Ergogenic Aids

Anything used to enhance athletic performance:increase exercise capacityenhance physiological processesdepress psychological inhibitionprovide mechanical advantage

Performance Enhancing DrugsAbuses and Consequences

1922 Most Perfectly Developed Man

John McEnroe

Jesse Ventura

Arnold

Florence Joyner

Lyle Alzado

1988 Summer Olympic Games, Ben Johnson tested 1988 Summer Olympic Games, Ben Johnson tested positive for anabolic-androgenic steroid stanozololpositive for anabolic-androgenic steroid stanozolol

Ancient Greece–Early Olympians use mushrooms, herbs, liquor, plant seeds.

Roman Period–Chariot racers drug horses and gladiators doped for vigorous and bloody spectacle.

Vikings –Psychedelic mushrooms

19th Century–Alcohol, caffeine, opium, strychnine, trimethyl

World War II–Amphetamines, testosterone

First Recorded Death Due to Performance Enhancing Drugs - 1886?

Arthur LintonDies of stimulanttrimethyloverdose

Only two Brits have won Bordeaux-Paris, Arthur Linton won in 1886 and Tom Simpson in 1963. Linton overdosed on trimethyl and Simpson died of amphetamines in 1967.

Cycling – Most Doped Sport?

• 1960 Danish cyclist Knut Jensen on amphetamine- powered bicycle dies

• July 13, 1967 British cyclist Tom Simpson dies on Mt. Ventoux– Amphetamines

1998 Tour De France

French team Festina

AmphetaminesEPOAAShGHPrescription drugsNarcotics

Richard Virenque

DOPING

• Dutch doop – Viscous opium juice

• World Anti-Doping Agency (WADA)

• U.S. Anti-Doping Agency (USADA)

“The presence of a prohibited substance or its metabolites or markers in an athlete’s bodily specimen; use or attempted used of a prohibited substance or method; tampering, or attempting to tamper, with any part of doping control; possession of prohibited substances and methods, trafficking in any prohibited substance or prohibited method; administration or attempted administration of a prohibited substance or prohibited method to any athlete, assisting, encouraging, aiding, abetting, covering up or any other type of complicity involving an anti-doping rule violation or any attempted violation”

DOPING• Withdrawing and saving red

blood cells for later re-infusion

• Later the term was used to describe taking Erythropoietin

• Generic term to describe any illegal performance- enhancing drug

Dr. Bjorn Ekblominvented “blood packing”in 1972

1860’s – Amsterdam swimmers take speedballs – mix of heroin and cocaine.

1904 - Marathoner Thomas Hicks dies at Olympics – “stimulating strychnine and courage-inspiring brandy”

1935 - Testosterone was first synthesized, and German soldiers were reportedly using it to perform better and to become more aggressive.

1950’s – During the 1952 Olympics the Russian weightlifting team won the gold medal due to synthetic steroid use.

History of Doping in Sport

Historical ControversyThe controversy surrounding steroids began in the 1950’s during the Olympic Games when the athletic community discovered that athletes from Russia and some East European nations, which had dominated the games, had taken large doses of steroids. It became evident that they had not been "healthy" due to the fact that many of the male athletes developed such large prostate glands that they needed a tube inserted in order to urinate. The females of these nations had developed so many male characteristics that chromosome tests were needed to prove that they were still female.

1950’s (cont) – A U.S. pharmaceutical firm develops the first anabolic steroids.

1952 Amphetamine-related illnesses of speed skaters in Olympics in Oslo, Norway

1968 Olympic drug testing begins in Mexico City

1975 – The International Olympic Committee officially bans the use of steroids, just prior to 1976 Montreal Games

1976 Olympics

East German Swimmers won 11 out of 13Olympic events.

In 1990 it emerges that they had been on an organized drug program

Newer agents–Erythropoietin (EPO)

–Growth hormone (hGH)

–Tetrahydrogestrinone (THG)

Avoiding Detection

Weightlifters Machine

1992• German sprinters Katrin Krabbe, Silke Muller

and Grit Breuer submit identical urine samples

Later suspended for + clenbuterol test

Scientific Milestones becoming Sports Millstone

Perfluorocarbon (PFC)–Synthetic blood

–Enormous O2 carrying capacity

–X-country skiers and skaters in Nagano?

Future Performance Enhancing Techniques?

Myostatin Inhibitors?

