Teen sports supplements: What to recommend, use with caution, and avoid

Sports supplements are no longer reserved for elite adult athletes. Creatine, caffeine, electrolyte products, protein powders, and pre-workout supplements are increasingly part of adolescent sports culture. So, what should pediatricians recommend? The answer shouldn’t automatically be “no supplements.” This article will help clinicians determine which products may be reasonable to support, which warrant caution, and which to avoid. But first, one question matters more than any supplement: Is this athlete eating enough to support their training?

Start with food: Carbohydrates fuel performance

No supplement can compensate for underfueling. When carbohydrate and overall energy intake are too low, athletes may experience fatigue, reduced performance, poorer recovery, and increased injury risk.¹ For most young athletes, meals and snacks should regularly include carbohydrate-rich foods such as bread, rice, pasta, potatoes, cereal, fruit, and milk.

Creatine monohydrate

Creatine is no longer a niche supplement among elite athletes. Creatine use becomes increasingly common as athletes move through high school, with use rising significantly between 9th and 12th grades.² Creatine is naturally produced by the body and is also found in foods such as meat and seafood. Within skeletal muscle, it helps rapidly regenerate adenosine triphosphate (ATP), making it particularly useful during repeated bouts of high-intensity exercise.³

Creatine monohydrate is one of the most extensively studied sports supplements in adults and can improve strength, power, training capacity, and gains in lean mass when combined with appropriate training.³ But the question pediatricians and parents really care about is different: Is creatine safe for teenagers? The pediatric evidence is smaller than the adult literature, but it is more reassuring than many clinicians realize. A 2021 review in the Journal of the International Society of Sports Nutrition evaluated this question directly and concluded that, based on the limited available evidence, creatine supplementation appears safe and potentially beneficial in children and adolescents.⁴

For adolescents considering creatine, first confirm that they are participating in serious, supervised training; meeting energy, carbohydrate, and protein needs; have no underlying renal disease or other contraindication; understand what creatine can and cannot do; and are choosing a simple, third-party-tested product.

Creatine monohydrate should be recommended rather than newer formulations. A loading phase is also unnecessary. Daily supplementation with approximately 3–5 grams can achieve similar muscle creatine saturation over time.³ Two common myths can also be put to rest: current evidence does not demonstrate that recommended doses of creatine cause kidney dysfunction in healthy individuals, nor does experimental evidence support the claim that creatine causes dehydration or muscle cramping.⁴

Protein powders

Most teen athletes can meet protein needs through food, and additional protein does not improve performance when intake is already adequate. Protein powders or shakes may be useful for convenience when meals or snacks are difficult to access, but they are not necessary for building muscle or improving performance.⁵

Sports drinks vs electrolyte powders

Sports drinks and electrolyte powders are often treated as interchangeable, but they serve different purposes. For most teens exercising for a short period in comfortable conditions, water and regular meals are adequate. Electrolytes become more relevant with prolonged exercise, heavy sweating, hot or humid conditions, or multiple events in one day. Sodium and chloride are the primary electrolytes lost in meaningful amounts through sweat, while losses of others such as potassium and magnesium are typically much smaller.⁶

The key question is whether the athlete also needs carbohydrate for fuel. During prolonged or intense activity, a sports drink can provide fluid, sodium, and readily available carbohydrate at the same time.⁷ An electrolyte powder without carbohydrate may help with fluid and sodium replacement, but does not provide the energy needed to sustain exercise. Targeted sodium replacement is generally unnecessary for the average teen athlete and is most relevant during prolonged exercise with substantial sweat losses.

Caffeine and energy drinks

Caffeine can improve alertness and reduce perceived exertion, but that does not mean it should be routinely recommended to adolescent athletes. Potential downsides include anxiety, jitteriness, GI upset, increased heart rate, and disrupted sleep.⁸ Energy drinks deserve extra caution. Unlike sports drinks, which provide fluid, carbohydrate, and electrolytes, energy drinks contain stimulants, usually caffeine, and may include additional performance-marketed ingredients. The American Academy of Pediatrics advises that stimulant-containing energy drinks should not be consumed by children or adolescents.⁵ If a teen feels they “need energy” before practice, look for the real reason: inadequate sleep, skipped meals, low carbohydrate intake, excessive training, iron deficiency, or low energy availability. Often, the better solution is more fuel, not more caffeine.

Pre-workout supplements

The teenager asking about “pre-workout” is rarely asking about one ingredient. Pre-workout supplements frequently contain combinations of caffeine, amino acids, herbal ingredients, stimulants, and proprietary blends. The doses may be high, the benefit of many ingredients is questionable, and adolescents have little safety data for these combinations.⁵ For teens, I’d recommend skipping them entirely. A carbohydrate-rich snack, adequate hydration, and sufficient sleep may not come in a neon tub, but they are far more important for performance.

