Performance Enhancing Performance Enhancing SubstancesSubstances

Ergogenic Aid – any substance, process, Ergogenic Aid – any substance, process, or procedure which may enhance or procedure which may enhance performance through improved speed, performance through improved speed, strength, response time, or endurancestrength, response time, or endurance

Can be physical and chemicalCan be physical and chemical

The Desire to WinThe Desire to Win

A 1997 SI survey of elite US athletes asked A 1997 SI survey of elite US athletes asked whether they would take an illegal drug that whether they would take an illegal drug that guaranteed an Olympic gold medalguaranteed an Olympic gold medal

- 195 of 198 athletes would take illegal - 195 of 198 athletes would take illegal drug if assured of not being caughtdrug if assured of not being caught

- 50% would take illegal drug even if side - 50% would take illegal drug even if side effects were lethal in 5 yearseffects were lethal in 5 years

Ancient Greeks ate mushroomsAncient Greeks ate mushrooms Aztec athletes ate human heartAztec athletes ate human heart 18001800’’s – European cyclists took heroin and s – European cyclists took heroin and

cocainecocaine 1904 Olympic marathon winner took strychnine 1904 Olympic marathon winner took strychnine

and brandy during the raceand brandy during the race 1920 Olympic 100 champ – drank sherry and 1920 Olympic 100 champ – drank sherry and

raw eggraw egg 1960 Olympics, 1967 Tour De France deaths 1960 Olympics, 1967 Tour De France deaths

from amphetaminesfrom amphetamines

Tom Simpson – amphetamines and alcohol, a Tom Simpson – amphetamines and alcohol, a lethal diuretic combinationlethal diuretic combinationHe reportedly was quoted as saying “If ten pills will kill me, I will take nine”.He reportedly was quoted as saying “If ten pills will kill me, I will take nine”.

- - ““ErgogenicErgogenic”” – Greek word means – Greek word means ““to make worto make workk””

-1889 – Dr. Brown-Sequard injects himself with -1889 – Dr. Brown-Sequard injects himself with extract from dog and guinea pig testiclesextract from dog and guinea pig testicles

- 1905 – hormones discovered1905 – hormones discovered- 1935 – testosterone isolated1935 – testosterone isolated- 19501950’’s – Russian weight lifters receiving s – Russian weight lifters receiving

injectionsinjections- US physicians develop Dianabol to keep pace US physicians develop Dianabol to keep pace

with the Russians – Dr. John Ziegler with the Russians – Dr. John Ziegler ““the the Godfather of SteroidsGodfather of Steroids””

- 1959 – first case of HS athlete taking steroids1959 – first case of HS athlete taking steroids

19601960’’s IOC banned steroid use and testing beginss IOC banned steroid use and testing begins U.S. Cycling team publicly admitted blood dopingU.S. Cycling team publicly admitted blood doping 2000 Olympics2000 Olympics

- 27 Chinese athletes removed from team- 27 Chinese athletes removed from team

- Bulgarian and Romanian weight lifting - Bulgarian and Romanian weight lifting teams expelledteams expelled

- USATF – alleged more than 12 positive - USATF – alleged more than 12 positive tests not reported during the previous 2 yearstests not reported during the previous 2 years

WADAWADA

World Anti-Doping AgencyWorld Anti-Doping Agency Established 11/10/99Established 11/10/99 Prohibited List – once a substance or Prohibited List – once a substance or

method is prohibited, it becomes method is prohibited, it becomes unequivocal, and there is no grey zone unequivocal, and there is no grey zone for the athlete or physician.for the athlete or physician.

SteroidsSteroids

Encompass a wide variety of useful chemicals Encompass a wide variety of useful chemicals and hormonesand hormones1. Estrogens and progesterone in birth control 1. Estrogens and progesterone in birth control pillspills2. Cortisone and prednisone for muscle injury 2. Cortisone and prednisone for muscle injury and asthmaand asthma3. Anabolic steroids for men with low hormone 3. Anabolic steroids for men with low hormone levels, delayed puberty, and body wasting levels, delayed puberty, and body wasting diseases. Used to treat hypogonadism – diseases. Used to treat hypogonadism – condition in which the testes produce low condition in which the testes produce low testosterone levels.testosterone levels.

