Most young athletes on protein supplements are also on medication. Few tell anyone.

Protein supplements have become a fixture of youth and young-adult athletics, and a scoping review published this month lays out how often that supplement use overlaps with regular medication — and how rarely anyone involved in a young athlete's care actually knows about it [s1].

What the review covered

Researchers searched PubMed, Scopus, and the Cochrane Library for studies published between January 2012 and December 2024 examining protein supplement and medication co-use among athletes aged 14 to 21, following the PRISMA extension for scoping reviews [s1]. Eighteen original peer-reviewed studies met the inclusion criteria, together covering 13,482 young athletes [s1]. Two reviewers independently assessed study quality using the NIH Quality Assessment Tool for observational cohort and cross-sectional studies, and the team applied a modified GRADE framework to judge how certain the overall evidence was [s1].

How common the overlap is

Protein supplement use was reported in 44% to 71% of participants across the 18 included studies [s1]. Among those supplement users, 58% to 75% also reported using at least one medication within the preceding month [s1]. Non-steroidal anti-inflammatory drugs — ibuprofen and naproxen among them — were the most commonly cited co-used medication, reported by 35% to 50% of the overlapping group [s1]. Antacids, proton pump inhibitors, and inhaled beta-2 agonists (a category that includes common asthma inhalers) rounded out the next most frequently reported medications [s1].

The disclosure gap

The review's most striking finding may be less about the overlap itself than about who knows about it: fewer than 10% of athletes who combined supplements and medications disclosed that co-use to a healthcare professional [s1]. That leaves the large majority of a widespread, documented pattern essentially invisible to the doctors, athletic trainers, and pharmacists who might otherwise be positioned to flag a potential interaction.

What's actually known about the risk

Here the review is notably restrained: no prospective cohort study has formally assessed clinical outcomes attributable to drug-protein interactions in this specific population [s1]. The certainty of evidence for clinically significant drug-protein interactions was rated very low under the GRADE framework [s1] — meaning the review is not reporting documented harm from these combinations, because the rigorous studies needed to detect that harm, if it exists, haven't been done. What the review documents is prevalence and an evidence gap, not a confirmed safety signal.

Why the gap matters anyway

Pharmacokinetic and pharmacodynamic interactions between protein intake and certain drug classes are plausible on mechanistic grounds even without population-specific outcome data — protein can affect gastric emptying and, in some cases, drug absorption, and NSAIDs carry their own gastrointestinal and renal considerations that could theoretically interact with high protein intake. The review's authors frame the near-total absence of disclosure as the more immediately actionable problem: a clinician or pharmacist who doesn't know a young athlete is taking a protein supplement can't evaluate whether it's relevant to whatever medication they're prescribing or recommending, regardless of whether an interaction risk turns out to be real or negligible once properly studied [s1].

What the review recommends, and what it doesn't

The authors call for routine questioning about supplement-medication co-use to become standard practice among pharmacists and clinicians working with young athletes, and for rigorous prospective research before any evidence-based clinical guidance on this specific combination can be formulated [s1]. Nothing in the review amounts to a recommendation for or against protein supplement use itself, and it does not identify any specific combination as dangerous — its contribution is documenting how common the overlap is and how rarely it's disclosed, not resolving whether that overlap carries meaningful risk.

Sources

• Drug–protein supplement interactions in young athletes: A scoping review exposing a major evidence gap — GSC Biological and Pharmaceutical Sciences, 2026-05-31