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terms for synthetic substances related to the
naturally occurring male sex hormone
testosterone
have both muscle building (anabolic) and
masculinizing effects and are therefore used
to enhance athletic performance and
appearance
Illicit use occurs among adolescents and
adults – both male and female athletes and
nonathletes
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One study
◦ 55% of 27 year old male and 10% 24 year old female
body builders use anabolic steroids
◦ More than 1 million Americans have used anabolic
steroids either to improve athletic ability or to
improve personal appearance
◦ 4-12% high school boys have used/abused AAS
(many starting by age 11)
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Juice, Roids, Gym Candy, Pumpers, Stackers,
Balls or Bulls, Weight Trainers, Arnies, A’s or
Anabolics
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Swallowed in tablets or liquid, injected** or
patches
Users take them in patterns called “cycling”
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take them over a specific period of time, stop,
then start taking them again
“stacking” –
◦ Taking different types of steroids in combination
with other drugs
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Highly lipid soluble
◦ Implications:
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Routes of administration
◦ Significant 1st pass metabolism
 Risk for liver
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Promote increased muscle mass and enhance
physical strength
Increase endurance, physical appearance, and
athletic performance
2003 -
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March 2004-
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Androstenedione – Mark McGwire –
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◦ previously undetectable anabolic steroid
tetrahydrogestrinione incited furor in media when high
prof
◦ High profile professional athletes admitted to using this
drug.
◦ FDA classified them as an illegal substance and now
tests are available to detect drug in urine.
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Used to treat delayed puberty
prevention of weight loss in renal failure
Muscle wasting in males with HIV/AIDS
related weight loss.
Repair of severe muscle loss following
trauma,
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T synthesized principally in Leydig cell of testes
Once in bloodstream, T (or the anabolic steroid)
passes through the cell walls of the target tissues
and attaches to steroid receptors in the
cytoplasm of cells
Hormone receptor complex carried into the
nucleus of the cell and then attaches to DNA
(genetic transcription; mRNA produced)
Translation of RNA results in production of new
proteins that leave the cell and mediate
biological functions
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Negative feedback loop
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Effects on negative feedback loop
abnormally high levels of steroids
◦ shut off production of GRF FSH and LH
◦ shut off spermatogenesis
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Cardiovascular
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Increase cardiac risk factors
Hypertension
Increase in ldl/hdl ratio
Increased risk for strokes/cardv event
Hepatic (if taken orally)
◦ Elevated liver enzymes
◦ Liver tumours
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Males
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Decreased T production
Abnormal spermatogenesis
Transient infertility
Testicular atrophy
Females
◦ Altered menstruation
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Increased thyroid function
Immune function (decreased
immunoglobulin)
Premature closure of bony growth centers
Tendon degeneration (so inc risk of tears)
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Males:
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Gynecomastia
Testicular atrophy
Acne
Acceleration of male-pattern baldness
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Clitoral enlargement
Acne
Increased facial/body hair
Coarsening of skin
Male pattern baldness
Deepened voice
Females:
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Severe mood swings
Aggression (?)
Psychotic episodes (?)
Depression
suicideality
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Adolescence –hormonally sensitive
developmental period
◦ Organizational vs activation effects of steroids
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Idiosyncratic in adults
Young males?
◦ “roid rage”
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Animal models
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(Farrell et al 2004)
◦ Male rats given AAS or T (5 days/week for 5 weeks
before began testing) and then 4 more weeks
during testing
◦ Tested in 3 environments
 Home cage
 Neutral cage
 Opponents cage
◦ Tested at three time points
 During AAS treatment
 During AAS withdrawal
 After AAS withdrawal
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AAS exposed males tested with
◦ Low threat (smaller male)
◦ High threat (cage of male w estrus female)
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Aggression toward females
◦ Estrus vs nonestrus females
◦ Provoked vs not
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AAS cocktails
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Differences in AAS
◦ Testosterone – androgenic and anabolic
 Several effects on numerous nt in adolescent brain
 Including 5HT
◦ Stanozolol – high anabolic; low androgenic affinity
 Seems to inhibit androgen-sensitive behaviors
◦ Nandrolone – highest affinity for androgen receptor
 Has both androgenic and anabolic
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Stacking in rodent studies very limited
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AAS treated males displayed aggression in
home cage
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WD from large doses of anabolic steroids can
be accompanied by moderate to severe
depression, fatigue, restlessness, insomnia,
etc, dissatisfaction with body image – suicide
risk
Still – no defined psychiatric wd system have
been described
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Congressional hearings (between 1988-1990)
held to determine the extent of AAS abuse
and whether the Controlled Substances Act
should be amended
◦ the reported adverse medical effects of steroid use,
such as potential liver damage and endocrinological
problems, were not really relevant to the criteria for
scheduling under the Controlled Substances Act
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added anabolic steroids as Schedule III
controlled substances criminalizing nonmedical use
It places steroids in the same legal class as
barbiturates, ketamine and LSD precursors.