Common Anabolic Common Anabolic Androgenic Steroids Androgenic Steroids

Testosterone

O

OH

Nandrolone Ester(R = CH3(CH2)8CO)

O

OR

Oxymetholone (androle)

O

OH

Methandrostenolone(dianabol)

O

OH

Androstenedione(Andro)

O

O

O

Oxandrolone

O

OH

Lacks methyl group

H

CH3

HO

Ester as prodrug

H H H

H HH

H H H

H HH

CH3

The “Designer” SteroidThe “Designer” Steroid

• Effective anabolic steroids which Effective anabolic steroids which can not be detected in routine can not be detected in routine doping testsdoping tests

• They are designed to remain They are designed to remain unknown to the testersunknown to the testers

• The Clear – designed by Patrick The Clear – designed by Patrick Arnold for BALCO (Bay Area Lab Co-Arnold for BALCO (Bay Area Lab Co-operative)operative)

• Used by Marion Jones and Jason Used by Marion Jones and Jason GiambiGiambi

• A U.S. sprint coach delivered a syringe A U.S. sprint coach delivered a syringe of the Clear t the USADAof the Clear t the USADA

Androgenic = masculizingAndrogenic = masculizing

The primary androgen is The primary androgen is TESTOSTERONETESTOSTERONE

Anabolic = tissue buildingAnabolic = tissue building

http://www.youtube.com/watch?v=mdJ7HZqD8p8http://www.youtube.com/watch?v=mdJ7HZqD8p8

Routes of AdministrationRoutes of Administration

Orally - by mouth as a form of a pill Orally - by mouth as a form of a pill Injection - injected to the muscle by a Injection - injected to the muscle by a

needle- intramuscularly (Users of needle- intramuscularly (Users of steroids who shares needles are at a risk steroids who shares needles are at a risk for serious infections such as Hepatitis A for serious infections such as Hepatitis A or B and HIV, the AIDS virus)or B and HIV, the AIDS virus)

Cream or gel - rub on to the muscle area Cream or gel - rub on to the muscle area to where you want to enhance. to where you want to enhance.

Why Abuse Anabolic Why Abuse Anabolic Steroids?Steroids?

1.1. Improve athletic performanceImprove athletic performance

2.2. To gain muscle mass and/or reduce body fat for To gain muscle mass and/or reduce body fat for desired physical appearancedesired physical appearance

3.3. Reduce recovery time between periods of strenuous Reduce recovery time between periods of strenuous activityactivity

4.4. No proven effect on endurance or staminaNo proven effect on endurance or stamina

http://www.youtube.com/watch?v=5mxjefR-vdIhttp://www.youtube.com/watch?v=5mxjefR-vdI

Results of Unnatural Results of Unnatural Anabolic Steroid UseAnabolic Steroid Use

In Women:In Women:

1. increased muscularity1. increased muscularity

2. decreased body fat2. decreased body fat

3. deepening of voice 3. deepening of voice

4. increased facial hair 4. increased facial hair

5. male-pattern balding5. male-pattern balding

6. enlargement of 6. enlargement of clitorisclitoris

In Men:In Men:1. decreased production 1. decreased production of naturally occurring of naturally occurring testosteronetestosterone2. gynecomastia – 2. gynecomastia – breast developmentbreast development3. testicular atrophy3. testicular atrophy4. sterility4. sterility5. prostate hypertrophy5. prostate hypertrophy6. accelerated puberty 6. accelerated puberty in kidsin kids

Side Effects in Both Sexes:Side Effects in Both Sexes:1. increase size/mass of muscle1. increase size/mass of muscle2. acne, increased body hair or baldness2. acne, increased body hair or baldness3. premature growth plate closure3. premature growth plate closure4. liver and kidney problems4. liver and kidney problems5. increased cholesterol and triglycerides5. increased cholesterol and triglycerides

6. hypertension, atherosclerosis, blood clotting6. hypertension, atherosclerosis, blood clotting7. possible liver cancer7. possible liver cancer

8. tendon damage8. tendon damage

..

Anabolic Steroid abusers may take 10 – Anabolic Steroid abusers may take 10 – 100 times higher doses than the doses 100 times higher doses than the doses used for medical conditionsused for medical conditions

StackingStacking – taking 2 or more different – taking 2 or more different steroidssteroids

Who was Lyle Alzado?Who was Lyle Alzado?

