Home/The science

The science I coach with

Know the body.Train with purpose.

How muscle, strength, conditioning, nutrition and recovery science inform your training. Your assessment determines how I apply them.

Training methods What we measure

Movements: measure, model, move, re-measure

Pillars of performance

Frontiers of longevity

Model, from your numbers

01 · Stimulus, recovery, adaptation

The gain comesafter the session.

Training provides the stimulus; recovery supports adaptation. I use your readiness score to adjust the next session.

Overload. The stimulus must exceed what the body is used to.
Specificity. Adaptation is influenced by the type of training performed.
Reversibility. What is not maintained is lost.
Individuality. The same dose draws a different response from each person.

Schematic of fatigue and adaptation; this curve is illustrative, not a measurement of an individual recovery window.

02 · Muscle

Tension, protein,and enough sets.

Muscle size, maximal strength and power need different training emphasis. For physique goals, I balance weekly volume, effort and recovery; for strength and power, I adjust load and movement speed. ACSM 2026: training goals.

Volume is a dose–response

Weekly training volume matters for muscle growth, but responses differ. Progress the number of challenging sets around your training history and recovery; a larger workload is not automatically a better one. Supporting evidence.

Proximity to failure

Sets nearer failure grow more muscle, not more strength; failure on every set buys fatigue. Most hypertrophy sets sit at one to three repetitions in reserve.

Protein, by the meal

Daily protein supports muscle repair and growth; distributing it across meals makes the plan practical. Requirements depend on body size, training and energy intake, especially during a deficit. Supporting evidence.

The fibres you keep

Power and muscle matter with age. Load, movement and progression are chosen for each client’s capacity and health.

What blunts the signal

Energy intake, sleep and recovery practices can affect adaptation. Blood tests add clinical context; they cannot identify every limiter or its cause.

Rotatable anatomy: the deltoid, by Anatomy Next on Sketchfab (new tab).

How the practice programmes volume, block by block

Where your output leaks decides the block.

03 · How strength becomes speed

A profile helps guidewhat to load.

Jump and sprint tests show whether you need more force, faster force, or both. That decides the training emphasis.

Maximal strength, heavy loads and few repetitions, develops maximal force; the response depends on the programme.
Rate of force development is trained with ballistic and plyometric work and read in the isometric mid-thigh pull and the jumps.
Velocity-based training uses bar speed to guide training. Lower velocity-loss thresholds can favour speed and power; higher thresholds may favour size. The threshold depends on the exercise, load and person.
The nervous system learns first, so a first block often moves the numbers before the mirror.

04 · The engine

Three energy systems.One continuum.

I match conditioning to your event and set intensity from your measured thresholds.

Illustrative energy-system contributions: all three overlap, with the balance changing by intensity and duration.

VO₂max. Higher cardiorespiratory fitness is associated with lower mortality in large observational cohorts. That association does not guarantee an individual lifespan or prove the effect of this programme.
The thresholds. VT1, VT2 and the maximal lactate steady state set zones from your expired gas and lactate, not your age.
Zone 2. Valuable and repeatable, but not uniquely so for mitochondria or fat oxidation; harder work moves fitness further per minute, so the practice uses both.
Repeat-effort decrement. The fall in output across repeated efforts helps guide conditioning and recovery work.

05 · Body recomposition

Composition followstraining, food and recovery.

Blood tests add context; clinical interpretation stays with your physician.

Testosterone and oestradiol

Recovery, drive, muscle and bone, in both sexes; they fall with deep deficits, short sleep and very low body fat, and can recover when energy availability is restored. Testing and interpretation follow the physician’s assessment.

Growth hormone and IGF-1

Pulsed at night and after hard sessions; IGF-1 is the daytime read. Sleep and training provide context; a physician interprets values outside range.

Insulin, cortisol, thyroid

Glucose, insulin, cortisol and thyroid results add clinical context. They do not determine where each calorie goes; diagnosis and interpretation belong to a physician.

What moves them without a prescription: a regular sleep window, body fat lean but not depleted, energy availability matched to training, heavy resistance work, alcohol counted. More on the peptides and hormones page.

06 · Sleep

Sleep protectsthe adaptation.

Sleep supports recovery and skill learning. A small, uncontrolled Stanford study found better sprinting and shooting after ten hours in bed for five to seven weeks.

Sleep duration and quality both matter. Most adults aged 18–60 need at least seven hours; individual needs vary. A consistent sleep schedule is a useful starting point. CDC: sleep basics
Read wearable trends alongside a sleep diary, symptoms and training response. Consumer sleep estimates do not replace a clinical evaluation. AASM: sleep technology. HRV is one contextual signal.
The last hard session, the last big meal, caffeine and light are all timed backwards from the window.
Persistent sleep problems need clinical review; coaching can support routines around that care.

Which wearables the practice trusts, and why

07 · Staying at your best

Train for strength.Plan for longevity.

I track fitness, muscle, bone, metabolic health and recovery to guide training for the years ahead.

Heart & circulation

VO₂max, resting and recovery heart rate, blood pressure, and the lipid particles: ApoB first, Lp(a) once, because it barely moves.

Strength & structure

Grip strength predicts mortality better than systolic blood pressure in the 140,000-person PURE study; leg power, lean mass and bone density complete the account.

Metabolism & blood

Fasting insulin and HOMA-IR where clinically indicated, alongside HbA1c; ferritin, thyroid, vitamin D, inflammation; continuous glucose where the history indicates it.

Sleep, stress & mind

Sleep architecture over weeks, the HRV trend, reaction time and perceived stress: what lets the other three adapt.

Epigenetic ‘biological age’ clocks are read as a trend, and only when they would change a decision. Evidence that supplements reverse them is thin; evidence that training moves VO₂max, strength and composition is not, and the longevity practice is built on it.

08 · From measurement to decision

The model supportsthe next decision.

Your tests feed the Performance Twin: readiness, load trends and the next training block. I make the coaching decisions and explain them.

The pipeline, closed by the twelve-week re-test.

The Performance Twin, explained line by line The method See your numbers in the model

Claims, with their sources: thirteen studies and guidelines

The evidence

Claims, withtheir sources.

Sources & further reading (13)

Science overview

Part II · The evidence

Every test,and the reason for it.

Your baseline and re-test come first; published reference points provide context.

Pillars

Frontiers

Tailored

Tests in the battery

Weeks to the re-test

Reading this page

Direction first, then stability.

Your baseline is the reference

The first assessment sets it; the re-test twelve weeks later, under the same conditions, shows what moved.

Read for you, not the population

Your sport, position, age, sex, history and calendar decide what good means; every result is explained to you personally, in person or on video.

Education, not medical advice

This page explains the tests; it does not diagnose or set targets. Where a marker needs a clinician, you are referred the same day.

Reference points are commonly cited figures from published guidance and large studies; none is an EVOX target or a client result.

The six pillars

The performance half, test by test.

The full battery

The test

10 / 20 / 30 m splitsGround-contact timeHorizontal force–velocity profileFlying-30 max velocity

Timing gates at 10, 20 and 30 metres and a flying 30 m; ground-contact time from a mat or high-speed video; a horizontal force–velocity profile from the splits and body mass.

Why

Acceleration and top speed are separate qualities with separate answers; only the splits tell them apart, and the profile shows which end of the curve is short.

What good looks like

Shorter splits, a faster flying 30 and a steadier contact time on re-test under the same protocol, surface and footwear. No universal target: a winger and a 100 m sprinter sit on different curves.

The test

Force–velocity profileRate of force developmentIsometric mid-thigh pullLeft–right asymmetry

Force plates throughout: countermovement and loaded jumps for a vertical force–velocity profile; an isometric mid-thigh pull (IMTP) for peak force and rate of force development; single-leg trials for left–right asymmetry.

Why

A one-repetition maximum is force once, slowly; sport wants it in a fraction of a second, which is what rate of force development measures. The profile says whether the block should be heavy or fast.

What good looks like

Peak force per kilogram rising or holding; early rate of force development improving; left–right differences that stay small. Commonly used return-to-play flags sit around 10–15%; a difference that grows between tests matters more than any single reading.

The test

VO₂maxLactate / ventilatory thresholdsRunning & cycling economyRepeat-effort decrement

A graded test to exhaustion with expired-gas analysis for VO₂max and the ventilatory thresholds, or a validated submaximal protocol where a maximal test is unwise; capillary lactate where indicated; economy and repeat-effort decrement from fixed-pace and repeated maximal efforts.

Why

Cardiorespiratory fitness is among the strongest predictors of all-cause mortality in large cohorts, and it trains at any age; the thresholds set the intensities sessions are written at.

What good looks like

A higher VO₂max, thresholds at a higher fraction of it, a lower oxygen cost at the same pace and a smaller decrement. The commonly cited shape is a decline of roughly a tenth per decade in untrained adults, which training slows.

The test

DXA lean & fat massRegional distributionBone mineral densityHydration & phase angle

DXA for lean mass, fat mass and bone mineral density, region by region; bioimpedance for phase angle and body water between scans; scale weight only as context.

Why

Weight cannot tell lean from fat or say where it sits; distribution decides how a physique photographs and how a fighter makes weight. Bone density is the skeleton’s balance sheet.

What good looks like

Lean mass held or gained while fat falls; bone density stable or rising; hydration consistent scan to scan. The commonly cited T-score cut-points are −1.0 and −2.5, diagnostic reference points used in defined adult populations; clinical interpretation also depends on age and sex.

The test

HRV & resting HR trendSleep stages & efficiencySession RPE & load ratiosMorning readiness score

Heart-rate variability and resting heart rate each morning from a validated wearable; sleep stages and efficiency; session RPE times duration for daily load; all combined into the morning readiness score.

Why

Training is a proposal; recovery decides whether the body accepts it. HRV is read as a trend against your own baseline, never as one day.

What good looks like

HRV and resting heart rate interpreted against your own rolling baseline, training response and symptoms; sleep efficiency commonly read as good above about 85%, inside a consistent window; chronic load rising gradually. Population references do not replace an individual trend.

The test

Controlled articular rangeJoint-by-joint screenEccentric hamstring strengthLanding & deceleration quality

Controlled range at each major joint, screened for range, control and pain; eccentric hamstring strength on a Nordic device, left against right; filmed, force-plate landing and deceleration tasks.

Why

Range you control under load is what the sport uses; passive flexibility proves little. Eccentric hamstring strength is a measurable part of hamstring injury risk; landings are where knee injuries happen.

What good looks like

Controlled range growing or holding, matched left to right; eccentric strength rising per kilogram, sides close; landings quiet and symmetrical. After an injury, return criteria are agreed in writing with your medical staff before rehabilitation starts.

See where each number is taken

The four frontiers

The long half,marker by marker.

Four areas I follow for long-term strength, fitness and health.

The longevity practice

The test

VO₂maxApoB · Lp(a)Blood pressureResting & recovery HR

VO₂max from a graded test with expired-gas analysis; a lipid panel with ApoB and Lp(a); blood pressure, seated and repeated; resting heart rate and heart-rate recovery at one and two minutes after exercise.

Why

Cardiorespiratory fitness is associated with long-term health in large observational cohorts. ApoB counts the particles that carry cholesterol into the artery wall; Lp(a) is largely inherited and missing from standard panels; blood pressure is interpreted alongside these markers.

What good looks like

VO₂max rising against your own baseline; heart rate recovering faster. Commonly cited reference points:

ApoB: below 100 mg/dL is a widely used prevention bound; lower where risk is higher.
Lp(a): above about 50 mg/dL (a separate commonly used threshold is 125 nmol/L) is commonly treated as elevated; it barely moves with lifestyle, so it is measured once and shared with your physician.
Blood pressure: below 120/80 mmHg is the commonly cited optimum.

Outside range, the target is your physician’s to set.

The test

DXA lean massBone mineral densityGrip strengthLeg power

DXA lean mass and bone mineral density; grip strength on a calibrated dynamometer, best of several attempts each side; leg power from a countermovement jump, or a timed chair-rise where a jump is unwise.

Why

Muscle and bone are the accounts; grip and leg power are how large studies read them, and both predict independence and mortality. Leg power falls faster than strength with age.

What good looks like

Lean mass and bone density stable or rising year on year; grip and leg power rising against your own baseline. The commonly cited cut-points for low grip strength, from the European working group’s definition of sarcopenia, sit around 27 kg for men and 16 kg for women.

The test

Fasting insulin · HbA1cFull lipid panelHormone & thyroid panelInflammation markers

Fasting glucose, fasting insulin and HbA1c; a full lipid panel; full blood count and ferritin; liver and kidney function; a thyroid panel; testosterone, oestradiol, SHBG and cortisol; vitamin D, B12, folate and magnesium; hs-CRP and inflammatory markers. Continuous glucose monitoring where the history calls for it.

Why

Blood tests can add metabolic and clinical context. HbA1c reflects longer-term glucose exposure; a physician interprets results alongside symptoms and history.

What good looks like

Markers inside the laboratory range and, more usefully, stable or improving between panels drawn the same way: fasted, rested, same time of day. The commonly cited threshold for normal glycaemia is an HbA1c below 5.7%. Otherwise the reading is your own trend.

The test

Sleep stages & efficiencyHRV & autonomic balanceCognitive reaction timePerceived stress & recovery

Sleep architecture and efficiency from a validated wearable over weeks; the HRV trend; a short reaction-time task repeated under the same conditions; a brief daily questionnaire on perceived stress and recovery.

Why

Sleep is where training becomes adaptation, and HRV reads the balance between stress and recovery; reaction time drifts with sleep debt before you notice, and the questionnaire catches what the sensors miss.

What good looks like

Sleep efficiency commonly read as good above about 85%, inside a regular window; HRV interpreted against your baseline and training response; reaction time stable or improving; perceived stress falling as recovery rises. All four are read together.

Explore the biomarker index

The second measurement

Why the re-test matters.

Week twelve repeats the agreed protocols under matched conditions. Comparing the results helps guide the next block; it cannot isolate every cause of change.

The re-test commitment, in full

Evidence watch: what changed, and where the page says so

Evidence watch

What changed, and wherethe page says so.

2026WADA Prohibited List 2026Tirzepatide joins semaglutide on the Monitoring Program: watched, not prohibited. The peptides page summarises selected substances; current, product-specific checks remain necessary.Where it is stated
2026US FDA compounding advisory votesThe FDA’s July 2026 advisory review is not drug approval. The practice’s explain, measure and refer boundary remains unchanged.Where it is stated
2026Supplement grades reviewed against the AIS frameworkAIS supplement groups inform the sports shelf; editorial notes and the longevity shelf are identified separately; the human trials behind NMN and NR, resveratrol, spermidine, urolithin A, taurine, GlyNAC, fisetin and CoQ10 read again; rapamycin and metformin left with physicians.Where it is stated
2026Training-science claims re-checkedVelocity-loss thresholds, the acute:chronic ratio’s limits as a predictor, repetitions in reserve, the volume dose–response, HRV-guided training and sleep extension, each sourced on the training and science pages.Where it is stated

A position revised by a new study is recorded here with its date and source.

Where this page stops

Results outside range belong to your physician, and a threshold quoted here is a reference point, not a recommendation.

How referrals work, in the policies

Next step

See your own numbers next to these.

Book the free discovery call

Science overview

Part III · Glossary

The words we use,in plain language.

Fifty-six definitions, with links to their use in coaching.

Search the glossary · all 56 terms

The index and the entries

Every term,and where it works.

A B C D E F H I L M N O P R S T V W

A

Acute:chronic workload ratio (ACWR): Recent training load divided by a longer-term average. A monitoring input, not an individual injury forecast.
What we measure
ApoB: Apolipoprotein B: a count of the particles that carry cholesterol into the artery wall; referred when out of range.
The four frontiers
Asymmetry: The left–right difference in a strength, force or range test, interpreted with its protocol and context.
The performance practice

B

Biological age: An estimate from a specified model, such as a DNA-methylation clock. It is not a direct measurement of lifespan.
What we measure

C

CGM: Continuous glucose monitoring: a sensor records glucose trends. Clinical interpretation belongs to your physician.
What we measure
CISSN: Certified Sports Nutritionist, International Society of Sports Nutrition.
Credentials
Clean sport and the Prohibited List: WADA’s list of prohibited substances and methods. Every recommendation is checked against it. EVOX never prescribes, recommends or sources anything on it, or anything requiring a therapeutic use exemption, for any client; for tested athletes the subject is closed.
The clean-sport policy
Complete Performance Programme: The fullest individual engagement: nutrition and supplementation, a longevity plan, in-person coaching, and competition, shoot, campaign and film preparation, from one model.
Programmes & fees
CPSS: Certified Performance and Sport Scientist, National Strength and Conditioning Association.
Credentials

D

Decade-by-decade plan: Training targets for strength, power, VO₂max and composition at 40, 50, 60 and beyond, set from your own baseline and reviewed at every twelve-week re-test; blood results are reviewed with your physician.
The performance practice
DPDP Act: India’s Digital Personal Data Protection Act, under which the practice operates; UK and EU GDPR requests are honoured, and your data can be exported or deleted within thirty days.
Privacy policy
DXA: Dual-energy X-ray absorptiometry: a scan estimating lean mass, fat mass and bone mineral density.
What we measure

E

Energy availability: The energy left for normal function after training: intake minus exercise expenditure, per kilogram of lean mass. Too low for too long costs hormones, bone, immunity and performance.
Aesthetic physique
EREPS: The European Register of Exercise Professionals, on which Sainath is registered; recognised internationally through ICREPS.
Credentials
Evidence grade: Two scales use similar letters. On the Supplements page, groups A–D follow the Australian Institute of Sport framework: A, strong evidence in specific situations; B, emerging; C, not supported; D, prohibited or high-risk. In Longevity knowledge, A–D and L are EVOX’s editorial labels for the human evidence behind each entry, from A, consistent human trials, to D, no human efficacy data, evidence against, or a use outside its approval; L marks the longevity shelf.
Supplements Longevity knowledge

F

Findings session: Ninety minutes at week three, in person or on video: what each number means, which few matter, and what the plan does about the limiter.
Force–velocity profile: The relationship between force and movement speed, used to inform strength and power programming.
The performance practice
Four frontiers: The four areas the longevity work follows: Heart & circulation; Strength & structure; Metabolism & blood; Sleep, stress & mind. Measured once a year, watched all year.
The longevity practice

H

HOMA-IR: A calculation using fasting glucose and insulin. Clinical interpretation belongs to the physician.
What we measure
HRV: Heart-rate variability: beat-to-beat variation in heart rhythm, read each morning as a trend against your own baseline; an input to the readiness score.
What we measure

I

IGF-1: Insulin-like growth factor 1: a growth-hormone-axis hormone, read with testosterone, SHBG, oestradiol, cortisol and thyroid as one picture.
What we measure
IMTP: Isometric mid-thigh pull: a maximal-strength test against a fixed bar on a force plate, without a heavy barbell.
What we measure

L

Limiter: A priority identified from the assessment that guides the next training block.
The performance practice
Lp(a): Lipoprotein(a): a largely inherited cardiovascular risk marker, reviewed with your physician.
The four frontiers

M

M1 (manipulation of blood and blood components): The section of WADA’s Prohibited List covering blood doping: transfusions, red-blood-cell products and artificially raising oxygen uptake, transport or delivery.
Clean sport
Method, the: Measure. Model. Move. Re-measure. The four movements of every EVOX programme, on a twelve-week loop: a number, a model, a plan, a comparison.
The EVOX Method
Minimal detectable change: A threshold used to distinguish measured change from expected measurement error.
Technology
MLSS: Maximal lactate steady state: the highest intensity at which lactate production and clearance balance; with the ventilatory thresholds it fixes paces and heart-rate zones.
What we measure
Monitoring Program (WADA): Substances WADA watches without prohibiting them: caffeine in competition and the GLP-1 medicines semaglutide and tirzepatide, among others. Monitored is not banned.
Peptides & hormones
Monotony and strain: Training-load indices: monotony describes day-to-day variation; strain combines monotony with weekly load.
What we measure

N

NBC-HWC: National Board Certified Health & Wellness Coach.
Credentials
Nutrigenomics: The study of interactions between nutrition and genetic variation. It does not determine an individual diet by itself.
What we measure

O

Omega-3 index: The proportion of EPA and DHA in red-blood-cell membranes.
What we measure

P

Peptides and hormones: Outside the practice. EVOX does not prescribe, recommend or source peptides, hormones or any prescription compound; hormone questions go to your physician in writing, and for a tested athlete the subject is closed.
The practice boundary
Performance longevity: Training for present performance while supporting long-term physical capacity.
Home
Performance Twin: Sainath’s model of your measurements and training history, used to support coaching decisions and explain their inputs.
The EVOX Method
Programmes, the three: The Performance Intensive (twelve weeks, individuals), Year-Round Coaching (all year, individuals) and the Team Performance Partnership (ongoing, organisations); starting prices are published, the scope agreed after the free call.
Programmes & fees

R

Rate of force development: How quickly force rises during a contraction.
The performance practice
Re-test: The same battery twelve weeks later under the same conditions, read side by side. If the markers agreed in writing have not moved, the next block is rebuilt and delivered without additional fee: a commitment about the plan, not a guarantee of a biological outcome.
The EVOX Method
Readiness score: One number each morning from HRV, sleep, yesterday’s load and their trend: push, maintain or repair, with the reason stated.
The EVOX Method
Repeat-effort decrement: The fall in performance across repeated efforts under a defined testing protocol.
The performance practice
Repetitions in reserve (RIR): How many more repetitions were possible when a set stopped; most sets here finish one to three short of failure.
Training methods
Resting metabolic rate: Energy used at complete rest, measured by expired-gas analysis rather than a formula, with the split between fat and carbohydrate; the anchor for fuelling.
What we measure
Return-to-play criteria: Measures agreed with the medical team to inform rehabilitation and return. Clinical clearance stays with the clinician.
For your coach & physio

S

S0 (non-approved substances): The first section of WADA’s Prohibited List: any pharmacological substance with no current approval from a government health authority for human use is prohibited at all times, named or not. Unapproved peptides sold online fall here unless another section of the List names them.
Clean sport
Session RPE: Rating of perceived exertion times session duration, giving a training load: cheap, validated, the basis of the acute and chronic windows.
What we measure
Six pillars: The performance half of the assessment: Speed; Strength & power; Endurance; Body composition; Recovery; Mobility & resilience. Each measured and trainable; any one can be the limiter.
The performance practice
Sleep efficiency: Time asleep as a fraction of time in bed, read with sleep stages and the regularity of the window, over weeks.
What we measure
Stimulus–recovery–adaptation: A model for planning training stress, recovery and adaptation.
The science
Strict liability: An athlete is responsible for prohibited substances found in their sample, regardless of intent. Supplement certification cannot remove all contamination risk.
Supplements

T

Therapeutic use exemption (TUE): Permission from the relevant anti-doping organisation to use a prohibited medicine for a documented medical condition, under its criteria.
Peptides & hormones
Twelve-week loop: Assessment, findings at week three, coached execution, a check at week eight, the full re-test at week twelve; the next loop written from what moved.
The EVOX Method

V

Velocity-based training: Setting strength work by bar speed rather than a fixed percentage of a one-repetition maximum; a set ends when speed drops by an agreed amount.
What we measure
VO₂max: The highest rate of oxygen use measured during a graded exercise test; one measure of cardiorespiratory fitness.
The four frontiers
VT1 / VT2: Ventilatory thresholds: changes in breathing response during a graded exercise test that inform training intensity.
What we measure

W

WADA ADEL: The World Anti-Doping Agency’s education platform, through which Sainath completed anti-doping education.
Credentials

Definitions are for orientation, not medical advice; where a term is a laboratory marker, interpretation belongs to your physician.

Read the research in context

The science is public.The plan is yours.

One testing day. Findings at week three. A matched re-test at week twelve.

Book the free discovery call Message on WhatsApp Apply

Performance and general health references · 146 records

Full records moved from Longevity knowledge. Their evidence, sources, status and limits are unchanged.

Knowledge references by subject

Choose a subject, then a name. Each link opens the complete existing record, with its evidence, status and limits.

Find a reference

248 linked records.

Therapies, injections, molecules and tests

Therapies & devices68 records

AcupunctureKnowledge reference
Altitude and hypoxic trainingKnowledge reference
Audio-visual entrainment headsetsKnowledge reference
Bioresonance therapy devicesKnowledge reference
Blood-flow-restriction trainingKnowledge reference
Blue-light-blocking glassesKnowledge reference
Bright-light therapy boxesKnowledge reference
Calorie restriction and fasting-mimicking dietsKnowledge reference
Cold-compression units (Game Ready-type)Knowledge reference
Cold-water immersionKnowledge reference
Colonic irrigation (colon hydrotherapy)Knowledge reference
Compression garmentsKnowledge reference
CPAP and oral appliances for sleep apnoeaKnowledge reference
Cranial electrotherapy stimulationKnowledge reference
Cryolipolysis and HIFEM body-contouring devicesKnowledge reference
Cupping therapyKnowledge reference
‘Detox’, as a conceptKnowledge reference
Dry needlingKnowledge reference
Electrical muscle stimulation (EMS and whole-body EMS)Knowledge reference
Elevation-type restrictive training masksKnowledge reference
Enhanced external counterpulsation (EECP)Knowledge reference
Extracorporeal shock wave therapyKnowledge reference
Faecal microbiota transplantationKnowledge reference
Flotation tanks (flotation-REST)Knowledge reference
Foam rolling (self-myofascial release)Knowledge reference
Grounding (earthing) mats and sheetsKnowledge reference
Heart-rate-variability biofeedbackKnowledge reference
Heat acclimationKnowledge reference
Hot-water immersion and heat therapyKnowledge reference
Hyperbaric oxygen therapyKnowledge reference
Hypnosis (clinical hypnotherapy)Knowledge reference
Infrared sauna and ‘ozone sauna’Knowledge reference
Inspiratory muscle training and breathing trainersKnowledge reference
Instrument-assisted soft-tissue mobilisation (IASTM)Knowledge reference
Intermittent fasting and time-restricted eatingKnowledge reference
Intermittent hypoxic–hyperoxic training (IHHT)Knowledge reference
Ketogenic dietsKnowledge reference
Kinesiology tapingKnowledge reference
Massage therapyKnowledge reference
Meditation and mindfulness-based stress reductionKnowledge reference
Microcurrent therapyKnowledge reference
Microneedling and radiofrequency microneedlingKnowledge reference
Molecular hydrogen (inhaled gas and hydrogen-rich water)Knowledge reference
Mouth taping during sleepKnowledge reference
NanoVi-type ‘bio-identical signal’ devicesKnowledge reference
Nebulised ‘lung detox’ therapiesKnowledge reference
Neurofeedback (EEG biofeedback)Knowledge reference
Non-invasive vagus nerve stimulation devicesKnowledge reference
Percussive therapy (massage guns)Knowledge reference
Photobiomodulation and red lightKnowledge reference
Pneumatic compression and full-body suitsKnowledge reference
Pulsed electromagnetic field therapyKnowledge reference
Radiofrequency and focused-ultrasound skin tighteningKnowledge reference
ReikiKnowledge reference
Remote ischaemic preconditioning (RIPC)Knowledge reference
Slow-paced breathingKnowledge reference
Spinal manipulation (chiropractic and osteopathic)Knowledge reference
Static magnets and magnetic braceletsKnowledge reference
Tai chi and qigongKnowledge reference
Tecar therapy (capacitive-resistive electric transfer)Knowledge reference
TENS (transcutaneous electrical nerve stimulation)Knowledge reference
Transcranial direct current stimulationKnowledge reference
Transcranial magnetic stimulationKnowledge reference
Whole-body cryotherapy chambersKnowledge reference
Whole-body hyperthermiaKnowledge reference
Whole-body vibration platformsKnowledge reference
Wim Hof MethodKnowledge reference
YogaKnowledge reference

Vitamin & nutrient shots12 records

B-complex and ‘energy’ shotsKnowledge reference
Biotin (vitamin B7) shots and ‘hair’ dripsKnowledge reference
Coenzyme Q10 injectionKnowledge reference
Folic acid injectionKnowledge reference
Ketorolac (Toradol-type) injectionsKnowledge reference
‘Lipotropic’ and ‘slim’ shotsKnowledge reference
Ondansetron injection as a drip add-onKnowledge reference
Vitamin A (retinyl palmitate) injectionKnowledge reference
Vitamin B12 injectionKnowledge reference
Vitamin B6 (pyridoxine) injectionKnowledge reference
Vitamin D injectionKnowledge reference
Vitamin K (phytonadione) injectionKnowledge reference

IV drips22 records

Amino-acid dripsKnowledge reference
Calcium injection (calcium gluconate) as a drip ingredientKnowledge reference
Curcumin infusionKnowledge reference
DMSO (dimethyl sulfoxide) injections and dripsKnowledge reference
EDTA chelation dripsKnowledge reference
Glutathione, intravenous and intramuscularKnowledge reference
Hydrogen-rich saline and hydrogen infusionsKnowledge reference
Intravenous hydrogen peroxideKnowledge reference
IV alpha-lipoic acidKnowledge reference
IV iron infusionsKnowledge reference
IV rehydration drips (saline and Ringer’s lactate)Knowledge reference
Magnesium injection and dripKnowledge reference
Methylene blue infusionKnowledge reference
NAD+ infusionKnowledge reference
Omega-3 lipid emulsion infusionKnowledge reference
Polyene phosphatidylcholine (essential phospholipid) injectionsKnowledge reference
Potassium chloride and potassium phosphate injectionsKnowledge reference
Resveratrol infusionKnowledge reference
Selenium and trace-mineral injectionsKnowledge reference
Tranexamic acid skin-brightening dripsKnowledge reference
Vitamin C, intramuscular and high-dose intravenousKnowledge reference
Zinc injection and dripKnowledge reference

