Toxicologist: Energy Drink Ingredient Could Have Triggered Positive Drug Test

AJ Allmendinger

There are no answers in the AJ Allmendinger case, at least not yet.

But whatever the explanation for his recent suspension may be, the saga of the Penske Racing driver has focused the national spotlight on the issue of unregulated sports drinks and supplements in amateur and professional athletics.

NASCAR currently includes more than 100 drugs on its list of banned substances. That list is not all-inclusive, though, since other substances can trigger a violation when used improperly. For example, cough syrup is acceptable when taken as directed. Two bottles at a time, however, will almost certainly result in a positive substance abuse test. 

Allmendinger’s longtime business manager, Tara Ragan, revealed Wednesday that the driver’s initial drug screen results showed stimulant levels that were “slightly above the threshold.” The 2012 NASCAR Sprint Cup Series rulebook defines stimulants as “amphetamine, methamphetamine, Ecstasy (MDMA), Eve (MDEA), MDA, PMA, Phentermine, and other amphetamine derivatives and related compounds.” Many health supplements, sports foods and energy drinks contain stimulants of one sort or another, ranging from simple caffeine to other, more complex chemical compounds. Some energy drinks actually contain multiple stimulants.

NASCAR encourages its drivers and crewmembers to document and report every medication they take – prescribed or otherwise – in an effort to avoid possible problems. Unfortunately, the vitamin and supplement industry is not regulated by the United States Food and Drug Administration. In the absence of such oversight, the amount of stimulants in these products is not always listed on the label. Even when such information is provided, many consumers are unfamiliar with the ingredients in question, leaving them incapable of making an informed decision. In some instances, manufacturers have even failed to list all the stimulants included in their products.

Inadvertant positive drug tests due to health supplements, sports food or energy drinks usually involve one of three different scenarios. 

1.     The supplement contains a banned substance as a stated ingredient, but the consumer is unaware that the substance is banned.

2.     The supplement contains a banned substance as an unstated ingredient. These ingredients may be added deliberately and not declared, added inadvertently as by-products of other ingredients, or added inadvertently as contaminants of the production process.

3.     The supplement contains a banned substance within its stated ingredients, but the consumer is unfamiliar with the substance in question. For example, guarana is a common ingredient in many energy drinks and supplements, but most consumers are unaware that guarana contains high levels of the stimulant caffeine. Some Chinese herbal products contain an ingredient identified only as “Ma Huang.” Ma Huang is the Chinese term for the stimulant ephedrine.

It is believed that Allmendinger has used both health supplements and sports foods as part of his physical training regimen.  He also signed a deal in March of this year to represent Fuel in a Bottle Energy and Protein Power Shots; a product billed as “a fast acting power shot that helps consumers meet their Energy or Protein needs at an affordable price.” Ingredients listed on the product’s label are Niacin, Vitamin B6 (Pridoxine HCL), Folate (Folic Acid), Vitamin B12 (Cyanocobalamin), Taurine, Malic Acid, L-phenylalanine, Caffeine, Glucuronolactone, Filtered Water, Sucralose, Natural Flavors, Potassium Sorbate and Potassium Benzoate (used as preservatives), Gum Acacia and Ester Gum.

Dr. Howard Greller

Dr. Howard Greller is an Assistant Professor of Emergency Medicine at North Shore/LIJ Hofstra School of Medicine in Manhasset, NY, attending physician at North Shore University Hospital and a member of the Board of Directors of the American College of Medical Toxicology. After examining NASCAR’s list of banned substances and the Fuel In a Bottle label, Greller said one of the product’s ingredients, L-phenylalanine, could cause a positive test for stimulants. 

“My understanding is that (Allmendinger’s) positive test was for amphetamines or an amphetamine-like stimulant,” said Greller. “Looking at the ingredients (in Fuel in a Bottle), it’s an energy drink. It has a lot of stimulants; caffeine and caffeine-like substances. It contains amino acids, and at least one of those amino acids, L-phenylalanine, looks structurally like an amphetamine. Whether or not that would cause a positive test result depends on the test. Not having access to the specific test, I would only be speculating as to whether it made (Allmendinger’s) test positive.”

