is healthy," Speier said. "These are rampant, and the presumption by every consumer is that they've got to be safe."

Androstenedione was widely debated in 1998, when the supplement was found in McGwire's locker as he chased the home-run record. The substance is converted into a steroid in the body and could have effects similar to those produced by banned anabolic steroids, said Frank Uryasz, president of the National Center for Drug-Free Sport based in Kansas City, Mo.

Studies of creatine have shown few short-term effects from moderate doses, Uryasz said. Some anecdotal reports suggest cramping and dehydration can result, but the real concern is that long-term effects are unknown, Uryasz said.

Now, the leading target is ephedrine, which is derived from the plant ephedra and is also called "ma huang." It can aid in weight loss because it boosts metabolism. But some users have reported side effects such as heart irregularities and seizures, while the FDA has associated the product with 80 deaths based on a series of "adverse event reports" collected during the 1990s.

"Taken in large doses, it can be as stimulating as methamphetamine," Uryasz said.

In 2000, two University of California, San Francisco, researchers studied 140 of the FDA's reports and published their results in the New England Journal of Medicine. They determined that 31 percent "definitely" or "probably" suffered an adverse effect from an ephedrine supplement. An additional 31 percent "possibly" suffered symptoms related to the substance.

Still, the ephedrine industry emphasizes there exists no proof of causal linkage between the substance and detrimental health effects.

"Clinical research and reviews support the use of ephedra when used responsibly," said Randy Pollack, a Sacramento lobbyist who represents an industry group called the Ephedra Education Council.

Pollack said the industry agrees with Speier that those under 18 should not use ephedrine. But he said his group remains neutral on banning the sale of products to minors.

"Our concern is, does this disrupt the flow of commerce?" he said. "Does the clerk have to ID everyone that comes through?"

Pollack said the industry principally objects to a proposed label that includes the toll-free number for the FDA's MedWatch program, which compiles reports of side effects related to medical products.

But perhaps the greater challenge will come from Gov. Gray Davis, who vetoed a weaker bill in 2000 that would have imposed several marketing and labeling requirements on the sale of ephedrine in California.

In his veto message, Davis said, "While regulation and labeling of dietary supplements containing ephedrine would seem prudent and in the interest of public safety, this is a matter of interstate commerce and clearly the responsibility of Congress to regulate, which they have thus far neglected to do."

Davis has no position on this year's bills, but he has not changed his view, according to spokesman Russell Lopez.

"The last I heard, he was saying the same thing, that he believes it's a federal issue and the federal government needs to take care of the problem," Lopez said.

Jeff Proul, 18, said he used creatine and protein powders the past two years to build muscle and enhance workouts. He said he graduated last year from Folsom High School, where he played football his senior season.

While he hasn't tried androstenedione or ephedrine, Proul said he opposes a ban on creatine because he thinks the supplement is safe when used properly.

"I took (creatine), no problem," Proul said. "But I read the instructions, and took it once a day before I started lifting."

But other high school athletes said they choose not to use herbal supplements, either because they are unfamiliar with them or don't want to become addicted.

At Sheldon High School, Cleo McGee, 15, practiced throwing the discus on an overcast afternoon. She said she has tried popular caffeinated energy drinks, but none with supplements -- a statement echoed by several teammates.

"I don't know much about creatine," she said. "I've heard it doesn't taste good and it doesn't look good."

Rochelle Gandy, a 16-year-old junior and track athlete at Sheldon High School, said she feels she should "depend on my own self to stay in shape."

"Once you start depending on it and using it," she said, "who says you'll be able to keep the shape you're in when you stop?"

With the popularity of supplements on the rise, local coaches said they increasingly face questions from athletes.

"What I tell kids is, the only surefire thing is hard work," said Bob Baker, track and field coach and athletic director at Sheldon High School. "I have a concern that even if someone's using it correctly, there could be long-term effects. If it's something new, who knows what's going on?"

While the NCAA bans androstenedione and ephedrine, California's high school sports are not regulated for substance use on a statewide basis.

Instead, the California Interscholastic Federation relies on local school districts to administer and enforce their own drug policies, said Roger Blake, CIF assistant executive director. With a $1.6 million budget, the organization can do little more than organize state championships and establish eligibility rules, he said.

SB 1562 would have CIF create a list of banned substances and require school districts to educate students on the effects of dietary supplements and anabolic steroids.

While CIF would not be able to conduct drug tests similar to the NCAA, local school officials could use the list to guide students and impose penalties.

"It would be nice to have it in written policy because if a student is caught with a banned substance, you could go to parents and say, 'It's on the list,' " said Rob Feickert, who coached football at McClatchy High School the past five years.

　　From Sacbee.com