Biologics & procedures13 records

Actovegin (deproteinised calf-blood extract)Knowledge reference
Botulinum toxin injections (Botox-type)Knowledge reference
Corticosteroid joint and soft-tissue injectionsKnowledge reference
Deoxycholic acid injection (Kybella)Knowledge reference
Exosome infusionKnowledge reference
‘Fat-dissolving’ injections that are not approvedKnowledge reference
Hyaluronic-acid joint injections (viscosupplementation)Knowledge reference
Hyaluronic-acid ‘skin boosters’Knowledge reference
Intravenous laser therapyKnowledge reference
MesotherapyKnowledge reference
Polynucleotide (PN) and PDRN ‘salmon DNA’ skin injectionsKnowledge reference
PRP and prolotherapy injectionsKnowledge reference
Stem-cell injectionsKnowledge reference

Healing & repair8 records

Ac-SDKPKnowledge reference
Acetyl hexapeptide-8 (Argireline)Knowledge reference
AfamelanotideKnowledge reference
AHK-CuKnowledge reference
GHK-Cu (copper peptide)Knowledge reference
Palmitoyl pentapeptide (Matrixyl)Knowledge reference
Teriparatide and abaloparatideKnowledge reference
VIP (aviptadil)Knowledge reference

Metabolic & weight12 records

Dulaglutide, lixisenatide and pramlintideKnowledge reference
EcnoglutideKnowledge reference
Enlicitide decanoate (Lipfendra)Knowledge reference
ExenatideKnowledge reference
GlucagonKnowledge reference
LiraglutideKnowledge reference
Metreleptin (Myalepta)Knowledge reference
OrforglipronKnowledge reference
SemaglutideKnowledge reference
SetmelanotideKnowledge reference
TesofensineKnowledge reference
TirzepatideKnowledge reference

Mitochondrial & longevity21 records

1,3-ButanediolKnowledge reference
17-alpha-estradiol (alfatradiol)Knowledge reference
AcarboseKnowledge reference
Aspirin, low-doseKnowledge reference
Captopril (ACE inhibitor)Knowledge reference
Dasatinib plus quercetin (D+Q)Knowledge reference
Everolimus and RTB101Knowledge reference
JAK inhibitors (ruxolitinib) as ‘senomorphics’Knowledge reference
Klotho (protein, ‘longevity factor’)Knowledge reference
MeclizineKnowledge reference
Metformin, longevity useKnowledge reference
NAD+ precursors (NMN, NR) — pointerKnowledge reference
Nordihydroguaiaretic acid (NDGA)Knowledge reference
PDE5 inhibitors (sildenafil, tadalafil) in ageing researchKnowledge reference
Protandim (herbal antioxidant blend)Knowledge reference
Rapamycin (sirolimus), low-dose longevity useKnowledge reference
Selegiline (L-deprenyl)Knowledge reference
SGLT2 inhibitors (canagliflozin, empagliflozin, dapagliflozin)Knowledge reference
SS-31 (elamipretide)Knowledge reference
StatinsKnowledge reference
TAME (Targeting Aging with Metformin) trialKnowledge reference

Cognitive & mood7 records

CerebrolysinKnowledge reference
Modafinil and armodafinilKnowledge reference
Noopept (GVS-111)Knowledge reference
Pinealon and the Khavinson bioregulatorsKnowledge reference
Piracetam and other racetamsKnowledge reference
SelankKnowledge reference
SemaxKnowledge reference

Immune3 records

Thymalin and thymogenKnowledge reference
Thymosin alpha-1 (thymalfasin)Knowledge reference
ThymulinKnowledge reference

Sexual & reproductive2 records

Oxytocin (nasal and injected)Knowledge reference
PT-141 (bremelanotide)Knowledge reference

Hormones20 records

Anti-androgens (bicalutamide, flutamide, cyproterone, enzalutamide)Knowledge reference
Cabergoline and bromocriptine (dopamine agonists)Knowledge reference
Calcitonin salmonKnowledge reference
Cortisol-synthesis inhibitors and glucocorticoid-receptor blockersKnowledge reference
Desiccated thyroid extract (Armour Thyroid, NP Thyroid)Knowledge reference
Estetrol and conjugated oestrogensKnowledge reference
Estriol, estrone and compounded ‘bioidentical’ hormone blendsKnowledge reference
Finasteride and dutasteride (5-alpha-reductase inhibitors)Knowledge reference
FludrocortisoneKnowledge reference
Follitropin alfa and menotropins (FSH and hMG)Knowledge reference
Hydrocortisone (cortisol) and ‘adrenal support’ claimsKnowledge reference
MelatoninKnowledge reference
Oestradiol and progesterone (menopausal HRT)Knowledge reference
Prednisone, dexamethasone and other glucocorticoidsKnowledge reference
PregnenoloneKnowledge reference
Somatostatin analogues and growth-hormone-receptor antagonistsKnowledge reference
Synthetic progestogens (medroxyprogesterone, norethisterone, dydrogesterone, drospirenone)Knowledge reference
Thyroid hormone (levothyroxine, liothyronine)Knowledge reference
Tiratricol (Emcitate)Knowledge reference
Vasopressin and carbetocinKnowledge reference

Tests & assessments60 records

Air-displacement plethysmography (Bod Pod)Knowledge reference
ALCAT testKnowledge reference
Anti-Müllerian hormone (AMH) and ovarian-reserve testsKnowledge reference
APOE genotypingKnowledge reference
Applied kinesiology (muscle testing)Knowledge reference
Bioelectrical-impedance body-composition scalesKnowledge reference
Blood-chemistry ‘phenotypic age’ calculatorsKnowledge reference
Breath tests for small intestinal bacterial overgrowth (SIBO)Knowledge reference
CANTAB-type computerised cognitive batteriesKnowledge reference
Computerised concussion tests (ImPACT-type)Knowledge reference
Consumer DNA and nutrigenomic panelsKnowledge reference
Consumer sleep trackers (wearables, rings and apps)Knowledge reference
Continuous glucose monitors in people without diabetesKnowledge reference
Coronary artery calcium (CAC) scoreKnowledge reference
Cystatin C (kidney function)Knowledge reference
Direct-to-consumer genetic health-risk reportsKnowledge reference
DUTCH dried-urine hormone panelsKnowledge reference
EchocardiographyKnowledge reference
Electrodermal testing (Vega test)Knowledge reference
Epigenetic clocks (DNA-methylation biological-age tests)Knowledge reference
Exercise stress test (treadmill ECG)Knowledge reference
Gait speed and chair-stand testsKnowledge reference
Gut microbiome testsKnowledge reference
Haemoglobin-mass testing (carbon-monoxide rebreathing)Knowledge reference
Hair mineral (trace-element) analysisKnowledge reference
Hair-strand bioresonance testsKnowledge reference
Handgrip strength testKnowledge reference
High-sensitivity C-reactive protein (hs-CRP)Knowledge reference
Homocysteine blood testKnowledge reference
IgG and IgG4 food-intolerance blood testsKnowledge reference
IgG glycan ‘glycan age’ testsKnowledge reference
Iridology (iris analysis)Knowledge reference
Live-blood (darkfield) analysisKnowledge reference
Liver elastographyKnowledge reference
Magnesium status testsKnowledge reference
Multi-biomarker ‘longevity’ and executive health-check panelsKnowledge reference
Multi-cancer early detection (MCED) blood testsKnowledge reference
NT-proBNP and BNP blood testsKnowledge reference
OligoScan and palm spectrophotometryKnowledge reference
Omega-3 IndexKnowledge reference
Pharmacogenomic (drug–gene) panelsKnowledge reference
Plasma p-tau217 and amyloid blood testsKnowledge reference
Polygenic risk scoresKnowledge reference
Polysomnography (overnight sleep study)Knowledge reference
Post-chelator-challenge (‘provoked’) urinary metal testsKnowledge reference
Provocation–neutralisation testingKnowledge reference
Pulse-wave velocity and arterial-stiffness testsKnowledge reference
Salivary-cortisol ‘adrenal stress’ panelsKnowledge reference
Semen analysisKnowledge reference
Smartwatch and smart-ring blood-glucose readingsKnowledge reference
Sweat-rate and sweat-sodium testingKnowledge reference
Telomere-length testsKnowledge reference
Thermography for breast cancer screeningKnowledge reference
Thyroid antibody testsKnowledge reference
Urine test strips and appsKnowledge reference
VO₂max estimates from wearables and smartwatchesKnowledge reference
What the practice measures firstKnowledge reference
Whole-body CT screening in people without symptomsKnowledge reference
Whole-body MRI screening in people without symptomsKnowledge reference
Zonulin (‘leaky gut’) blood testsKnowledge reference

Therapies & devicesAcupuncture Needle acupuncture · Medical acupuncture

BNot prohibitedDevice

What it is: A technique in which practitioners insert fine needles into the skin to treat health problems. Marketed for pain, sports injuries, stress, sleep and general wellbeing.
What the evidence shows: NCCIH says research shows acupuncture may help several pain conditions, including back or neck pain, knee pain from osteoarthritis and postoperative pain. It gives no study counts. No evidence for stress, sleep or general wellbeing is cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. NCCIH states that the US FDA regulates acupuncture needles as medical devices and requires that they be sterile and labelled for single use only.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: Relatively few complications from using acupuncture have been reported, according to NCCIH. Those reported are mostly from non-sterile needles or improper delivery.

Sources: Acupuncture: What You Need To Know (NCCIH, October 2022)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesAltitude and hypoxic training Live High-Train Low (LHTL) · Intermittent hypoxic training (IHT) · Hypoxic tent · Altitude tent · Altitude house · Hypoxic chamber

BNot prohibitedMethod or practice

What it is: Living or training in reduced-oxygen air, natural (altitude) or simulated (tents, chambers), to raise endurance capacity; the classic model is live high-train low. Marketed for endurance performance, aerobic-capacity gains and altitude preparation.
What the evidence shows: A 2023 network meta-analysis of randomised trials in athletes included 59 studies. Live-high train-low, live-high train-high and intermittent hypoxic training outperformed normoxic training for VO2max. A 2023 Olympic-programme review gives practical lessons on individual response, iron status and natural versus simulated hypoxia. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: A training method rather than a regulated product; no regulatory approval was verified for tents or chambers.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List. A CBC report states that WADA chose not to add oxygen tents to the list of banned substances and methods for 2007. S2.1.2 names hypoxia-inducible factor (HIF) activating agents such as cobalt and xenon.
What can go wrong: No adverse-effect data are cited here for altitude or hypoxic training.

Sources: Optimal type and dose of hypoxic training for improving maximal aerobic capacity in athletes: systematic review and network meta-analysis (Frontiers in Physiology, 2023) · Anti-doping agency won't ban oxygen tents (CBC report on WADA's 2006 decision) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesAudio-visual entrainment headsets BrainTap-type headset · Binaural beats · Isochronic tones · Light-and-sound therapy · AVE · Brainwave entrainment

CNot prohibitedDevice

Headphones with a visor that pulse light and sound at chosen frequencies

What it is: Rhythmic light and sound intended to nudge brain rhythms towards a target frequency, sold with guided-relaxation audio and a subscription.
What it is sold for: Marketed for sleep, stress, focus, ‘brain fitness’ and recovery.
What the evidence shows: A 2019 meta-analysis of 22 studies of binaural beats found a medium pooled effect on cognition, anxiety and pain perception, larger with longer exposure, from mostly small laboratory experiments with mixed memory results. That is evidence that rhythmic sound changes a state for a while, not that a headset improves sleep, learning or recovery in daily life, for which no controlled trial of the commercial devices exists. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Device. General-wellness products with no medical clearance and none claimed; a claim to treat insomnia, ADHD or anxiety would fall outside that policy.
Anti-doping status, 2026 List: Not prohibited. Not a substance or a method on the List.
What can go wrong: Flashing light at 5–30 Hz is the classic trigger of photosensitive seizures, which affect about 3 per cent of people with epilepsy; anyone with epilepsy or a family history should not use a flashing visor. Migraine and eye strain in some users.
What the practice does: Sleep is measured as regularity, duration and efficiency and coached through the sleep protocol first. A client who finds a headset relaxing may use it as the wind-down, after the epilepsy question has been asked.

Sources: Garcia-Argibay et al., 2019 — efficacy of binaural auditory beats: a meta-analysis (Psychological Research) · Epilepsy Foundation — photosensitivity and seizures · US FDA — general wellness: policy for low-risk devices (2026)

Link to this entry

Therapies & devicesBioresonance therapy devices Bioresonance · Bioresonance therapy · Biophysical information therapy (BIT)

DNot prohibitedMethod or practice

What it is: A therapy in which a device applies electromagnetic oscillations to the body, also called biophysical information therapy (BIT). Small studies describe its use for atopic dermatitis, allergy, depression, thyroid problems and pain.
What the evidence shows: A double-blind randomised trial in 32 children hospitalised with atopic dermatitis found that BIT had no significant additive measurable effect, and concluded that BIT has no place in the treatment of children with atopic dermatitis. Other reports (case reports, observational and quasi-experimental studies, two small randomised trials and one review) describe benefits but are mostly uncontrolled, small or single-centre. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: No regulator approval or warning on bioresonance devices is cited here, and the technique is not validated.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: No safety data or regulator safety statement on bioresonance devices is cited here.

Sources: Efficacy Trial of Bioresonance in Children with Atopic Dermatitis (Schöni et al., Int Arch Allergy Immunol)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesBlue-light-blocking glasses Blue-blockers · Blue-light glasses · Amber glasses · Blue-light filtering spectacle lenses · Computer glasses

CNot prohibitedDevice

What it is: Spectacle lenses that filter blue-wavelength light. Marketed for less eyestrain from screens, retina (macular) protection and better sleep quality.
What the evidence shows: A Cochrane review of 17 randomised trials with 619 participants, with follow-up from under one day to five weeks, found that blue-light-filtering lenses may not reduce short-term eyestrain from computer work. Effects on sleep are unclear: three studies showed improvement and three showed no difference. No finding on macular protection is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Device. Spectacle lenses, treated as a device. No regulatory approval or position on the blue-light-filtering claims was verified.
Anti-doping status, 2026 List: Not prohibited. Blue-light-blocking glasses are not named on the 2026 Prohibited List, including under M2, chemical and physical manipulation.
What can go wrong: No adverse-effect or safety data for blue-light-filtering lenses are cited here.

Sources: Blue-light filtering spectacle lenses for visual performance, macular protection and sleep quality (Cochrane) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesBright-light therapy boxes Light box · SAD lamp · Bright-light therapy · Seasonal affective disorder light

BNot prohibitedDevice

What it is: A box that mimics outdoor light, thought to cause a chemical change in the brain that lifts mood and eases symptoms of seasonal affective disorder (SAD). Sold for SAD and winter low mood.
What the evidence shows: Mayo Clinic states that light therapy boxes can offer an effective treatment for seasonal affective disorder and may work better combined with an antidepressant or psychotherapy. No study counts are cited here; the statement concerns seasonal affective disorder. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. Light boxes are devices. Mayo Clinic states that they are not regulated by the US Food and Drug Administration (FDA) for SAD treatment and can be bought without a prescription.
Anti-doping status, 2026 List: Not prohibited. Light boxes are not named on the 2026 Prohibited List, including under M2, chemical and physical manipulation.
What can go wrong: Mayo Clinic says that in bipolar disorder too much exposure too fast may induce manic symptoms.

Sources: Seasonal affective disorder treatment: light therapy (Mayo Clinic, updated 30 March 2022) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesCold-compression units (Game Ready-type) Game Ready system · Cryo-compression therapy (CCT) · Cold compression therapy · Dynamic cold-compression unit

BNot prohibitedDevice

What it is: A powered wrap that combines cold with intermittent inflation (compression) over a limb, marketed for post-injury and post-surgery swelling and pain, and for sports recovery.
What the evidence shows: One 2025 randomised trial in 48 combat-sport athletes compared pneumatic compression (two pressures), cryo-compression and passive rest after fatiguing jump exercise: both compression types improved tissue perfusion and muscle elasticity versus rest, and cryo-compression gave a more immediate reduction in soreness. No clear performance advantage was established, and no systematic review is cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. FDA 510(k) clearance K243572 (2025) covers the Game Ready system as a Class II device (powered inflatable tube massager), indicated for the temporary relief of minor muscle aches and pains and for localised therapy where cold temperature therapy is necessary or desirable.
Anti-doping status, 2026 List: Not prohibited. Cold-compression units are not named on the 2026 Prohibited List.
What can go wrong: No adverse-effect data for cold-compression units are cited here.

Sources: FDA 510(k) clearance letter K243572, Game Ready system (2025) · WADA 2026 Prohibited List (copy published by the International Testing Agency) · Effect of pneumatic and cold compression on muscle performance and recovery in combat sports athletes (Scientific Reports, 2025)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesCold-water immersion Ice bath · Cold plunge · CWI · Contrast bathing · Cold therapy tub

BNot prohibitedDevice

Immersion to the neck or waist in cold water

What it is: Cooling the body in water, which narrows blood vessels, slows nerve conduction and blunts the inflammatory signalling that follows hard exercise.
What it is sold for: Marketed for recovery, soreness, inflammation, mood, immunity and resilience.
What the evidence shows: Soreness is perceived as lower after immersion in most trials, though in one placebo-controlled study the effect was no larger than placebo. The cost is adaptation: Roberts and colleagues found twelve weeks of strength training with cold immersion produced smaller gains in strength, muscle mass, type II fibre area and satellite cells than active recovery, and Fyfe and colleagues found seven weeks with 15 minutes at 10°C blunted fibre hypertrophy and mTOR signalling while strength was preserved. Mood and immune claims are speculation. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. Regulation depends on the product, its intended use and its claims. Wellness marketing does not establish medical benefit.
Anti-doping status, 2026 List: Not prohibited. Not a substance or a method on the List.
What can go wrong: The cold-shock response causes gasping and hyperventilation in the first minutes; simultaneous sympathetic and parasympathetic drive can trigger fatal arrhythmias, and most cold-water drownings are of good swimmers. A medical question for heart disease or hypertension.
What the practice does: Cold is scheduled, not habitual: kept out of strength and hypertrophy blocks, reserved for congested competition weeks and pre-cooling in heat, and a medical question first for a client with a cardiac history. Recovery is read as HRV, sleep and readiness.

Sources: Roberts et al., 2015 — post-exercise cold water immersion attenuates anabolic signalling and long-term adaptations (J Physiol; record with abstract, IAT Leipzig) · Fyfe et al., 2019 — cold water immersion attenuates fibre hypertrophy but not strength gain (J Appl Physiol; Edith Cowan University repository) · Piñero et al. — post-exercise cold water immersion and resistance-training hypertrophy: systematic review and meta-analysis (SportRxiv preprint of the 2024 Eur J Sport Sci paper) · Tipton et al., 2017 — cold water immersion: kill or cure? (Experimental Physiology)

Link to this entry

Therapies & devicesColonic irrigation (colon hydrotherapy) Colonics · Colon cleanse · Enema cleanse

DNot prohibitedMethod or practice

What it is: Cleansing the lower intestinal tract with enemas, laxatives or colon hydrotherapy, offered as part of ‘detoxification’ programmes. Marketed for ‘detox’, toxin removal, weight loss and general health.
What the evidence shows: NCCIH states that there is limited clinical evidence validating colonic irrigation and insufficient evidence for its prescribed uses. A 2015 review found no compelling research to support ‘detox’ diets for weight management or for removing toxins. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: A method rather than a regulated product. NCCIH says the FDA and FTC have acted against some detox products for hidden ingredients, false disease claims or unapproved uses.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: NCCIH says some ‘detoxification’ or ‘cleansing’ programmes can be unsafe and falsely advertised.

Sources: Detoxes and Cleanses: What You Need To Know (NCCIH, March 2025) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesCompression garments Compression tights · Compression sleeves · Compression socks · Recovery compression wear · Compression clothing

BNot prohibitedMethod or practice

What it is: Close-fitting elastic garments (tights, sleeves, socks) that apply pressure to the limbs during or after exercise. Marketed for less muscle soreness, faster recovery, circulation and lower perceived fatigue.
What the evidence shows: In a meta-analysis of 99 recovery studies, compression garments, massage, immersion, contrast water therapy, cryotherapy and active recovery each gave small to large reductions in muscle soreness. The authors say perceived fatigue can be managed with compression garments, massage or water immersion. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: A method rather than a regulated product. No approval as a medicine was verified for compression garments.
Anti-doping status, 2026 List: Not prohibited. Compression garments are not named on the 2026 Prohibited List.
What can go wrong: No adverse-effect data on compression garments are cited here.

Sources: Dupuy et al. 2018, post-exercise recovery techniques: systematic review with meta-analysis (Frontiers in Physiology) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesCranial electrotherapy stimulation CES · Cranial electrical stimulation · Alpha-Stim-type device · Head-worn electrical stimulator

CNot prohibitedDevice

What it is: A prescription device that applies electrical current, not intended to induce a seizure, to a patient’s head to treat psychiatric conditions. Marketed for anxiety, insomnia and depression.
What the evidence shows: The FDA’s 2019 order reviewed published studies. Treatment-group outcomes improved in all large published studies and in 18 of 24 small ones (under 50 patients). Evidence is limited, and weakest for depression, so that use needs premarket approval. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Device. FDA reclassified CES for anxiety and/or insomnia from class III to class II (special controls), effective 20 December 2019. CES for depression requires premarket approval (PMA).
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: The FDA order identified headache, dizziness, skin irritation, electrical shocks and burns as risks.

Sources: Neurological Devices; Reclassification of Cranial Electrotherapy Stimulator Devices (FDA final order, Federal Register, 20 December 2019) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesCryolipolysis and HIFEM body-contouring devices CoolSculpting-type · Zeltiq (applicant name in FDA records) · HIFEM (high-intensity focused electromagnetic) · Emsculpt-type · Electromagnetic muscle stimulation for body contouring

BNot prohibitedDevice

What it is: Cryolipolysis applies controlled cooling to skin to injure fat cells and is sold for non-surgical reduction of localised fat. HIFEM (high-intensity focused electromagnetic) devices apply a focused electromagnetic field to make muscle contract and are sold for toning.
What the evidence shows: Cryolipolysis: a 2022 systematic review of five studies found that most showed significant localised fat reduction, and a 2025 meta-analysis of submental treatment (8 studies, 206 patients) pooled a mean fat-thickness reduction of 2.78 mm. The underlying studies are limited and mostly small. Electromagnetic (HIFEM-type) stimulation: a 2022 systematic review of 14 clinical studies describes the evidence for efficacy as tenuous. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. In FDA records both are devices. Cooling devices for body contouring are class II (21 CFR 878.4340); electromagnetic muscle stimulators are powered muscle stimulators (21 CFR 890.5850), with a 2018 BTL summary listing toning of the abdomen, buttocks and thighs.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 List of prohibited substances and methods.
What can go wrong: For cryolipolysis, a 2020 review of 53 articles lists erythema, numbness, bruising and oedema as the commonest adverse events, and also paradoxical adipose hyperplasia. A 2025 meta-analysis of 28 studies put its incidence at 0.22% (1 in 455) and said this appears higher than manufacturer reports. No adverse-event data are cited for electromagnetic stimulation.

Sources: FDA 510(k) summary K180813, BTL 799-2 (21 CFR 890.5850, product code NGX) · WADA 2026 Prohibited List (copy published by the International Testing Agency) · Cryolipolysis for Submental Fat Reduction: A Systematic Review and Meta-Analysis

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesCupping therapy Dry cupping · Wet cupping · Hijama · Fire cupping · Myofascial decompression cupping

CCheck on Global DROMethod or practice

What it is: Suction cups placed on the skin, used for pain and muscle tightness; ‘wet’ cupping is a variant that the reviews list separately. Marketed for back and neck pain, muscle tightness and sports recovery.
What the evidence shows: A systematic review of 22 studies rated the evidence moderate for soft-tissue flexibility, low to moderate for back or neck pain and very low to low for other conditions. An umbrella review of 21 reviews and 301 studies reported low confidence; most of the reviews found cupping generally ineffective for musculoskeletal pain. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: A method rather than a regulated product. No approval as a medicine was verified for cupping.
Anti-doping status, 2026 List: Check on Global DRO. Not named in the 2026 Prohibited List text reviewed. If wet cupping draws blood, the M1 rule on withdrawing blood or blood components needs checking; it excepts withdrawal for analytical purposes, including medical tests or Doping Control. Check the exact procedure on Global DRO.
What can go wrong: Cupping can cause mild or moderate adverse events; no serious events were reported in the umbrella review.

Sources: Evidence-based and adverse-effects analyses of cupping therapy in musculoskeletal and sports rehabilitation (Journal of Back and Musculoskeletal Rehabilitation, 2023) · Effectiveness of cupping therapy for musculoskeletal pain: an umbrella review (Human Movement, 2024) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devices‘Detox’, as a concept Detoxification · Cleanse · Toxin flush · Heavy-metal detox · Lymphatic detox

DCheck on Global DROUnapproved for the described use

Sold as drips, suits, saunas, foot baths, teas, chelation and colonics

What it is: A marketing word borrowed from the treatment of poisoning. The liver modifies waste and drugs for excretion; the kidneys filter roughly 140 litres of blood a day and send wastes, excess fluid and acid out as urine.
What it is sold for: Marketed as removing unnamed ‘toxins’ to restore energy, skin, weight and immunity.
What the evidence shows: NCCIH’s summary: a 2015 review found no compelling research that detox diets remove toxins or manage weight, and the FDA and FTC have acted against detox products for hidden ingredients and false claims. No device, drip, sauna or foot bath has been shown to remove a named toxin from a person who was not poisoned. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. Not a medical procedure. Chelation is an approved treatment for measured heavy-metal poisoning and nothing else.
Anti-doping status, 2026 List: Check on Global DRO. The word is not on the List, but the products can be: ‘detox’ teas and capsules have contained diuretics (S5) and stimulants, and IV drips totalling more than 100 mL in twelve hours are prohibited under M2.2 unless legitimately received during hospital treatment, surgery or clinical diagnostic investigation.
What can go wrong: Dehydration and electrolyte loss from laxatives and diuretics; infection from colonics; death from chelation given for imagined poisoning, as in the three hypocalcaemia deaths the CDC reported from disodium EDTA.
What the practice does: The practice explains what the liver and kidneys do and measures them: liver enzymes, GGT, creatinine and eGFR are in the standard panel, and anything out of range goes to a physician.

Sources: NCCIH — detoxes and cleanses: what you need to know · NIDDK — your kidneys and how they work · CDC MMWR — deaths associated with hypocalcaemia from chelation therapy, 2003–2005

Link to this entry

Therapies & devicesDry needling Trigger-point dry needling · Intramuscular needling · Myofascial trigger point needling

BNot prohibitedMethod or practice

What it is: A minimally invasive treatment that inserts a needle into muscle trigger points. Marketed for neck, shoulder and low-back pain, muscle tightness and sports injury recovery.
What the evidence shows: A 2023 umbrella review of 36 systematic reviews found dry needling superior to sham or no intervention, and equally effective to other interventions, for short-term pain relief regardless of body region. Functional results were contradictory, and mid- and long-term data were limited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: A method rather than a regulated product; no approval specific to dry needling was verified. NCCIH states that the US FDA regulates acupuncture needles as medical devices that must be sterile and labelled for single use only.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: In the umbrella review, minor adverse effects occurred in 47% of trials, and no major events occurred across 210 unique randomised trials.

Sources: Clinical Effectiveness of Dry Needling in Patients with Musculoskeletal Pain: An Umbrella Review (Journal of Clinical Medicine, 2023) · NCCIH

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesElevation-type restrictive training masks Elevation Training Mask (ETM) · Altitude training mask · Airflow-restricting training mask

DNot prohibitedDevice

What it is: A face mask that restricts airflow during exercise, with settings labelled as simulated altitudes; promoted for altitude-style conditioning, endurance performance and respiratory muscle training.
What the evidence shows: A 2020 critically appraised topic found no difference in VO2max improvement compared with the same training without the mask, although several studies showed improvements in respiratory-function measures. A 2019 trial in 36 young soccer players found no significant difference between mask and control groups in anaerobic power, VO2max, speed or flexibility. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Device. A training device. No regulator statement on these masks is cited.
Anti-doping status, 2026 List: Not prohibited. The mask is not named on the 2026 Prohibited List; the nearest item, M1.2, covers artificially enhancing the uptake, transport or delivery of oxygen.
What can go wrong: No adverse-effect data are cited here.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · The Elevation Training Mask: A Critically Appraised Topic (Int J Athl Ther Train, 2020) · Long-term effects of wearing the Elevation Training Mask on physical performance in young soccer players (Kinesiologia Slovenica, 2019)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesEnhanced external counterpulsation (EECP) EECP · External counterpulsation · External counter-pulsating device · Counter-pulsating device, external

BNot prohibitedDevice

What it is: A non-invasive treatment in which cuffs on the calves, thighs and pelvis apply pressure to the limbs in time with the heartbeat. Cleared use: chronic stable angina refractory to optimal anti-anginal medical therapy.
What the evidence shows: A 2026 meta-analysis of 26 studies in chronic refractory angina found lower angina class and nitroglycerin use, and better walking test, treadmill and quality-of-life results. Only two studies were randomised and sham-controlled, heterogeneity was high, and the largest effects were driven substantially by uncontrolled before-after data. No controlled human trial in healthy people, sport performance or longevity is cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. US FDA regulation 21 CFR 870.5225 describes a noninvasive prescription device: Class II with special controls for chronic stable angina refractory to optimal anti-anginal therapy and without options for revascularisation; Class III (premarket approval) for other listed uses, including athletic injuries.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List, including under M1.2, which concerns artificially enhancing the uptake, transport or delivery of oxygen.
What can go wrong: Adverse events in the meta-analysis were usually mild: leg pain, skin irritation or abrasion. Withdrawal was more frequent with active EECP than with sham treatment.

