Introduction

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     Athletes use performance enhancing natural products in order to achieve a more competitive edge over their opponents.  These natural products are used at various levels of athletic competition, ranging from secondary schools to international. There is no general guideline for the use of these performance enhancing natural products in athletic competitions, but specific guidelines for each organization.  Some organization ban use of the products by their athletes, and others do not, either way these performance aids tempt athletes to achieve an advantage over their competition.
    Many of these performance enhancing natural products are available over the counter and there is a large market for these products resulting in about a $3 billion per year and growing. These products are not considered nonprescription or prescription drugs, but a category of "dietary supplements". Since the Food and Drug Administration do not approve them there is no protection from any possible dangerous side effects or other health risks to the consumer. The manufacturer only removes them from the shelves when FDA can prove that the product(s) are unsafe.
    The question: Is appropriate to exclude athletes from sanctioned competition if they have consumed performance enhancing natural products?  Focusing on the natural products creatine, epinephrine, and androstenedione, as well as athletic organization guidelines this question will be addressed.  It is our opinion that it is not appropriate to exclude athletes from competitions due to consumption of performance enhancing natural products.
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