Performance Enhancing Drugs: The Dark Arts (part 1)

Performance enhancing drugs (PEDs) have been a controversial topic for ages. They have been used by everyone from high school students to elite athletes. Some of the most abused PEDs are anabolic steroids, which can be taken orally, topically, or injected intramuscularly. There are a variety of different types of steroids that can be purchased from websites or overseas. However, steroids can only be prescribed legally by physicians for medicinal purposes. In this article I’ll focus on testosterone.

One of the most frequently used steroids is testosterone. It is created in a variety of different forms. Some of those most popular are: testosterone enanthate, testosterone cypionate, testosterone propionate, and sustanon. These all have the standard testosterone molecular structure, but vary in the overall structure. Esterification of testosterone is done in order to improve the solubility of testosterone in oil, which in turn slows the release of the testosterone from the site where it enters the body.

Physicians prescribe testosterone in hormone replacement therapy for men over 40, who have reduced circulating testosterone in the blood. The goal of this treatment is to return testosterone to normal levels so that the body can function properly. New research has highlighted that these men have an increased risk of cardiovascular disease if taking testosterone for extended periods of time. Moreover, men who chronically abuse testosterone may experience effects that would seem to be contrary to the hormone’s purpose, including breast development, shrunken testicles, enlarged prostate and infertility.

It has been well established that anabolic steroids (AS) increase muscle size while limiting muscle breakdown. Specifically, testosterone has been shown to increase lean body mass (LBM) and decrease total fat mass. Research shows that injecting testosterone in normal healthy men with doses of 600mg a week, which is the largest dose seen in the literature, will boost muscle size, strength and fat-free mass, especially when combined with strength training (Bhasin et al 1996). In this study subjects taking large doses of testosterone over a 10-week treatment period gained 13.4 pounds of fat free mass. Muscle strength was measured by 1 rep max, in the bench-press and squat. The subjects that received testosterone and exercise increased these by 38% and 22%, respectively. There was no observed occurrence of angry behavior by these subjects nor was there a change in mood when given a Multidimensional Anger Inventory.

Another study was done by a research group in Australia to determine the effects of TE on strength, body composition and health. They found significant increases in arm and rectus femoris circumference compared to a placebo. Furthermore, abdomen skinfold showed significant decreases in the TE group compared to the placebo group after treatment and up to 12 weeks post treatment. Changes to baseline health indicators were reported in some subjects following testosterone usage. These included an average elevation in systolic blood pressure in all TE subjects by 10 mm Hg, a mild increase in hereditary frontal alopecia (hair loss), increased muscle tightness (hamstrings and pectorals), a mild increase in libido over the first two weeks with a subsequent fall to normal, mild acne, subjective changes to personality including an increase in aggression, irritability and positive mood responses.

Numerous studies have looked into the use of testosterone to enhance endurance. Yet, there has not been sufficient evidence to suggest that it can benefit endurance. This component of muscle performance is regulated by other means, which will be discussed in a future article.

The improvement in some of these physiological variables, although impressive, is counterbalanced by possible negative side effects. Testosterone administration will disturb the endogenous production of testosterone and gonadotrophins that may persist for months after drug withdrawal. There are also cardiovascular risk factors which include elevation of blood pressure and depression of serum high-density lipoprotein (HDL)-, HDL2- and HDL3-cholesterol levels. In echocardiographic studies in male athletes, anabolic steroids did not seem to affect cardiac structure and function, although in animal studies these drugs have been observed to exert hazardous effects on heart structure and function. In studies of athletes, AS were not found to damage the liver.

In a laboratory setting, testosterone use has limited results for a number of possible reasons. There are ethical guidelines that must be followed during experiments. This data represents dosages that are high, but not equivalent to that of some bodybuilders or athletes. For example, some users may inject or ingest doses three to five times larger than most research studies can provide (2000-3000mg). The real danger of PEDs occurs with repeated use. It is much more likely to have negative side effects if abused for long periods of time. In addition, because most steroids used by athletes are obtained on the black market, their quality and content cannot be guaranteed.

Sources

1. Bhasin, S., T. W. Storer, N. Berman, C. Callegari, B. Clevenger, J. Phillips, T. J. Bunnell, R. Tricker, A. Shirazi, and R. Casaburi. “The Effects of Supraphysiologic Doses of Testosterone on Muscle Size and Strength in Normal Men.” The New England Journal of Medicine 335, no. 1 (July 4, 1996): 1–7. doi:10.1056/NEJM199607043350101.
2. Deyssig, R., H. Frisch, W. F. Blum, and T. Waldhör. “Effect of Growth Hormone Treatment on Hormonal Parameters, Body Composition and Strength in Athletes.” Acta Endocrinologica 128, no. 4 (April 1993): 313–18.
3. Giorgi, A., R. P. Weatherby, and P. W. Murphy. “Muscular Strength, Body Composition and Health Responses to the Use of Testosterone Enanthate: A Double Blind Study.” Journal of Science and Medicine in Sport / Sports Medicine Australia 2, no. 4 (December 1999): 341–55.
4. Liu, Peter Y., Alison K. Death, and David J. Handelsman. “Androgens and Cardiovascular Disease.” Endocrine Reviews 24, no. 3 (June 2003): 313–40. doi:10.1210/er.2003-0005.
5. Kuipers, H., J. A. Wijnen, F. Hartgens, and S. M. Willems. “Influence of Anabolic Steroids on Body Composition, Blood Pressure, Lipid Profile and Liver Functions in Body Builders.” International Journal of Sports Medicine 12, no. 4 (August 1991): 413–18. doi:10.1055/s-2007-1024704.
6. Hartgens, Fred, and Harm Kuipers. “Effects of Androgenic-Anabolic Steroids in Athletes.” Sports Medicine (Auckland, N.Z.) 34, no. 8 (2004): 513–54.

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