Sources: 21 CFR 870.5225, external counter-pulsating device (eCFR) · WADA 2026 Prohibited List (copy published by the International Testing Agency) · Enhanced External Counterpulsation Versus Standard Medical Therapy for Chronic Refractory Angina: A Systematic Review and Meta-Analysis (Biomedicines, 17 September 2026)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesExtracorporeal shock wave therapy ESWT · Shockwave therapy · Radial shockwave · Focused shockwave · Acoustic wave therapy

BNot prohibitedDevice

What it is: A non-invasive procedure that delivers high-energy shockwave impulses through the skin to stimulate healing in damaged tissue such as the plantar fascia. Marketed for plantar fasciitis, tendon injuries and chronic soft-tissue pain in athletes.
What the evidence shows: AAOS patient information states that results of ESWT for plantar fasciitis are mixed and it is not clear that the treatment is helpful, so ESWT is not commonly performed. No trial counts are cited here. Evidence for tendon injuries and other soft-tissue pain is not cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. FDA premarket approval P040026 (Orthospec, approved 1 April 2005) covers one device for proximal plantar fasciitis in patients 18 years of age or older with symptoms for 6 months or more after failed conservative therapy. No approval for other uses was verified.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: No adverse-event data are cited here for shock wave therapy.

Sources: Plantar Fasciitis and Bone Spurs (AAOS OrthoInfo) · FDA PMA record P040026, Orthospec extracorporeal shock wave therapy device

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesFaecal microbiota transplantation FMT · REBYOTA (donor human stool suspension) · VOWST (faecal microbiota spores, live-brpk)

DNot prohibitedUnapproved for the described use

What it is: Transfer of processed stool from a screened donor into another person’s gut to alter the recipient’s gut bacteria. The labelled medical use is preventing recurrent Clostridioides difficile infection (CDI) in individuals aged 18 and older.
What the evidence shows: For preventing recurrent CDI, a randomised placebo-controlled study of one donor-stool product in 262 adults found treatment success (no CDI diarrhoea within 8 weeks) of 70.6% against 57.5% with placebo. No controlled-trial evidence for ageing, longevity or general wellness use is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. FDA labels for two donor-stool-derived products limit use to preventing recurrence of CDI in individuals aged 18 and older; neither is indicated to treat CDI. No approval as a medicine was verified for wellness, ageing or longevity use.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: Both labels warn that products made from human faecal matter may carry a risk of transmitting infectious agents. In 2019 FDA reported two immunocompromised adults who developed invasive ESBL-producing E. coli infections after investigational FMT; one died.

Sources: REBYOTA prescribing information, DailyMed (NLM): indications and usage · US FDA safety alert on fecal microbiota transplantation and risk of serious adverse reactions (June 2019)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesFlotation tanks (flotation-REST) Float tank · Isolation tank · Sensory-deprivation tank · Floatation therapy · Epsom-salt float pod · REST

BNot prohibitedMethod or practice

What it is: Lying in an enclosed tank of buoyant salt water with minimal sensory input, to induce deep relaxation (restricted environmental stimulation therapy, REST). Marketed for stress and anxiety relief, pain, sleep, athletic recovery and creativity.
What the evidence shows: A systematic review searched to May 2024 found 63 studies with 1,838 participants. Positive effects were reported for pain, athletic performance, stress, mental well-being and clinical anxiety; there was limited or no effect on sleep disorders and smoking cessation. The authors call for more research. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: A method rather than a regulated product. No approval as a medicine was verified for flotation.
Anti-doping status, 2026 List: Not prohibited. Flotation is not named on the 2026 Prohibited List.
What can go wrong: The systematic review notes that flotation may not be appropriate for some individuals because of medical conditions such as open wounds, claustrophobia or severe skin conditions.

Sources: A systematic review of flotation-restricted environmental stimulation therapy (REST), BMC Complementary Medicine and Therapies, 2025 · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesFoam rolling (self-myofascial release) Foam roller · SMR · Roller massage

BNot prohibitedMethod or practice

What it is: Self-applied pressure and rolling over a muscle on a cylinder of dense foam, done before or after exercise. Marketed for flexibility, warm-up, soreness and recovery.
What the evidence shows: A meta-analysis of 21 studies found that rolling before exercise gave small improvements in sprint performance (0.7%) and flexibility (4.0%), with negligible effects on strength, and that rolling after exercise modestly reduced muscle soreness. The authors judged the effects ‘rather minor’ and support foam rolling as a warm-up rather than a recovery tool. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: A method rather than a regulated product. No approval as a medicine was verified for foam rolling.
Anti-doping status, 2026 List: Not prohibited. Foam rolling is not named on the 2026 Prohibited List.
What can go wrong: No adverse-effect data on foam rolling are cited here.

Sources: A Meta-Analysis of the Effects of Foam Rolling on Performance and Recovery (Wiewelhove et al., Frontiers in Physiology, 2019) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesGrounding (earthing) mats and sheets Earthing · Grounding · Earthing mat · Grounding sheet · Barefoot earthing

CNot prohibitedDevice

What it is: Connecting the body electrically to the earth, for example barefoot or through conductive mats and sheets, claimed to reduce pain and improve wellbeing.
What the evidence shows: A selective evidence-based-medicine review of grounding for pain identified three studies: a double-blind randomised placebo-controlled trial, a randomised placebo-controlled trial and a prospective cohort. Two showed pain reduction and one showed no significant difference. Samples were small; the authors say grounding shows promise for subjective pain and that more data are needed. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Device. Conductive mats and sheets are classed as devices. No regulatory approval or position on grounding products or their pain claims was verified.
Anti-doping status, 2026 List: Not prohibited. Grounding mats and sheets are not named on the 2026 Prohibited List, including under M2, chemical and physical manipulation.
What can go wrong: No adverse-effect or safety data for grounding are cited here.

Sources: Does Grounding to the Earth Reduce Subjective Experience of Pain? (selective EBM review, PCOM) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesHeat acclimation Heat acclimatisation · Heat adaptation · Heat training · Training in the heat

ANot prohibitedMethod or practice

What it is: Repeated exposure to hot conditions, usually by exercising in the heat, so that the body adapts to warm-hot environments. Aimed at better performance and comfort when competing in hot conditions.
What the evidence shows: Consensus recommendations published in the British Journal of Sports Medicine in 2015 state that heat acclimatisation improves thermal comfort and both submaximal and maximal aerobic exercise performance in warm-hot conditions. Most adaptations develop within the first week and more slowly over the following 2 weeks. No evidence on passive heating, such as baths or sauna, is cited here. Grade A · Consistent human trials support the claimed use, in the people it is claimed for
Regulatory status: A training method rather than a regulated product.
Anti-doping status, 2026 List: Not prohibited. Heat acclimation is not named on the 2026 Prohibited List, including under M2, chemical and physical manipulation.
What can go wrong: No safety or adverse-effect data for heat acclimation are cited here.

Sources: Consensus recommendations on training and competing in the heat (British Journal of Sports Medicine, 2015) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesInspiratory muscle training and breathing trainers IMT · Respiratory muscle training (RMT) · Inspiratory muscle trainer · Threshold-type trainer · POWERbreathe-type device

BNot prohibitedDevice

What it is: Hand-held trainers that add resistance to breathing in, so the muscles of inspiration work against a load; promoted for sports performance and breathing efficiency. The reviews describe threshold loading, resistive loading and normocapnic hyperpnoea as training methods.
What the evidence shows: A 2024 systematic review in para-athletes (8 studies, 108 participants) found gains in respiratory muscle strength and endurance but concluded the training should not be the primary method for boosting exercise performance. A 2025 narrative review of 10 studies in athletes and healthy people found inconsistent effects on lung-function measures and a debatable added benefit on top of regular training. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. Inspiratory muscle trainers appear in FDA 510(k) records as Class 2 devices under product code BWF, ‘Spirometer, Therapeutic (Incentive)’; the decisions listed date from 1984 to 1998.
Anti-doping status, 2026 List: Not prohibited. Inspiratory muscle training is not named on the 2026 Prohibited List; item M2.1 concerns tampering with samples collected during doping control.
What can go wrong: No adverse-effect data are cited here.

Sources: FDA product classification database: product code BWF, spirometer, therapeutic (incentive) · WADA 2026 Prohibited List (copy published by the International Testing Agency) · Respiratory Muscle Training in Para-Athletes: A Systematic Review on the Training Protocols and Effects on Reported Outcomes (J Sport Rehabil, 2024)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesInstrument-assisted soft-tissue mobilisation (IASTM) IASTM · Graston Technique · Astym · advantEDGE · Instrument-assisted massage

BNot prohibitedMethod or practice

What it is: A hands-on therapy in which a clinician uses specialised hand-held tools to manipulate muscles, tendons, myofascia and skin, promoted for soft-tissue pain, restricted range of motion and sports recovery.
What the evidence shows: Systematic reviews of randomised trials show short-term pain and range-of-motion benefit in some groups; study quality is modest. A 2019 review of 13 randomised trials found support for improving range of motion in uninjured people and pain or patient-reported function in injured people, and called for more high-quality research. A 2024 review of 18 studies (6 pooled) reported lower pain than control comparators. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: A method delivered by a clinician using hand-held tools; no regulatory class for the tools was verified.
Anti-doping status, 2026 List: Not prohibited. IASTM is not named on the 2026 Prohibited List; item M2.1 concerns tampering with samples collected during doping control.
What can go wrong: No adverse-effect data are cited here.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · Instrument-Assisted Soft Tissue Mobilization: A Systematic Review and Effect-Size Analysis (Journal of Athletic Training, 2019) · Instrument assisted soft tissue mobilization in management of athletic and musculoskeletal conditions: a systematic review and meta-analysis (Turk J Physiother Rehabil, 2024)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesKetogenic diets Keto diet · KD · Nutritional ketosis · Carbohydrate-restricted high-fat diet

BNot prohibitedMethod or practice

What it is: A diet so low in carbohydrate and high in fat that the body enters nutritional ketosis. It is used as a specialist diet that can reduce seizures in epilepsy and is studied for exercise performance in healthy adults.
What the evidence shows: The 2024 ISSN position stand finds a ketogenic diet has largely neutral or detrimental effects on athletic performance in healthy exercising adults, compared with higher-carbohydrate eating. In children with drug-resistant epilepsy and two metabolic disorders, a 2024 scoping review that included 23 randomised trials reported that its key findings suggest the diet is efficacious, safe and tolerable. NICE poses its long-term effectiveness as a research question. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: A method rather than a regulated product: a dietary pattern. The NHS lists it as a specialist diet that can reduce seizures. Exogenous ketone supplements are a separate question that the ISSN review does not address.
Anti-doping status, 2026 List: Not prohibited. The diet is not named on the 2026 Prohibited List. Exogenous ketone supplements are a separate question.
What can go wrong: The ISSN judges nutritional ketosis intrinsically neither harmful nor to be confused with ketoacidosis, a life-threatening clinical condition. A 2025 review lists side effects: gastrointestinal disorders, hypoglycaemia, lipid abnormalities, kidney stones and micronutrient deficiencies.

Sources: Epilepsy: treatment (NHS, last reviewed 6 March 2025) · International society of sports nutrition position stand: ketogenic diets (Journal of the International Society of Sports Nutrition, 2024) · The use of ketogenic diets in children living with drug-resistant epilepsy, glucose transporter 1 deficiency syndrome and pyruvate dehydrogenase deficiency: A scoping review (Journal of Human Nutrition and Dietetics, 2024)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesKinesiology taping Kinesio tape · KT tape · Elastic therapeutic tape · Sports taping

CNot prohibitedMethod or practice

What it is: Stretchy adhesive tape applied over muscles or joints in sports and rehabilitation. Marketed for pain relief, muscle support, strength, balance and injury prevention.
What the evidence shows: A 2024 meta-analysis of lower-limb tape after fatigue in healthy people included 16 randomised trials, all at high risk of methodological bias. Tape reduced fatigue-related pain (837 subjects) and improved strength (605 subjects); balance results were mixed. The authors call for more rigorous research. No trial in injured people is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: A method rather than a regulated product; no regulatory approval for kinesiology tape was verified.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: No adverse-effect data are cited here for kinesiology tape.

Sources: Does lower limb kinesio taping affect pain, muscle strength, and balance following fatigue in healthy subjects? (BMC Sports Science, Medicine and Rehabilitation, 2024)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesMassage therapy Sports massage · Deep-tissue massage · Soft-tissue massage · Remedial massage

BNot prohibitedMethod or practice

What it is: Manual manipulation of the body’s soft tissues by a trained therapist, including sports and deep-tissue massage. Marketed for muscle soreness, recovery, pain, relaxation and stress.
What the evidence shows: A meta-analysis of 99 recovery studies ranked massage the most effective technique for delayed-onset muscle soreness and perceived fatigue. NCCIH describes the evidence for chronic low-back pain as of low strength and says benefit for neck or shoulder pain may be short-lived. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: A method rather than a regulated product. The regulation cited is practitioner licensing: in the 45 US states and the District of Columbia that regulate massage therapy, therapists must get a licence or certification before practising massage.
Anti-doping status, 2026 List: Not prohibited. Massage therapy is not named on the 2026 Prohibited List.
What can go wrong: NCCIH says the risk of harm from massage therapy appears to be low, although serious side effects have been reported rarely.

Sources: Dupuy et al. 2018, post-exercise recovery techniques: systematic review with meta-analysis (Frontiers in Physiology) · Massage Therapy: What You Need To Know (NCCIH, May 2019) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesMicrocurrent therapy Microcurrent electrical stimulation (MES) · Microcurrent electrical neuromuscular stimulation (MENS) · Microcurrent TENS · Microcurrent facial device

BNot prohibitedDevice

What it is: Electrical stimulation at currents in the microampere range, said to resemble the body’s own bioelectric currents, delivered through skin electrodes or hand-held probes. Marketed for pain, wound and scar healing, muscle recovery and facial lifting or toning.
What the evidence shows: A 2026 systematic review of 11 clinical studies (2012 to 2024) on wound healing and scars found possible benefit but inconsistent results; the authors say evidence is limited by study variability and small sample sizes. No systematic review for pain, muscle recovery or facial-toning outcomes is cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. Several microcurrent stimulators are FDA-cleared by 510(k) as Class 2 devices, mostly under 21 CFR 882.5890. One example, decided 23 May 2025, is regulated as a transcutaneous electrical nerve stimulator for pain relief and indicated for over-the-counter cosmetic use.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List. Item M2.1 concerns tampering, or attempting to tamper, to alter the integrity and validity of samples collected during doping control.
What can go wrong: No safety findings are cited here.

Sources: FDA 510(k) clearance letter K250361, SmartAppGuided MicroCurrent Face-Lift Pen (2025) · WADA 2026 Prohibited List (copy published by the International Testing Agency) · Role of Microcurrent Electrical Stimulation in Tissue Healing and Scar Modulation: A Systematic Review (Int J Lower Extremity Wounds, 2026)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesMicroneedling and radiofrequency microneedling Powered microneedle device (FDA term) · Skin microneedling · SkinPen-type microneedling · Radiofrequency microneedling (MNRF) · Fractional radiofrequency microneedling · Morpheus8-type

BNot prohibitedDevice

What it is: Devices that puncture the skin with needles in a controlled way; radiofrequency versions also deliver radiofrequency energy through electrode pins, and the technique is marketed for facial acne scars, skin rejuvenation and skin laxity.
What the evidence shows: A 2022 systematic review and meta-analysis of randomised trials of microneedling alone for acne scars (12 trials, 414 participants) concluded that microneedling is a favourable choice for treating acne scarring; the authors gave it level of evidence III. No systematic review of radiofrequency microneedling is cited here, and nothing cited covers wider rejuvenation, ageing or longevity outcomes. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. A 2018 FDA De Novo decision for a microneedling system created the class II product code Powered Microneedle Device, indicated for facial acne scars in adults aged 22 or older. Radiofrequency microneedling systems such as Morpheus8 were cleared as electrosurgical devices; the 2019 summary lists electrocoagulation and haemostasis, not microneedling.
Anti-doping status, 2026 List: Not prohibited. Microneedling and radiofrequency microneedling are not named on the 2026 Prohibited List.
What can go wrong: FDA defines a powered microneedle device as one that mechanically punctures and injures skin tissue for aesthetic use, and radiofrequency versions add radiofrequency energy through electrode pins. No adverse-event data are cited here.

Sources: FDA De Novo decision summary DEN160029, SkinPen Precision System · WADA 2026 Prohibited List (copy published by the International Testing Agency) · Microneedling Monotherapy for Acne Scar: Systematic Review and Meta-Analysis of Randomized Controlled Trials (Aesthetic Plastic Surgery, 2022)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesMolecular hydrogen (inhaled gas and hydrogen-rich water) Hydrogen gas inhalation · Hydrogen-rich water · H2 water · Hydrogen water · Hydrogen tablets · Hydrogen-rich saline

CNot prohibitedMethod or practice

What it is: Hydrogen gas (H2), studied for antioxidant effects and given by inhalation, as hydrogen-enriched drinking water or as hydrogen-rich saline injection. Marketed for general health benefits; sold as H2-enriched water, tablets and generator machines.
What the evidence shows: A review of the 81 identified clinical trials and 64 scientific publications on human studies reports positive indications across cardiovascular, cancer, respiratory, central-nervous-system and infectious diseases. Evidence is limited to disease areas; no sport or longevity outcome data are cited here. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Treated as a method rather than a regulated product. Hydrogen-enriched water, generator machines and tablets for making hydrogen-rich water are already sold around the world with health claims; no approval as a medicine was verified for this use.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List. A route-specific rule applies to intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period, which is relevant to injected hydrogen-rich saline.
What can go wrong: The review notes that hydrogen is explosive and poorly soluble, which makes administration difficult. No adverse-effect data are cited here.

Sources: Molecular Hydrogen Therapy: A Review on Clinical Studies and Outcomes (Molecules, 2023) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesMouth taping during sleep Mouth tape · Mouth-taping

CNot prohibitedMethod or practice

What it is: Taping the lips shut with adhesive tape during sleep so that breathing happens through the nose instead of the mouth. Promoted on social media as a home remedy for mouth breathing, snoring and sleep apnoea.
What the evidence shows: A 2025 PLOS ONE systematic review found 10 eligible studies with 213 patients; two showed statistically significant improvement in sleep-apnoea markers, others no difference. A small preliminary 2022 study in mouth-breathers with mild obstructive sleep apnoea reported a median apnoea-hypopnoea index fall from 8.3 to 4.7 events per hour. Cleveland Clinic says there is not strong enough evidence that mouth tape is beneficial. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: A method rather than a regulated product. No regulator statement or approval for mouth taping as a treatment for snoring or sleep apnoea was verified. Cleveland Clinic says mouth taping is not part of its current practice to treat any sleep disorder.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: The 2025 PLOS ONE review authors concluded there is a potentially serious risk of harm for people practising the trend indiscriminately, citing asphyxiation risk in the presence of nasal obstruction. Cleveland Clinic lists redness, irritation or allergic reactions on the lips and skin.

Sources: Is Mouth Tape Safe To Use While Sleeping? (Cleveland Clinic, last reviewed 25 July 2025) · Mouth taping: a systematic review of safety and efficacy (PLOS ONE, 21 May 2025)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesNebulised ‘lung detox’ therapies Nebulised glutathione · Nebulised hydrogen peroxide · Nebulised colloidal silver · Nebulised NAC · Lung cleanse · Inhalation therapy

DCheck on Global DROUnapproved for the described use

A nebuliser turns a liquid into a mist; clinics fill it with agents of their choosing

What it is: A drug-delivery device for prescribed asthma medicines, used by clinics to inhale antioxidants, peroxide, silver or unnamed blends.
What it is sold for: Marketed for lung cleansing, immunity, ‘pathogen eradication’ and pollution recovery.
What the evidence shows: Nothing supports the wellness use. The Asthma and Allergy Foundation of America warned in 2021 that inhaled hydrogen peroxide irritates the airway at household strength and injures the lung at higher concentrations, and that only prescribed medicines belong in a nebuliser. Colloidal silver has no known function in the body, was ruled not safe or effective by the FDA in 1999 and causes permanent argyria. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. The nebuliser is a cleared device; none of the agents is approved for inhalation for any wellness purpose.
Anti-doping status, 2026 List: Check on Global DRO. The device itself is not prohibited. Medication rules depend on substance and route: some inhaled beta-2 agonists have limits, while inhaled glucocorticoids are not prohibited within licensed therapeutic use. Confirm the exact medicine with the anti-doping organisation.
What can go wrong: Bronchospasm, chemical pneumonitis and pulmonary oedema from irritant mists; permanent blue-grey skin from silver; a delayed diagnosis when a real respiratory condition is treated with a blend.
What the practice does: Respiratory symptoms are referred to a physician the same day. Poor air-quality days in Hyderabad are planned around with indoor sessions, not with a mist.

Sources: Asthma and Allergy Foundation of America — do not nebulise hydrogen peroxide (2021) · NCCIH — colloidal silver · WADA 2026 Prohibited List (copy published by CONMEBOL)

Link to this entry

Therapies & devicesNeurofeedback (EEG biofeedback) Brainwave training · QEEG-guided neurofeedback

CNot prohibitedDevice

What it is: A type of biofeedback in which an electroencephalograph uses scalp pads to monitor brain waves so the person learns to control them. Stress, ADHD and chronic pain are among the conditions Mayo Clinic lists for biofeedback.
What the evidence shows: Mayo Clinic describes EEG biofeedback within biofeedback generally and lists conditions treated: stress, ADHD, chronic pain, high blood pressure and incontinence. It gives no study counts or efficacy ratings for neurofeedback. No controlled human trial of neurofeedback is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Device. In the US, biofeedback devices are Class II (special controls); prescription battery-powered units for relaxation training and muscle re-education are exempt from premarket notification (21 CFR 882.5050). No ruling specific to neurofeedback was verified.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: Mayo Clinic calls biofeedback generally safe but says it might not be right for everyone. Biofeedback machines may not work with some medical problems.

Sources: Biofeedback (Mayo Clinic, updated 26 March 2025) · US Code · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesPercussive therapy (massage guns) Massage gun · Percussion massager · Theragun-type device · Hypervolt-type device · Percussive massage

BNot prohibitedDevice

What it is: A handheld powered device that delivers rapid repeated pulses to a muscle belly or tendon, used as a portable form of massage or vibration. Marketed for muscle soreness, warm-up, flexibility and recovery.
What the evidence shows: A systematic literature review of 13 studies, all with limitations in methodological quality or reporting, linked a single application to acute increases in muscle strength, explosive strength and flexibility, and repeated treatment to lower reported pain. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. In the US a therapeutic massager is a device subject to general controls and exempt from premarket notification (21 CFR 890.5660). Consumer wellness-only claims fall under FDA general-wellness policy.
Anti-doping status, 2026 List: Not prohibited. Percussive therapy is not named on the 2026 Prohibited List.
What can go wrong: No adverse-effect data on percussive therapy are cited here.

Sources: The Effect Of Percussive Therapy On Musculoskeletal Performance And Experiences Of Pain: A Systematic Literature Review (IJSPT, 2023) · 21 CFR 890.5660 Therapeutic massager · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesPneumatic compression and full-body suits Intermittent pneumatic compression · IPC · Recovery boots · NormaTec-type sleeves · Flowpresso-type suit · Lymphatic drainage suit

BNot prohibitedDevice

Inflatable sleeves on the limbs; full-body suits add infrared heat

What it is: Sleeves that inflate in sequence to squeeze fluid out of a limb, from lymphoedema clinics and thrombosis prevention, repackaged for recovery lounges and, in suit form, sold with ‘detox’ claims.
What it is sold for: Marketed for recovery, soreness, ‘lymphatic drainage’, ‘flushing lactic acid’ and detox.
What the evidence shows: A 2024 meta-analysis of 17 studies and 319 participants found trivial-to-small benefits for muscle function and trivial-to-moderate effects on perceived soreness; a 2025 trial in 48 combat athletes found changes in perfusion and elasticity and no clear performance advantage. Lactate is cleared by metabolism within an hour, not by squeezing. The full-body suit has no controlled trial for any claim. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. Compressible limb sleeves are Class II devices under 21 CFR 870.5800, identified as preventing pooling of blood in a limb; hospital uses are thrombosis prevention and lymphoedema. Recovery use is a wellness claim.
Anti-doping status, 2026 List: Not prohibited. Not a substance or a method on the List.
What can go wrong: Low. Contraindicated with acute deep-vein thrombosis, severe arterial disease and heart failure with oedema. The main cost is the belief that recovery has been done.
What the practice does: Where a client owns the boots, a pleasant sit with no adaptation cost. Recovery is measured as HRV, sleep and readiness. No suit is prescribed for detox, because there is nothing to drain.

Sources: Effects of lower-limb intermittent pneumatic compression on sports recovery: systematic review and meta-analysis (Biology of Sport, 2024) · Effect of pneumatic and cold compression on recovery in combat athletes (Scientific Reports, 2025) · 21 CFR 870.5800 — compressible limb sleeve (US FDA device classification)

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Therapies & devicesPulsed electromagnetic field therapy PEMF · PEMF mat · Bone growth stimulator · Magnetic field therapy · BEMER-type mat

BNot prohibitedDevice

Coils in a mat, pad or brace; hospital stimulators are worn over a fracture for months

What it is: Low-frequency pulsed magnetic fields that induce small currents in tissue, with real approvals in orthopaedics and a large wellness afterlife in mats.
What it is sold for: Marketed for pain, circulation, sleep, energy and ‘cellular charging’.
What the evidence shows: Non-invasive bone growth stimulators, three of them PEMF, hold US pre-market approvals from 1979 onward for established non-union fractures and as an adjunct to spinal fusion, on data from 831 patients with fusion rates of 67–85 per cent against 43–75 in controls. A 2026 meta-analysis of nine knee-osteoarthritis trials found no pain benefit at one month, small early WOMAC changes that may not be clinically meaningful, and high risk of bias. Mat claims have no controlled evidence. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. Bone growth stimulators are US FDA-approved Class III devices, with a proposal to reclassify them to Class II; consumer mats are general-wellness products with no approved indication.
Anti-doping status, 2026 List: Not prohibited. Not a substance or a method on the List.
What can go wrong: Low for the approved devices, mainly skin irritation under electrodes. Makers exclude users with pacemakers and pregnancy. The wellness harm is the mat used instead of the diagnosis.
What the practice does: A fracture that will not unite is a surgeon’s decision. For pain, sleep and recovery the practice measures the thing itself and refers where a value is clinical.

Sources: US FDA — bone growth stimulators: executive summary for the reclassification panel · PEMF therapy in knee osteoarthritis: systematic review and meta-analysis (Medicina, 2026) · US FDA — general wellness: policy for low-risk devices (2026)

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Therapies & devicesRadiofrequency and focused-ultrasound skin tightening Thermage-type radiofrequency · Monopolar radiofrequency skin tightening · Ultherapy-type microfocused ultrasound · Microfocused ultrasound (MFU) · Ulthera System (FDA device name)

BNot prohibitedDevice

What it is: Two heat-based, non-surgical device types sold to tighten or lift lax skin. Radiofrequency systems pass electrical energy into the skin while cooling the surface; microfocused ultrasound delivers focused ultrasound energy within the tissue.
What the evidence shows: A 2023 systematic review of microfocused ultrasound found 16 eligible studies, all in female patients and none randomised, with follow-up of 3 months to 1 year; it concluded the treatment is effective in tightening mildly to moderately lax facial skin. A 2022 systematic review of radiofrequency devices (23 articles) reported measurable improvement in skin laxity. Evidence is limited to cosmetic endpoints; no longevity outcomes are cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. In the United States both are regulated as devices, not medicines. The Ulthera System is class II (21 CFR 878.4590), with indications including lifting lax tissue under the chin and neck; Thermage radiofrequency systems have been cleared since 2000 as electrosurgical devices.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 List of prohibited substances and methods.
What can go wrong: No adverse-event data are cited here for either device type. Follow-up in the microfocused-ultrasound studies was 3 months to 1 year.

Sources: FDA 510(k) K134032, Ulthera System: indications for use · WADA 2026 Prohibited List (copy published by the International Testing Agency) · A Systematic Review of the Efficacy of Microfocused Ultrasound for Facial Skin Tightening (Int J Environ Res Public Health, 2023)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesReiki Reiki healing · Energy healing

CNot prohibitedMethod or practice

What it is: A complementary health approach in which practitioners place their hands lightly on or just above a person, with the goal of directing energy to help facilitate the person’s own healing response. Offered for relaxation.
What the evidence shows: NCCIH says Reiki has been studied for pain, anxiety and depression, but most of the research has not been of high quality and the results have been inconsistent. It has not been clearly shown to be effective for any health-related purpose. NCCIH also states there is no scientific evidence supporting the existence of the energy field thought to play a role in Reiki. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: A method rather than a regulated product. No regulation, licensing rule or approval specific to Reiki was verified.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: NCCIH states that Reiki has not been shown to have any harmful effects.