Flex Wheeler

Belgian Blue Cow

Myostatin knock-out mouse

Insulin-Like Growth Factor – 1 (IGF-I)

Detection of Illegal “Nutrition”Random drug tests during competition

(forces athletes to become more sophisticated in use)Unannounced drug tests year-roundLie detectors

1. Steroids – Derivatives of Testosterone*Banned by the NCAA and IOC*Illegal to use outside of physician supervision and dosing recommendations

A. Anabolic: “to build”-accelerated growth of bone, muscle, red cells, and enhanced neural conduction

B. Androgenic: “produce male-like traits”

C. Do they work?

-How they work:

Promote Anabolism:Intracellular androgen receptors bind to nuclear chromatin to

activate ribonucleic acid-polymerase system

Heavy resistance training is required for beneficial effects

Prevent Catabolism:cross binding with glucocorticoid receptors interferes with

glucocorticoid receptor-activated catabolism

faster recovery time *May also decrease fat mass and increase use of fat for energy

How Steroids Work

• Exert actions inside cells

• Binds to androgen receptors inside the cell

• Influences gene transcription and translation to enhance protein production

Psychological Effects

• Increased sense of well-being• Irritability• Mania• Depression• Euphoria• Aggressiveness• Enhanced pain tolerance • Sexual arousal• Suicidality

Side Effects

• There really aren’t any…

– Med Sci Sport Exerc 38(9); 1578, 2006

– Future predictors of AAS use• Alcohol use• Power sports

• Side effects are real and potentially very severe

– J Phys Act Health 2; 460, 2005

Side Effects

Elevated LDH Prostatic hypertrophyElevated blood pressure Prostate cancerEdema Risk of AIDS/HepAccelerated clotting immune function cholesterol, TG, and LDL Irregular Heart BeatsDepressed HDL GI distressElevated blood glucose Muscle cramps/spasmsPsychosis Increased nervous tensionAltered electrolyte balance NosebleedsDecreased spermatogenesis Clitoral enlargementLowered testosterone levels Lowered voiceLH and FSH production AcneIncreased urine production Sore nipplesAltered Libido Increased aggressivenessPremature closure of epiphyses Decreased sperm countAIDS/HIV or TB Cancer

Side Effects

• Cardiovascular– Elevates “bad” LDL cholesterol– Elevates blood pressure – Promotes blood clots– Left ventricular hypertrophy– Cardiac arrhythmia*Operative Risk

Side Effects

• Hepatic – Elevated liver enzymes

• Alanine and aspartate aminotransferases– Formation of blood filled cysts

• Peliosis hepatis– Liver cancer: hepatocellular carcinoma– Impaired bile flow: cholestasis

*Orally administered steroids

Side Effects

• Dermatologic– Acne: propionibacteria acnes– Hair loss: alopecia– Excessive hair growth: hirsutism– Stretch marks: striae

Side Effects• Endocrine/Reproductive

– Men• Libido changes• Testicular atrophy• Impotence• Prostatic hypertrophy

– Women• Masculinization• Menstrual irregularities• Reduced breast size• Clitoral enlargement

Side Effects

• Behavioral– Depression– Mania– Psychosis– Aggression– Withdrawal syndrome

• Fatigue• Depression• Reduced libido• Craving next cycle

Derrick WhitsettDied Jan 2004

Sonny Schmidt – Died at 509 years after being Master’s Olympia Champion

Detecting Steroid Use

Detecting Steroid Use• Appearance

– Muscular hypertrophy– Gynecomastia

• Skin– Acne, stretch marks, needle marks, baldness

• Behavioral changes

*enlarged nipples

2. Human Chorionic GonadotropinUsed to boost endogenous testosterone and prevent muscle loss after steroid use.

*anabolic adjunct – mimics leuteinizing hormone to stimulate testosterone

(Pregnancy test)

Some reports that HCG may aid in weight loss…

3. Human Growth Hormone hGHincreases lean body mass primarily by hyperplasia and facilitated AA transport into cells

-hGH persistently stimulates IGF-1 -reduces fat mass (perhaps by stimulating lipolysis)

side effects:-incorrect usage/dosage-Stimulates the growth of all tissues, not just muscle (including internal organs; resembles

acromegaly)-Left ventricular hypertrophy w/ SV

-Swollen feet and ankles, joint pain, carpal tunnel syndrome, -Development of a diabetic or prediabetic condition

4. “Androgens”Androstenedione and Dehydroepiandrosterone: weak adrenal androgens

1600 mg/day 30% decline in fat mass

300 mg/day increases serum testosterone

Eight Research Findings - Androgens Little or no elevation of plasma testosterone concentrations No favorable effect on muscle mass No favorable effect on muscular performance No favorable alterations in body composition Elevates a variety of estrogen subfractions No favorable effects on muscle protein synthesis or tissue anabolism Impairs the blood lipid profile in apparently healthy men Increases likelihood of testing positive for steroid use

5. Insulin

• Promotes anabolism and stimulates IGFs

*risks hypoglycemic shock

6. ClenbuterolBeta- adrenoceptor 2 agonist, central stimulant, stimulates protein anabolism, and acts as a thermogen.

endurance athletes

serious side effects: MI, cardiomegally, anorexia, and insomnia.

