Ergogenic risks elevate health risks in young athletes

Young athletes may use many products and techniques in an attempt to increase competitive edge in sports. The doping techniques that were previously seen in elite adult athletes are now being noted in increasingly competitive elementary, middle, and high school male and female athletes. The risk of significant morbidity and mortality associated with the use of these products is substantially increased when other risk factors are present. The risk for heat-related illness and possible heat-related mortality is higher in physiologically immature, overweight, and poorly conditioned young athletes. These are the same athletes who may be more likely to use stimulant or anabolic steroid products in attempts to catch up on training and conditioning regimens, improve their competitive advantage, or improve their physiques. The risk for heat-related incidents is higher in young athletes who are predisposed to these events because of a family trait or a previous heat-related adverse event in their own medical histories. Combinations of these factors (eg, high osmotic dietary supplements, stimulants, pre-existing medical factors, adverse ambient conditions) may significantly increase a young athlete's chances of a serious, potentially fatal event. Similarly, the risk of cardiac-related sudden death in a young athlete is significantly increased by the use of stimulants such as methamphetamine. As is the case with heat-related adverse events, the risk of cardiac-related morbidity and mortality may be significantly increased when other variables are present, such as the presence of other medications and pre-existing medical factors. As athletic competition becomes increasingly intense for younger athletes, pediatricians need to be aware of the possibility that their young patients are using ergogenic aids that may increase the risk for sudden death significantly. Pediatricians should be aware of the products available to these young competitors, and of the co-factors that substantially increase the risk of morbidity and mortality in this population.