Sources: Reiki (NCCIH, last updated December 2018)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesRemote ischaemic preconditioning (RIPC) Ischaemic preconditioning (IPC) · Remote ischaemic conditioning (RIC) · Limb ischaemic preconditioning

BNot prohibitedMethod or practice

What it is: Brief episodes of restricted and restored blood flow, usually applied to a limb. First studied to protect the heart and other tissues during surgery; now tested and marketed for exercise performance and recovery.
What the evidence shows: Human trials show mixed results. A 2016 meta-analysis (19 studies, 15 pooled) reported a small beneficial effect on exercise performance, unclear for power and sprint performance; its abstract says conclusions about efficacy cannot yet be drawn. A 2024 meta-analysis of 7 randomised trials (88 subjects) found faster heart-rate recovery but no effect on resting heart-rate variability; its authors cite the small sample as a limit. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: A method rather than a regulated product. No regulator statement on its use for performance or recovery was verified. The 2016 meta-analysis states that conclusions about efficacy cannot yet be drawn.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List. The List’s M1.3 wording concerns intravascular manipulation of the blood or blood components by physical or chemical means.
What can go wrong: No safety findings are cited here.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · Ischemic Preconditioning and Exercise Performance: A Systematic Review and Meta-Analysis (Int J Sports Physiol Perform, 2016) · The effect of ischemic preconditioning on the cardiac autonomic nervous system after exercise: A systematic review and meta-analysis (Quality in Sport, 2024)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesSpinal manipulation (chiropractic and osteopathic) Chiropractic adjustment · Spinal adjustment · Osteopathic manipulation · Joint manipulation

BNot prohibitedMethod or practice

What it is: A technique in which practitioners use their hands or a device to apply a controlled thrust to a joint of the spine. Offered for low-back pain and other musculoskeletal complaints; some practitioners also claim benefit for non-musculoskeletal conditions.
What the evidence shows: NCCIH reports that spinal manipulation is linked to a modest improvement in acute low-back pain, similar to that seen with non-steroidal anti-inflammatory drugs. For chronic low-back pain it was slightly better than other therapies for function. For non-musculoskeletal conditions, none of the studies showed a clear benefit. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: A method rather than a regulated product. Most spinal manipulations are done by chiropractors, and also by osteopathic physicians and physical therapists.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: NCCIH reports that mild side effects such as pain, stiffness and headache are common, and that serious ones are very rare.

Sources: Spinal Manipulation: What You Need To Know (NCCIH, September 2022) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesStatic magnets and magnetic bracelets Magnetic bracelet · Magnet therapy · Static magnetic therapy · Magnetic insoles

DNot prohibitedDevice

What it is: Static magnets, for example in bracelets, that are not electrically powered. Marketed for pain relief, especially arthritis and sports aches.
What the evidence shows: A 2007 meta-analysis of randomised trials identified 29 potentially relevant trials. Nine placebo-controlled trials with a pain scale were pooled and showed no significant difference in pain reduction. The authors conclude that the evidence does not support static magnets for pain relief. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Device. Classed as a device. No regulatory approval or clearance for pain relief was verified.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: The evidence cited here reports on pain outcomes and does not describe adverse effects.

Sources: Static magnets for reducing pain: systematic review and meta-analysis of randomized trials (CMAJ, 2007) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesTecar therapy (capacitive-resistive electric transfer) TECAR · CRET · Capacitive and resistive electric transfer · Transfer energy capacitive and resistive · Radiofrequency diathermy (INDIBA-type, Human Tecar-type)

BNot prohibitedDevice

What it is: A physiotherapy device that passes a radiofrequency current between an active electrode and a neutral plate, in capacitive or resistive mode, to warm tissue. Used for musculoskeletal pain and sports injuries; marketed for rehabilitation and recovery in sport.
What the evidence shows: Several systematic reviews of mostly small randomised trials report improvements in pain and function in musculoskeletal conditions, including chronic low back pain. In the 2020 review, only two of nine randomised trials were at low risk of bias. A 2022 meta-analysis reported pain reductions with very high heterogeneity. The reviews call for more and better randomised trials. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. FDA 510(k) clearances exist for tecar-type devices in the United States (Class II), intended to provide topical heating to raise tissue temperature for treatment of selected medical conditions.
Anti-doping status, 2026 List: Not prohibited. Tecar therapy is not named on the 2026 Prohibited List; item M2.1 concerns tampering with samples collected during doping control.
What can go wrong: A 2024 review of five studies in 192 athletes with muscle injury reported no important adverse effects, and the technique was tolerated in all studies.

Sources: FDA 510(k) clearance letter K241107, Indiba Diathermia Radiofrequency devices (2025) · WADA 2026 Prohibited List (copy published by the International Testing Agency) · Capacitive and resistive electric transfer therapy in rehabilitation: a systematic review (Int J Rehabil Res, 2020)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesTENS (transcutaneous electrical nerve stimulation) TENS unit · TENS machine · Electrical nerve stimulation · Pain-relief stimulator

BNot prohibitedDevice

What it is: A treatment that applies an electrical current to electrodes on the skin to give temporary pain relief. Marketed for muscle and joint pain, injury rehabilitation and recovery.
What the evidence shows: The NHS states that TENS gives temporary pain relief but does not work for everyone, and that it is thought to work by encouraging the release of endorphins and by blocking pain messages. No trial or study counts are cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. In the US, a transcutaneous electrical nerve stimulator for pain relief is a Class II (performance standards) device under 21 CFR 882.5890, used to apply an electrical current to electrodes on a patient’s skin.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: Cautions noted by the NHS include epilepsy, pacemakers and pregnancy. No adverse-event figures are cited here.

Sources: TENS (NHS, reviewed 14 February 2025) · 21 CFR 882.5890 TENS for pain relief

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesTranscranial direct current stimulation tDCS · Brain stimulation headset · Direct current brain stimulation

CNot prohibitedDevice

What it is: A non-invasive brain stimulation method delivered by a head-worn device. One home-use device is FDA-approved for depression.
What the evidence shows: The evidence cited is regulatory only: the FDA approved one home-use device for moderate to severe major depressive disorder in adults not considered treatment-refractory, and NIMH lists tDCS among other non-invasive brain stimulation therapies. No controlled human trial of tDCS is cited here, and no sport or cognition data. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Device. On 8 December 2025 the FDA granted premarket approval (PMA) to one home-use tDCS device for major depressive disorder, the first PMA of a home-use non-invasive brain-stimulation device for depression. No approval was verified for other tDCS products or uses.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: The evidence cited here does not describe adverse effects of tDCS.

Sources: US FDA approves home-delivered tDCS for treating depression (Brain Stimulation, 2026) · Brain Stimulation Therapies (NIMH, reviewed March 2024) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesTranscranial magnetic stimulation TMS · rTMS · Repetitive transcranial magnetic stimulation · Magnetic brain stimulation

BNot prohibitedDevice

What it is: A procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of major depression. Cleared uses are depression, OCD, migraine and smoking cessation; wellness offers for focus or mood fall outside these.
What the evidence shows: Mayo Clinic describes TMS as used when other depression treatments have failed, and as also cleared for OCD, migraine and smoking cessation. No controlled human trial of TMS is cited here, and no evidence is cited for wellness uses. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. NIMH lists rTMS as FDA-cleared for treatment-resistant depression, OCD, migraines, anxiety with depression and smoking dependence. Classed as a device.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: Mayo Clinic lists scalp discomfort, headache and facial twitching as common side effects; seizures and mania are uncommon.

Sources: Transcranial magnetic stimulation (Mayo Clinic, updated 7 April 2023) · Brain Stimulation Therapies (NIMH, reviewed March 2024) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesWhole-body cryotherapy chambers WBC · Cryo chamber · Cryosauna · Electric cryotherapy · Nitrogen cryotherapy

CNot prohibitedDevice

A brief stand in a chamber at around −110°C to −140°C, cooled by nitrogen vapour or refrigeration

What it is: Brief exposure of the skin to extremely cold dry air, developed in Japan for rheumatoid arthritis and now a recovery-lounge product.
What it is sold for: Marketed for recovery, soreness, inflammation, weight loss and ‘boosting metabolism’.
What the evidence shows: The Cochrane review found four small trials in 64 young adults, almost all men, very low-quality evidence that soreness might be lower after exercise, the possibility of no effect or worse pain, and no monitoring of adverse events in any trial. The US FDA stated in 2016 that not a single chamber had been cleared or approved for any medical condition and that it found very little evidence of safety or effectiveness. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Device. No US FDA clearance or approval for any medical use; sold as a wellness service.
Anti-doping status, 2026 List: Not prohibited. Not a substance or a method on the List.
What can go wrong: Asphyxia and loss of consciousness from nitrogen displacing oxygen in a poorly ventilated chamber, which the FDA names as a hazard; frostbite, cold burns and eye injury; a cardiac question for heart disease or uncontrolled hypertension.
What the practice does: Where a client wants cold, the practice prefers water, which reaches the muscle and has the better trials, and schedules it away from strength blocks. A chamber session is not recorded as recovery.

Sources: Cochrane review — whole-body cryotherapy for muscle soreness after exercise (Costello et al., 2015) · US FDA consumer update, 2016 — whole body cryotherapy: a ‘cool’ trend that lacks evidence, poses risks (reproduced by Drugs.com)

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Therapies & devicesWhole-body hyperthermia Hyperthermia therapy · Whole-body heating · Systemic hyperthermia · Thermal chamber therapy

DNot prohibitedMethod or practice

What it is: Heating the whole body in a thermal chamber or with hot-water blankets. Studied mainly as an add-on to cancer treatment in research settings.
What the evidence shows: The National Cancer Institute (NCI) says whole-body hyperthermia is used for cancer that has spread throughout the body, is not widely available, and is used experimentally at some centres alongside other therapies. It is not clear whether it helps people live longer. No human evidence is cited here for ‘detox’ or longevity use. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: A method rather than a regulated product. No approval as a medicine was verified for this use.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List.
What can go wrong: NCI lists burns, blisters and pain as side effects. Diarrhoea, nausea and vomiting are common after whole-body treatment, and heart and blood-vessel problems can occur.

Sources: Hyperthermia to Treat Cancer (National Cancer Institute, reviewed 15 May 2025) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Therapies & devicesWim Hof Method Wim Hof breathing · WHM · Iceman method · Wim Hof breathing method (WHBM)

CNot prohibitedMethod or practice

What it is: A method combining a breathing technique, cold exposure and ‘commitment’, which its founder claims has several benefits for physical and mental health. Claimed benefits include lower inflammation and better exercise performance.
What the evidence shows: A systematic review (searched to July 2022) included 9 papers from 8 trials. Evidence is limited to these trials. Findings suggest the method may reduce inflammation in healthy and non-healthy participants, linked to higher adrenaline (epinephrine) and interleukin-10 and lower pro-inflammatory cytokines. Effects on exercise performance and respiratory measures were mixed. The authors call for studies in people with inflammatory disorders. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: A method rather than a regulated product. No approval as a medicine was verified for this use.
Anti-doping status, 2026 List: Not prohibited. The Wim Hof Method is not named on the 2026 Prohibited List, including under M2, chemical and physical manipulation.
What can go wrong: No safety or adverse-effect data for the method are cited here.

Sources: Does the Wim Hof Method have a beneficial impact on physiological and psychological outcomes in healthy and non-healthy participants? A systematic review (PLOS ONE) · WADA 2026 Prohibited List (copy at worldnaturalbb.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Vitamin & nutrient shotsVitamin D injection Cholecalciferol injection · Ergocalciferol injection · Vitamin D shot · Vitamin D3 depot

BCheck on Global DROApproved medicine

Sold as an intramuscular injection; also added to drips

What it is: A depot of cholecalciferol or ergocalciferol in muscle, released over weeks; the same molecule is sold as a tablet or drop.
What it is sold for: Marketed for immunity, energy and ‘optimised levels’ in people never tested.
What the evidence shows: Correcting a measured deficiency is medicine, and the oral route does it: in a Berlin pharmacokinetic study a single intramuscular dose raised 25(OH)D no faster than daily oral dosing, so the authors reserved the injection for malabsorption or poor adherence. In replete adults VITAL found no reduction in fractures, cardiovascular events or cancer. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. A prescription medicine where licensed, for deficiency in which oral treatment fails; a top-up in a replete client is outside that indication. The oral route is the standard prescription.
Anti-doping status, 2026 List: Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips.
What can go wrong: A depot cannot be withdrawn; repeated large doses have caused hypercalcaemia, kidney stones and calcification, with adverse effects possible above 125 nmol/L. Injection-site abscess; the sterility record of clinic drips.
What the practice does: 25(OH)D and calcium sit in the standard panel. A low value is referred to the physician, who chooses the route; a replete client is told so. Re-read at twelve weeks.

Sources: NIH Office of Dietary Supplements — vitamin D fact sheet for health professionals · Single intramuscular high dose vs oral long-term cholecalciferol: pharmacokinetics (PLOS One, 2017) · USADA — IV infusions: explanatory note · US FDA — compounding in medical offices and clinics under insanitary conditions (2021)

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Vitamin & nutrient shotsVitamin B12 injection Cyanocobalamin injection · Hydroxocobalamin injection · Methylcobalamin injection · B12 shot

BCheck on Global DROApproved medicine

Sold as an intramuscular or subcutaneous injection and in ‘energy’ drips

What it is: Cobalamin, absorbed in the ileum with intrinsic factor. The injection bypasses the gut; a high enough tablet does not need to.
What it is sold for: Marketed for energy, metabolism and ‘brain fog’ regardless of blood level.
What the evidence shows: For pernicious anaemia or after gastric surgery the injection is standard care, and not the only route: the 2018 Cochrane review (three trials, 153 people) found high-dose oral B12 normalised serum levels as well as injections, at lower cost. Without a deficiency there is no effect on energy or performance, as the NIH fact sheet states. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. Cyanocobalamin and hydroxocobalamin injections are approved for deficiency due to malabsorption, and the US label indicates nothing else. Hydroxocobalamin injection is on India’s 2022 essential medicines list.
Anti-doping status, 2026 List: Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips.
What can go wrong: Low toxicity, yet the label records anaphylactic shock and death after parenteral B12, hypokalaemia and sudden death when severe anaemia is treated intensively, and optic atrophy in Leber’s disease.
What the practice does: Serum B12, with methylmalonic acid where borderline, is in the panel. A deficiency goes to the physician; a normal level with fatigue sends the practice to sleep, load, iron and thyroid.

Sources: NIH Office of Dietary Supplements — vitamin B12 fact sheet for health professionals · Cochrane review — oral versus intramuscular vitamin B12 for deficiency (Wang et al., 2018) · US FDA label — cyanocobalamin injection, 2021 revision · India — National List of Essential Medicines 2022 (CDSCO)

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IV dripsVitamin C, intramuscular and high-dose intravenous Ascorbic acid injection · High-dose IV vitamin C · IVC · Ascor

DCheck on Global DROApproved, used off-label

Sold as an intramuscular shot and as a high-dose drip

What it is: Ascorbic acid by vein reaches plasma levels the gut cannot deliver: oral absorption falls below half above a gram and the kidney excretes the rest.
What it is sold for: Marketed for immunity, skin, ‘antioxidant support’ and, in some clinics, cancer.
What the evidence shows: The high plasma level is real; a benefit from it is not. The US National Cancer Institute summarises the cancer trials as safe but mixed, with no proven effect on tumour growth. Regular oral vitamin C shortens colds by about 8 per cent in adults; no drip trial has done better. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved, used off-label. Ascor (ascorbic acid injection) was approved by the US FDA in 2017 for short-term treatment of scurvy only. Every other intravenous use is off-label; most clinic drips are compounded.
Anti-doping status, 2026 List: Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips.
What can go wrong: Oxalate nephropathy and kidney stones; haemolysis in G6PD deficiency, which occurs in several Indian populations; false glucose readings for 24 hours; iron loading in haemochromatosis.
What the practice does: Dietary intake and, where warranted, plasma vitamin C are read; an adequate diet is the answer for almost everyone. Immune questions go to a physician; recovery is answered with sleep, fuel and load.

Sources: NIH Office of Dietary Supplements — vitamin C fact sheet for health professionals · US National Cancer Institute — high-dose vitamin C (PDQ) · US FDA label — Ascor (ascorbic acid injection), 2017 · USADA — IV infusions: explanatory note

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IV dripsMagnesium injection and drip Magnesium sulfate injection · Magnesium chloride drip · ‘Relaxation’ drip

CCheck on Global DROApproved, used off-label

Sold as an intravenous drip, alone or in cocktails

What it is: An electrolyte with a real hospital medicine behind it: magnesium sulfate for eclampsia, given with monitoring of reflexes, breathing and serum levels.
What it is sold for: Marketed for cramps, sleep, stress, migraine and recovery.
What the evidence shows: Serum magnesium correlates poorly with body stores, so most clients sold a drip have never had a meaningful measurement. Oral magnesium is probably effective for migraine prevention and lowers blood pressure by a few millimetres of mercury; neither finding involves a drip. No placebo-controlled trial of a wellness infusion exists. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Approved, used off-label. US labelling includes treatment of magnesium deficiency and seizure prevention or control in pre-eclampsia and eclampsia. A clinical indication does not establish a benefit from a wellness drip. US product label.
Anti-doping status, 2026 List: Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips.
What can go wrong: Hypermagnesaemia: flushing, hypotension, loss of the knee reflex, respiratory depression and cardiac arrest at high levels. The label requires reflexes, breathing and serum magnesium to be watched and warns of intoxication with renal insufficiency.
What the practice does: Serum magnesium is in the panel; cramps or palpitations go to a physician. The practice reviews diet, hydration, heat exposure and training load as coaching context; it does not diagnose the cause.

Sources: NIH Office of Dietary Supplements — magnesium fact sheet for health professionals · US FDA label — magnesium sulfate in water for injection · India — National List of Essential Medicines 2022 (CDSCO) · USADA — IV infusions: explanatory note

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IV dripsZinc injection and drip Zinc sulfate injection · Zinc chloride · ‘Immunity’ drip

CCheck on Global DROApproved, used off-label

Sold in intravenous ‘immune’ drips; approved as a trace element in parenteral nutrition

What it is: A trace mineral for hundreds of enzymes and for immune cells. Serum zinc is a weak marker, falling with infection and inflammation.
What it is sold for: Marketed for immunity, skin, hair, testosterone and wound healing.
What the evidence shows: Zinc corrects deficiency; in a replete person more zinc does nothing measurable. Lozenges may shorten a cold by about two days on low-certainty evidence and do not prevent colds; no drip has been trialled for immunity. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Approved, used off-label. Zinc sulfate injection was approved by the US FDA in 2019 as a source of zinc for parenteral nutrition, never given directly. A wellness drip is off-label. India lists zinc as a dispersible tablet.
Anti-doping status, 2026 List: Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips.
What can go wrong: Excess zinc suppresses copper absorption, causing anaemia, neuropathy and ataxia, and lowers HDL and immune function above the 40 mg daily upper level. The injectable label warns of vein damage with peripheral infusion.
What the practice does: Plasma zinc and copper are read together where diet, hair loss or wound healing raise the question, against same-day inflammation markers. A real deficiency is corrected with food and, where the physician agrees, an oral supplement with a re-test.

Sources: NIH Office of Dietary Supplements — zinc fact sheet for health professionals · US FDA label — zinc sulfate injection, 2019 · USADA — IV infusions: explanatory note · US FDA — compounding in medical offices and clinics under insanitary conditions (2021)

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Vitamin & nutrient shotsB-complex and ‘energy’ shots Vitamin B complex injection · B12 plus B-complex · Energy shot · Thiamine injection · Neurobion-type injections

DCheck on Global DROApproved, used off-label

Sold as intramuscular shots and as the base of ‘energy’ drips

What it is: Water-soluble B vitamins by injection. The body uses what its enzymes need and excretes the rest within hours.
What it is sold for: Marketed for energy, metabolism, stress and ‘burnout’.
What the evidence shows: B vitamins are cofactors in energy metabolism, which seeds the claim; more than the enzymes can use makes no more energy. The NIH fact sheets are direct: B12 has no effect on performance without a deficiency, a review of fourteen trials found insufficient evidence that B6 improves cognition, and a Cochrane review found no effect on mood in healthy people. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved, used off-label. Approved prescription medicines for deficiency states; hydroxocobalamin injection is on India’s essential medicines list. The energy indication exists on no label.
Anti-doping status, 2026 List: Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips.
What can go wrong: Anaphylaxis to parenteral B vitamins is documented and the B12 label records deaths. High cumulative pyridoxine causes sensory neuropathy; the US upper level is 100 mg a day.
What the practice does: Fatigue is measured before it is treated: sleep regularity, HRV trend, training load, ferritin, thyroid, B12 and folate. A deficiency goes to the physician; a normal panel with fatigue sends the practice to the training week.

Sources: NIH Office of Dietary Supplements — vitamin B6 fact sheet for health professionals · NIH Office of Dietary Supplements — vitamin B12 fact sheet for health professionals · US FDA label — cyanocobalamin injection, 2021 revision · USADA — IV infusions: explanatory note

Link to this entry

Vitamin & nutrient shots‘Lipotropic’ and ‘slim’ shots MIC injection · Methionine–inositol–choline · Lipo-C · L-carnitine injection · Fat-burner shot

DCheck on Global DROUnapproved for the described use

Sold as intramuscular injections, usually with B12

What it is: A compounded mix of methionine, inositol and choline, sometimes with L-carnitine, sold on the idea that injecting nutrients of fat transport mobilises body fat.
What it is sold for: Marketed for fat loss, ‘liver detox’ and energy, as a course sold with a diet.
What the evidence shows: There is no placebo-controlled trial of a lipotropic injection for weight loss. Choline moves lipid out of the liver; the NIH fact sheet describes no weight-loss effect in the replete. Oral L-carnitine averaged 1.3 kg more loss than placebo across nine trials, and the body makes its own. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. Compounded lipotropic mixtures do not have demonstrated weight-loss benefit in the cited evidence. Levocarnitine injection is approved only for carnitine deficiency and dialysis.
Anti-doping status, 2026 List: Check on Global DRO. No ingredient is a prohibited substance, and a small intramuscular shot is not caught by M2.2 (intravenous infusions or injections over 100 mL per 12 hours, at all times, outside hospital treatment, surgery or clinical diagnostics). An L-carnitine infusion was the prohibited method in the 2019 Nike Oregon Project case.
What can go wrong: Fishy odour, sweating, hypotension and gut upset from choline; nausea and cramps from carnitine; raised trimethylamine-N-oxide, a cardiovascular risk marker. Injection-site abscess; the crash diet sold with the shot.
What the practice does: DXA, resting metabolic rate and the food actually eaten decide a deficit the bloods and training can support. Fat loss is re-measured at twelve weeks, not felt.

Sources: NIH Office of Dietary Supplements — carnitine fact sheet for health professionals · NIH Office of Dietary Supplements — choline fact sheet for health professionals · USADA v. Alberto Salazar — AAA arbitration award, 2019 (over-limit L-carnitine infusion as a prohibited method) · US FDA — 503A bulk drug substances by category (May 2026)

Link to this entry

Vitamin & nutrient shotsBiotin (vitamin B7) shots and ‘hair’ drips Biotin injection · Biotin IV · Hair IV drip · Vitamin B7 injection

CNot prohibitedNo approval verified

What it is: Biotin is a B vitamin. Clinics sell it as an add-on shot or a ‘biotin-enriched’ hair drip for hair, skin and nail ‘beauty’ claims.
What the evidence shows: NIH ODS states that severe biotin deficiency in healthy people eating a normal mixed diet has never been reported, and that hair, skin and nail claims are supported, at best, by only a few case reports and small studies. No controlled trial of biotin shots or drips is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: NIH ODS covers biotin as a dietary supplement. No approved biotin injection was found on DailyMed, which does not prove that none exists.
Anti-doping status, 2026 List: Not prohibited. Biotin is not named on the 2026 Prohibited List.
What can go wrong: Biotin can distort laboratory tests. NIH ODS cites an FDA report of a death after a falsely low troponin result in a patient with a high intake of supplemental biotin.

Sources: Biotin, fact sheet for health professionals (NIH Office of Dietary Supplements)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Vitamin & nutrient shotsVitamin K (phytonadione) injection Phytonadione injectable emulsion · Vitamin K1 injection · Vitamin K shot

DNot prohibitedApproved medicine

What it is: Vitamin K1 (phytonadione) as an injectable emulsion, an approved medicine labelled for vitamin K deficiency bleeding in neonates.
What the evidence shows: NIH ODS states that clinically significant vitamin K deficiency in adults is very rare. No controlled human trial of injected vitamin K as a wellness shot is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved medicine. Approved medicine. The DailyMed label gives the indication as prophylaxis and treatment of vitamin K deficiency bleeding in neonates.
Anti-doping status, 2026 List: Not prohibited. Vitamin K is not named on the 2026 Prohibited List.
What can go wrong: The label warns of fatal hypersensitivity reactions, including anaphylaxis, during and immediately after intravenous and intramuscular injection.

Sources: Phytonadione Injectable Emulsion, DailyMed label (Alembic) · Vitamin K, fact sheet for health professionals (NIH Office of Dietary Supplements)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Vitamin & nutrient shotsVitamin B6 (pyridoxine) injection Pyridoxine hydrochloride injection · B6 shot

DNot prohibitedApproved, used off-label

What it is: Pyridoxine hydrochloride injection is an approved medicine for pyridoxine deficiency. Vitamin B6 also appears as an ingredient in multivitamin ‘glow’ beauty drips.
What the evidence shows: The label calls it effective for pyridoxine deficiency. NIH ODS states that frank vitamin B6 deficiency is relatively rare in the United States, and that a review found insufficient evidence of an effect of B6 supplementation on cognitive function. No trial of ‘glow’ drips is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved, used off-label. Approved for treating pyridoxine deficiency. Use as a ‘glow’ or wellness ingredient is not the labelled use.
Anti-doping status, 2026 List: Not prohibited. Vitamin B6 is not named on the 2026 Prohibited List.
What can go wrong: The label lists paraesthesia, somnolence and low serum folic acid levels among reported reactions.

Sources: Pyridoxine Hydrochloride Injection, DailyMed label (Fresenius Kabi) · Vitamin B6, fact sheet for health professionals (NIH Office of Dietary Supplements)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Vitamin & nutrient shotsFolic acid injection Folic acid shot

DNot prohibitedApproved medicine

What it is: Folic acid injection is an approved medicine for megaloblastic anaemia due to folic acid deficiency, not a general wellness shot.
What the evidence shows: The label says folic acid alone is effective for megaloblastic anaemias due to folic acid deficiency. NIH ODS states that isolated folate deficiency is uncommon. No trial of folic acid injection as a wellness shot is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved medicine. Approved medicine. The label gives the indication as megaloblastic anaemias due to a deficiency of folic acid.
Anti-doping status, 2026 List: Not prohibited. Folic acid is not named on the 2026 Prohibited List.
What can go wrong: The label says folic acid alone is improper therapy in pernicious anaemia and other megaloblastic anaemias where vitamin B12 is deficient. NIH ODS notes it can mask vitamin B12 deficiency until its neurological consequences become irreversible.

Sources: Folic Acid Injection, DailyMed label (Fresenius Kabi) · Folate, fact sheet for health professionals (NIH Office of Dietary Supplements)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Vitamin & nutrient shotsKetorolac (Toradol-type) injections Ketorolac tromethamine injection · Toradol · Toradol shot

DNot prohibitedApproved, used off-label

What it is: A nonsteroidal anti-inflammatory drug (NSAID). The FDA-labelled injection is for short-term management of moderately severe acute pain that needs opioid-level analgesia. Also described as used in sport and in ‘recovery’ shots.
What the evidence shows: The FDA label limits ketorolac to short-term management of moderately severe acute pain that needs opioid-level analgesia, and says it is not indicated for minor or chronic painful conditions. No controlled human trial of ketorolac as a recovery or preventive shot in healthy athletes is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved, used off-label. An FDA-labelled NSAID injection for short-term management of moderately severe acute pain at the opioid level, with a boxed warning. A recovery or preventive shot is not a labelled use, so such use is off-label.
Anti-doping status, 2026 List: Not prohibited. Ketorolac is not named on the 2026 Prohibited List. A separate List rule covers intravenous infusions and/or injections above a set total volume per 12-hour period.
What can go wrong: MedlinePlus lists ulcers, bleeding or holes in the stomach or intestine, a higher risk of heart attack or stroke, and kidney failure among its warnings. The label carries a boxed warning and says ketorolac is not indicated for paediatric patients.

