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Anabolic Steroids • • • • Steroids vs. anabolic steroids Probably first appeared at 1952/54 Olympics 1976 Olympics - limited steroid testing – 4 days 1980 no athlete tested +ve for steroids but abnormal peaks detected (later identified as unusually high levels of testosterone) – use of natural rather than synthetic hormones. • 1982 Testosterone joined list of banned drugs • 1988 Mass spectrometers reduced time for testing to 24-36 hrs • 2003 Designer steroids (THG), (DMT 2005) Tetrahydrogestrinone (THG) • Designer drug • 19 nor-steroid – substitution of –H for methyl group at position C-19 • Structurally related to gestrinone (used tx of endometriosis) – apparently with addition 4 x H Use in sport • Androgenic (mascularising) effect and anabolic (musclebuilding) effect • Increase erythropoiesis, Hb and Hct • Increase lbm, bone mineral density • Increase muscle strength, power, endurance • Increase glycogen storage • Decrease body fat (increased lipolysis) • Increased neural transmission • Reduced muscle damage and increased pain tolerance • Enhance recovery from training/injury • Increase aggressiveness Saudan et al., 2006 Mechanism of Steroids Steroid biochemical effects • Androgenic: – due to dihydrotestosterone – formed by conversion of testosterone by 5αreductase enzyme – high in testicles, skin, prostate. • Anabolic: – muscles, bone, heart – little 5α-reductase activity – anabolic effects prevail here ie.protein synthesis, erythropoiesis • Anti-catabolic effect – anabolic hormones displace glucocorticoids from receptors • Strength training increases steroid effects:maybe increases number of receptors? • Difficult to hold onto effects when stop training? • Also faster recovery times? – Baume et al., (2006) no evidence in endurance runners on markers of physical stress, or on performance Patterns of Administration • Cycling (6-8 weeks on, 6-8 weeks off) Prevent side-effects • Pyramiding Gradual to peak and then withdraw Fewer mood changes compared to coming right off • Stacking – – – – > 1 steroid at a time, avoid plateauing Increases potency Oral and parenteral routes evidence increased muscle fibre size (Hartgens et al., 2002) Use by athletes • Information sparse; • Bodybuilders – doses range from 250 to 3500mg/week – 40x recommended therapeutic dose • Testosterone, 19-nortestosterone (or precursors), stanozolol, and methandienone are anabolic steroids most frequently found in athlete samples Evidence on strength effects • Freed et al. (1975) greater effect on strength in placebo group, though wt increased in drug treated group. • Ryan (1981) reviewed 37 studies 1968-77. Only good design in 13 – no substantial evidence for increase lbm or muscle strength • Haupt and Rovere (1984) summarised criteria required to increase strength: – Intensive training immediately prior to regime and continue intensive training throughout regime – High protein diet – Query dose ??? Other effects • • • • Aerobic Performance Muscle repair Tendon damage (side effect) Behaviour Side effects • Can divide into categories: CV, hepatic, endocrine/reproductive, psychological, tendon injury • Females – masculinization – body and facial hair, voice changes (irreversible), menstrual disturbances, reduction body fat, cliteromegaly; • Adolescent males – stunting of growth; • Males – gynaecomastia, heart disease, hypertension, liver toxicity, premature baldness, testicular atrophy and reduced fertility; • All – severe acne, liver problems (jaundice), psychological effects, oedema, risk of diabetes • Long term risks • Medical issues associated with anabolic steroids have been questioned – (Hoffman and Ratamess, 2006) 19-noradrosterone in urine • Main urinary metabolite of nandrolone and other 19norsteriod hormones • >2ng/ml +ve finding - numerous +ve tests; • Many undoubtedly due to presence in nutritional supplements – many not labelled as such • 19-nortestosterone present in ‘intact’ boar (cf pig) – ?Advised to avoid meals composed of pig offal in hours preceeding test • Exercise does not seem to be a significant factor • Rarely some urine samples appear to be a suitable medium for metabolites being formed in situ GDR systematic doping • From 1966, hundreds of physicians etc. administered drugs to thousands of athletes (esp women); • Documents – – – – Types of drugs; Times of admin Dosages Performance and side effects • Also systematic talent id for sports schools • Permanent strength effects after critical period GDR systematic doping • Performance improvements within 4 years (women) – – – – – – Shot-put 4.5-5m Discuss 11-20m Javelin 8-15m 400m 4-5s 800m 5-10s 1500m 7-10s • Steps to avoid +ve samples – Tests prior to departure exclusion Franke and Berendonk, 1997 Testosterone Prohormones • Androstenedione, androstenediol, dehydroepiandrosterone (DHEA) • Marketed as testosterone enhancing, and muscle building • However no evidence of anabolic or ergogenic effects in men; • May see effect in older men, or in certain individuals (‘responders’); • Possible that higher doses may have an effect; • Increases serum [estrogen] in men • Increases [testosterone] in women • Widely used despite lack of evidence • Currently no well-accepted technique for detecting prohormone supplement use Brown et al., (2006) Refs • Saudan et al., (2006) Testosterone and doping control. Br J Sports Med 40 (Suppl I):i21-i24 • Franke and Berendonk (1997) Hormonal and androgenization of athletes: a secret program of the German Democratic Republic government. Clin Chem 43(7): 1262 - 1279 • Brown et al., (2006) Testosterone prohormone supplements. Med Sci Sports Exerc 38: (8) 1451 1461