Anabolic Steroids

What are they?

Hormones synthesized from cholesterol Produced by interaction of hypothalmic,

pituitary & gonadal glands Male production=5-10 mg./day Female production = 1-2 mg./day

Stored in blood – not the glands Effects on body

anabolic androgenic

Effects of Anabolic Steroids Mimics Testosterone Androgenic Effects

male sex characteristics want to limit these effects

Anabolic Effects increase protein & creatine phosphate

synthesis increase muscle mass increase aggressiveness**increase oxygen carrying capacity -

not proven

Anabolic Steroids Usage began in the 1940’s Synthetic substance developed in 1953 IOC banned steroids in late 1960’s IOC instituted testing at 1976 Summer

Olympics 21 FB players banned from bowl games

in 1987 Recent increase in usage

History

Developed in early 1950s for the anabolic effects 1954 Olympic games first reported use when

syringes were found in Soviet Union locker room Introduced to US in 1960’s Banned by IOC in 1968 First urine tests done in 1976 at Olympic games First confirmed use by women at 1976 Olympics

after + tests of E. German swimmers

History cont.

NCAA instituted drug testing in 1986 at national competitions. 21 FB tested + that year at bowl games.

Federal Anabolic Steroid Act of 1990 classified them as controlled substances Schedule III of Controlled Substances Act

Use has been on decline since 1980s Probably due to increased use of

prohormones Exception is women

Types of Anabolic Steroids

Exogenous, synthetic steroids developed to decrease androgenic effects without affecting anabolic effects

Also modified to prevent 1st pass breakdown in liver Oral (short ½ life) Injectable (bypass liver)

Modified oral compounds have additional carbon molecule, C-17 alkylated steroids which withstand liver degradation. These are very hard on the liver. Most injectable steroids are oil based, lipid soluble.

How do they work?

Bind to receptors in skeletal muscle, prostate, heart, testes, & brain

Cause increased protein synthesis & nitrogen retention which causes increased muscle size and strength

Prevent catabolic effects of cortisol by controlling it’s release during intense training

Anabolic Steroids - Sources

Prescription anemia, replacement therapy,

increase appetite, abnormal protein synthesis

NORMAL dose = 5-10 mg/day Veterinarian Blackmarket

Legitimate Medical Use

Hypogonadal men Burn victims, AIDS patients, severe

osteoporosis, breast cancer, malnourishment, adolescent disease

?? Uses being tested Injury treatment Male contraception Anti-aging Lowering serum cholesterol

How are they taken?

Cycling Take for a period of time and then cycle off

before beginning again. Method used to beat drug testing

Stacking Take more than one at a time trying to

achieve synergistic effect Pyramiding

Gradually increase number and amount of compounds to maximize effects and decrease side effects

Health Risks of Steroid Use

Not well tested or documented History of misinformation by medical

community Unethical to administer doses equal

to abuse levels Funding Retrospective studies are unreliable

Abuse Effects on Women

Hirsutism - facial Skin coarsening ** Deepening of voice ** Breast tissue reduction Alteration of menstrual cycles Facial masculization ** Clitoral enlargement ** irreversible after prolonged use

Abuse Effects on Men Decreased endogenous serum

testosterone (as little as 3 weeks) (12 weeks = problems)

Testicular atrophy Impaired sperm production Impotence Male pattern baldness ** Prostate enlargement ** Gynecomastia (aromatization) ** ** irreversible after prolonged use

Abuse Effects on Teenagers

Same sex effects

Premature epiphyseal growth plate closure

Abuse Effects on Both Sexes

Severe acne Weakened tendons Jaundice Fluid retention Cardiovascular effects

Effects on liver

Liver toxicity Cancer Formation of blood filled sacs Pre-existing conditions could lead

to more serious problems

Cardiovascular Effects

Reduction of HDL levels

High BP

Enlargement of heart

Psychiatric Symptoms

“Roid rage” Not well documented, anecdotal

evidence Reported after high dosage levels,

sustained use Athletes could be predisposed to anger

Psychological dependence “bigger biceps” mindset Sociological pressure Suppressed endogenous testosterone

production after abuse

Other Adverse Effects

Connective tissue injuries Musculotendinous areas

Needle contamination Blood borne pathogens

Counterfeit steroids Contamination

Drugs used to counter effects

Cytadren & Arimidex (s) Counters aromatization

Tamoxifen Reduce gynecomastia

Clomid (s) Restore natural testosterone production

Nolvadex Anti-bloating

HCG (Human chorionic gonadotropin) Avoiding testicular atrophy

Legal Implications Anabolic Steroid Act 1990 classified them

as controlled substances Use

1st offense = 1 yr. jail & $1000 fine 2nd offense = up to 2 yrs. jail & minimum

of $2500 fine Selling & distribution

Federal offense 1st offense = up to 5 yrs. jail and

$250,000 fine 2nd offense = up to 10 yrs. jail & higher

fine

Common Brands, Names Anadrol

oxymetholone Arimidex

anastrozole Deca Durabolin

Nandrolone deconaoate

Dianabol methandrostenolone

Equipoise boldenone

Parlodel bromocriptine

Primobolan Depot Methenolone

enanthate Trenbolone acetate Winstrol Depot

stanozolol Oxandrin

oxandrolone

Anabolic Steroids - Administration

Oral – Dianabol, Android, Anadrol, Oxandrin EXCESSIVE dose = >25-50 mg/day (200

mg/day) Injection – Deca-Durabolin, DEPO-

Testosterone EXCESSIVE dose = >100-200 mg/week

Programs stacking - use of oral & injectable pyramiding - then usage cycling - on/off (6-12 wks)

