What are the recommended guidelines for taking pre-workout supplements (Performance Enhancing Supplements)?

Pre-Workout Supplements: Evidence-Based Recommendations

Pre-workout supplements can be used selectively with only caffeine and creatine having strong evidence for performance enhancement, but extreme caution is warranted due to significant contamination risks (15-25% of supplements contain undeclared prohibited substances) and the lack of robust evidence for most multi-ingredient formulations. 1

Supplements with Strong Evidence

Caffeine

• Caffeine is the most evidence-supported pre-workout supplement, reducing fatigue perception and enhancing endurance, repeated sprint performance, skill execution, and cognitive function. 1
• The recommended protocol is 3-6 mg/kg body weight of anhydrous caffeine (pill or powder form) consumed approximately 60 minutes before exercise. 1
• Lower doses (<3 mg/kg body weight, ~200 mg) can be provided both before and at half-time when consumed with a carbohydrate source. 1
• Start with lower caffeine doses to assess individual response, especially if using regularly in training. 1
• Side effects with high doses include anxiety, nausea, insomnia, tremors, reduced sleep quality, tachycardia, and arrhythmias. 1, 2

Creatine

• Creatine improves high-intensity repeated sprint performance and enhances training capacity, increasing muscle strength, power, and lean body mass. 1
• Loading phase: ~20 g/day (divided into four equal daily doses) for 5-7 days. 1
• Maintenance phase: 3-5 g/day (single dose) for the duration of supplementation. 1
• Lower dose approaches (2-5 g/day) for 28 days may avoid the associated 1-2 kg body mass increase. 1
• Concurrent consumption with a mixed protein/carbohydrate source (~50 g of each) may enhance muscle creatine uptake via insulin stimulation. 1

Supplements with Weaker or Contradictory Evidence

Beta-Alanine

• Evidence is contradictory for beta-alanine, with only modest potential benefits for high-intensity exercise and repeated sprint performance. 1, 3
• If used, the protocol requires daily consumption of ~65 mg/kg body weight via split-dose regimen (0.8-1.6 g every 3-4 hours) to give up to 6.4 g/day. 1, 3
• Supplementation must continue for 4-12 weeks for optimal results. 1, 3
• Possible side effects include skin rashes and transient paraesthesia (skin tingling). 1
• Long-term supplementation beyond 12 weeks requires further investigation. 1, 3

Nitrate

• Limited evidence exists for nitrate supplementation, with most studies conducted in amateur rather than elite athletes. 1
• Acute performance benefits may occur within 2-3 hours following a nitrate bolus of 5-9 mmol (310-560 mg). 1
• High nitrate-containing foods (spinach, rocket salad, celery, beetroot) may provide a food-first solution. 1

Multi-Ingredient Pre-Workout Supplements (MIPS)

• Evidence for multi-ingredient pre-workout supplements is scant, inconclusive, or conflicting, despite their widespread popularity. 2, 4
• Most MIPS use "proprietary blends" that do not disclose specific amounts of ingredients, making direct comparisons impossible. 2, 4
• Some research suggests MIPS may positively influence muscular endurance and subjective mood, with mixed results for force and power production. 4
• Chronic consumption may augment beneficial changes in body composition through increased lean mass accretion. 4, 5
• Safety data is limited to short-term studies (less than 8 weeks), with insufficient information regarding long-term supplementation safety. 4, 5

Critical Safety Concerns

Contamination Risk

• 15-25% of sports supplements contain prohibited substances not declared on the label, including anabolic steroids, stimulants, and other banned agents. 1
• Contamination may be intentional adulteration rather than accidental. 1
• Pre-workout "boosters" have been found to contain banned stimulants, selective androgen receptor modulators, aromatase inhibitors, β2-agonists, and growth hormone releasing peptides. 1

Risk Reduction Strategies

• Only use supplements provided or recommended by sports nutritionists or approved by team physicians. 1
• Choose supplements screened by third-party testing programs (Informed Sport for UK, Kölner Liste for Germany, AFNOR NF V 94-001 for France, HASTA for Australia). 1, 3
• These programs reduce but cannot eliminate contamination risk entirely. 1
• Trial and monitor supplements in training before using in competition due to large interindividual variability in response. 1, 6

Practical Implementation Algorithm

1. First-line approach: Use only caffeine (3-6 mg/kg, 60 minutes pre-exercise) and/or creatine (loading then maintenance protocol) as standalone supplements. 1

2. Consider beta-alanine only if: You have 4-12 weeks for supplementation, can commit to split-dosing regimen, and accept modest/inconsistent benefits. 1, 3

3. Avoid multi-ingredient formulations unless: They disclose all ingredients and amounts, have third-party testing certification, and you've trialed them extensively in training. 1, 4

4. Prioritize sports foods over supplements: Carbohydrate-electrolyte drinks, gels, recovery shakes, and protein drinks provide convenient alternatives when whole foods aren't feasible. 1

Common Pitfalls to Avoid

• Do not assume supplement labels accurately reflect contents—contamination is common. 1
• Do not use supplements without baseline testing in training sessions first. 1, 6
• Do not exceed recommended caffeine doses to avoid adverse cardiovascular effects. 1, 2
• Do not purchase supplements independently without professional guidance. 1
• Do not assume "natural" or "herbal" supplements are safe—these frequently contain undeclared prohibited substances. 1