7. HMBbeta-hydroxy-beta-methylbutyrate: amino acid metabolite

•may boost muscle mass and strength•may decrease protein loss during stress by inhibiting protein catabolism •increases fatty acid oxidation

•The mechanism for HMB’s action on muscle metabolism, strength improvement, and body composition remains unknown.

8. Creatine Monohydrate

- increases power output

ATP ADP + Pi + Energy

ADP + CP ATP

Supplemental creatine increases muscle CP content by 20%

20 g/day for first 6 days

2g/day for up to 28 days

-Can be derived from protein in foods (but not in same quantity)-Doesn’t improve endurance, strength, or power, not an anabolic, and doesn’t improve lactate tolerance-Can improve short-term high-intensity repetitive exercise, best for improving

“burst-type, phasic activity”

-body building

-skating

-sprints

-basketball

-Significant increases in body weight and muscle

cross-sectional area.

*potent placebo effect

Risks? No long term studies yet

Muscle cramps

Diarrhea

Nausea

Weight gain

Renal function?

9. Amphetaminespsychotropic drugs that mask fatigue

do not have a pure physiological effect, mainly improve reaction time and stamina in fatigued states (mostly animal studies).

Side effects: numerous deaths in sport are ascribed to amphetamines.

arrhythmias hypertension anginahypothermia hallucinations aggressiveness

• 1960 Danish cyclist Knut Jensen on amphetamine- powered bicycle dies

• July 13, 1967 British cyclist Tom Simpson dies on Mt. Ventoux

– Amphetamines

http://www.youtube.com/watch?v=YtAyGvZqiwk

10. CaffeineStimulant that increases lipid mobilization and utilization

prolongs endurance by increasing fat utilization and reducing COH

may increase speed of muscle contraction

IOC limits caffeine (4-7 cups of coffee 30 min prior to ex)

600-800 mg

*Effectiveness is reduced as use of caffeine increases

Warnings about Caffeine Effects become less apparent when

someone:

-Consumes a high-carbohydrate diet

-Uses caffeine habitually Can cause restlessness, headaches,

insomnia, nervous irritability, muscle twitching, tremulousness, psychomotor agitation, and elevated heart rate and blood pressure and trigger premature left ventricular contractions

Acts as a diuretic

11. BuffersPrevent metabolic and lactate acidosis

sodium bicarbonatesodium citrate

*diuresis and gas (extreme gi distress in 50% of users)

12. Anti-Cortisol Compoundsreduce protein breakdown by inhibiting cortisol release.

PhosphatidylserineGlutamine

13. COH LoadingProlongs endurance performanceImproves training timePrevents use of protein for energy“Supercompensation” after COH depletion

-increased water retention-gi problems-compromised training during depletion phase

14. B Vitamin Loading

Folate, B-6 and B-12 for muscle buildingNiacin, Riboflavin and Thiamin for endurance performance

15. Amino Acid SupplementsProtein ShakesMay help prevent catabolism after a hard workout…Conflicting Reports?

16. L-CarnitineCarnitine levels correlate well with use of lipids as energy source during exercise.May improve endurance performance (~6%)Beware of racemic mixtures (D,L-Carnitine) D-Carnitine

causes muscle cramps and weakness.

17. Chromium May decrease body fat, increase lean mass and reduce LDLEffect is marginal at best

-some studies show placebo works better-some studies show increased muscle mass without increased strength

Competes for iron and zinc binding proteins in gi tract

18. Ephedra/Ephedrine/Ma HuangSympathomimetic, alpha and beta receptor agonist -increases metabolic rate  -may enhance mobilization of fats, and suppress appetite -not an ergogenic aid -Risks: Sudden death, Tachycardia, PVC, intracerebral hemorrhage, Increased BP

other vascular events

19. Blood Doping: 2 waysAutologous RBC’s or Exogenous Erythropoietin

 Improves O2 carrying capacityCan improve VO2 maxincreases viscosity of the blood (increased work of heart)

Erythropoietin: hormone that stimulates RBC production-side effects: hypertension, stroke, heart failure, seizures