Athletes are always searching for an edge over the competition. And increasingly, they’re turning to supplements. But when it comes to young athletes, are they appropriate? Should parents allow these substances in their kids’ still-growing bodies?

The complex answer is: It depends.

First, it’s important to get a lay of the land. According to Council for Responsible Nutrition guidelines, which were reviewed by the National Institute of Health’s Office of Dietary Supplements, sports supplements fall into three general categories when it comes to use by those under 18 years old: normal nutritional support (always acceptable), qualified use, and inappropriate for use. This last category of substances to be avoided completely includes any over-the-counter steroid precursors, like androstenedione (famously used by baseball slugger Mark McGwire), as well as any supplements containing ephedrine alkaloids.

Filling the gap

Ideally, people should get all their necessary proper nutrients through their daily diet, says Dr. Taylor Wallace, senior director of Scientific and Regulatory Affairs at the Council for Responsible Nutrition, the trade association for nutritional supplements. “But when you don’t, filling the gap with nutritional supplements or dietary supplements is perfectly appropriate,” Wallace says. “In fact, most people in the U.S. could benefit from a multivitamin and a little extra vitamin D.”

The first CRN guideline category—“normal nutritional support”—includes things like multivitamins, mineral supplements, antioxidants, herbs, fish oils, electrolyte replacement drinks, and protein bars, all of which are completely acceptable for young athletes. (Of course, all supplements should be taken within prescribed dosages and are best done with the consultation of a doctor or licensed dietitian.)

Wallace adds that both vitamin D and calcium—two crucial nutrients associated with bone health—are commonly insufficient in kids today. Vitamin D is also important as it is increasingly recognized for its role on the overall impact of physiological body functions, such as regulating the immune and nervous systems, absorbing calcium and phosphate, maintaining muscle strength, and stabilizing blood pressure.

Still, he points out that the safety of nutritional supplements is based on the dosage recommended. “That’s another thing parents need to be aware of. More is not always better.” (Consult the Office of Dietary Supplements age-based recommended levels for more information.)

Wallace advises parents to take the lead role in their child’s use by consulting a physician, reading the labels, and sticking with trusted brands.

No substitute for a healthy diet

While popular products like protein powders are likewise acceptable in all cases, Dr. Joel Brenner, chairman of the American Academy of Pediatrics Council on Sports Medicine and Fitness, says people in the U.S. generally get enough protein in their daily diets already. As a result, the extra protein provided by nutritional supplements, he explains, is often excreted out of the body without any significant impact.

“You might end up just peeing out your money, basically,” says Brenner, who practices out of the Children’s Hospital of the King’s Daughters in Norfolk, Virginia. “I think people would be better off spending the money to meet with a registered dietitian for an hour than spending the money every month using supplements.”

Safety vs. Performance

Still, many young athletes who are looking for added strength, speed, and stamina turn to products in the “qualified use” category, which can contain stimulants such as caffeine or guarana. These should be carefully monitored or avoided altogether, according to Brenner. Other “qualified use” supplements that can impact muscle recovery or enhance performance contain creatine as their main active ingredient.

Creatine is a natural substance, one that the body already produces on its own. Some believe taking creatine can provide muscles with added energy, particularly during strenuous workouts. But since creatine more easily triggers dehydration, it must be used carefully and is not recommended for use on game day.

Brenner, however, cautions against any use of supplements containing creatine in young athletes for a couple reasons. First, because the Food and Drug Administration doesn’t regulate over-the-counter supplements, consumers cannot know the purity of the substances available for purchase. In addition, he emphasizes parents and athletes must carefully read and understand all supplement labels because some companies use different names and words to describe the presence of creatine in their product.

“They might call it ‘protein supercharge’ or ‘protein bust’ or something like that,” Brenner explains. “And if you look at the fine print on the bottle under the ingredients, it will say creatine.”

But it’s the lack of safety data for people under the age of 18 that presents the bigger concern, Brenner says. Research and safety information is all currently gathered and recorded for adults only.

“Your [child is] going to see some benefits in terms of it might increase their sprinting ability or their strength,” Brenner concedes, “but from a young athlete’s standpoint, they’re also taking an unknown risk with safety.”

And then finally there’s the ethical question about using supposed performance-enhancing supplements. Brenner asks if it’s fair for a youth athlete to turn to these substances if most of their opponents or teammates are likely not using them. Still, he acknowledges the temptation to gain any kind of a competitive edge, particularly when many pre-teens are already striving toward an athletic scholarship. Nevertheless, he believes the focus at that age should be on diet and proper training instead.