Sources: DailyMed: ketorolac tromethamine injection labels (boxed warning) · MedlinePlus Drug Information: Ketorolac (last reviewed 15 Mar 2021) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Vitamin & nutrient shotsOndansetron injection as a drip add-on Ondansetron hydrochloride injection · Zofran

DNot prohibitedApproved, used off-label

What it is: Ondansetron is an anti-nausea medicine in the class called serotonin 5-HT3 receptor antagonists. Its injectable form is FDA-labelled for preventing nausea and vomiting from cancer chemotherapy and after surgery; it is described as an add-on to ‘recovery’ drips.
What the evidence shows: The labelled uses are prevention of nausea and vomiting with emetogenic cancer chemotherapy and after surgery. No human evidence for use as a drip add-on for recovery, hangover or wellness is cited here. The label says routine prophylaxis is not recommended where little postoperative nausea is expected. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved, used off-label. Ondansetron injection is FDA-labelled in the United States for chemotherapy-related and postoperative nausea and vomiting. Addition to a recovery or wellness drip is not a labelled use, so it is off-label.
Anti-doping status, 2026 List: Not prohibited. Ondansetron is not named on the 2026 List. The List text also carries a rule on intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period.
What can go wrong: Label warnings include dose-dependent QT prolongation, postmarketing Torsade de Pointes cases and serotonin syndrome, which has been reported with 5-HT3 receptor antagonists.

Sources: DailyMed: ondansetron injection labels (indications) · MedlinePlus Drug Information: Ondansetron (last reviewed 15 Sep 2026) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

IV dripsCurcumin infusion Intravenous curcumin · Turmeric drip · Curcumin emulsion for injection

DCheck on Global DROUnapproved for the described use

Sold as an intravenous drip of a compounded emulsion; the supplement is oral

What it is: The principal polyphenol of turmeric, poorly absorbed by mouth and chemically unstable, which some naturopathic clinics inject to bypass the gut.
What it is sold for: Marketed for inflammation, pain, ‘immune modulation’ and cancer.
What the evidence shows: Oral curcumin has modest, formulation-dependent evidence for soreness. A controlled trial studied intravenous curcumin alongside cancer treatment; it does not establish benefit for wellness use. Clinical trial. It has a death: in 2017 the US FDA investigated two severe hypersensitivity reactions to a compounded emulsion, one fatal within minutes in a 30-year-old woman; the product contained ungraded castor-oil emulsifier with diethylene glycol and about 1 per cent of the labelled curcumin. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. The US FDA lists curcumin as a compounding bulk substance under evaluation; this is not approval of a wellness infusion.
Anti-doping status, 2026 List: Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips. Curcumin is not on the List.
What can go wrong: Anaphylaxis and cardiac arrest from the emulsifier, as in the 2017 case; the FDA noted that PEG castor oil carries hypersensitivity warnings on approved medicines and none on the compounded product.
What the practice does: The practice explains the difference between a spice with modest oral evidence and an unlicensed emulsion in a vein. Inflammation is measured as hs-CRP.

Sources: US FDA — investigation of two serious adverse events with a compounded curcumin emulsion for injection (2017) · US FDA — 503A bulk drug substances by category (May 2026) · USADA — IV infusions: explanatory note

Link to this entry

IV dripsOmega-3 lipid emulsion infusion Fish-oil infusion · Omegaven · Intravenous EPA/DHA · Lipid drip

DCheck on Global DROApproved, used off-label

Sold by a few clinics as a lipid drip

What it is: A sterile emulsion of fish-oil triglycerides designed to feed patients who cannot eat, infused over many hours with monitoring.
What it is sold for: Marketed for inflammation and ‘rapid repletion’ of the omega-3 index.
What the evidence shows: The approved evidence is in sick children: Omegaven was approved in 2018 for parenteral nutrition-associated cholestasis. In healthy adults the omega-3 index rises with fish or an oral supplement over weeks, and the large oral outcome trials were null. No trial has infused lipid into a healthy person and measured an outcome. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved, used off-label. Omegaven was approved by the US FDA in 2018 for paediatric parenteral nutrition-associated cholestasis; a wellness infusion is off-label use of a hospital product.
Anti-doping status, 2026 List: Check on Global DRO. Not a prohibited substance. M2.2 prohibits intravenous infusions and/or injections over 100 mL per 12 hours at all times, except in hospital treatment, surgery or clinical diagnostics; no TUE is granted for wellness drips. Lipid emulsions run in volumes and over hours that breach the rule outside hospital.
What can go wrong: The label warns of hypersensitivity, fat-overload syndrome, hypertriglyceridaemia, and infection because lipid supports microbial growth. It requires a filter and blood monitoring, which a lounge does not provide.
What the practice does: The omega-3 index is measured where a cardiovascular question justifies it and corrected with fish first. Lipids in a vein belong to a hospital nutrition team.

Sources: US FDA label — Omegaven (fish oil triglycerides) injectable emulsion, 2018 · USADA — IV infusions: explanatory note · US FDA — compounding in medical offices and clinics under insanitary conditions (2021)

Link to this entry

IV dripsIV rehydration drips (saline and Ringer’s lactate) Hydration drip · Rehydration drip · Normal saline drip · Lactated Ringer’s drip · Recovery drip

DCheck on Global DROApproved medicine

What it is: Intravenous saline or lactated Ringer’s fluid, given in wellness clinics as a ‘hydration’ or recovery drip for rehydration, hangover, jet-lag and post-training recovery. Ringer’s is an approved medicine for replacing water and electrolytes.
What the evidence shows: USADA states that IV fluid replacement after exercise to speed recovery is not clinically indicated nor substantiated by the medical literature, and that oral rehydration is the preferred therapeutic choice. No controlled human trial of recovery drips is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved medicine. Approved medicine: the Ringer’s label gives the indication as a source of water and electrolytes. Use as a wellness or recovery drip in healthy people is not described on the label.
Anti-doping status, 2026 List: Check on Global DRO. M2.2 on the 2026 List covers intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period. Sport Integrity Australia states this applies to any substance. Check the exact volume on Global DRO.
What can go wrong: The Ringer’s label warns that fluid can cause overloading and dilution of serum electrolyte concentrations, overhydration, congested states, pulmonary oedema or acid-base imbalance.

Sources: Is it prohibited for athletes to use IV infusions for rehydration and recovery? (USADA) · Athlete warning: IV infusions (Sport Integrity Australia) · Lactated Ringer's Injection, DailyMed label (Becton Dickinson)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

IV dripsIV iron infusions Iron drip · Iron infusion · Ferric carboxymaltose · Injectafer (brand name) · Iron sucrose

BCheck on Global DROApproved, used off-label

What it is: Intravenous iron products such as ferric carboxymaltose, approved for iron deficiency anaemia. Offered to athletes for low iron stores and fatigue; USADA and a trial in runners address that use.
What the evidence shows: Approved for iron deficiency anaemia after intolerance of, or an unsatisfactory response to, oral iron. One blinded, placebo-controlled trial in 14 distance runners without clinical iron deficiency found less perceived fatigue and better mood, with no gain in oxygen transport capacity or performance. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved, used off-label. Approved for iron deficiency anaemia in patients with intolerance of, or an unsatisfactory response to, oral iron. Use for fatigue or performance without iron deficiency is not a labelled use.
Anti-doping status, 2026 List: Check on Global DRO. USADA: an iron infusion or injection is permitted at 100 mL or less per 12-hour period; more than 100 mL in 12 hours is prohibited (M2.2) unless legitimately received in a hospital treatment. Check the exact product and volume on Global DRO.
What can go wrong: The Injectafer label reports symptomatic low blood phosphate (hypophosphataemia) with serious outcomes including osteomalacia and fractures, and serious hypersensitivity reactions, including anaphylactic-type reactions, some life-threatening and fatal.

Sources: Injectafer (ferric carboxymaltose) prescribing information, FDA label 2025 · Four Weeks of IV Iron Supplementation Reduces Perceived Fatigue and Mood Disturbance in Distance Runners (PLOS ONE, 2014) · Iron deficiency treatment (USADA)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

IV dripsIV alpha-lipoic acid Thioctic acid injection · ALA drip · Alpha-lipoic acid infusion · Lipoic acid IV

BCheck on Global DROUnapproved for the described use

What it is: Alpha-lipoic acid is an antioxidant made in the body. Wellness menus offer it as an intravenous drip or add-on shot, alone or blended with glutathione, for antioxidant and skin ‘glow’ claims.
What the evidence shows: A 2016 American Family Physician article cites meta-analyses in diabetic neuropathy of four randomised controlled trials (N = 653) and, in 2012, 15 trials (N = 1,058); it says it is unclear why IV therapy was more effective than oral and that no evidence covers long-term treatment. Many studies came from one German group funded by the manufacturer. No trial of skin or antioxidant drips is cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Unapproved for the described use. Approved for diabetic neuropathy in Germany; sold as a dietary supplement without a prescription in the US. Skin or antioxidant drips are not an approved use.
Anti-doping status, 2026 List: Check on Global DRO. M2.2 on the 2026 List is the rule on intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period. Whether a drip or shot falls under it depends on volume; check the product on Global DRO.
What can go wrong: The Linus Pauling Institute reports two mild anaphylactoid reactions and one severe anaphylactic reaction, including laryngospasm, after intravenous lipoic acid administration.

Sources: Alpha-Lipoic Acid for Treatment of Diabetic Peripheral Neuropathy (American Family Physician, 2016) · Lipoic acid (Linus Pauling Institute Micronutrient Information Center) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

IV dripsIntravenous hydrogen peroxide IV H2O2 · Hydrogen peroxide infusion · Hydrogen peroxide drip

DCheck on Global DROUnapproved for the described use

What it is: Hydrogen peroxide solution promoted for ‘medicinal’ use and given by vein or by mouth.
What the evidence shows: FDA states that no one has presented any evidence that hydrogen peroxide taken internally has any medical value. Science Feedback (2023) cites plenty of evidence that injecting or ingesting it can cause serious harm. No controlled human trial of intravenous use is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. FDA’s 2006 release says the high-strength concentration is not approved for any purpose. No approval as a medicine was verified for intravenous use.
Anti-doping status, 2026 List: Check on Global DRO. A volume rule applies: M2.2 on the 2026 List covers intravenous infusions and/or injections above a total of 100 mL per 12-hour period. Check the exact product, route and volume on Global DRO.
What can go wrong: FDA lists inflammation of the blood vessel at the injection site, gas embolisms (bubbles in blood vessels) and potentially life-threatening allergic reactions. Science Feedback says evidence shows injecting or ingesting it can cause serious harm.

Sources: FDA Warns Consumers Against Drinking High-Strength Hydrogen Peroxide For Medicinal Use (FDA release, 2006, via ScienceDaily) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

IV dripsHydrogen-rich saline and hydrogen infusions Hydrogen saline · Hydrogen-rich saline injection · H2 infusion

CCheck on Global DRONo approval verified

What it is: Saline or glucose-electrolyte solution with dissolved hydrogen gas, studied by injection or infusion and promoted with antioxidant and anti-inflammatory claims in skin and cosmetic medicine. Separate from hydrogen water and hydrogen inhalation.
What the evidence shows: A 2025 skin and cosmetic review says most current experiments remain preliminary, in animal models and small-scale clinical trials. One human example it cites is a 2012 report of a hydrogen-containing glucose electrolyte injection in one patient with facial herpes zoster. Evidence is limited. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: No approval as a medicine was verified for hydrogen-containing injections or infusions.
Anti-doping status, 2026 List: Check on Global DRO. M2.2 on the 2026 List sets a volume rule for intravenous infusions and/or injections: more than a total of 100 mL per 12-hour period. Check the exact product and volume for a hydrogen infusion on Global DRO.
What can go wrong: No safety data for hydrogen-containing infusions are cited here; the evidence is preliminary.

Sources: Progress in the Application of Molecular Hydrogen in Medical Skin Cosmetology (Clinical, Cosmetic and Investigational Dermatology, 2025) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

IV dripsEDTA chelation drips Chelation therapy · Disodium EDTA infusion · Heavy-metal chelation drip · Detox chelation drip

DCheck on Global DROUnapproved for the described use

What it is: Intravenous disodium EDTA, a metal-binding agent, offered by wellness clinics as a heart, circulation or ‘heavy-metal detox’ drip.
What the evidence shows: NIH’s Trial to Assess Chelation Therapy (TACT) randomised 1,708 patients; overall, chelation showed an 18 per cent reduced risk of later cardiac events, which NCCIH says is not sufficient on its own to support routine use after a heart attack. TACT2 randomised 1,000 people with diabetes and a prior heart attack and did not reproduce those results. No trial of ‘detox’ use is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. Disodium EDTA is not approved by the FDA to treat coronary heart disease. Mayo Clinic says the FDA has not approved chelation therapy as a heart disease treatment.
Anti-doping status, 2026 List: Check on Global DRO. The 2026 List (M2.2) covers intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period. An EDTA drip depends on volume; check the exact product on Global DRO.
What can go wrong: Serious potential side effects include hypocalcaemia (low blood calcium levels) and toxicity to the kidneys.

Sources: Questions and answers: the NIH trials of EDTA chelation therapy for coronary heart disease (NCCIH) · In a Large Multicenter Trial, Chelation Therapy Did Not Reduce Cardiovascular Disease Events in Patients With Diabetes and a History of Heart Attack (NCCIH, August 2024) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

IV dripsPolyene phosphatidylcholine (essential phospholipid) injections PPC injection · Essential phospholipids · EPL · ‘Liver’ drip

CCheck on Global DRONo approval verified

What it is: A phospholipid preparation (polyene phosphatidylcholine) given by injection in China for liver injury and studied as essential phospholipids in fatty liver disease. Marketed for liver support.
What the evidence shows: A 2022 multicentre, retrospective observational cohort of 6,052 patients (471 with HBV infection) found polyene phosphatidylcholine lowered ALT and AST regardless of HBV status; the route given is not specified in the paper. A 2016 review says most clinical studies of essential phospholipids in fatty liver have too few patients and that larger randomised double-blind trials are needed. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: A 2022 paper says injection has been used in China for years in the management of liver injury. No approval as a medicine was verified for injected use.
Anti-doping status, 2026 List: Check on Global DRO. Under M2.2 of the 2026 List, the volume rule concerns intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period. Check the product and volume on Global DRO.
What can go wrong: No safety data for injected polyene phosphatidylcholine are cited here.

Sources: A Multicenter Real-World Study Evaluating the Hepatoprotective Effect of Polyene Phosphatidylcholine Against Chronic Hepatitis B (Frontiers in Medicine, 2022) · Essential phospholipids in fatty liver: a scientific update (Clinical and Experimental Gastroenterology, 2016) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

IV dripsCalcium injection (calcium gluconate) as a drip ingredient Calcium gluconate injection · Calcium drip · Myers cocktail with calcium

DCheck on Global DROApproved, used off-label

What it is: Calcium gluconate injection is an approved medicine for acute symptomatic low blood calcium. Menus list calcium inside Myers-type and hair-tonic drips.
What the evidence shows: The label gives acute symptomatic hypocalcaemia as the indication. No controlled human trial of calcium as a wellness-drip ingredient is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved, used off-label. Labelled for acute symptomatic hypocalcaemia in paediatric and adult patients. Wellness-drip use is not the labelled use.
Anti-doping status, 2026 List: Check on Global DRO. The 2026 List rule on intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period (M2.2) is the relevant rule for a drip. Check the exact product and volume on Global DRO.
What can go wrong: The label names tissue necrosis, ulceration and secondary infection as the most serious complications, and warns of cardiac arrhythmias if calcium and cardiac glycosides are given together.

Sources: Calcium Gluconate Injection, DailyMed label (Fresenius Kabi) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

IV dripsTranexamic acid skin-brightening drips Transamin (brand name) · TXA drip · Tranexamic acid infusion

DCheck on Global DROUnapproved for the described use

What it is: Tranexamic acid is an antifibrinolytic medicine labelled for patients with haemophilia. A Thai clinic menu lists it in ‘radiant skin’ drips under the brand name Transamin.
What the evidence shows: No trial of intravenous tranexamic acid for skin brightening is cited here. The label indication cited is in patients with haemophilia. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. The label indication is in patients with haemophilia. Skin brightening by drip is not a labelled use.
Anti-doping status, 2026 List: Check on Global DRO. M2.2 of the 2026 List sets a volume limit on intravenous infusions and/or injections: more than a total of 100 mL per 12-hour period. Check the exact product and volume on Global DRO.
What can go wrong: The label says tranexamic acid is an antifibrinolytic and may increase the risk of thromboembolic events.

Sources: Tranexamic Acid Injection, DailyMed label (Armas) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

IV dripsDMSO (dimethyl sulfoxide) injections and drips Dimethyl sulfoxide · IV DMSO · RIMSO-50 (the approved bladder product)

DCheck on Global DROUnapproved for the described use

What it is: Dimethyl sulfoxide is a solvent-derived drug. An approved product, RIMSO-50, exists for interstitial cystitis.
What the evidence shows: No efficacy data for injected or infused DMSO are cited here; the approved product’s indication is interstitial cystitis. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. RIMSO-50 is approved for symptomatic relief of interstitial cystitis. No approval as a medicine was verified for injected or infused use.
Anti-doping status, 2026 List: Check on Global DRO. Intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period are the subject of M2.2 on the 2026 List. Check the exact product and the volume of any DMSO infusion on Global DRO.
What can go wrong: The label of the approved product states: not for intramuscular or intravenous injection. No adverse-effect data for injected use are cited here.

Sources: RIMSO-50 (dimethyl sulfoxide), DailyMed label (Mylan Institutional) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

IV dripsPotassium chloride and potassium phosphate injections Potassium drip · Potassium chloride injection · Potassium phosphates injection · Phosphate injection

DCheck on Global DROApproved, used off-label

What it is: Approved injectable electrolytes for potassium or phosphorus deficiency in patients who cannot replace them by mouth. An Indian menu lists potassium in a ‘hair tonic’ drip.
What the evidence shows: The evidence cited is label indications, not trials: potassium chloride concentrate for potassium deficiency when oral replacement is not feasible, and potassium phosphates for hypophosphataemia. No controlled human trial of wellness use is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved, used off-label. Labelled for treating potassium deficiency (chloride) or hypophosphataemia (phosphates) when oral or enteral replacement is not possible. Wellness-drip use is not the labelled use.
Anti-doping status, 2026 List: Check on Global DRO. For a potassium or phosphate drip, M2.2 on the 2026 List is the volume rule: intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period. Check Global DRO for the exact product.
What can go wrong: The chloride label warns that, in patients with renal insufficiency, potassium chloride may cause potassium intoxication and life-threatening hyperkalaemia. The phosphate label warns of an increased risk of hyperkalaemia, including life-threatening cardiac events.

Sources: Potassium Chloride for Injection Concentrate, USP, DailyMed label (Fresenius Kabi, rev. February 2023) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Biologics & proceduresPRP and prolotherapy injections Platelet-rich plasma · PRP · Dextrose prolotherapy · Orthobiologics

BNot prohibitedApproved, used off-label

Injected into a tendon, ligament or joint, usually under ultrasound, by a physician

What it is: PRP is the client’s own blood spun to concentrate platelets and injected at the injury; prolotherapy injects an irritant, usually dextrose, to provoke healing.
What it is sold for: Marketed for tendinopathy, osteoarthritis and faster return to sport.
What the evidence shows: The Cochrane review of platelet-rich therapies for soft-tissue injury (19 small trials, 1,088 people) found no clinically relevant difference in function and a marginal short-term effect on pain, on very low-quality evidence. The Cochrane review of prolotherapy for chronic low-back pain (five trials, 366 people) found injections alone no better than control, with some benefit combined with exercise. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved, used off-label. PRP is a physician’s preparation of the patient’s own blood, not a licensed medicine for tendons or joints. Dextrose prolotherapy is off-label use of an approved solution.
Anti-doping status, 2026 List: Not prohibited. PRP is not prohibited: USADA states it plainly, and the 2026 List does not name platelet preparations. Purified growth factors given separately are prohibited under S2.3 at all times, and added growth factors or hormones change the answer.
What can go wrong: Post-injection pain and swelling, infection, nerve or tendon injury with poor technique, and the cost of repeated courses; adverse-event rates were comparable to controls.
What the practice does: A persistent tendon or joint problem goes to a sports physician with imaging, and the practice coaches the progressive loading the better trials paired with the injection.

Sources: USADA — orthobiologics: what athletes need to know about PRP · Cochrane review — platelet-rich therapies for musculoskeletal soft tissue injuries (Moraes et al., 2014) · Cochrane review — prolotherapy injections for chronic low-back pain · WADA 2026 Prohibited List (copy published by CONMEBOL)

Link to this entry

Biologics & proceduresActovegin (deproteinised calf-blood extract) Solcoseryl · Deproteinised calf haemodialysate · Calf-blood extract

CCheck on Global DRONo approval verified

What it is: A deproteinised extract of calf blood with more than 200 bioactive constituents, also called Solcoseryl. It is injected, and promoted in sport for muscle-injury recovery and ‘performance’.
What the evidence shows: A 2016 paper cites studies in which it did not improve aerobic capacity compared with saline in humans, shortened recovery from 8.3 to 5.5 weeks, and cut return to play by 8 days in injured professional footballers compared with physiotherapy alone (p=0.033). A 2024 review calls performance effects anecdotal and muscle-injury findings promising. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: A 2016 paper describes it as a biological drug produced from deproteinised haemodialysate of calf serum. No approval as a medicine was verified for injection in sport.
Anti-doping status, 2026 List: Check on Global DRO. A 2016 paper records that the IOC banned it as an ergogenic substance in December 2000. A 2024 review says intravenous injections exceeding 100 mL are prohibited; check the exact product, route and volume on Global DRO.
What can go wrong: A calf-blood extract containing more than 200 bioactive constituents; no adverse-effect data are cited here.

Sources: The Implications of Actovegin® in Sport: A Brief Review (EABR Experimental and Applied Biomedical Research, March 2024) · Actovegin Equals to Performance Enhancing Drug Doping: Fact or Fiction? (Journal of Tissue Science and Engineering, 2016) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Biologics & proceduresPolynucleotide (PN) and PDRN ‘salmon DNA’ skin injections PDRN · Polydeoxyribonucleotide · Polynucleotides · Salmon DNA injection · DNA skin booster

BCheck on Global DRONo approval verified

What it is: DNA-derived bioproducts, mostly sourced from salmon gonads, injected into skin or wounds as ‘skin boosters’ and for scar and wound healing.
What the evidence shows: A 2026 systematic review of randomised clinical trials included seven trials with 183 participants and says the evidence supports a potential role for these therapies as regenerative interventions in skin rejuvenation, postoperative scar prevention and wound healing. A 2026 narrative review cites inconsistent evidence and asks for more controlled trials. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: No approval as a medicine was verified for polynucleotide or PDRN injections.
Anti-doping status, 2026 List: Check on Global DRO. The 2026 List text on nucleic acids covers ‘the use of nucleic acids or nucleic acid analogues that may alter genome sequences and/or gene expression by any mechanism’. Check the exact product on Global DRO.
What can go wrong: A 2026 narrative review says caution needs to be exercised so that patient safety is not compromised. No adverse-effect data are cited here.

Sources: Polynucleotides and Polydeoxyribonucleotides for Skin Rejuvenation, Postoperative Scar Prevention, and Wound Healing: A Systematic Review of Randomized Clinical Trials (Cureus, 2026; Europe PMC full text) · Polynucleotides and polydeoxyribonucleotides in dermatology – A narrative review (Journal of Cutaneous and Aesthetic Surgery, 2026) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Biologics & proceduresHyaluronic-acid joint injections (viscosupplementation) Hyaluronan injection · Intra-articular hyaluronic acid · Viscosupplementation

DNot prohibitedNo approval verified

What it is: Hyaluronan injected into a joint to manage osteoarthritis symptoms. Separate from hyaluronic acid in oral supplements or skin fillers.
What the evidence shows: NICE guideline NG226 (2022) advises not to offer intra-articular hyaluronan injections for osteoarthritis. Its rationale found no evidence that they improved quality of life or physical function, or reduced pain, and evidence of potential harm for hip osteoarthritis. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: No approval as a medicine was verified for intra-articular hyaluronan injections.
Anti-doping status, 2026 List: Not prohibited. Hyaluronan joint injections are not named on the 2026 Prohibited List.
What can go wrong: NICE found evidence of potential harm for hip osteoarthritis.

Sources: Osteoarthritis in over 16s: diagnosis and management (NICE guideline NG226, 2022; NCBI Bookshelf copy)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Biologics & proceduresCorticosteroid joint and soft-tissue injections Cortisone shot · Steroid injection · Intra-articular corticosteroid · Triamcinolone (Kenalog) injection · Dexamethasone injection

BCheck on Global DROApproved medicine

What it is: Glucocorticoid medicines such as triamcinolone, injected into a joint or soft tissue to calm inflammation. Used in orthopaedic and sports medicine for joint pain and soft-tissue inflammation.
What the evidence shows: NICE says to consider intra-articular corticosteroid injections for osteoarthritis when other pharmacological treatments are ineffective or unsuitable, or to support therapeutic exercise, and that they provide only short-term relief (2 to 10 weeks). No trial data are cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. Approved medicine. The triamcinolone acetonide injectable suspension label gives it as adjunctive therapy for short-term administration during an acute episode or exacerbation.
Anti-doping status, 2026 List: Check on Global DRO. S9 on the 2026 List: all glucocorticoids are prohibited, in competition, when given by any injectable, oral (including oromucosal) or rectal route. Check the exact product and route on Global DRO.
What can go wrong: The triamcinolone label warns of serious neurological events, some resulting in death, with epidural injection of corticosteroids.

Sources: Osteoarthritis in over 16s: diagnosis and management (NICE guideline NG226, 2022; NCBI Bookshelf copy) · Kenalog-40 and Kenalog-80 (triamcinolone acetonide injectable suspension), DailyMed label · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Biologics & procedures‘Fat-dissolving’ injections that are not approved Lipodissolve · Aqualyx · Lipo Lab · Kabelline · Phosphatidylcholine-deoxycholate injections

DNot prohibitedUnapproved for the described use

What it is: Injections, often phosphatidylcholine with sodium deoxycholate, sold online and in clinics for body contouring and fat reduction. FDA says unapproved fat-dissolving injections can be harmful.
What the evidence shows: No controlled human trial of these injections is cited here. The FDA page cited describes harms from unapproved fat-dissolving injections, not efficacy. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. FDA states that these fat-dissolving injections are not FDA approved and are marketed and sold online under brand names such as Aqualyx, Lipodissolve, Lipo Lab and Kabelline. The only approved fat-dissolving injectable is for fat under the chin.
Anti-doping status, 2026 List: Not prohibited. Fat-dissolving injections are not named on the 2026 Prohibited List.
What can go wrong: FDA reports permanent scars, serious infections, skin deformities, cysts and deep, painful knots. Some consumers received injections at clinics or med spas from personnel who might not have been properly licensed.

Sources: Using fat-dissolving injections that are not FDA approved can be harmful (FDA, 2023)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Biologics & proceduresDeoxycholic acid injection (Kybella) Kybella · Deoxycholic acid · Submental fat injection

BNot prohibitedApproved medicine

What it is: The only fat-dissolving injectable FDA names as approved, for reducing fat under the chin in adults. It is the approved comparator to unapproved ‘fat-dissolving’ products.
What the evidence shows: FDA’s 2023 page names it as the only approved fat-dissolving injectable, for fat under the chin. No trial results are cited here; approval for this narrow use is the evidence cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. FDA names it as the only fat-dissolving injectable drug approved to reduce the amount of fat under the chin.
Anti-doping status, 2026 List: Not prohibited. Deoxycholic acid is not named on the 2026 Prohibited List.
What can go wrong: No adverse-effect data for the approved product are cited here. FDA’s warning on harms concerns unapproved fat-dissolving injections.

Sources: Using fat-dissolving injections that are not FDA approved can be harmful (FDA, 2023)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Biologics & proceduresMesotherapy Intradermal cocktail injections

DCheck on Global DROUnapproved for the described use

What it is: Many small injections of mixtures of plant extracts, vitamins, enzymes, nutrients, hormones and medications into the skin, used in cosmetic and body-contouring settings.
What the evidence shows: DermNet NZ says that although mesotherapy has been used for decades in Europe there is very little scientific or clinical evidence to support it, and that the American Society of Plastic Surgeons does not endorse it. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. DermNet NZ states that the FDA has not approved any medications for use in mesotherapy or body contouring.
Anti-doping status, 2026 List: Check on Global DRO. Contents vary and can include hormones and medications. Not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.
What can go wrong: DermNet NZ lists side effects including allergic reaction, skin infection, pigmentation, bruising, ulceration, scarring, deformity at the injection site and panniculitis.

Sources: Mesotherapy (DermNet NZ)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Biologics & proceduresBotulinum toxin injections (Botox-type) Botox · Botox Cosmetic · OnabotulinumtoxinA · ‘Preventative’ Botox

ANot prohibitedApproved medicine

What it is: OnabotulinumtoxinA (Botox) is an acetylcholine release inhibitor and neuromuscular blocking agent, marketed for softening frown lines and wrinkles; some clinics also offer ‘preventive’ use before lines form.
What the evidence shows: The labelled indications rest on placebo-controlled trials described in the FDA label. The Botox Cosmetic label describes two randomised, multicentre, double-blind, placebo-controlled studies of glabellar lines (405 treated and 132 placebo participants, combined). No human study of ‘preventive’ use in people without lines is cited here. Grade A · Consistent human trials support the claimed use, in the people it is claimed for
Regulatory status: Approved medicine. Botox is an approved medicine, FDA-labelled for medical uses and, in a separate Botox Cosmetic label, for temporary improvement of moderate to severe glabellar, lateral canthal and forehead lines and platysma bands in adults. The Botox Cosmetic label lists existing moderate to severe lines and states no ‘preventive’ indication.
Anti-doping status, 2026 List: Not prohibited. Botulinum toxin is not named on the 2026 List. The List text also carries a rule on intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period.
What can go wrong: The boxed warning says the effects of Botox and all botulinum toxin products may spread from the injection site, with swallowing and breathing difficulties that can be life threatening and reports of death.