- $30,000/year on steroids - $30,000/year on steroids and growth hormoneand growth hormone- 1991 diagnosed with brain1991 diagnosed with brain cancercancer- - In his account to Sports Illustrated, Alzado said he began taking anabolic In his account to Sports Illustrated, Alzado said he began taking anabolic

steroids in college in 1969 and never stopped. "It wasn't worth it," Alzado wrote. steroids in college in 1969 and never stopped. "It wasn't worth it," Alzado wrote. "If you're on steroids or human growth hormone, stop. I should have.""If you're on steroids or human growth hormone, stop. I should have."

After receiving a radical chemotherapy treatment and contracting pneumonia, After receiving a radical chemotherapy treatment and contracting pneumonia, Alzado died on May 14, 1992 at his home in Portland, Ore. The official cause of Alzado died on May 14, 1992 at his home in Portland, Ore. The official cause of death was complications from brain cancer.death was complications from brain cancer.

Human Growth Hormone Human Growth Hormone (hGH)(hGH)

A protein produced by the pituitary glandA protein produced by the pituitary gland Levels rise after exercise, trauma, sleepLevels rise after exercise, trauma, sleep Production peaks at puberty, declines at middle ageProduction peaks at puberty, declines at middle age Increases muscle size but not proportional strengthIncreases muscle size but not proportional strength Increases strength/size of connective tissue, tendons, Increases strength/size of connective tissue, tendons,

and ligamentsand ligaments Cannot detect in urineCannot detect in urine Very expensive – 1 yr supply for hormone deficient Very expensive – 1 yr supply for hormone deficient

patients = $13,000patients = $13,000

Study of volunteersStudy of volunteers 303 received GH injections303 received GH injections 137 received placebos137 received placebos Daily injections for 20 daysDaily injections for 20 days Lean body mass increased on average by 4.6 Lean body mass increased on average by 4.6

pounds (those that received injections)pounds (those that received injections) However, no measurable increase in strength or However, no measurable increase in strength or

exercise capacityexercise capacity Subjects getting GH – fluid retention and increased Subjects getting GH – fluid retention and increased

fatigue than placebo groupfatigue than placebo group

Excessive hGH secretion:Excessive hGH secretion:

During childhood = During childhood = gigantismgigantism – person is – person is abnormally tallabnormally tall

After puberty = After puberty = acromegalyacromegaly – disease – disease characterized by characterized by widening of bones, widening of bones, arthritis, organ arthritis, organ enlargementenlargement

https://www.youtube.com/watch?v=Ebhf1qKVA9Ahttps://www.youtube.com/watch?v=Ebhf1qKVA9A

Signs of hGH use:Signs of hGH use:

Increase size/mass Increase size/mass of facial bones, of facial bones, especially jaw bonesespecially jaw bones

Space between teethSpace between teeth Increase size of Increase size of

hands and feethands and feet

Blood DopingBlood Doping

Athletes are reinfused with their own Red Athletes are reinfused with their own Red Blood Cells (RBCBlood Cells (RBC’’s) or someone elses) or someone else’’s to s to temporarily increase the quantity of temporarily increase the quantity of RBCRBC’’s in the body and therefore the s in the body and therefore the oxygen carrying capacity of the blood.oxygen carrying capacity of the blood.

Erythropoietin – stimulates production of Erythropoietin – stimulates production of new RBCnew RBC’’s, naturally produced in s, naturally produced in kidneyskidneys

Ergogenic Effect = increased oxygen Ergogenic Effect = increased oxygen carrying capacity of blood due to carrying capacity of blood due to increased RBCincreased RBC’’ss

Side Effects:Side Effects:

- thickness of blood- thickness of blood

- increase risk of stroke, heart attack, - increase risk of stroke, heart attack, blood clotsblood clots

Hematocrit – measurement of the Hematocrit – measurement of the percentage of packed RBCpercentage of packed RBC’’s in a whole s in a whole blood sample blood sample

USADA – October 10, 2012:USADA – October 10, 2012:‘‘The evidence shows beyond any doubt that The evidence shows beyond any doubt that the US Postal Service Pro Cycling Team ran the the US Postal Service Pro Cycling Team ran the most sophisticated, professionalised and most sophisticated, professionalised and successful doping program that sport has ever successful doping program that sport has ever seen.seen.””

https://www.youtube.com/watch?v=G7KZxIR1t-ohttps://www.youtube.com/watch?v=G7KZxIR1t-o

