Antidoping Concept of Play Clean to Win Clean: Implication of Herbal Supplements uses for Athletes in Competitive Sports

The popularity of doping in competitive sports is relevant for all those involved in sports, particularly for evaluating anti-doping policy measures. However, there is a gap of information that addresses this subject so far. As a consequence, the prevalence of doping in competitive sports in resource limited countries is unknown. Even though it is challenging to uncover the exact prevalence of herbal products with prohibited activity such as doping, various methods put in place by world antidoping agency (WADA) have now been adopted to uncover parts of this particular problem, and enables the circumvention to some extend the issues of honesty, definition problems and the limits of pharmacological evidence. It is evident that current doping control test results can show a distinct underestimation of true doping prevalence in low middle income countries (LMIC). Nowadays, doping is a critical issue at international levels of sporting competitions. Athletes’ use of herbal supplements has seen a significant increase in the past two decades. At the top of the list of popular herbs used in sports are echinacea and ginseng, whereas garlic, St. John’s wort, soybean, ephedra and others are also gaining popularity or have been historically prevalent. Despite the increasing popularity of herbal supplements, recent events have illustrated possible concerns regarding efficacy and safety of herbal supplements usage. Remarkable sports performances at the end of the 20th century raised suspicions about herbal supplement use by athletes, prompting the formation of WADA. With WADA creation it was not long when the deaths of two professional athletes raised concerns that the herbal supplement ephedra, may have contributed to their deaths. These events and others have prompted clinicians and scientists to reexamine and evaluate the role of herbal supplements in competitive sports. This review attempts to give an insight into the use of herbal supplement in doping within the concept of play clean to win clean. An attempt has been made to provide guidance on the efficacy and side effect of most used herbal supplements found in sporting activities, especially in international competitive sports.