SOURCE: Van Wagoner RM, et al. JAMA 2017;318:2004-2010.

For those of British or British Colonial heritage, “sticky wicket” probably needs no explanation, referring to the game of cricket as it does. In the United States, the term generally refers to croquet, so stated when a wicket is particularly difficult to pass through.

Enhancement of androgens in the United States is big business. But can consumers rely on internet-advertised products as safe, effective, and containing the stated constituents without adulterants? Van Wagoner et al obtained product samples (44 different products) of androgen receptor modulators sold online and analyzed their contents using the rigorous methods approved by the World Anti-Doping Agency.

Less than half the products tested contained the amount of active product claimed on the label. Almost 20% of the products contained none of the claimed active component. Some products contained substances banned by the World Anti-Doping Agency, and some contained growth hormone secretagogues.

Because many of these products are sold as dietary supplements, they are not subject to the same FDA regulations and surveillance as proprietary pharmaceutical drugs. Since many of the supplements contain substances that either have not been studied in humans or feature little safety data, clinicians should inform potential users about the limitations of such products.