Dietary supplements: Educate yourself first before trying them Published Jan. 3, 2022 TRICARE Communications FALLS CHURCH, VIrginia -- Many military service members love dietary supplements. Steeped in a culture of fitness and optimal performance, military professionals take dietary supplements at far higher rates than their civilian counterparts. Studies show that nearly two in every three service members take some sort of daily dietary or herbal supplement. Some supplements include basic ingredients like protein or multi-vitamins. Troops cite reasons for taking supplements that include "fitness, physical appearance, and occupational demands," according to one 2021 study in the Journal of the Academy of Nutrition and Dietetics. Yet, many others contain unfamiliar and unregulated ingredients that are hyped as tools for boosting testosterone and sexual performance, or speeding up the natural process for bodybuilding and losing weight. "Many of these can be contaminated with undeclared drug ingredients, steroids, steroid-like ingredients and/or prescription drugs," said Dr. Melissa Givens, director of the Consortium for Health and Military Performance, or CHAMP. Dietary supplements - and their sometimes dubious claims of health effects - are regulated differently than conventional foods or drugs by the Food and Drug Administration. All dietary and herbal supplements claims are labeled with the disclaimer: "This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease." Dietary and herbal supplement firms are responsible on their own for evaluating the safety and labeling of their products before marketing to ensure that they meet all the requirements of the Dietary Supplement Health and Education Act. FDA is responsible for taking action against any adulterated or misbranded dietary supplement product after it reaches the market. Marketers and advertisers often target service members with flashy logos and quick-fix claims about these supplements. That's why, to counter any health-related misinformation, CHAMP has created an online reference tool called Operation Supplement Safety. Here you can find a list of prohibited dietary supplements that are considered high risk or are unapproved drugs. You'll also find the brands and names these supplements are marketed under. DOD follows federal regulations on dietary supplements. "Operation Supplement Safety's mission is to provide the best evidence-based information about dietary supplements to service members, their families, health care providers, and leaders to achieve human performance optimization," Givens explained. "OPSS's goal is to provide the tools and resources to help users make informed decisions about dietary supplements." OPSS includes an "Ask the Expert" feature that allows users to post questions about supplements directly to health experts. Products claiming to boost testosterone levels are often marketed as body-building products. Testosterone is a natural hormone but artificial testosterone products can elevate those natural hormone levels to the point where "the body slows down, regulating the natural production of the hormone and you can become dependent on the product," said Army Capt. Joshua Lockwood, chief of Nutrition Clinical Services at Blanchfield Army Community Hospital, Fort Campbell, Kentucky. "This withdrawal can affect your sleep, increase fatigue, negatively affect your sex drive, and cause steroid cravings," Lockwood said. These products can damage your liver and kidneys if taken orally over a longer period of time, he said. Testosterone or artificial testosterone-boosting products can also increase the size of the heart, "where the left ventricle thickens" and can lead to high blood pressure and baldness, Lockwood said. One of the products on the CHAMPS "prohibited" list is selective androgen receptor modulators, or SARMs, and yet "we see these marketed just off base," Lockwood said. "The culture is you want to be a strong warrior," Lockwood said. "There's no harm in that unless you go about becoming that strong warrior by use of risky supplements or you are suffering from an altered self-image condition called muscle dysmorphia," which is a mental health disorder in which you can't stop thinking you are small or weak even though you are above average in strength and muscle size. The final piece of advice from experts is to try for performance fueling from your regular diet. CHAMP offers many resources on that topic. Additionally, consult with your health care provider to see what, if any, dietary supplements you might need. For example, your health care provider may want to check your vitamin D levels as some people are low in that vitamin, especially if they are not regularly exposed to sunlight. "Eating a well-balanced diet should provide you with all the vitamins and minerals you need for optimal health," said Navy Lt. Lorna Brown, head of Naval Hospital Bremerton's Nutrition Management department, Washington state, and a registered dietitian. "Occasionally people may follow a diet, or have food intolerance or allergy that can affect the intake of some vitamins and minerals. Consult a registered dietitian to see what dietary adjustments can be made or to discuss picking a dietary supplement safely," she said.