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“He cures most successfully in whom the people have the greatest confidence.”

Galen, 180 AD

Western history first records myriad medical treatments in 1550 bc in the Ebers Papyrus, which is a 110-page scroll containing 700 formulas and remedies (animal, vegetable, and mineral) used by ancient Egyptian healers.1,2 Historical records from ancient China and India also reveal extensive herbal and plant-based pharmacopoeias.3 The attempt by athletes to improve their sports performance by taking various remedies and drugs has been observed for thousands of years. For example, athletes taking part in the ancient Greek and Roman games consumed various mixtures of mushrooms, figs, and opioids that contained stimulants such as strychnine, and other substances in attempts to seek victory over opponents in sports competition.4,5

Athletes in the 20th-century Olympics events also used strychnine to gain a competitive edge, even though it was known as a potential poison. Indeed, part of the 20th-century Olympic history is the discovery of various substances taken by some athletes in attempts to win and attempts by the Olympics Committees to find and stop these attempts.5 Athletes of all ages in the 21st century are willing to take a wide variety of drugs, concoctions, herbals, “health” foods, and others if they feel it will help “win” the game and sometimes even if they know deleterious effects may occur. Many athletes take various chemicals even without any evidence of their benefit or lack of safety. Very few of the thousands of herbal remedies now available have been shown to improve health or even sports performance. Despite this, billions of dollars are spent by athletes hoping for an edge in their sports competition.4–7

The United States Pure Food and Drug Act of 1906 was passed by the US Congress, which prevented adulterated or misbranded food and drugs from being manufactured, sold, or transported across the state lines.4 The 1938 Federal Food, Drug, and Cosmetic Act (FFDCA) then made it law that medications be tested for safety; however, it was not until 1962 that the Harris-Kefauver Amendment of the FFDCA was passed making it law that these drugs must be proven effective for their intended use prior to marketing.4

In order to avoid the close supervision provided to medications, intense lobbying convinced the US Congress to pass the 1994 Dietary Supplement Health and Education Act (DSHEA) in which “dietary supplements” were placed in a separate category. These chemicals were legally defined as substances that were mineral, vitamin, herb, other botanical substances, amino acid, or constituents of these products, metabolites, or even related concentrations, extractions, or combinations of these substances.8 The result is that makers of these products do not need to prove the safety or efficacy of their products. While they cannot claim to prevent, treat, or cure a specific disease, they can denote that the ...

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