Sources: DailyMed: BOTOX Cosmetic label (indications and boxed warning) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Biologics & proceduresHyaluronic-acid ‘skin boosters’ SKINVIVE by Juvéderm · Skin boosters · Injectable skin boosters · Intradermal hyaluronic acid

BNot prohibitedDevice

What it is: Skin boosters are hyaluronic-acid gel injections into the skin to improve its quality, distinct from deeper volumising fillers; marketed for skin smoothness, ‘quality’ and neck lines.
What the evidence shows: FDA says its filler approvals rest on controlled clinical studies. SKINVIVE by Juvéderm is approved for narrow indications, cheek skin smoothness and neck lines, in adults over 21; the trial results are not reported here. No systematic review of skin boosters, and no trial of other skin-booster products, is cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Device. Regulated in the US as a medical device (PMA P110033). FDA states that SKINVIVE by Juvéderm is indicated to improve cheek skin smoothness and to reduce neck lines in adults over 21. The regulatory status of other skin-booster products is not covered here.
Anti-doping status, 2026 List: Not prohibited. The 2026 Prohibited List does not name hyaluronic-acid skin boosters; it carries a rule on intravenous infusions and/or injections of more than a total of 100 mL per 12-hour period.
What can go wrong: No adverse-effect data or regulator warnings for skin boosters are cited here.

Sources: FDA: Dermal Fillers (Soft Tissue Fillers) · FDA: FDA-Approved Dermal Fillers · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Healing & repairAHK-Cu Alanyl-histidyl-lysine copper · distinct from GHK-Cu

CProduct review requiredResearch reference

What it is: A copper-binding tripeptide investigated in hair-follicle biology.
Evidence and limits: Human follicles and dermal papilla cells have been studied in the laboratory. This is not a clinical hair-growth trial or evidence of systemic benefit.
Regulatory context: No systemic therapeutic approval was verified in this review. Cosmetic use does not establish approval as a medicine.
Sport status: A product-specific review is required. Unapproved pharmacological substances can fall under WADA S0; a cosmetic label is not sport clearance.
Safety context: Clinical and systemic safety cannot be inferred from cultured cells.
Coaching boundary: Explain the evidence and refer clinical questions to the physician. No prescribing, recommending or sourcing.

Sources: Original follicle study · WADA 2026 List

Link to this entry · Research note reviewed 29 September 2026. Approval and sport status are specific to the exact substance and formulation.

Healing & repairVIP (aviptadil) Vasoactive intestinal peptide · Aviptadil · Invicorp (with phentolamine) · Zyesami

DCheck on Global DROApproved medicine

A prescription intracavernosal injection where licensed; sold illicitly as a nasal spray or subcutaneous injection

What it is: A 28-amino-acid neuropeptide that dilates blood vessels, relaxes smooth muscle and modulates inflammation; synthetic VIP is called aviptadil.
What it is sold for: Marketed for mould illness, chronic fatigue, ‘CIRS’, lung repair and inflammation.
What the evidence shows: Aviptadil with phentolamine is a licensed medicine in the UK for erectile dysfunction, with trial evidence comparable to prostaglandin injections. The inflammation claims were tested at scale in the NIH-run TESICO trial of intravenous aviptadil in COVID-19 respiratory failure: 471 patients, no improvement in recovery or 90-day mortality, more serious adverse events, and a stop for futility. No trial supports the ‘mould illness’ use. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved medicine. Approvals depend on formulation and indication. India granted restricted emergency approval for severe COVID-19 with ARDS; this is not a general wellness approval. Confirm current local labelling with a physician. CDSCO approval record.
Anti-doping status, 2026 List: Check on Global DRO. Not named on the 2026 List and, as an approved medicine, outside the S0 catch-all. Verify on Global DRO for the country and route before any use.
What can go wrong: Hypotension, flushing, diarrhoea and tachycardia; priapism and injection pain with the licensed use; more serious adverse events than placebo in the COVID trial; unregulated nasal products.
What the practice does: Explained with the TESICO result, the largest test of the inflammation claim. Fatigue and breathlessness are worked up by a physician; the practice measures sleep, HRV, VO₂max and bloods and reads them as a trend.

Sources: Scottish Medicines Consortium — aviptadil/phentolamine (Invicorp): licensed indication and advice · TESICO trial, Lancet Respiratory Medicine 2023 — intravenous aviptadil in COVID-19 respiratory failure (abstract record) · 2026 Prohibited List, full text (VADA copy of the WADA List in force from 1 January 2026)

Link to this entry

Healing & repairAfamelanotide Scenesse · Melanotan I

BCheck on Global DROApproved medicine

What it is: A melanocortin-pathway peptide given as an under-the-skin implant for erythropoietic protoporphyria, a rare disease that causes intolerance to light. A relative of melanotan II.
What the evidence shows: Authorised for erythropoietic protoporphyria under exceptional circumstances; trial details are not summarised here. No evidence for tanning or cosmetic use is cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. EU: authorised 22 December 2014 under exceptional circumstances, because comprehensive efficacy and safety data could not be provided.
Anti-doping status, 2026 List: Check on Global DRO. Not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.
What can go wrong: The authorisation was granted under exceptional circumstances because comprehensive efficacy and safety data could not be provided. No adverse-effect data are cited here.

Sources: Scenesse EPAR summary, EMA · WADA 2026 Prohibited List (copy published by Japan Anti-Doping Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Healing & repairAcetyl hexapeptide-8 (Argireline) Argireline · acetyl hexapeptide-8 amide · acetyl hexapeptide-3

CCheck on Global DROUnapproved for the described use

What it is: A synthetic cosmetic hexapeptide ingredient, classed as a skin-conditioning agent. It is a cosmetic ingredient, not a drug.
What the evidence shows: The source cited is a CIR safety assessment. No efficacy trial is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Unapproved for the described use. Reviewed as a cosmetic ingredient: CIR (2021) found it safe in cosmetics at concentrations not exceeding 0.005%. No drug approval was found.
Anti-doping status, 2026 List: Check on Global DRO. Not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.
What can go wrong: The CIR assessment found it safe in cosmetics at concentrations not exceeding 0.005%. That finding covers cosmetic use only.

Sources: Safety Assessment of Acetyl Hexapeptide-8 Amide as Used in Cosmetics (CIR, 2021) · WADA 2026 Prohibited List (copy published by Japan Anti-Doping Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Healing & repairAc-SDKP AcSDKP · N-acetyl-seryl-aspartyl-lysyl-proline

CCheck on Global DROUnapproved for the described use

What it is: An acetylated peptide released when prolyl oligopeptidase hydrolyses thymosin beta-4 and described as a regulator of fibrosis in heart, kidney, liver and lung; it is grouped with healing peptides because of that origin.
What the evidence shows: Evidence is limited to laboratory and animal work. A 2022 review reports that the thymosin beta-4, prolyl oligopeptidase and Ac-SDKP axis exists in liver, kidney, heart and lung and provides protective effects against organ fibrosis. Rat studies of cardiac fibrosis and a 2023 abstract in cultured human cardiac fibroblasts are also cited. No human treatment trial is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Unapproved for the described use. No approval as a medicine was verified for this use. A 2022 review frames the pathway only as a possible future anti-fibrosis therapy.
Anti-doping status, 2026 List: Check on Global DRO. Not named in the 2026 Prohibited List text reviewed. S2.3 names thymosin-beta-4 and its derivatives; the List does not say whether Ac-SDKP counts as one. S0 may apply if no government has approved it. Check the exact product on Global DRO.
What can go wrong: Human safety cannot be inferred from rat studies and cultured cells.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · The Role of Tβ4-POP-Ac-SDKP Axis in Organ Fibrosis (Int J Mol Sci, 2022)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Healing & repairPalmitoyl pentapeptide (Matrixyl) Matrixyl · pal-KTTKS · palmitoyl-lysine-threonine-threonine-lysine-serine

BCheck on Global DROUnapproved for the described use

What it is: A synthetic palmitoylated pentapeptide (pal-KTTKS) designed as a cosmetic agent to stimulate collagen production for an anti-wrinkle benefit. It is marketed in anti-wrinkle and photoaged-skin creams.
What the evidence shows: One 2005 peer-reviewed trial in photoaged human facial skin reported that the peptide was well tolerated and gave significant improvement over placebo control in wrinkles and fine lines. The trial size, duration and sponsor are not given here, and no replication is cited; evidence rests on this single study. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Unapproved for the described use. No approval as a medicine was verified for this use, and no regulator or cosmetic-safety-panel statement on this ingredient is cited.
Anti-doping status, 2026 List: Check on Global DRO. Not named in sections S2.2 and S4.4 of the 2026 Prohibited List; WADA does not say whether S0, non-approved substances, reaches a cosmetic ingredient. Status can depend on route, volume or formulation, so check Global DRO.
What can go wrong: The 2005 trial in photoaged human facial skin reported that the peptide was well tolerated by the skin. No longer-term or systemic safety data are cited here.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · Topical palmitoyl pentapeptide provides improvement in photoaged human facial skin (2005)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Metabolic & weightGlucagon Baqsimi

BCheck on Global DROApproved medicine

What it is: A pancreatic peptide hormone that raises blood glucose, used as a rescue treatment for severe hypoglycaemia; one form is a nasal product (Baqsimi).
What the evidence shows: Approved as a rescue medicine for severe hypoglycaemia; trial details are not summarised here. No sport or anti-ageing evidence is cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. EU: Baqsimi authorised 16 December 2019 for severe hypoglycaemia in people with diabetes aged 1 year or older.
Anti-doping status, 2026 List: Check on Global DRO. Not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.
What can go wrong: No safety data are cited here.

Sources: Baqsimi EPAR summary, EMA · WADA 2026 Prohibited List (copy published by Japan Anti-Doping Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Metabolic & weightSetmelanotide Imcivree

BCheck on Global DROApproved medicine

What it is: A melanocortin-4 receptor agonist peptide for obesity from certain genetic conditions. It is a melanocortin relative of bremelanotide and melanotan II.
What the evidence shows: Approved for rare genetic obesity conditions, a narrow population; trial details are not summarised here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. EU: authorised 16 July 2021 for obesity and hunger caused by certain genetic conditions. A review table lists a 2020 approval for chronic weight management of obesity.
Anti-doping status, 2026 List: Check on Global DRO. Not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.
What can go wrong: No safety data are cited here.

Sources: Imcivree EPAR summary, EMA · Review of approved therapeutic peptides (PubMed Central, PMC8844085) · WADA 2026 Prohibited List (copy published by Japan Anti-Doping Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Metabolic & weightMetreleptin (Myalepta) Myalepta · leptin analogue

BCheck on Global DROApproved medicine

What it is: A leptin analogue authorised in the EU, in addition to diet, for lipodystrophy: loss of fatty tissue under the skin with fat build-up elsewhere.
What the evidence shows: Authorised for lipodystrophy, a rare population. No evidence for general obesity or wellness use is cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. EU marketing authorisation issued 30 July 2018 for lipodystrophy, as a medicine used in addition to diet. No other use is listed.
Anti-doping status, 2026 List: Check on Global DRO. Not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.
What can go wrong: No safety data are cited here.

Sources: EMA: Myalepta (metreleptin) EPAR · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Cognitive & moodNoopept (GVS-111) GVS-111 · omberacetam · N-phenylacetyl-L-prolylglycine ethyl ester

CCheck on Global DROUnapproved for the described use

What it is: Noopept is a substituted Pro-Gly dipeptide designed as a drug at the State Zakusov Institute of Pharmacology. It is sold as a nootropic and described as used for traumatic brain injury, mood disorders and cerebral vascular disease.
What the evidence shows: Human evidence is small: one Russian clinical study, summarised in a 2016 review, reported reduced cognitive impairment and an anxiolytic effect in patients with mild cognitive impairment of cerebrovascular and post-traumatic origin. The mechanism work is experimental. No trial in healthy people is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Unapproved for the described use. A 2021 paper describes omberacetam, which it identifies with Noopept, as available in Russia but not FDA-approved. The FDA has issued warning letters to companies selling omberacetam supplements. Russian prescription or over-the-counter status was not verified.
Anti-doping status, 2026 List: Check on Global DRO. Not named in the 2026 Prohibited List text reviewed under either name. S0 would not apply if a government has approved it for human therapeutic use; it is described as available in Russia. The exact product must be checked on Global DRO.
What can go wrong: A 2021 paper associates the unapproved drugs it found in supplements, including omberacetam, with adverse effects including increased and decreased blood pressure, insomnia, agitation, dependence, sedation, hospitalisation and intubation.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · Molecular Mechanism Underlying the Action of Substituted Pro-Gly Dipeptide Noopept (Acta Naturae, 2016) · Five Unapproved Drugs Found in Cognitive Enhancement Supplements (Neurology: Clinical Practice, 2021)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Cognitive & moodPiracetam and other racetams piracetam · aniracetam · levetiracetam · fonturacetam · 4-phenylpiracetam · carphedon

DCheck on Global DROUnapproved for the described use

What it is: A family of drugs named after piracetam, with members including aniracetam, levetiracetam and fonturacetam (4-phenylpiracetam, carphedon). Some are sold as cognitive-enhancement (nootropic) supplements.
What the evidence shows: Cochrane reviews of piracetam in stroke (2012), foetal distress in labour (2012) and sickle cell crises (2016) found no proven benefit or too little evidence. No benefit for cognition in healthy people is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. No approval of piracetam for cognitive enhancement was verified. A 2021 paper states that only levetiracetam among the racetams is FDA-approved in the US, that aniracetam is approved for dementia in several countries, and that the FDA has sent warning letters to sellers of aniracetam and omberacetam supplements.
Anti-doping status, 2026 List: Check on Global DRO. Fonturacetam (4-phenylpiracetam, carphedon) is named on the 2026 Prohibited List under S6.A, non-specified stimulants, and is prohibited in-competition only. Piracetam, aniracetam and oxiracetam are not named in the List text; the exact product must be checked on Global DRO.
What can go wrong: In acute ischaemic stroke, a Cochrane review found some suggestion, not statistically significant, of an unfavourable effect of piracetam on early death. A 2021 study found aniracetam and omberacetam in supplements sold for cognitive enhancement.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · Five Unapproved Drugs Found in Cognitive Enhancement Supplements (Neurology: Clinical Practice, 2021) · Piracetam for reducing the incidence of painful sickle cell disease crises (Cochrane Database Syst Rev, 2016)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Cognitive & moodModafinil and armodafinil Provigil · Nuvigil · R-modafinil

BCheck on Global DROApproved medicine

What it is: Modafinil is a wakefulness-promoting agent sold as Provigil; armodafinil (Nuvigil) is its R-enantiomer. Both are FDA-labelled medicines for excessive sleepiness, and are also used off-label for alertness and focus outside the labelled conditions.
What the evidence shows: Trials support the labelled sleepiness indications, a narrow clinical population. In healthy rested adults, meta-analyses found small or weak effects: SMD 0.12 for modafinil in a 2020 meta-analysis, and a relatively weak pooled effect in a 2012 one. A 2010 systematic review reported improved attention in well-rested people and, in sleep-deprived people, better maintenance of wakefulness, memory and executive functions than placebo. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. US FDA labels cover excessive sleepiness in adults with narcolepsy, obstructive sleep apnoea or shift work disorder; Provigil is not approved in children. Both are controlled substances in the US. Use for focus in healthy people is not a labelled indication.
Anti-doping status, 2026 List: Check on Global DRO. Modafinil is named on the 2026 Prohibited List (S6.A, non-specified stimulants), prohibited in-competition only. Armodafinil is not named individually, but the List covers all stimulants including all optical isomers and armodafinil is the R-enantiomer. Check the exact product on Global DRO.
What can go wrong: The labels warn of serious rash requiring hospitalisation, angioedema and anaphylaxis, multi-organ hypersensitivity, psychiatric symptoms and cardiovascular events.

Sources: PROVIGIL (modafinil) tablets label (DailyMed) · WADA 2026 Prohibited List (copy published by the International Testing Agency) · How effective are pharmaceuticals for cognitive enhancement in healthy adults? Meta-analyses of modafinil, methylphenidate and D-amphetamine (Eur Neuropsychopharmacol, 2020)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Cognitive & moodSemax Met-Glu-His-Phe-Pro-Gly-Pro · ACTH(4–7)-Pro-Gly-Pro

CCheck on Global DROApproved medicine

Prescription nasal drops in Russia; sold elsewhere as a nasal spray

What it is: A seven-amino-acid analogue of a fragment of ACTH with a stabilising tail, developed at the Institute of Molecular Genetics in Moscow.
What it is sold for: Marketed as a nootropic for focus, memory and mood in healthy people.
What the evidence shows: Semax is a registered prescription medicine in Russia (re-registered March 2025) for cognitive impairment after cerebrovascular disease, stroke recovery, transient ischaemic events and optic-nerve disease. The label also covers mental fatigue and adaptation to extreme conditions; the trials are Russian, mostly small and rarely blinded, and none is replicated outside Russia. The US FDA cited insufficient safety data and immunogenicity risk; advisory review is not FDA approval. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Approved medicine. Approved in Russia only (Peptogen; prescription). Not approved in the EU, US or India; its US compounding nomination was withdrawn and the July 2026 vote changes nothing until a rule is made.
Anti-doping status, 2026 List: Check on Global DRO. Not named on the 2026 List. It is a registered medicine in Russia, so the S0 definition (no approval by any governmental regulatory health authority) does not fit, and no other class does; but no agency has published a ruling. Verify on Global DRO and assume nothing.
What can go wrong: Mild nasal irritation with prolonged use is the labelled effect; systemic and long-term effects are unstudied; imported product is unregulated.
What the practice does: The practice reviews reported focus and mood concerns alongside sleep, HRV and training load; a persistent problem is referred to a psychiatrist or neurologist. The practice does not suggest nootropics.

Sources: Vidal (Russia) — Semax 0.1% nasal drops: registration, indications, prescription status · US FDA — bulk drug substances that may present significant safety risks in compounding (Category 2 and withdrawn nominations; updated 22 April 2026) · McDermott Will & Schulte — PCAC backs a majority of the peptides: vote counts and what happens next (27 July 2026)

Link to this entry

Cognitive & moodSelank Thr-Lys-Pro-Arg-Pro-Gly-Pro · TP-7

CCheck on Global DROApproved medicine

Over-the-counter nasal drops in Russia; sold elsewhere as a nasal spray

What it is: A seven-amino-acid analogue of the immune peptide tuftsin with a stabilising tail, from the same Moscow institute as Semax.
What it is sold for: Marketed as an anxiolytic nootropic without sedation or dependence.
What the evidence shows: Registered in Russia (July 2025, over the counter) for anxiety disorders, neurasthenia, adaptation disorders and stress. Russian clinical studies report an anxiolytic effect comparable to benzodiazepines, but they are small; the mechanism work is in cells and rodents (Frontiers in Pharmacology 2017). There is no trial outside Russia and none in healthy adults for performance. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Approved medicine. Approved in Russia only (Peptogen; sold without prescription there). Not approved in the EU, US or India; its US compounding nomination was withdrawn for insufficient safety data.
Anti-doping status, 2026 List: Check on Global DRO. Not named on the 2026 List. As a medicine registered in Russia it falls outside the S0 definition and no other class fits, but no agency has published a ruling; verify on Global DRO.
What can go wrong: Allergic reactions and an unpleasant taste are the labelled effects; systemic and long-term effects unstudied; imported product unregulated.
What the practice does: Anxiety is taken seriously and referred to a psychiatrist or psychologist; the practice reads the sleep and HRV trends that go with it and adjusts load. It does not suggest peptides for mood.

Sources: Vidal (Russia) — Selank 0.15% nasal drops: registration, indications, OTC status · Frontiers in Pharmacology 2017 — Selank and the GABAergic system (mechanism) · US FDA — bulk drug substances that may present significant safety risks in compounding (Category 2 and withdrawn nominations; updated 22 April 2026)

Link to this entry

Sexual & reproductivePT-141 (bremelanotide) Bremelanotide · Vyleesi

BCheck on Global DROApproved medicine

A prescription subcutaneous autoinjector where approved; sold illicitly as a nasal spray or vial

What it is: A melanocortin-receptor agonist derived from melanotan II that acts on brain pathways for sexual desire rather than on blood flow.
What it is sold for: Marketed as a libido and erection peptide for both sexes.
What the evidence shows: Approved by the US FDA in 2019 for premenopausal women with acquired, generalised hypoactive sexual desire disorder; the label states it is not for postmenopausal women or men and not for enhancing performance. In the trials nausea affected 40% (8% stopped for it), flushing 20%, blood pressure rose transiently after each dose, and frequent use produced focal skin darkening that was not always reversible. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. Approved in the US (Vyleesi, 2019) for one indication in premenopausal women; not approved in India. Prescription-only where approved; nasal and vial products sold online are unapproved copies.
Anti-doping status, 2026 List: Check on Global DRO. An approved medicine not named on the 2026 List and outside S0. Verify on Global DRO before any use, and note that its parent, melanotan II, is prohibited.
What can go wrong: Nausea, flushing, injection-site reactions, headache and vomiting; a transient rise in blood pressure, so contraindicated with uncontrolled hypertension or cardiovascular disease; focal hyperpigmentation, more likely in darker skin; slowed absorption of other oral medicines.
What the practice does: Sexual desire and function are clinical matters, referred to a sexual-medicine physician, gynaecologist or urologist. The practice reviews sleep and training context; clinical interpretation of the panel stays with the physician.

Sources: US FDA — Vyleesi (bremelanotide) prescribing information, 2019 · 2026 Prohibited List, full text (VADA copy of the WADA List in force from 1 January 2026)

Link to this entry

Sexual & reproductiveOxytocin (nasal and injected) Pitocin · Syntocinon

DNot prohibitedApproved medicine

A prescription intravenous or intramuscular injection in hospital; sold as a nasal spray for ‘bonding’

What it is: The nine-amino-acid pituitary hormone that contracts the uterus and drives milk let-down, and which acts in the brain on social behaviour.
What it is sold for: Marketed as a nasal ‘love hormone’ for connection, anxiety, orgasm and social confidence.
What the evidence shows: Approved uses are obstetric: induction or augmentation of labour and control of postpartum bleeding, under hospital supervision. The social claims were tested in the largest trial to date, 277 children with autism given intranasal oxytocin or placebo for 24 weeks (NEJM 2021, NIH-funded): no improvement in social function. Smaller adult studies are inconsistent. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved medicine. Established obstetric uses depend on the local product label; nasal oxytocin for social or sexual use is unlicensed and, in the US, compounded without approval. Prescription-only.
Anti-doping status, 2026 List: Not prohibited. Not on the 2026 List and outside its classes; an approved medicine. Confirm on Global DRO as with any prescription.
What can go wrong: In obstetric use, uterine hyperstimulation, hypertensive episodes, water intoxication and fetal distress; nasal products of unverified content; effects of repeated use on the social brain unknown.
What the practice does: Connection and confidence are not peptide problems. The practice reads sleep, stress and load, and refers persistent anxiety to a psychologist or psychiatrist.

Sources: NIH, October 2021 — oxytocin does not improve social functioning in children with autism (NEJM trial) · US FDA — Pitocin (oxytocin) prescribing information · 2026 Prohibited List, full text (VADA copy of the WADA List in force from 1 January 2026)

Link to this entry

HormonesThyroid hormone (levothyroxine, liothyronine) T4 · T3 · Synthroid · Cytomel

DNot prohibitedApproved medicine

Prescription tablets

What it is: Replacement for hypothyroidism; misused for ‘metabolism’ and weight in people whose thyroid is normal.
What it is sold for: Sold in physique circles as a fat-loss and energy tool.
What the evidence shows: The label carries a boxed warning: not for obesity or weight loss. Supraphysiological doses cause thyrotoxicosis, which wastes muscle and reduces exercise capacity; the performance claims lack objective support. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved medicine. Approved for hypothyroidism and for TSH suppression in thyroid cancer; prescription-only.
Anti-doping status, 2026 List: Not prohibited. Not on the 2026 List; WADA has considered thyroid hormones and not prohibited them. Confirm on Global DRO.
What can go wrong: Arrhythmia and angina, bone loss, muscle loss, anxiety, insomnia.
What the practice does: TSH, free T4 and free T3 read annually and in any long prep, interpreted by a physician; an abnormal result during a deficit must not automatically be treated as an adaptation. See peptides and hormones.

Sources: US FDA — Synthroid (levothyroxine) prescribing information: boxed warning, indications · Journal of the Endocrine Society 2023 — thyroid hormone abuse among elite athletes

Link to this entry

HormonesDesiccated thyroid extract (Armour Thyroid, NP Thyroid) Armour Thyroid · NP Thyroid · Natural desiccated thyroid · Thyroid tablets (porcine)

DCheck on Global DROUnapproved for the described use

What it is: Dried, powdered pig or cow thyroid gland containing thyroid hormones and other proteins, prescribed for hypothyroidism; not a purified single hormone. Sold as prescription tablets in the US.
What the evidence shows: For hypothyroidism, the American Thyroid Association says desiccated thyroid extract is less frequently prescribed today, because its T4 and T3 content varies by batch. No controlled human trial of desiccated thyroid extract is cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Unapproved for the described use. DailyMed lists Armour Thyroid under the marketing category ‘unapproved drug other’, with no application number. The label indication is replacement or supplemental therapy in hypothyroidism.
Anti-doping status, 2026 List: Check on Global DRO. Desiccated thyroid is not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.
What can go wrong: MedlinePlus states that thyroid hormone should not be used to speed weight loss in people who are overweight but do not have a thyroid condition. No adverse-effect data are cited here.

Sources: American Thyroid Association: thyroid hormone treatment · MedlinePlus: thyroid tablets (Armour Thyroid) · DailyMed: Armour Thyroid label

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

HormonesTiratricol (Emcitate) Emcitate

BCheck on Global DROApproved medicine

What it is: EU-authorised rare-disease medicine for peripheral thyrotoxicosis (excess blood levels of certain thyroid hormones) in people with MCT8 deficiency (Allan-Herndon-Dudley syndrome).
What the evidence shows: Authorised by the EMA for a narrow, rare population: people with MCT8 deficiency. No trial data are cited here, and no evidence for wellness or weight-loss use is cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. EMA issued an EU marketing authorisation on 12 February 2025; the orphan designation dates from 8 November 2017. No approval in other regions was verified.
Anti-doping status, 2026 List: Check on Global DRO. Tiratricol is not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.
What can go wrong: No adverse-effect data are cited here, and no evidence is cited for use outside the rare-disease indication.

Sources: EMA: Emcitate (tiratricol) EPAR

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

HormonesHydrocortisone (cortisol) and ‘adrenal support’ claims Hydrocortisone · Cortisol · Adrenal fatigue (concept)

DCheck on Global DROApproved medicine

What it is: Hydrocortisone is a corticosteroid; NHS describes the tablets as a steroid for adrenal gland problems such as Addison’s disease. ‘Adrenal support’ claims are linked to the concept of ‘adrenal fatigue’.
What the evidence shows: Hydrocortisone is an approved treatment for adrenal gland problems. For ‘adrenal fatigue’, a systematic review of 58 studies found no substantiation that it is an actual medical condition. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved medicine. Approved medicine: NHS lists hydrocortisone tablets for adrenal gland problems such as Addison’s disease. A BMC systematic review finds no support for ‘adrenal fatigue’ as a condition.
Anti-doping status, 2026 List: Check on Global DRO. S9 on the 2026 List names hydrocortisone among the glucocorticoids, prohibited in competition only and by specified routes. Check the exact product and route on Global DRO.
What can go wrong: No adverse-effect data are cited here.

Sources: NHS: hydrocortisone tablets · BMC Endocrine Disorders: Adrenal fatigue does not exist, a systematic review · WADA 2026 Prohibited List (ITA copy): S9

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

HormonesPrednisone, dexamethasone and other glucocorticoids Prednisone · Prednisolone · Dexamethasone · Methylprednisolone · Betamethasone · Budesonide

BCheck on Global DROApproved medicine

What it is: Anti-inflammatory corticosteroids, as described by MedlinePlus and NHS: a class that includes prednisone, prednisolone, dexamethasone, methylprednisolone and others.
What the evidence shows: MedlinePlus and NHS describe uses in inflammatory and other conditions. No trial data are cited here, and no evidence for performance use is cited. NHS notes that these steroids are not the same as anabolic steroids. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. Approved medicines. MedlinePlus and NHS describe prednisone, dexamethasone and methylprednisolone as corticosteroids for inflammatory and other conditions.
Anti-doping status, 2026 List: Check on Global DRO. S9 on the 2026 List prohibits all glucocorticoids given by any injectable, oral (including oromucosal) or rectal route, in competition only. Check the exact product and route on Global DRO.
What can go wrong: No adverse-effect data are cited here.

Sources: MedlinePlus: prednisone · NHS: steroids · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

HormonesFludrocortisone

BCheck on Global DROApproved medicine

What it is: A corticosteroid used to help control the amount of sodium and fluid in the body, for Addison’s disease and syndromes with excessive urinary sodium loss, according to MedlinePlus.
What the evidence shows: MedlinePlus lists Addison’s disease and syndromes in which excessive amounts of sodium are lost in the urine as uses. No trial data are cited here, and no evidence for other uses is cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. Approved medicine. MedlinePlus describes it as a corticosteroid used to help control the amount of sodium and fluids in the body.
Anti-doping status, 2026 List: Check on Global DRO. Fludrocortisone is not named in the 2026 Prohibited List text reviewed. S9 covers glucocorticoids, and status can depend on route and formulation, so check Global DRO.
What can go wrong: No adverse-effect data are cited here.