Herbal SupplementsHerbal Supplements

Contain plant or plant partsContain plant or plant parts Have not been scientifically scrutinizedHave not been scientifically scrutinized Why? Do not have to get approval from Why? Do not have to get approval from

the Food and Drug Administration (FDA)the Food and Drug Administration (FDA) Examples of claims:Examples of claims:Echinacea to prevent colds. Ginkgo to improve memory. Flaxseed to Echinacea to prevent colds. Ginkgo to improve memory. Flaxseed to

lower cholesterollower cholesterol

Are they safe?Are they safe? Categorized as Dietary SupplementsCategorized as Dietary Supplements

Do not need FDA approvalDo not need FDA approval Must follow good manufacturing practicesMust follow good manufacturing practices FDA is responsible for monitoring safety once on the marketFDA is responsible for monitoring safety once on the market

The FDA requires that the following information be included on the labels of all herbal The FDA requires that the following information be included on the labels of all herbal supplements:supplements: The name of the herbal supplementThe name of the herbal supplement The name and address of manufacturer or distributorThe name and address of manufacturer or distributor A complete list of ingredients — either in the Supplement Facts panel or listed beneath itA complete list of ingredients — either in the Supplement Facts panel or listed beneath it Serving size, amount and active ingredientServing size, amount and active ingredient

THESE RULES DO NOT GAURANTEE THAT HERBAL THESE RULES DO NOT GAURANTEE THAT HERBAL SUPPLEMENTS ARE SAFESUPPLEMENTS ARE SAFE

According to the market report the top According to the market report the top 10 best selling herbs in 2011 were, in 10 best selling herbs in 2011 were, in rank order:rank order:

CranberryCranberry Saw palmettoSaw palmetto SoySoy GarlicGarlic GingkoGingko EchinaceaEchinacea Milk thistleMilk thistle Black cohoshBlack cohosh St. John's WortSt. John's Wort GinsengGinseng

StimulantsStimulants Amphetamines:Amphetamines:

AdderallAdderall

RitalinRitalin

EphedrineEphedrine CaffeineCaffeine

Jason Grimsely revealed to federal investigators that amphetamines Jason Grimsely revealed to federal investigators that amphetamines

were readily available in clubhouses.were readily available in clubhouses.

““greeniesgreenies”” - - ““as an antidote for everything from hangovers to garden-variety as an antidote for everything from hangovers to garden-variety fatigue.fatigue.””

During the Pittsburgh drug trials in the mid-During the Pittsburgh drug trials in the mid-1980s, outfielder John Milner testified that 1980s, outfielder John Milner testified that Willie Mays introduced him to a liquid Willie Mays introduced him to a liquid amphetamine known as "red juice." More than amphetamine known as "red juice." More than a decade later, Tony Gwynn spoke of rampant a decade later, Tony Gwynn spoke of rampant amphetamine use in the game, and David amphetamine use in the game, and David Wells referred to greenies in his book, "Perfect Wells referred to greenies in his book, "Perfect I'm Not: Boomer on Beer, Brawls, Backaches, I'm Not: Boomer on Beer, Brawls, Backaches, and Baseball." and Baseball."

Amphetamines have become as much a part of Amphetamines have become as much a part of the clubhouse scene as card games and hot the clubhouse scene as card games and hot feet. In a Kansas City Star story, former Royals feet. In a Kansas City Star story, former Royals outfielder Brian McRae recalled how there outfielder Brian McRae recalled how there were always two pots of coffee brewing in the were always two pots of coffee brewing in the clubhouse -- one conventional and the other clubhouse -- one conventional and the other laced with stimulants. "I had to make sure I got laced with stimulants. "I had to make sure I got the unleaded," McRae said. the unleaded," McRae said.

Why Amphetamines?Why Amphetamines?

Stimulative Effects:Stimulative Effects: WakefullnessWakefullness AlertnessAlertness Decreased sense of fatigueDecreased sense of fatigue Decreased appetiteDecreased appetite

Acute side effects include:Acute side effects include:

Increased heart rate, Increased blood pressure, Reduced appetite and weight loss, Increased heart rate, Increased blood pressure, Reduced appetite and weight loss, Insomnia, Headaches, Convulsions, Hallucinations and paranoia. Death may also Insomnia, Headaches, Convulsions, Hallucinations and paranoia. Death may also occur due to ruptured blood vessels in the brain, heart attacks, heart rhythm occur due to ruptured blood vessels in the brain, heart attacks, heart rhythm abnormalities and heatstrokeabnormalities and heatstroke

Can be detected for 2-4 days in urineCan be detected for 2-4 days in urine

Who can use Amphetamines?Who can use Amphetamines?

