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Aggressive marketing has led millions of recreational and elite athletes to use nutrition supplements in hopes of improving performance. Unfortunately, these aids can be costly and potentially harmful, and the advertised ergogenic gains are often based on little or no scientific evidence. No benefits have been convincingly demonstrated for amino acids, L-carnitine, L-tryptophan, or chromium picolinate. Creatine, beta-hydroxy-beta-methylbutyrate, and dehydroepiandrosterone (DHEA) may confer ergogenic or anabolic effects. Chromium picolinate and DHEA have adverse side effects, and the safety of the other products remains in question.

In brief A triathlete and two distance runners sought medical advice for gastrointestinal (GI) symptoms that were brought on by increased training and hard runs. Collectively, their symptoms included heartburn, nausea, abdominal cramping, diarrhea, and bloody diarrhea. One patient had an up-per-GI motility disorder; one had a lower-GI motility disorder; the third had ischemia-related GI bleeding. The first two patients' symptoms improved with pharmacologic therapy and dietary changes, respsectively. The third patient did not require treatment.

This article was written in May 1992, after Magic Johnson announced he had tested positive for the human immunodeficiency virus that causes AIDS and was retiring from the Los Angeles Lakers. Since then, Johnson played in the 1992 Summer Olympic Games and, after a brief return to the Lakers, permanently retired from the NBA.

A group of experts from the University of California, Los Angeles, met to discuss a case from another institution. This case conference is part of a series featuring a variety of sports medicine topics.