Drug Testing Urine test Test 1 hr. after announcing test Masking agents – Benemid,

Corticosteroids, DHEA, other substances

T/E Ratio also measure concentration of

testosterone and specific gravity

Drug Testing Problems

Detection of substances that occur naturally in the body is difficult. Also must set standards of sensitivity to accommodate these levels.

Testosterone / epitestosterone ratio of 6:1 is standard guide but higher ration can occur naturally in 2-3% of population.

Baseball, NHL, NBA do not ban their use. IOC, NCAA, NFL do ban use.

Androgens & GH Releasers

History Through 1980’s the medical establishment

concluded “use of these agents (androgens) does not cause an increase in muscle bulk, strength, or athletic performance”.

Athletes “knew better” Bhasin (1996) study found 600 mg. / week

of testosterone ethanthate increased triceps and quadriceps size in non-exercising group as well as exercise group. No changes in mood, behavior or cardiac indicators (HDL, LDL, triglycerides)

Prohormones Anabolic Steroid Control Act of 1990

made use of agents a federal offense.. however..

DSHEA labeled prohormones as a nutritional supplement.

Compounds that are precursors to testosterone and readily convert, based on their proximity in the metabolic pathway.

Testosterone

Androstenedione / Androstenediol^^

DHEA^^

17-OH-pregnenolone^^

Pregnenolone^^

cholesterol

^^

Questions That Need Answers Does compound survive digestion? Does compound appearing in blood

convert to the active compound? Are there downstream effects? Do metabolic byproducts appear in

the urine in a form identical to banned substances?

Does supplement have the claimed effects?

Androstenedione / Androstenediol

Made famous by Mark McGuire Earnest (2000), Ziegenfuss (1998, 1999)

found androgens converted to higher levels of serum testosterone in males. Effects on body composition only seen after 450 mg. sublinqual dose, 3-4 weeks.

Mahesh & Greenblat found 100 mg. androgens increased testosterone levels in women.

Also found elevated estradiol & estrone levels & decreased HDL levels in untrained males.

Androstenedione Natural substance – produced in

adrenal glands Nutritional supplement Anabolic effects, increase energy,

enhance recovery

19-Norandrostenedione19-Norandrostenediol Gammeren, et. Al, found 100 mg. Of N-

dione and 56 mg. Of N-diol had no effects on body composition or strength.

Studies have shown 10 micrograms will cause + urine tests (intense training can increase concentration in urine so there can be combined effect in athletes).

50 mg. Dose can be detected for 7-10 days after ingestion

DHEA Brown, et. al, found 50 mg dose

increased androstenedione concentrations by 150% within 60 minutes of ingestion.

150 mg./day for 8 weeks increased serum androstenedione but had no effect on serum levels of testosterone. No difference in strength gains between groups

DHEA (Dehydroepiandrosterone)

Natural steroid hormone produced in the adrenal glands converted to testosterone – anabolic

effects Medicinal uses – heart disease,

obesity, diabetes, amount in body decreases w/age

Masking agent – normalizes T/E ratio Available as a supplement

Delta 5 Metabolites

All studies probe these metabolites double or triple urinary testosterone & epitestosterone ratio a few hours after ingestion.

Human Growth Hormone(Somatotropin)

Hormone secreted from pituitary gland

Effects stimulate protein synthesis stimulate growth increase muscle mass increase strength of muscles,

tendons, etc

Human Growth Hormone Adverse effects

acromegaly - large hands & feet abnormal shaped head increase size of heart, liver, kidneys increase cholesterol

Alternative to steroids cheaper harder to detect

Growth Hormone Enhancers

Amino acids (Aa) have been used to increase circulating growth hormone (GH) concentrations.

Strength training increases GH serum concentrations so looking for synergistic effect.

Most common Aa used are arginine, lysine & ornithine

Studies of Aa effects Many studies confirm increased GH

concentrations after ingestion of arginine & lysine.

Effects are modified by training level, sex, diet and age.

High levels produce stomach cramps & diarrhea Women have greater response. People on high protein levels (1.7-2.2 g/kg day)

have less effects Ingestion right before exercise blunts absorption

Peptide Secretagogues

Being developed and studied as compounds that stimulate secretion of endogenous GH.

Studies have all been done on GH deficient patients.

No reports of athletes using them but doesn’t mean there isn’t illegal use.

Other GH Releasing Agents

Clonidine, L-dopa & methylphenidate have been shown to induce GH release.

L-dopa most commonly used by athletes but no studies have been done on effectiveness but does induce nausea & vomiting.