Fighter pilotsFighter pilots ““Go pills” – DexidrineGo pills” – Dexidrine The military says use is The military says use is

voluntary and pilots may voluntary and pilots may refuse themrefuse them

CaffeineCaffeine

-- increases time to fatigueincreases time to fatigue

- likely beneficial to endurance - likely beneficial to endurance

- no real strength/power benefit- no real strength/power benefit

Doses:Doses:

2-5 mg/kg effective2-5 mg/kg effective

250-500 mg250-500 mg

Cola: 40mg, Coffee: 100mg, Tea: 20-100mg, Red Bull: 115mgCola: 40mg, Coffee: 100mg, Tea: 20-100mg, Red Bull: 115mg

Ephedra (Ma Huang)Ephedra (Ma Huang)

Increases alertness and euphoriaIncreases alertness and euphoria Often stacked with other stimulants such Often stacked with other stimulants such

as caffeineas caffeine Decreased sense of fatigue Decreased sense of fatigue

Side Effects:Side Effects:

- dehydration- dehydration

- loss of thermal autoregulation- loss of thermal autoregulation

- tachycardia – rapid heartbeat- tachycardia – rapid heartbeat

- heat exhaustion and heat stroke- heat exhaustion and heat stroke

FDA banned sale of ephedra containing supplements on FDA banned sale of ephedra containing supplements on 4/12/044/12/04

Currently banned by the IOC, WADA, NFL, NBACurrently banned by the IOC, WADA, NFL, NBA

Linked to recent deaths:Linked to recent deaths:

- Steve Bechler – Balt. Orioles pitcher- Steve Bechler – Balt. Orioles pitcher

heat stroke temp 108 degreesheat stroke temp 108 degreesUsing ephedra and did not eat for 2 daysUsing ephedra and did not eat for 2 days

- Cory Stringer – Minnesota Vikings- Cory Stringer – Minnesota Vikingswas using Ripped Fuel – contains ephedrawas using Ripped Fuel – contains ephedra

- Implicated in a - Implicated in a ““friendly firefriendly fire”” incident in incident in Afganistan. As of October 2007, on list of Afganistan. As of October 2007, on list of banned substances for the militarybanned substances for the military

CreatineCreatine First used in 1992 by British sprintersFirst used in 1992 by British sprinters Ergogenic Effect:Ergogenic Effect:

increase resting levels of creatine phosphate so as to increase resting levels of creatine phosphate so as to regenerate more ATP and delay fatigueregenerate more ATP and delay fatigue

Synthesized by liver and pancreasSynthesized by liver and pancreas Dietary sources – meats and fishDietary sources – meats and fish 95% stored in skeletal muscle95% stored in skeletal muscle

- Other than a small weight gain (muscle, water?), seems to Other than a small weight gain (muscle, water?), seems to be few short term side effects other than dehydration and be few short term side effects other than dehydration and crampingcramping

- Questions remain regarding long term effect on muscles Questions remain regarding long term effect on muscles (heart) and kidneys (Anecdotal)(heart) and kidneys (Anecdotal)

Steroid Precursors (Prohormones)Steroid Precursors (Prohormones)

Androstendione (Androstendione (““AndroAndro””))

a potent anabolic-androgenic steroid produced by a potent anabolic-androgenic steroid produced by the adrenal glands and gonadsthe adrenal glands and gonads

Converted by the body into testosterone or estroneConverted by the body into testosterone or estrone DHEADHEA

a weak androgen produced by the adrenal cortexa weak androgen produced by the adrenal cortex

converted to androstendione and then converted to androstendione and then testosteronetestosterone

Adverse EffectsAdverse Effects

Potential male gynecomastiaPotential male gynecomastia Decrease in natural testosterone production Decrease in natural testosterone production

over timeover time

Gregg ValentinoGregg Valentino

http://www.youtube.com/watch?http://www.youtube.com/watch?v=oYlNfvwFN_Iv=oYlNfvwFN_I

http://www.youtube.com/watch?http://www.youtube.com/watch?v=58K_JzRQpRUv=58K_JzRQpRU

http://www.youtube.com/watch?http://www.youtube.com/watch?v=UPwhAMD1He8v=UPwhAMD1He8

http://www.youtube.com/watch?http://www.youtube.com/watch?v=SPcvuPHhIfwv=SPcvuPHhIfw