Beetroot juice

Beetroot juice provides dietary nitrate, which increases nitric oxide availability and may improve exercise performance in adults, particularly in endurance and some high-intensity activities.⁹ Pediatric data are limited, and there are no specific adolescent guidelines recommending nitrate supplementation. For most teen athletes, start with nitrate-rich foods such as beets and leafy greens. Concentrated supplements are better reserved for athletes with a specific performance goal under the professional guidance of a sports dietitian.

Tart cherry and other polyphenol supplements

Tart cherry, blackcurrant, pomegranate, and other polyphenol supplements are marketed for recovery, soreness, inflammation, and sleep.¹⁰ Adult studies suggest potential benefit, but evidence in adolescents is limited and pediatric recommendations are lacking. For most teens, food is the better starting point. Berries, cherries, grapes, and pomegranate naturally provide polyphenols along with carbohydrates and other nutrients. I’d rather see berries in the smoothie than another recovery supplement on the counter.

Fat burners, testosterone boosters, and muscle-building blends

Products marketed to “burn fat,” “boost testosterone,” or rapidly build muscle should raise a red flag. Many lack good evidence and may contain undeclared stimulants, hormones, or other contaminants.⁵ Also ask why the teen wants the product. Current guidelines recommend exploring motivations such as body image, peer pressure, and performance expectations.² A teen trying to get “leaner,” “bigger,” or “more shredded” may need a very different conversation than one asking how to recover between games.

Before recommending any supplement

When an athlete mentions a supplement, start with: “What are you hoping this supplement will do for you?” Then ask about training, typical intake, fueling around exercise, caffeine use, sleep, body image or weight concerns, who recommended the product, and the exact supplement being used. Ask them to bring the container or pull up the label on their phone.

Third-party testing matters

Even when a supplement is reasonable, the product still matters. Supplements do not undergo the same premarket approval process as medications, and contamination or inaccurate labeling can occur. Recommend independently third-party-tested products whenever possible. Testing does not guarantee a product is necessary or effective, but it helps reduce the risk of undeclared ingredients.

The pediatrician’s bottom line

Young athletes do not need a cabinet full of supplements to perform well. Start with enough food, especially carbohydrates around training, and address protein, hydration, sleep, recovery, and any nutrient deficiencies first. The goal is not to scare adolescents away from every supplement. It is to help them understand that supplements are exactly what the name implies: an addition to a solid nutrition and training foundation, not a replacement for one.

References

1. Williams, N.I., De Souza, M.J., Misra, M. et al. 2025 Update to the Female Athlete Triad Coalition Consensus Statement Part 2: Clinical Guidelines for Screening, Diagnosis, Treatment, and Return to Play for Adolescents and Adults. Sports Med 56, 375–427 (2026). https://doi.org/10.1007/s40279-025-02332-0

2. Putukian M, LeClere LE, Herring SA, et al. The adolescent athlete and the team physician: a consensus statement. 2025 update. Med Sci Sports Exerc. 2026;58(2):371-402. doi:10.1249/MSS.0000000000003863

3. Kreider, R.B., Kalman, D.S., Antonio, J. et al. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine. J Int Soc Sports Nutr 14, 18 (2017). https://doi.org/10.1186/s12970-017-0173-z

4. Antonio J, Candow DG, Forbes SC, et al. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?. J Int Soc Sports Nutr. 2021;18(1):13. Published 2021 Feb 8. doi:10.1186/s12970-021-00412-w

5. LaBotz M, Griesemer BA, Council on Sports Medicine and Fitness. Use of performance-enhancing substances. Pediatrics. 2016;138(1):e20161300. doi:10.1542/peds.2016-1300

6. Exercise and Fluid Replacement. Medicine & Science in Sports & Exercise 39(2):p 377-390, February 2007. | DOI: 10.1249/mss.0b013e31802ca597

7. Kyla Cordrey, Sarah A. Keim, Ruth Milanaik, Andrew Adesman; Adolescent Consumption of Sports Drinks. Pediatrics June 2018; 141 (6): e20172784. 10.1542/peds.2017-2784

8. Temple JL. Review: Trends, Safety, and Recommendations for Caffeine Use in Children and Adolescents. J Am Acad Child Adolesc Psychiatry. 2019;58(1):36-45. doi:10.1016/j.jaac.2018.06.030

9. Silva KVC, Costa BD, Gomes AC, Saunders B, Mota JF. Factors that Moderate the Effect of Nitrate Ingestion on Exercise Performance in Adults: A Systematic Review with Meta-Analyses and Meta-Regressions. Adv Nutr. 2022;13(5):1866-1881. doi:10.1093/advances/nmac054

10. Hill JA, Keane KM, Quinlan R, Howatson G. Tart Cherry Supplementation and Recovery From Strenuous Exercise: A Systematic Review and Meta-Analysis. Int J Sport Nutr Exerc Metab. 2021;31(2):154-167. doi:10.1123/ijsnem.2020-0145