Sources: MedlinePlus: fludrocortisone

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

HormonesCabergoline and bromocriptine (dopamine agonists) Cabergoline · Bromocriptine

DCheck on Global DROApproved medicine

What it is: Dopamine receptor agonists that lower prolactin. MedlinePlus lists hyperprolactinaemia for both, plus Parkinson’s disease, acromegaly and type 2 diabetes for bromocriptine.
What the evidence shows: MedlinePlus lists hyperprolactinaemia as an approved use of both medicines. No trial data are cited here, and no evidence for performance or testosterone-support use is cited. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved medicine. Approved medicines. MedlinePlus lists hyperprolactinaemia for both; male ‘optimisation’ or performance use is not among the uses described.
Anti-doping status, 2026 List: Check on Global DRO. Cabergoline and bromocriptine are not named in the 2026 Prohibited List text reviewed; status can depend on route, volume or formulation, so check Global DRO.
What can go wrong: No adverse-effect data are cited here.

Sources: MedlinePlus: cabergoline · MedlinePlus: bromocriptine

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

HormonesFinasteride and dutasteride (5-alpha-reductase inhibitors) Finasteride · Dutasteride

BCheck on Global DROApproved medicine

What it is: 5-alpha-reductase inhibitors. NHS lists finasteride for benign prostate enlargement and hair loss in men; MedlinePlus lists dutasteride for benign prostatic hyperplasia.
What the evidence shows: NHS and MedlinePlus describe approved uses in prostate enlargement and, for finasteride, male hair loss. No trial data are cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. Approved medicines. NHS and MedlinePlus describe both as medicines for prostate enlargement; finasteride is also listed for hair loss in men.
Anti-doping status, 2026 List: Check on Global DRO. Neither is named in the S1–S5 and S9 sections of the 2026 Prohibited List text reviewed. Status can depend on route, volume or formulation, so check Global DRO.
What can go wrong: No adverse-effect data are cited here.

Sources: NHS: finasteride · MedlinePlus: dutasteride

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

HormonesVasopressin and carbetocin Arginine vasopressin · Vasostrict · Carbetocin

DCheck on Global DROApproved medicine

What it is: Vasopressin is a natural antidiuretic peptide hormone marketed as an injection (Vasostrict). Carbetocin is a long-acting oxytocin-analogue peptide used to treat postpartum haemorrhage.
What the evidence shows: Both are approved medicines; no trial results are cited here. No sport or anti-ageing evidence is cited for vasopressin, and no evidence for non-obstetric use is cited for carbetocin. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Approved medicine. Drugs@FDA lists Vasostrict (vasopressin) as approved on 17 April 2014, as a drug already marketed. A review table lists carbetocin as approved in 2001 for postpartum haemorrhage; the regulator and current US status were not verified.
Anti-doping status, 2026 List: Check on Global DRO. The analogue desmopressin is named by WADA; vasopressin and carbetocin were not found by name in the S2, S4.3, S4.4 or S5 sections of the 2026 text reviewed. Check Global DRO for the exact product.
What can go wrong: No adverse-effect data are cited here.

Sources: Drugs@FDA overview, NDA 204485 (Vasostrict) · Review of approved therapeutic peptides (PubMed Central, PMC8844085)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

HormonesFollitropin alfa and menotropins (FSH and hMG) Menotropins · Human menopausal gonadotrophin · Menopur · Follitropin alfa · Gonal-f · FSH

BCheck on Global DROApproved medicine

What it is: Fertility gonadotrophins: Menopur is a purified preparation with FSH and LH activity, extracted from the urine of postmenopausal women; Gonal-f is recombinant FSH (follitropin alfa).
What the evidence shows: Authorised uses include assisted reproduction (Menopur) and, for Gonal-f, stimulation of spermatogenesis in men with hypogonadotrophic hypogonadism alongside hCG. No trial data are cited here, and no evidence for performance or ‘optimisation’ use is cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. DailyMed: Menopur is labelled for development of multiple follicles and pregnancy in ovulatory women as part of Assisted Reproductive Technology (ART). The EMA authorised Gonal-f on 20 Oct 1995, including for male hypogonadotrophic hypogonadism with hCG.
Anti-doping status, 2026 List: Check on Global DRO. S2.2.1 names chorionic gonadotrophin (CG) and LH among testosterone-stimulating peptides in males. FSH is not named in the text reviewed, and menotropins carry LH activity per the Menopur label, so check Global DRO for the exact product.
What can go wrong: No adverse-effect data are cited here.

Sources: DailyMed: Menopur (menotropins) label · EMA: Gonal-f (follitropin alfa) EPAR · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

HormonesAnti-androgens (bicalutamide, flutamide, cyproterone, enzalutamide) Antiandrogens · Androgen receptor inhibitors · Casodex · Eulexin · Xtandi · Cyproterone

BNot prohibitedApproved medicine

What it is: Medicines that block the action of androgens (male sex hormones): bicalutamide and flutamide (non-steroidal antiandrogens), enzalutamide and cyproterone. Prescription treatment of prostate cancer; cyproterone is also used for androgen-dependent conditions such as hirsutism and acne.
What the evidence shows: Evidence cited covers narrow clinical uses: regulator and label wording for prostate cancer, and the 2020 EMA review of cyproterone, which found the tumour meningioma to be a rare side effect, with risk rising with cumulative dose. No evidence is cited for use in healthy men or for physique goals. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. Approved medicines: FDA labels cover bicalutamide (Casodex) and flutamide (Eulexin) for prostate cancer. EMA authorised enzalutamide (Xtandi) on 21 June 2013 and reviewed cyproterone in 2020 because of meningioma, leaving prostate-cancer use unchanged. No US approval as a medicine was verified for cyproterone.
Anti-doping status, 2026 List: Not prohibited. None of the four is named on the 2026 Prohibited List. S4.2, anti-oestrogenic substances, lists other substances, among them clomifene and tamoxifen.
What can go wrong: The Casodex label reports severe hepatic injury and fatal hepatic failure. The Eulexin label reports postmarketing hospitalisation and, rarely, death from liver failure. Both labels have no indication for women. EMA found meningioma a rare side effect of cyproterone (between 1 and 10 in 10,000 people).

Sources: DailyMed: Casodex (bicalutamide) label · EMA: cyproterone-containing medicinal products, referral (page last updated 20 May 2020) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

HormonesSomatostatin analogues and growth-hormone-receptor antagonists Octreotide acetate · Sandostatin · Lanreotide acetate · Somatuline Depot · Somavert · Palsonify

BNot prohibitedApproved medicine

What it is: Prescription medicines that lower growth hormone (GH) activity. Octreotide and lanreotide are synthetic analogues of somatostatin; paltusotine is a somatostatin receptor agonist; pegvisomant blocks the binding of GH to its receptors. All four treat acromegaly.
What the evidence shows: Evidence cited is label wording on approved uses in narrow patient groups. Acromegaly is the shared approved use. Octreotide is also indicated for carcinoid tumours and VIPomas, lanreotide for gastroenteropancreatic neuroendocrine tumours and carcinoid syndrome. No data in healthy people or athletes are cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. Approved prescription medicines with FDA labels: Sandostatin (octreotide), Somatuline Depot (lanreotide), Somavert (pegvisomant) and Palsonify (paltusotine; label effective 16 September 2025). No EU approval as a medicine was verified.
Anti-doping status, 2026 List: Not prohibited. None of the four is named on the 2026 Prohibited List. The growth hormone entry, S2.2.3, covers growth hormone, its analogues and fragments and does not name them.
What can go wrong: The octreotide and paltusotine labels warn that these medicines may inhibit gallbladder contractility and decrease bile secretion, which may lead to gallbladder abnormalities, sludge or stones. The lanreotide label warns of low or high blood glucose; the pegvisomant label reports cases of lipohypertrophy.

Sources: DailyMed: Sandostatin (octreotide acetate) label · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

HormonesCortisol-synthesis inhibitors and glucocorticoid-receptor blockers Metyrapone · Metopirone · Ketoconazole · Ketoconazole HRA · Mifepristone · Korlym

BNot prohibitedApproved medicine

What it is: Prescription medicines that lower cortisol or block its receptor: metyrapone, ketoconazole and mifepristone, marketed for diagnosis or treatment of cortisol excess or adrenal disease. Label and regulator wording describes no use for stress, body composition or performance.
What the evidence shows: Label and regulator wording covers narrow clinical uses only, such as Cushing’s syndrome and the diagnosis of adrenal insufficiency. No trial data are cited here, and none is cited for stress, body-composition or performance claims. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Approved medicine. Approved medicines, varying by product and region. US: Korlym (mifepristone) for hyperglycaemia secondary to hypercortisolism in Cushing’s syndrome; Metopirone (metyrapone) as a diagnostic aid; ketoconazole tablets for systemic fungal infections, not Cushing’s syndrome. EU: Ketoconazole HRA authorised for Cushing’s syndrome in 2014.
Anti-doping status, 2026 List: Not prohibited. Metyrapone, ketoconazole and mifepristone are not named on the 2026 Prohibited List. Osilodrostat is named under S1.2, other anabolic agents, and is covered separately.
What can go wrong: The US ketoconazole tablet label carries boxed warnings for serious hepatotoxicity, including fatal cases, and for QT prolongation. The Korlym boxed warning says mifepristone will result in termination of pregnancy; the label also warns of adrenal insufficiency. Metopirone is contraindicated in adrenal cortical insufficiency.

Sources: DailyMed: ketoconazole tablets labels · EMA: Ketoconazole HRA EPAR overview (page last updated 5 May 2025) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsConsumer DNA and nutrigenomic panels Nutrigenomics test · DNA diet test · Fitness genetics · Genetic wellness panel · SNP report

DNot prohibitedTest

A cheek swab genotyped for common variants and returned as a report on diet, training, caffeine, vitamins and ‘risk’

What it is: Genotyping of common variants, each explaining a small fraction of the trait it is attached to, translated by an algorithm into lifestyle advice.
What it is sold for: Marketed as the diet, the training type and the supplements ‘your genes want’.
What the evidence shows: The variants are real; the advice built on them has been tested and added nothing. In the Food4Me trial, 1,607 adults in seven countries were randomised to standard advice or to personalised advice based on diet alone, diet plus blood and body measurements, or those plus genotype: personalised advice beat standard advice, and adding phenotype or genotype improved nothing further. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. Not validated for the dietary or training claims. Accreditation is the tell: ISO 9001 is a general quality-management standard that says nothing about the accuracy of results; ISO 15189 is the medical-laboratory standard.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: Diets and supplements bought on a report; false reassurance or needless anxiety about disease risk; privacy, because a genome is identifying and companies change hands.
What the practice does: The practice runs genomic profiling once, to inform rather than dictate, and treats it as the least important input in the model. What decides the plan is measured.

Sources: Celis-Morales et al., 2017 — the Food4Me randomised trial (International Journal of Epidemiology) · ISO 15189:2022 — medical laboratories: requirements for quality and competence · ISO 9001:2026 — quality management systems: requirements

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Tests & assessmentsGut microbiome tests Stool microbiome sequencing · 16S test · Metagenomic gut test · Gut health kit · Microbiome score

CNot prohibitedTest

A stool sample sequenced and returned as a list of organisms, a ‘diversity score’ and food or supplement recommendations

What it is: Sequencing of bacterial DNA in one stool sample: a real research technique and an immature clinical one, since the field cannot yet say what a healthy microbiome is.
What it is sold for: Marketed as diagnosing gut health, explaining symptoms, and prescribing foods and probiotics.
What the evidence shows: When US standards researchers sent the same stool material to seven consumer services (published 2026), replicates from one company disagreed in their recommendations, only three genera were reported by all providers, and the services disagreed on whether a named pathogen was present. A 2025 legal review found the tests lack analytical and clinical validity; a 2025 international consensus statement found insufficient evidence for clinical microbiome testing. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Test. Not validated for the clinical claims. The United States has no proficiency-testing scheme for microbiome tests. Research value is real; the consumer report is not a diagnosis.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: Restrictive diets and supplement courses started on a report; anxiety; missed diagnoses when a symptom is explained by a bacterium instead of a colonoscopy; data sold on.
What the practice does: Gut symptoms are referred to a gastroenterologist and the practice supports the clinician’s plan. Fibre, diet quality and the illness log are tracked. A microbiome report is not acted on.

Sources: Evaluating the analytical performance of direct-to-consumer gut microbiome testing services (Communications Biology, 2026) · Is the current regulatory framework for direct-to-consumer microbiome tests sufficient? (Journal of Law and the Biosciences, 2025) · International consensus statement on microbiome testing in clinical practice (Lancet Gastroenterology & Hepatology, 2025)

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Tests & assessmentsUrine test strips and apps Vivoo-type strips · Wellness urinalysis · Smartphone dipstick · Ketone strips · Hydration strips

CNot prohibitedTest

A dipstick photographed by a phone app that returns scores for hydration, ketones, vitamins, minerals and ‘wellness’

What it is: The clinical dipstick, which tests protein, glucose, ketones, blood, nitrites, pH and specific gravity, repackaged with extra pads and an app that turns colour blocks into lifestyle scores.
What it is sold for: Marketed as daily tracking of hydration, nutrition, stress, vitamin C and mineral status.
What the evidence shows: A dipstick measures what is in that void of urine, which reflects the last few hours and the last drink. Specific gravity and colour are reasonable hydration cues; urinary magnesium, calcium and vitamin C are excretion, not status. The one validation study of a leading app was written by the company’s staff, used artificial urine and one phone, and reported 88 per cent exact agreement with laboratory readings. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Test. Clinical dipsticks are regulated in-vitro diagnostics; the wellness apps are sold under general-wellness rules and are not validated for nutritional status.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: Low, apart from the behaviour it drives: over-drinking to chase a score, which risks hyponatraemia in endurance athletes, or supplements bought for an excretion reading.
What the practice does: Hydration is prescribed from a measured sweat rate and checked by morning weight and urine colour. Nutritional status is read in blood, and anything a strip flags is sent to the physician.

Sources: Smartphone-based point-of-care urinalysis Vivoo app: a validation study (Dergipark) · NIH Office of Dietary Supplements — magnesium fact sheet for health professionals

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Tests & assessmentsOligoScan and palm spectrophotometry OligoScan · Spectrophotometric mineral scan · Tissue mineral scan · Heavy-metal palm scan · SO/Check

DNot prohibitedTest

A hand-held spectrophotometer pressed to the palm, returning in seconds a report of minerals, heavy metals and vitamins

What it is: A device that shines visible light into the skin and maps the reflected spectrum to a list of elements through proprietary software, with no published method.
What it is sold for: Marketed as an intracellular mineral and heavy-metal profile without a blood test, used to sell chelation and ‘detox’.
What the evidence shows: There is no peer-reviewed validation against blood, urine or tissue analysis, and the maker cites none. Exposure to lead, mercury, cadmium and arsenic is measured in blood and urine, which is how national biomonitoring does it. A palm cannot report vitamin B12 or vitamin D from reflected light. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. The maker describes the scan as complementary; that does not establish diagnostic validity. Check the specific device and its authorised claims.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: Chelation courses started on a number that measures nothing; the CDC has reported deaths from hypocalcaemia when disodium EDTA was given to remove ‘heavy metals’ that were never measured; false reassurance in a real exposure.
What the practice does: Where an exposure is plausible, the practice asks the physician for a blood or urine test for the specific metal. A palm-scan result is filed and not acted on, with the reasons explained.

Sources: OligoScan — the maker’s description of the device and its claims · CDC — about biomonitoring (chemicals measured in blood and urine) · NIH Office of Dietary Supplements — zinc fact sheet for health professionals · CDC MMWR — deaths associated with hypocalcaemia from chelation therapy, 2003–2005

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Tests & assessmentsSalivary-cortisol ‘adrenal stress’ panels Adrenal fatigue test · Salivary cortisol profile · Adrenal stress panel

DNot prohibitedTest

What it is: Cortisol measured in saliva at several times of day and read as a measure of ‘adrenal’ or stress status. Sold to diagnose ‘adrenal fatigue’, an alleged condition attributed to chronic exposure to stressful situations.
What the evidence shows: A 2016 systematic review (3,470 articles found; 58 studies met the criteria: 33 in healthy people, 25 in symptomatic patients) reported almost systematic conflicting results across study methods and concluded there is no substantiation that ‘adrenal fatigue’ is an actual medical condition. The evidence concerns the claimed condition; no study cited evaluates specific saliva panels. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. Not validated: a systematic review found no substantiation that ‘adrenal fatigue’ is an actual medical condition. No regulatory status for saliva panels was verified.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: No harm from the test itself is cited here. The cited concern is that the condition the panels are sold to diagnose is not substantiated as a medical condition.

Sources: Adrenal fatigue does not exist: a systematic review (Cadegiani and Kater, BMC Endocrine Disorders, 2016)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsSemen analysis Sperm count · Semen test · At-home sperm test kit

ANot prohibitedTest

What it is: A test of the quantity and quality of semen and sperm, including sperm count and whether sperm are moving properly. Used to investigate male fertility problems; at-home sperm-test kits are also sold.
What the evidence shows: MedlinePlus says a semen analysis, also called a sperm count, measures the quantity and quality of semen and sperm. The NHS says it checks for problems such as a low sperm count or sperm that are not moving properly. It is the standard fertility work-up. Grade A · Consistent human trials support the claimed use, in the people it is claimed for
Regulatory status: Test. Used in standard clinical care. No regulatory approval or clearance was verified for at-home sperm-test kits.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: MedlinePlus states at-home sperm tests are useful but cannot provide as much information as a full semen analysis. No adverse effects or false-result harms are cited here.

Sources: Semen analysis (MedlinePlus medical test) · Infertility: diagnosis (NHS)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsThyroid antibody tests TPO antibodies · Thyroglobulin antibodies · TSI · TRAb

ANot prohibitedTest

What it is: Antibodies against thyroid proteins measured in blood, used to help find the cause of a thyroid problem. Ordered to help diagnose conditions such as autoimmune thyroiditis or Graves’ disease.
What the evidence shows: The American Thyroid Association (ATA) says measuring thyroid antibody levels may help diagnose the cause of a thyroid problem and helps in the initial diagnosis of autoimmune hypothyroidism. Following levels over time is not helpful in detecting development of hypothyroidism or response to therapy. In Graves’ patients, following antibody levels may help assess response to treatment. Grade A · Consistent human trials support the claimed use, in the people it is claimed for
Regulatory status: Test. No regulatory status was verified for thyroid antibody tests.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: No harm from the test itself is cited here. In autoimmune hypothyroidism, following antibody levels over time is described as not helpful for detecting development of hypothyroidism or response to therapy.

Sources: Thyroid function tests (American Thyroid Association)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsIgG and IgG4 food-intolerance blood tests IgG food sensitivity test · IgG4 food panel · York Test · Food intolerance blood test

DNot prohibitedTest

What it is: Blood tests that measure IgG or IgG4 antibodies to a panel of foods and report them as ‘intolerances’ or foods to avoid. Sold to identify foods said to cause intolerance symptoms.
What the evidence shows: The EAACI task force states that food-specific IgG4 does not indicate food allergy or intolerance but a physiological response after exposure to food, and that IgG4 testing to foods is irrelevant for the laboratory work-up of food allergy or intolerance. A Choosing Wisely document adds that IgG antibodies to food are formed in all healthy asymptomatic people. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. Not validated for diagnosing food allergy or intolerance: the EAACI task force considers IgG4 testing to foods irrelevant for that work-up and says it should not be performed for food-related complaints. No regulatory approval for specific kits was verified.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: A positive IgG reflects food exposure, not intolerance, yet results are reported as foods to avoid. No adverse effects beyond misleading results are cited here.

Sources: Testing for IgG4 against foods is not recommended as a diagnostic tool: EAACI Task Force Report (Stapel et al., Allergy, 2008;63:793-796) · Choosing Wisely on the use of alternative testing in the diagnosis of food allergy and food intolerance (PDF on bsaci.org; author D. Choudhury, RCGP Allergy representative; undated)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsALCAT test ALCAT · Antigen Leucocyte Cellular Antibody Test

DNot prohibitedTest

What it is: Blood leucocyte (white-cell) reactions to food antigens, reported as foods to avoid. Sold to identify foods that cause intolerance.
What the evidence shows: A Choosing Wisely document on alternative testing for food allergy and food intolerance, hosted on the BSACI site, states that controlled trials show the ALCAT test is ineffective for diagnosis. No trial details are given. The document is undated and is the only source cited for this test. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. Not validated: the cited document states that controlled trials show the test is ineffective for diagnosis. No regulatory status was verified.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: No harm from the test itself is cited here. The document’s concern is that the test is ineffective for diagnosis, although it reports foods to avoid.

Sources: Choosing Wisely on the use of alternative testing in the diagnosis of food allergy and food intolerance (PDF on bsaci.org; author D. Choudhury, RCGP Allergy representative; undated)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsHair mineral (trace-element) analysis Hair analysis for minerals and metals · Hair mineral test

DNot prohibitedTest

What it is: A test of the concentrations of minerals and trace metals in a hair sample, read as nutritional status or toxic-metal exposure. Sold to assess individual nutritional status or suspected environmental exposures.
What the evidence shows: A 2001 JAMA study of hair mineral analysis from several laboratories found it unreliable: differences between laboratories for a split sample exceeded 10-fold for 12 minerals. ATSDR panelists state that ‘normal’ reference ranges do not exist for most trace minerals in hair and that no washing method reliably removes external contaminants. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. Not validated for this use: the JAMA authors found laboratory results unreliable and advise health care practitioners to refrain from using the analysis to assess individual nutritional status or suspected environmental exposures. No regulatory approval was verified.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: No physical adverse effects are cited here. The documented problem is unreliable results: laboratories disagreed widely on a split sample, and external contamination cannot be reliably washed from hair.

Sources: Seidel et al., JAMA 2001;285(1):67-72 (hair mineral analysis from several laboratories) · Appendix C: Pre-meeting comments, Hair Analysis Panel Discussion: Exploring the State of the Science (ATSDR, 6 Jun 2001)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsHair-strand bioresonance tests Hair strand analysis for food intolerance · Bioresonance hair test · Hair analysis (bioresonance/hair strand analysis)

DNot prohibitedTest

What it is: A hair sample analysed and reported as foods or substances to which a person is said to be intolerant. Sold to identify food allergies or intolerances from a strand of hair.
What the evidence shows: A Choosing Wisely document on alternative testing for food allergy and intolerance, hosted on the BSACI site, lists hair analysis (bioresonance/hair strand analysis). It states that research has confirmed clear diagnostic failure and lack of reproducibility, with discrepancies between matched samples of hair. The document is undated and is the only source cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. Not validated: the cited document states that research confirmed clear diagnostic failure and lack of reproducibility. No regulatory status was verified.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: No harm from the test itself is cited here. The cited concern is diagnostic failure and lack of reproducibility, with discrepancies between matched samples of hair.

Sources: Choosing Wisely on the use of alternative testing in the diagnosis of food allergy and food intolerance (PDF on bsaci.org; author D. Choudhury, RCGP Allergy representative; undated)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsPost-chelator-challenge (‘provoked’) urinary metal tests Provoked urine metal test · Chelation challenge urine test · Post-challenge urinary metal testing

DNot prohibitedTest

What it is: Measurement of metals in urine collected after a chelating agent has been given. Offered to assess the body’s metal load and to guide chelation treatment.
What the evidence shows: The American College of Medical Toxicology (ACMT, June 2009) states that post-challenge urinary metal testing has not been scientifically validated and has no demonstrated benefit, and that scientifically acceptable normal reference values for post-challenge urine metal testing have not been established. No human trial data are cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. The ACMT 2009 position is that the testing has not been scientifically validated. No regulatory approval was verified.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: The ACMT states the testing may be harmful when applied in the assessment and treatment, and warns of harm from unwarranted and prolonged use of chelating agents that can follow.

Sources: ACMT position statement: Post-chelator challenge urinary metal testing (June 2009)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsZonulin (‘leaky gut’) blood tests Serum zonulin · Gut permeability marker test · Leaky gut test

DNot prohibitedTest

What it is: Zonulin measured with commercial assays and presented as a marker of intestinal barrier (‘gut permeability’) function. Described as a popular serological marker of the integrity of the intestinal mucosal barrier.
What the evidence shows: A 2019 PLOS ONE study found limited information on the utility of serum zonulin to indicate gastrointestinal disease and on the validity of zonulin detection in widely used commercial assays. Top matches for the antigen the assays detect included haptoglobin and complement C3, and the authors say commercial assays are not detecting the actual protein as prehaptoglobin-2. The evidence concerns commercial serum zonulin kits. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. Not validated: the study concludes that current commercial zonulin assays are not detecting the intended protein. No regulatory status was verified.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: No harm from the test itself is cited here. The cited concern is validity: limited information supports the utility of serum zonulin to indicate gastrointestinal disease.

Sources: Serum zonulin as a marker of intestinal mucosal barrier function: may not be what it seems (Ajamian et al., PLOS ONE, 2019)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsBreath tests for small intestinal bacterial overgrowth (SIBO) Hydrogen breath test · Methane breath test · Lactulose breath test · Glucose breath test

BNot prohibitedTest

What it is: Tests of hydrogen and methane in exhaled breath after a sugar drink, used to infer bacterial overgrowth in the small intestine. Used to diagnose small intestinal bacterial overgrowth in people with gut symptoms.
What the evidence shows: The 2020 ACG guideline says small-bowel aspirate and culture is often considered the gold standard for diagnosing SIBO, and that current breath tests have low sensitivity and specificity, with additional validation studies needed for standardisation. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Test. Used in standard clinical care. No regulatory approval or clearance of specific breath-test products was verified.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: The guideline suggests against breath testing for SIBO diagnosis in asymptomatic patients on PPIs (conditional recommendation, very low level of evidence). Low sensitivity and specificity limit how far a result can be relied on.

Sources: ACG clinical guideline: small intestinal bacterial overgrowth (Pimentel et al., Am J Gastroenterol, 2020; PDF copy hosted on commdx.com)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsMagnesium status tests Serum magnesium · Blood magnesium test · Magnesium tolerance test

CNot prohibitedTest

What it is: Tests of magnesium concentration, most often in serum, used to judge magnesium status. Offered in wellness panels to check magnesium status or deficiency.
What the evidence shows: NIH ODS says the most commonly used and readily available method for assessing magnesium status is serum magnesium, even though serum levels have little correlation with total body magnesium levels or concentrations in specific tissues, and that no single method is considered satisfactory. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Test. A standard clinical test also offered in wellness panels. No regulatory approval or clearance was verified for a specific magnesium status test.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: A normal serum value does not reliably reflect body stores, so a result can mislead about magnesium status. No adverse effects are cited here.

Sources: Magnesium: fact sheet for health professionals (NIH Office of Dietary Supplements, 6 Jan 2026)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsPharmacogenomic (drug–gene) panels Pharmacogenetic testing · PGx test · Pharmacogenetic reports · Drug-response DNA test

BNot prohibitedTest

What it is: Genetic tests for variants that may change how a person metabolises or responds to certain medicines. Sold to predict how a person will respond to specific medicines.
What the evidence shows: Evidence is limited to listed gene–drug pairs. FDA’s table of pharmacogenetic associations states that inclusion of a gene–drug pair does not necessarily mean the FDA advocates using a pharmacogenetic test before prescribing the corresponding medicine, unless the test is a companion diagnostic. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Test. FDA lists 23andMe PGS Pharmacogenetic Reports among authorised direct-to-consumer tests and warns against pharmacogenetic tests with unapproved claims to predict an individual’s response to a specific therapeutic drug.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: In a 2019 warning letter FDA said it was unaware of data showing one laboratory’s tests could guide treatment decisions, and that acting on the results could lead to potentially serious health consequences. FDA states patients should not adjust their medicines without consulting their prescriber.

Sources: Table of pharmacogenetic associations (FDA, page dated 10 Sep 2026) · FDA issues warning letter to genomics lab for illegally marketing genetic test that claims to predict patients' responses to specific medications (FDA, 4 Apr 2019) · Direct-to-consumer tests (FDA)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsPolygenic risk scores Polygenic risk score · Genome-wide risk score · PRS report · PRS

CNot prohibitedTest

What it is: A score combining many small genetic differences to estimate a person’s risk of developing a disease. Generated by private healthcare and direct-to-consumer companies to report disease risk to consumers.
What the evidence shows: The National Human Genome Research Institute (NHGRI) says polygenic risk scores are not yet routinely used by health professionals because there are no guidelines for practice. Most genomic studies have examined people of European ancestry, so accuracy may only be valid and useful for European-ancestry populations. No controlled human trial of the scores as a guide to health outcomes is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Test. No regulatory status for polygenic risk scores was verified. NHGRI notes that private and direct-to-consumer companies have already begun generating them.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: No harm from the test itself is cited here. The cited limits are practical: there are no practice guidelines, and accuracy may hold only for European-ancestry populations.

