With the rise of herbal medication in North America, it is becoming increasingly important that we know the benefits and side-effects of herbal supplementation in sports. Researchers in Croatia and Tunisia recently reviewed the evidence on several types of herbal medicine on the market to determine if they live up to their claims.
The perception of herbal medicine has changed dramatically over the past few decades. More Canadians are using complementary and alternative medicines (CAM), including herbal medicines, to treat their illnesses, especially when coping with pain.
The use of CAMs is particularly strong among younger generations, which may be due to recent social changes towards holistic self-care methods that emerged in the 1970s. It is not surprising that athletes are now adopting herbal medicine for their training regimens to boost physical and mental performance as it is considered more socially acceptable than traditional anabolic steroid use.
Many herbal medicines have yet to be proven safe or effective by FDA standards
Herbal medicines are plant-based treatments that contain a number of active ingredients such as terpenoids, alkaloids, and phenolic compounds, which have been known for their health benefits.
Around 17% of collegiate women athletes are currently using herbal medicine during training. Statistics reveal that these athletes usually opt for fat burning and muscle growing treatments. With a plethora of commercially available herbal medications that claim to increase physical performance or boost metabolism, athletes are enjoying the overabundance of options available to them.
However, many herbal medicines have yet to be proven safe or effective under the Food and Drug Administration (FDA) standards. And while clinical studies on herbal medicines have been conducted, many of them suffer from numerous incongruent factors making it difficult to compare contrasting results. Factors such as where the plant was grown, how it was prepared, dosage, and use with other medications make any claims of these herbal medicines difficult to validate. In a recent review published in the Journal of the International Society of Sports Nutrition, researchers cross-examined previous studies on a number of herbal medicines to determine if these medicines live up to their claims.
Ginseng is one of the most popular and researched herbal medicine for physical performance enhancement. Although there are several species of ginger spread throughout Asia, the most commonly studied is Chinese ginseng (Panax ginseng), which is very popular in Chinese and Korean medical practice. Ginseng has several critical health compounds such as vitamins, minerals, saponins, and most importantly ginsenosides, which is the main active ingredient in ginseng.
Previous studies on ginseng found that when participants took only a small daily amount of Chinese ginseng, there were significant improvements in cognition and anaerobic exercise performance, such as sprinting, regardless of age. These effects are likely due to its antioxidant properties that inhibit tissue oxidation and improve energy metabolism. Other researchers studying ginseng have found that these effects are greatest for sedentary or active participants compared to trained athletes. Some research suggests ginseng can also offer sexual function benefits to improve male libido and erectile dysfunction.
Though the benefits are great, there are notable side effects that researchers caution. Ginseng has been demonstrated to cause diarrhea, digestion complications, headaches, insomnia, and blood pressure imbalances.
Woman taking ginseng have been known to have vaginal bleeding and sensitive breasts after use. With some incompatibilities with certain medications, such as insulin, and mental health patients, it is important to consult your doctor before taking ginseng.
Caffeine is a natural product of many plants grown in tropic or sub-tropic regions. As many know from drinking coffee, caffeine has great benefits for boosting alertness and decreasing reaction times.
When researchers gave cyclists and runners a small dose of caffeine one hour before exercising, they found a significant increase in strength and blood catecholamine levels which are known to improve anaerobic and aerobic performances.
Although caffeine does have health consequences in very high doses, it is a relatively safe herbal medicine and has even been lifted from the World Anti-Doping Agency (WADA) prohibition list.
Guarana is a native herb from the Amazon that contains key alkaloids such as caffeine, theophylline, theobromine, tannins, and saponins. Guarana seeds have been used to treat paralysis, urinary tract infections, diarrhea, and headaches.
When combined with additional caffeine, researchers found guarana to have fat burning and weight loss properties. However, researchers found guarana can cause anxiety, insomnia, high heart rate, and upset stomach due to its high concentration of caffeine.
Green tea is one of the most well-known herbal medicines globally. In combination with additional caffeine, green tea has been shown by researchers to improve metabolism and increase fat burning. Green tea extracts have been shown to be a potent antioxidant and fat burner for diabetics. However, there are currently no studies examining the long-term side-effects of green tea extracts. Nonetheless, green tea is considered a reliable herbal medicine with minimal side-effects.
Yerba mate is an evergreen plant commonly grown throughout South America. While it can be prepared as a tea, yerba mate oral supplementation has been found to be a potent fat burner and improve overall metabolism in obese patients. However, some researchers have shown it can cause higher blood pressure and even confusion in some individuals.
Ginger is commonly grown in Southern Asia with a rich history as a treatment for inflammation. When researchers gave ginger supplements to male participants after an intensive exercise, they found lowered levels of blood inflammation markers. However, other research has shown it has no effect on body physique, strength, or metabolism. Still, ginger is a popular subject for herbal medicine research that has minimal side-effects and is even classified as a safe supplement under FDA guidelines.
Tribulus Terrestris extracts became a notorious herbal medication after Bulgarian athletes claimed their success was due to the herb in the 1996 Summer Olympics in Atlanta. Since then it has been a hot topic for research and has shown promising results in increasing testosterone levels in men. When researchers provided extract supplements to athletes and weightlifters, they found participants to have greater muscle anabolism and higher levels of luteinizing hormone which stimulates testosterone production.
However, conflicting studies suggest tribulus terrestris extracts do not improve strength, endurance, or testosterone levels within a short time frame. While the supposed benefits may be merely a placebo effect, strength sports athletes continue to use tribulus terrestris extracts for their exercise regiments with minimal side-effects.
Ginkgo biloba is a very popular herb cultivated in Asia. Its active ingredients are flavonoids and terpenoids, which are known to improve brain blood circulation. Indeed, it is even used to treat cognitive degenerative disorders such as Alzheimer’s disease to mitigate symptoms.
There is conflicting evidence that ginkgo biloba supplements are effective for peripheral arterial disease patients in long distance walking. Yet, gingko supplements are considered as safe supplements for healthy adults but should be avoided by diabetics due to its blood glucose lowering properties.
Saffron is the dried stamen of the Crocus sativus flower which is known globally for its culinary uses and position as the most expensive herb by weight. Saffron contains several important active ingredients such as terpenes, terpene alcohol, and esters which are known to treat depression, inflammation, and muscle tension.
While some studies have shown saffron supplementation in sedentary women can lower blood factors such as lactate dehydrogenase and TNF-α, there seems to be no improvement in resistance exercise performance. Additionally, saffron has been shown to cause serious side effects at high doses (more than 5g/day) and even death at extremely high doses (20g/day). It is recommended that saffron supplementation should be taken with extreme precaution.
With the rise of herbal medication in North America, it is becoming increasingly important that we know the benefits and side-effects of herbal supplementation in sports. Researchers reviewing the evidence on the most common herbal medicines on the market determine if they live up to their claims.
The researchers concluded that ginseng and caffeine can stimulate the central nervous system and improve mental function. However, other herbal medicines should be taken with precaution due to their side-effects and it is recommended to consult with your doctor before experimenting with herbal medicines.
Written by Aaron Kwong, MSc
(1) Sellami, M. et al. Herbal medicine for sports: A review. Int. Soc. Sports Nutr. 15, 1–14 (2018).
(2) Canizares, M., Hogg-Johnson, S., Gignac, M. A. M., Glazier, R. H. & Badley, E. M. Changes in the use practitioner-based complementary and alternative medicine over time in Canada: Cohort and period effects. PLoS One 12, 1–17 (2017).