Amy Pearce, Fuel in a Bottle's director of brand development, told SB Nation’s Jeff Gluck yesterday, “All ingredients in Fuel in a Bottle are recognized as safe by the Federal Food and Drug Administration. These ingredients are similar to those found in virtually all energy shots and energy drinks, as well as in many common foods like eggs, fish, beef, cheese and milk."

 “(L-Phenylalanine) is not a rare or unique substance,” confirmed Greller. “It is found in a lot of different foods and products, but its (chemical) structure looks a lot like the backbone of an amphetamine molecule.” 

Greller said one of the major issues facing drug enforcement officials today is the ability of chemists to subtly alter the chemical makeup of an illegal drug, making it technically legal while not impacting its effect on the user.  

“That’s what a designer drug is,” he said. “If you make one very, very small change (in a drug), technically it’s a new compound and no longer falls under the current law.” He said there is “an ongoing war between the people who make drugs and illicit substances and the people trying to prevent them from getting into the hands of the public. There is a constant battle between the two sides, trying to change, modify and come up with a (slightly) new product that skirts the illegality of the old compound.”

Greller said there have been numerous examples of athletes running afoul of their respective leagues after taking legal, over-the-counter drugs and supplements. 

“During the (2002 Winter) Olympic Games in Utah, there was controversy surrounding an athlete that had taken a medication for asthma,” he recalled. Part of the problem is that many compounds considered inappropriate for sports-- stimulants or other medications – often have legitimate value and use for people.  

“It comes down to intent,” he said. “Were you using it because you have a legitimate medical issue and need to treat yourself? Or were you using it because it’s a stimulant and you were trying to enhance your performance? That’s not something that the test can tell you.” 

Greller said intent can often be determined by examining the amount of a drug in the athlete’s system.

“There are different levels… that the lab uses to determine whether something is being used illicitly, or whether someone simply had a poppy seed bagel for breakfast that morning,” said Greller. “There are significant differences in the amount of compound you get from eating a bagel, versus shooting heroin.”

He said a number of factors, considered together, help toxicologists determine whether an actual violation of policy has occurred. “The amount (of drug detected) plays in,” he said. “Where it’s detected plays in, and what specific compound is found plays in. There are a lot of variables, and it’s more than just a black-and-white, yes or no test.”

While having no specific knowledge of Allmendinger’s case, Greller said he expects the driver’s second, or “B sample” test to focus more closely on the offending compound.

“In most cases of occupational or sports testing, the initial test is designed to be as broad as possible in order to catch as many things as possible,” he said. “Once you have a positive test, the next test is a confirmatory test; a more sensitive test to try and determine what caused the positive result. Was it really the compound in question, or was it merely something similar? The second test is a much more difficult test to perform, and involves much more chemistry to figure out the answers.”

Allmendinger now must hope for one of two results. If his “B” sample — the other half of the urine specimen collected in Kentucky -- tests clean, it would indicate a procedural or clerical error on the part of NASCAR’s testing agent, Aegis Laboratories.

If his “B” sample is also found to contain stimulants, Allmendinger must hope that the specific drug and concentration found will clear him of intentional, illicit substance abuse. In anticipation of a possible second positive test, Ragan said her driver is “collecting his medicines and supplements for testing, to determine whether an over-the-counter product caused his positive test.”

Allmendinger is the ninth NASCAR National Series driver to be suspended for violating NASCAR’s substance abuse policy since 2009; joining Jack Smith, Shane Sieg, Jeremy Mayfield, Shane Hmiel, Kevin Grubb, Aaron Fike, Tyler Walker and Brian Rose. Driver Tim Richmond was also suspended after testing positive for banned substances in 1988, prior to the advent of NASCAR’s modern-day testing policy.  

Hmiel, Walker, Grubb and Rose were eventually reinstated for competition after completing the sanctioning body’s Road to Recovery program. Hmiel failed a pair of subsequent drug tests in 2005 and 2006 and was banned from NASCAR for life. Grubb was suspended indefinitely after refusing to undergo a NASCAR mandated screening in 2006, and died of a self-inflicted gunshot wound in May of 2009.