Sources: Polygenic risk scores (National Human Genome Research Institute)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsThermography for breast cancer screening Breast thermography · Infrared breast imaging · Thermogram

DNot prohibitedDevice

What it is: An infrared camera records skin-surface temperature patterns that are read as possible signs of breast cancer. Marketed by some manufacturers as an alternative to mammography.
What the evidence shows: In 2023 FDA stated that thermography has not been shown to be effective as a standalone test for breast cancer screening and detecting early-stage breast cancer. No trial data supporting use in place of mammography are cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Device. FDA states thermography devices have only been cleared as an ‘adjunctive’ tool, used alongside a primary screening test like mammography, and that it will take appropriate regulatory action against manufacturers who market them as an alternative to mammography.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: No direct adverse effects are cited here. FDA’s consumer update is titled ‘Breast cancer screening: thermogram no substitute for mammogram’.

Sources: Breast cancer screening: thermogram no substitute for mammogram (FDA consumer update, Oct 2023)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsComputerised concussion tests (ImPACT-type) ImPACT · CNS Vital Signs · Computerised neurocognitive test batteries · Baseline concussion testing

BNot prohibitedTest

What it is: Computer-based tests of reaction time, memory and processing speed used to assess an athlete after suspected concussion. Used in sport to help assess concussion, sometimes against a pre-season baseline.
What the evidence shows: The Amsterdam 2022 consensus statement says computerised neurocognitive test results should be interpreted in the context of broader clinical findings and are not to be used in isolation to inform management or diagnostic decisions. Baseline testing is of limited use in younger athletes because of neurocognitive development; para athletes may benefit from baselines. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Test. No regulatory status was verified for computerised concussion tests.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: No harm from the test itself is cited here. The consensus statement says results are not to be used in isolation to inform management or diagnostic decisions.

Sources: Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport, Amsterdam, October 2022 (BJSM, 2023)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsElectrodermal testing (Vega test) Vegatest · Vega testing · Electrodermal screening

DNot prohibitedTest

What it is: Skin electrical measurements, taken with a device, that are read as sensitivity to allergens or foods. Offered to diagnose allergies and food intolerances.
What the evidence shows: A BMJ study (Lewith et al., 2001) found Vegatest electrodermal results did not correlate with skin prick tests and could not distinguish atopic from non-atopic participants, and no operator was better than any other. It concluded electrodermal testing cannot be used to diagnose environmental allergies. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. Not validated: a Choosing Wisely document hosted by BSACI states there is no evidence to validate use and no studies evaluating the technique for food allergy diagnosis. No regulatory approval was verified.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: No adverse effects are cited here. Results did not correlate with skin prick tests, so a reported sensitivity cannot be taken as an environmental-allergy diagnosis.

Sources: Is electrodermal testing as effective as skin prick tests for diagnosing allergies? (Lewith et al., BMJ, 2001;322:131) · Choosing Wisely on the use of alternative testing in the diagnosis of food allergy and food intolerance (PDF on bsaci.org; author D. Choudhury, RCGP Allergy representative; undated)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsApplied kinesiology (muscle testing) Muscle testing · Kinesiology testing

DNot prohibitedTest

What it is: Muscle-strength responses interpreted as evidence of food or substance sensitivities. Offered to detect food intolerances or other sensitivities.
What the evidence shows: A Choosing Wisely document on alternative testing for food allergy and intolerance, hosted on the BSACI site, states of applied kinesiology that there is no evidence for diagnostic accuracy or effectiveness for any condition. No trial details are given; the document is undated and is the only source cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. Not validated: the cited document states there is no evidence for diagnostic accuracy or effectiveness for any condition. No regulatory status was verified.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: No harm from the test itself is cited here. The cited concern is that no evidence of diagnostic accuracy exists, yet responses are read as food or substance sensitivities.

Sources: Choosing Wisely on the use of alternative testing in the diagnosis of food allergy and food intolerance (PDF on bsaci.org; author D. Choudhury, RCGP Allergy representative; undated)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsProvocation–neutralisation testing Provocation neutralisation test

DNot prohibitedTest

What it is: An allergy and intolerance test based on provoking and then ‘neutralising’ symptoms. Offered to diagnose allergies or intolerances and guide treatment.
What the evidence shows: A Choosing Wisely document on alternative testing for food allergy and intolerance, hosted on the BSACI site, states that multiple studies have concluded the test lacks scientific validity. No trial data are cited here. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. Described as lacking scientific validity. No regulatory approval was verified.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: The document states the test should not be used to make diagnostic or therapeutic decisions. No adverse effects are cited here.

Sources: Choosing Wisely on the use of alternative testing in the diagnosis of food allergy and food intolerance (PDF on bsaci.org; author D. Choudhury, RCGP Allergy representative; undated)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsIridology (iris analysis) Iris diagnosis · Iris analysis

DNot prohibitedTest

What it is: Examination of the iris, claimed to show pathological changes elsewhere in the body. Offered as a way to identify disease or organ changes from markings in the iris.
What the evidence shows: In a 2013 South African study (Frank et al.), none of the three raters could show a significant success rate in identifying people with a previous history of acute appendicitis, and the authors state that the null hypothesis that appendicectomy does not manifest in corresponding iris lesions is supported. It is a single small study of one condition. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. Not validated: a 2013 study found no significant success rate for identifying previous acute appendicitis from the iris. No regulatory status was verified.
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: No harm from the test itself is cited here. The cited concern is validity: raters could not identify people with a previous history of acute appendicitis from the iris.

Sources: The validity and reliability of iridology in the diagnosis of previous acute appendicitis as evidenced by appendectomy (Frank, Ferreira and Pellow, S Afr Optom, 2013)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsSmartwatch and smart-ring blood-glucose readings Non-invasive glucose smartwatch · Smart ring glucose estimate · Glucose-measuring wearable

DNot prohibitedDevice

What it is: Smartwatches and smart rings that claim to measure or estimate blood-glucose values. Marketed with claims to measure blood glucose levels from a watch or ring.
What the evidence shows: No accuracy data are cited here. FDA’s safety communication concerns smartwatches and smart rings that claim to measure blood glucose levels, and it identifies no authorised device of this type. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Device. FDA states it has not authorised, cleared or approved any smartwatch or smart ring intended to measure or estimate blood glucose values (21 February 2024).
Anti-doping status, 2026 List: Not prohibited. Not applicable; a test is neither a substance nor a method.
What can go wrong: FDA advises against using smartwatches or smart rings that claim to measure blood glucose levels. No specific adverse events are cited here.

Sources: Do not use smartwatches or smart rings to measure blood glucose levels: FDA safety communication (21 Feb 2024)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsDUTCH dried-urine hormone panels DUTCH test · DUTCH method · Dried Urine Test for Comprehensive Hormones · Dried-urine hormone metabolite panel · Precision Analytical dried-urine panel

CNot prohibitedTest

What it is: A laboratory test of hormone metabolites in urine dried onto filter paper and analysed by gas chromatography with tandem mass spectrometry. Offered by a commercial laboratory to medical practitioners and individuals as hormone testing.
What the evidence shows: The method is designed to measure oestrogen, progesterone, androgen and cortisol metabolites, free cortisol and melatonin in dried urine. A small validation paper evaluated only the oestrogen and progesterone metabolites, in 52 samples, and called dried urine a good surrogate for serum testing of oestradiol and progesterone. The competing-interests statement in that paper names the selling laboratory. No outcome study is cited here. Grade C · Mechanistic, animal or small uncontrolled human data only
Regulatory status: Test. No FDA clearance or approval was verified for this panel. For context, FDA defines a laboratory developed test (LDT) as a test designed, manufactured and used within a single laboratory; on 31 March 2025 a federal district court vacated its LDT final rule.
Anti-doping status, 2026 List: Not prohibited. A test is not a substance; it carries no anti-doping status. The 2026 Prohibited List does not name it.
What can go wrong: No clinical validity data, reference ranges or false-positive and false-negative rates are cited here. The authors call for further validation, including 24-hour and serum correlation for additional hormones. No professional-body position on dried-urine hormone panels is cited here.

Sources: Laboratory Developed Tests (FDA) · WADA 2026 Prohibited List (copy published by the International Testing Agency) · Evaluating urinary estrogen and progesterone metabolites using dried filter paper samples and gas chromatography with tandem mass spectrometry (Newman et al., BMC Chemistry, 2019)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsNT-proBNP and BNP blood tests BNP test · B-type natriuretic peptide test · NT-proBNP test · N-terminal pro-B-type natriuretic peptide · Natriuretic peptide test

BNot prohibitedTest

What it is: Blood tests for B-type natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP). Used in clinical care as an aid to diagnosis in people with suspected heart failure.
What the evidence shows: The test measures the concentration of BNP or NT-proBNP in blood. NICE guideline NG106 recommends measuring NT-proBNP in people with suspected heart failure, a narrow clinical use, with higher levels prompting earlier specialist assessment. No evidence is cited here for screening people without symptoms, for use in athletes or for wellness panels, and no sensitivity or specificity figures are cited. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Test. The FDA regulates BNP test systems (21 CFR 862.1117, Class 2) as in vitro diagnostic devices that measure BNP in whole blood and plasma as an aid in diagnosing congestive heart failure. The regulation does not name NT-proBNP.
Anti-doping status, 2026 List: Not prohibited. The test is not named on the 2026 Prohibited List. The 2026 List wording on withdrawing blood or blood components makes an exception for withdrawal performed for analytical purposes including medical tests or Doping Control.
What can go wrong: NICE notes that obesity, African or African–Caribbean family background and treatment with diuretics, ACE inhibitors, beta-blockers, ARBs or MRAs can reduce levels of serum natriuretic peptides, and asks for alternative causes of symptoms to be reviewed when NT-proBNP is low.

Sources: NICE guideline NG106: chronic heart failure in adults: diagnosis and management (recommendation 1.2.2) · 21 CFR 862.1117, B-type natriuretic peptide test system (CFR 2024 edition, govinfo) · WADA 2026 Prohibited List (copy published by the International Testing Agency)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsAnti-Müllerian hormone (AMH) and ovarian-reserve tests AMH test · Anti-Mullerian hormone test · Ovarian reserve test · Access AMH · Elecsys AMH · ADVIA Centaur AMH

BNot prohibitedTest

What it is: A blood test for anti-Müllerian hormone (AMH), used as an aid in assessing ovarian reserve in women. It is also used in fertility clinics to predict how the ovaries will respond to stimulation before IVF.
What the evidence shows: The test measures the concentration of anti-Müllerian hormone in serum or plasma. A 2014 meta-analysis describes it as an established marker of ovarian reserve and a good predictor of poor or excessive ovarian response after controlled hyperstimulation, but its predictive accuracy for live birth after assisted conception is poor. No evidence on predicting natural fertility in women not seeking fertility treatment is cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Test. The FDA classifies the ‘Anti-Müllerian Hormone Test System’ as a Class 2 in vitro diagnostic device. The FDA 510(k) database lists AMH assays cleared as substantially equivalent; the Access AMH summary limits the claim to women presenting to fertility clinics.
Anti-doping status, 2026 List: Not prohibited. The test is not named on the 2026 Prohibited List. The List’s wording on withdrawal of blood or blood components carries an exception for withdrawal performed for analytical purposes, including medical tests.
What can go wrong: The Access AMH summary states that it is not intended for monitoring women undergoing controlled ovarian stimulation. Predictive accuracy for live birth after assisted conception is poor, so a result is not a reliable forecast of that outcome.

Sources: FDA 510(k) summary K223679, Access AMH (Beckman Coulter, 2023): indications for use · WADA 2026 Prohibited List (copy published by the International Testing Agency) · The predictive accuracy of anti-Müllerian hormone for live birth after assisted conception: a systematic review and meta-analysis (Iliodromiti et al., Human Reproduction Update, 2014)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsLive-blood (darkfield) analysis Live blood analysis · Live blood cell analysis · LBA · Darkfield blood microscopy · Dark-field live-blood analysis

DNot prohibitedTest

What it is: A practitioner places blood on a slide and views the living cells under a specialised microscope with a video monitor. Some providers use the results to assess nutritional deficiencies or the effects of treatment.
What the evidence shows: The method shows the appearance of living blood cells under a microscope. UK advertising guidance (CAP/ASA, 2022) says CAP is yet to see any evidence for its efficacy as a diagnostic tool or treatment therapy. The HHS Office of Inspector General (2001) says its study did not address validity or accuracy, but surveyors believe the results are inconsistent with basic principles of biology, chemistry and physics. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. The HHS Office of Inspector General treats live blood cell analysis as an ‘unestablished laboratory test’; CLIA certified laboratories that conduct it do so outside the scope of their certificate. No FDA or MHRA clearance was verified for the method.
Anti-doping status, 2026 List: Not prohibited. The method is not named on the 2026 Prohibited List. The List’s wording on withdrawal of blood or blood components carries an exception for withdrawal performed for analytical purposes, including medical tests.
What can go wrong: UK advertising guidance tells marketers not to claim that current or future health risks can be detected through live blood analysis, and not to discourage essential treatment for conditions for which medical supervision should be sought.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · Health: Live Blood Analysis (Advertising Standards Authority / Committee of Advertising Practice, 15 Feb 2022)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsHaemoglobin-mass testing (carbon-monoxide rebreathing) Total haemoglobin mass (tHb-mass) test · Hb-mass test · Optimised CO-rebreathing method

BCheck on Global DROTest

What it is: A diagnostic test that estimates total haemoglobin mass (tHb-mass) by carbon-monoxide rebreathing and blood sampling. It is used in sports medicine and some clinical settings; a 2026 review describes diagnostic tHb-mass assessment in endurance sport.
What the evidence shows: It measures total haemoglobin mass (tHb-mass). In a validation by phlebotomy, the optimised CO-rebreathing method had a typical error of 1.7% (95% limit of agreement 3.3%). A 2026 narrative review of 33 sources concludes that standardised CO rebreathing can provide reproducible tHb-mass estimates, but procedures are not automatically interchangeable and a tHb-mass increase is not proof of ergogenic benefit. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Test. A test used in sports medicine and research. No regulator clearance for the procedure was verified.
Anti-doping status, 2026 List: Check on Global DRO. M1.4 of the 2026 WADA List prohibits non-diagnostic carbon-monoxide rebreathing; a diagnostic procedure under the supervision of a medical or scientific professional is excepted. UCI rules add cycling-specific conditions. The exact procedure and equipment must be checked on Global DRO.
What can go wrong: One validation study reported a 3.0% reduction in VO2max after the procedure. A 2026 review says that acute CO impairs oxygen-dependent exercise, that long-term safety of repeated exposure is unquantified and that safety evidence is inadequate.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · The optimised CO-rebreathing method: a new tool to determine total haemoglobin mass routinely (Schmidt and Prommer, Eur J Appl Physiol, 2005) · Carbon Monoxide Rebreathing in Endurance Sport: From Diagnostic Total Haemoglobin Mass Assessment to Prohibited Non-Diagnostic Use (Talarowski et al., Quality in Sport, 2026)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsSweat-rate and sweat-sodium testing Sweat test (sports) · Sweat patch test · Whole-body washdown · Hydration and sweat-rate profiling

BNot prohibitedTest

What it is: Tests that estimate an athlete’s sweat rate (from body-mass change during exercise) and sweat sodium loss (from sweat collected by whole-body washdown or a local skin patch), used to guide personalised fluid and electrolyte replacement.
What the evidence shows: A peer-reviewed review says sweat testing can be a useful tool to estimate athletes’ sweat rate and sweat sodium loss when collected and interpreted appropriately. The simplest and most accurate way to assess whole-body sweat rate is body-mass change during exercise; whole-body washdown is the reference method for sodium loss. Day-to-day whole-body sweat rate varies by about 5–7%. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Test. Sports-science test. No regulator clearance or approval for sports sweat testing was verified. The NATA position statement (2017) supports individualised hydration plans that consider sweat rate, established with help from athletic trainers or other health care providers.
Anti-doping status, 2026 List: Not prohibited. Sweat testing is not named on the 2026 Prohibited List.
What can go wrong: Sodium results vary with the collection system, duration of collection, skin cleaning, sample handling and analytical technique; unstandardised methods and challenging field conditions can produce inconsistent or inaccurate results. Local-patch sodium is usually not a valid direct surrogate for whole-body sodium.

Sources: WADA 2026 Prohibited List (copy published by the International Testing Agency) · National Athletic Trainers' Association Position Statement: Fluid Replacement for the Physically Active (McDermott et al., J Athl Train, 2017) · Sweating Rate and Sweat Sodium Concentration in Athletes: A Review of Methodology and Intra/Interindividual Variability (Baker, Sports Medicine 47, Suppl 1)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsExercise stress test (treadmill ECG) Exercise ECG · Exercise electrocardiography · Treadmill ECG · Exercise stress test

DNot prohibitedTest

What it is: A test that records an electrocardiogram during exercise such as treadmill walking. It checks for coronary artery disease in people with chest pain and is also offered as a screening test in people without symptoms.
What the evidence shows: It measures the effect of exercise on the heart, recorded as an electrocardiogram. For screening adults without symptoms, the US Preventive Services Task Force (2018) found no net benefit at low risk of cardiovascular events (grade D) and concluded the evidence is insufficient at intermediate or high risk. Its use in people with chest pain is separate from screening. Grade D · No human efficacy data, human evidence against, or a use that is not what it is approved for
Regulatory status: Test. A test. No regulator approval statement for the test as a service is cited here. The task-force position on screening adults without symptoms is not a regulator decision.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List. A test is not a substance; it carries no anti-doping status.
What can go wrong: An abnormal result, true or false positive, can lead to invasive confirmatory testing and treatment that have the potential for serious harm. Some people may have chest pain or may faint or collapse during the test; a heart attack or dangerous irregular heart rhythm is rare.

Sources: MedlinePlus Medical Encyclopedia, Exercise stress test (review date 7/14/2024) · USPSTF, Cardiovascular Disease Risk: Screening With Electrocardiography (June 12, 2018), adults at low risk

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Tests & assessmentsEchocardiography Echocardiogram · Transthoracic echocardiogram (TTE) · Exercise or stress echocardiogram · Transoesophageal echocardiogram (TOE)

BNot prohibitedTest

What it is: A scan of the heart done to see how well it is working. The NHS lists transthoracic (TTE), exercise or stress, and transoesophageal (TOE) types. It is used in defined clinical situations.
What the evidence shows: It measures cardiac structure and function. The evidence is limited to defined clinical use: the 2018 ESC/ESH hypertension guideline lists it among tests for more detailed screening for hypertension-mediated organ damage, when this information will influence treatment decisions. No guideline or trial supporting use as a screening test in people without symptoms is cited here. No accuracy figures are cited here. Grade B · Some human trials — limited, mixed, or in a narrow clinical population
Regulatory status: Test. An imaging test. The NHS page describes the scan and its types; no separate regulator approval statement for the test is cited here.
Anti-doping status, 2026 List: Not prohibited. Not named on the 2026 Prohibited List. A test is not a substance; it carries no anti-doping status.
What can go wrong: The NHS notes that a TOE is not painful, but people can find it uncomfortable. No other harms are cited here.

Sources: Echocardiogram - NHS (page last reviewed 26 February 2026) · 2018 ESC/ESH Guidelines for the management of arterial hypertension (Table 15, more detailed screening for HMOD)

Link to this entry · Research note reviewed 1 October 2026. Approval and sport status are specific to the exact substance and formulation.

Knowledge by coaching goal

Start with what
you want to improve.

Choose a coaching topic. The separate reference explains therapies, products and tests you may hear about.

Bodybuilding & physique

Build muscle, plan composition changes and prepare for a competition or camera date.

Physique coaching

Nutrition & fuelling

Connect energy intake, food choices and recovery nutrition to training and your goal.

Nutrition and recovery

Strength & athletic performance

Choose methods for strength, speed, power and conditioning, then review the response.

Training methods

Recovery & consistency

Understand sleep, workload, travel and the routines that support sustained training.

Sleep and recovery science

Longevity & daily capacity

Follow strength, fitness, mobility and function as your priorities change.

Longevity coaching

Measurement & technology

Use repeatable tests and useful trends; understand what a number can and cannot tell you.

What we measure

For a closer look

Compare the evidence.

Open a table to see how related entries differ.

Comparison notes

The GLP-1 family, compared3 rows

Medicine	Receptors	Status (September 2026)	Key trial result, adults with obesity	WADA 2026
Liraglutide	GLP-1	Approved (EU 2015, US); daily injection	7.5% vs 2.3% placebo (SCALE, EMA summary)	Not prohibited; not monitored
Semaglutide	GLP-1	Approved (EU 2022, US, India; Indian generics from late 2025)	About 15% vs 2% at 68 weeks (STEP 1); fewer cardiovascular events (SELECT)	Not prohibited; markers on the Monitoring Program
Tirzepatide	GIP + GLP-1	Approved (EU 2022, US; India, launched March 2025)	At least 15% vs about 3% at 72 weeks (SURMOUNT-1)	Not prohibited; markers on the Monitoring Program from 2026

All of them lose lean mass with the fat. All are prescription medicines and a physician’s decision. Approved status and Monitoring Program entries checked September 2026 against the EMA, FDA, USADA, AIU and NADA sources listed on each entry.

Thymic peptides, compared2 rows

Peptide	What it is	Approved anywhere?	Best human evidence	WADA 2026
Thymosin alpha-1 (thymalfasin)	28-amino-acid immunomodulator	Yes: Italy (vaccine adjuvant) and other countries; not FDA/EMA	TESTS sepsis trial (about 1,100 patients): no mortality benefit	Not named; verify on Global DRO
Thymalin	Calf thymus extract	Russia only	Russian studies; Khavinson-group follow-up series	Not named; verify on Global DRO

Similar molecular names do not mean the same anti-doping status. The exact molecule and formulation must be checked; naming similarities are not evidence of permission.

Oral, intramuscular, intravenous: the same nutrient, three routes3 rows

Route	What it does that the others do not	When medicine uses it	What the wellness claim adds	Anti-doping (2026)
Oral tablet, drop or food	As effective as the other routes for almost everyone: B12, vitamin D, magnesium, zinc and vitamin C all correct a deficiency by mouth in the trials	The default prescription for deficiency	Nothing to add; it is the evidence	Permitted; supplements checked for contamination
Intramuscular shot	Bypasses the gut for people who cannot absorb (pernicious anaemia, bowel surgery) or cannot adhere	Malabsorption, severe deficiency, Wernicke’s	‘Energy’, ‘immunity’, ‘fat burning’: no trial supports any of them	Check the substance separately; the M2.2 volume rule concerns intravenous infusions and injections, not the intramuscular route
Intravenous drip	Reaches plasma levels the gut cannot (vitamin C) and delivers fluid and electrolytes to someone who cannot drink	Hospital treatment: dehydration with vomiting, eclampsia, scurvy, parenteral nutrition	Wellness drips as a category: tested once (the Myers cocktail) and no better than placebo	Prohibited at all times above 100 mL in 12 hours outside hospital, surgery or diagnostics (M2.2); no TUE for wellness

Sources: the reference entries. The volume rule applies whatever the bag contains; the substance rule is separate and checked on Global DRO.

NAD+ by route: infusion versus oral precursors4 rows

Route	Blood NAD+	Human outcome evidence	Regulatory status	Anti-doping (2026)	Grade
Intravenous NAD+	Rises during a multi-hour infusion, with metabolites; broken down outside cells by CD38 before uptake	Five human studies, none placebo-controlled for efficacy; infusion reactions common	Unapproved; compounded from an FDA Category 1 bulk substance	Substance not listed; sold in volumes above the M2.2 limit	C
Oral NMN	Rises dose-dependently	The cited eight-trial analysis found no consistent benefit for glucose, insulin, HbA1c or lipids	Sold as a supplement; regulatory status contested in the United States	Permitted; check the batch	L
Oral NR	Rises reliably	Small trials; a general longevity benefit is not established	Supplement	Permitted; check the batch	L
Training, sleep, energy balance	Tissue NAD+ metabolism is exercise-responsive	Training can improve fitness, strength and metabolic health; responses vary	None needed	Permitted	A

Grades follow the supplements page for the oral precursors (longevity shelf) and the NAD+ infusion entry.

Heat: Finnish sauna, infrared cabin and heat acclimation3 rows

Type	Air temperature	Evidence	Regulatory position	Anti-doping
Finnish dry sauna	About 80°C, 10–20 per cent humidity	Kuopio cohort: 2,315 men, 21 years; 4–7 sessions a week associated with 63 per cent lower sudden cardiac death and 40 per cent lower all-cause mortality than one session (observational)	General wellness; no clearance needed	Permitted
Infrared cabin	45–60°C, skin warmed directly	Small studies in heart failure and chronic pain; no outcome data; the Finnish figures do not transfer	General wellness; no clearance needed	Permitted
Heat acclimation (the practice)	Exercise in heat over a planned block	Established for performance in hot conditions; planned from a measured sweat rate	Not a device	Permitted

Unstable heart disease and pregnancy are medical decisions before any heat session; alcohol and heat do not mix.

Compression devices, compared4 rows

Device	Evidence for recovery	Regulatory position	What it cannot do
Pneumatic leg sleeves	17 studies, 319 people: trivial-to-small effect on muscle function, trivial-to-moderate on perceived soreness	Class II compressible limb sleeve (21 CFR 870.5800); hospital uses are thrombosis prevention and lymphoedema	Clear lactate (metabolism does that within an hour) or replace sleep
Full-body compression suit with infrared heat	No controlled trial for any claim	Wellness product; no cleared indication	Drain ‘toxins’, reset the nervous system, or improve sleep on any evidence
Compression garments	Mixed small trials for soreness and swelling; cheap and harmless	Clothing	Add to adaptation
Cold-water immersion (for comparison)	Reduces perceived soreness; blunts hypertrophy, and in some trials strength gains, when used after strength sessions	Not a device	Be used habitually in a muscle-building block

None of these is prohibited in sport; none has an adaptation cost except cold water; none is a substitute for the recovery variables the practice measures.

Cells are drawn from the reference entries, which carry the sources; the compression-garment row is an editorial summary.

Every page, seven groups

Know the body.Train with purpose.

The gain comesafter the session.

Tension, protein,and enough sets.

Volume is a dose–response

Proximity to failure

Protein, by the meal

The fibres you keep

What blunts the signal

A profile helps guidewhat to load.

Three energy systems.One continuum.

Composition followstraining, food and recovery.

Testosterone and oestradiol

Growth hormone and IGF-1

Insulin, cortisol, thyroid

Sleep protectsthe adaptation.

Train for strength.Plan for longevity.

Heart & circulation

Strength & structure

Metabolism & blood

Sleep, stress & mind

The model supportsthe next decision.

Claims, withtheir sources.

Every test,and the reason for it.

Direction first, then stability.

Your baseline is the reference

Read for you, not the population

Education, not medical advice

The performance half, test by test.

01SpeedHow fast you get to top speed, and how long you hold it.

02Strength & powerNot what you can lift. What you can use.

03EnduranceThe engine, and the cost of running it.

04Body compositionWeight is noise. Composition is signal.

05RecoveryWhat you can absorb decides what you can do.

06Mobility & resilienceRange you own, not range you borrow.

The long half,marker by marker.

01Heart & circulationOxygen, and what your blood carries.

02Strength & structureAfter forty, the accounts you spend from.

03Metabolism & bloodBlood markers in clinical context.

04Sleep, stress & mindThe frontier that makes the other three possible.

Why the re-test matters.

What changed, and wherethe page says so.

The words we use,in plain language.

Every term,and where it works.

A

B

C

D

E

F

H

I

L

M

N

O

P

R

S

T

V

W

The science is public.The plan is yours.

Knowledge references by subject

Therapies, injections, molecules and tests

Therapies & devicesAcupuncture Needle acupuncture · Medical acupuncture

Therapies & devicesAltitude and hypoxic training Live High-Train Low (LHTL) · Intermittent hypoxic training (IHT) · Hypoxic tent · Altitude tent · Altitude house · Hypoxic chamber

Therapies & devicesAudio-visual entrainment headsets BrainTap-type headset · Binaural beats · Isochronic tones · Light-and-sound therapy · AVE · Brainwave entrainment

Therapies & devicesBioresonance therapy devices Bioresonance · Bioresonance therapy · Biophysical information therapy (BIT)

Therapies & devicesBlue-light-blocking glasses Blue-blockers · Blue-light glasses · Amber glasses · Blue-light filtering spectacle lenses · Computer glasses

Therapies & devicesBright-light therapy boxes Light box · SAD lamp · Bright-light therapy · Seasonal affective disorder light

Therapies & devicesCold-compression units (Game Ready-type) Game Ready system · Cryo-compression therapy (CCT) · Cold compression therapy · Dynamic cold-compression unit

Therapies & devicesCold-water immersion Ice bath · Cold plunge · CWI · Contrast bathing · Cold therapy tub

Therapies & devicesColonic irrigation (colon hydrotherapy) Colonics · Colon cleanse · Enema cleanse

Therapies & devicesCompression garments Compression tights · Compression sleeves · Compression socks · Recovery compression wear · Compression clothing

Therapies & devicesCranial electrotherapy stimulation CES · Cranial electrical stimulation · Alpha-Stim-type device · Head-worn electrical stimulator

Therapies & devicesCryolipolysis and HIFEM body-contouring devices CoolSculpting-type · Zeltiq (applicant name in FDA records) · HIFEM (high-intensity focused electromagnetic) · Emsculpt-type · Electromagnetic muscle stimulation for body contouring

Therapies & devicesCupping therapy Dry cupping · Wet cupping · Hijama · Fire cupping · Myofascial decompression cupping

Therapies & devices‘Detox’, as a concept Detoxification · Cleanse · Toxin flush · Heavy-metal detox · Lymphatic detox

Therapies & devicesDry needling Trigger-point dry needling · Intramuscular needling · Myofascial trigger point needling