Transcript Drugs and Anabolics

Anabolic Steroids
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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
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> 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
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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
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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)
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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