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 (muscle-

building) 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 5α-

reductase 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

• PyramidingGradual to peak and then withdrawFewer 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 19-norsteriod 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