The current evidence of the performance enhancing effects of 20-hydroxyecdysone: A Scoping review with meta-analytical approach

Purpose 20-Hydroxyecdysone (20E) has gained attention for its potential anabolic effects, with suggested efficacy comparable to prohibited agents. Consequently, the World Anti-Doping Agency (WADA) added 20E to its monitoring programme. 20E is supposed to enhance protein synthesis and muscle hypertrophy; however, human evidence remains limited and often inaccessible due to Slavic and Turkic publications. Therefore, we aimed to evaluate the effects of 20E supplementation on strength performance and body composition in adults performing resistance training. Methods A systematic literature search was conducted in PubMed, Web of Science, SURF databases, and SportDiscus according to PRISMA guidelines. Eligible studies were randomized controlled trials administering a defined dose of 20E to participants performing resistance training and assessing strength performance (upper and/or lower body) and body composition (body weight, fat-free mass, fat mass). In vitro, animal, and observational studies were excluded . Results Four trials including 113 males and 37 females (mean age 33.4 ± 4 years) met inclusion criteria. Meta-analysis revealed a small but statistically significant effect of 20E on lower body strength (SMD: 0.39; 95% CI: 0.03–0.76; p = 0.03), with no significant effects on upper body strength or body composition. Only two studies verified the 20E content of the supplements, and one confirmed biological activity. Conclusion Evidence suggests a small beneficial effect of 20E on lower body strength. Findings are limited by the small number of studies and inadequate verification of supplement content and bioactivity. Future research should ensure accurate dosing and biological validation before conducting human intervention trials.