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This paper was an assignment for a course in my final
year (1991) of Physical Education at the University of
British Columbia, Canada. References and a
Bibliography can be found at the end. Hopefully this
paper appears relatively objective and is of some help
to its readers. This is also my first submission to
Compuserve and hopefully not my last. Thoughtful
open-minded comments about previous experiences
and further questions are welcomed through
Compuserve mail, confidentiality will be strictly
respected. Address mail to: Paul Baker, Compuserve
-70711,3266.
INTRODUCTION
Since Ben Johnson tested positive for
Anabolic-Androgenic steroids at the 1988 Summer
Olympic games, the use of Anabolic-Androgenic
Steroids in the many varied fields of athletics has
become one of the great sports performance topics of
recent years. In this paper I will cover some of the
more popular topics that have been raised in regard to
Anabolic-Androgenic Steroids. I will first attempt to
give a brief history of Anabolic-Androgenic Steroids
concerning their discovery and their initial uses. This
will then be followed by a brief description of
Testosterone synthesis and metabolism in the body.
The largest topic to be covered in this paper will be
the side effects associated with Anabolic-Androgenic
Steroids including: medical uses, positive athletic
uses, negative physiological side effects, and the
psychological side effects. A particular emphasis will
be placed on the Psychological side effects of
Anabolic-Androgenic Steroids as current research has
indicated that the effect of Anabolic-Androgenic
Steroids on the mind may be significant. An
overview of the current drug testing methods used by
the International Olympic Committee will follow the
section on side effects. This section on drug testing
will lead to an overview of the current trends and
practices athletes are using to escape detection in the
drug tests. This paper covers a broad array of topics
in the study of Anabolic-Androgenic Steroids, and I
hardly intend this to be an entirely comprehensive
study of all of the research done in these areas.
What I have done is intended to give an overview of
some current research in these areas mixed in with
some of the common athlete's beliefs/myths and
glued it together with a little bit of practical
experience.
A Brief History of Anabolic-Androgenic Steroids:
Since testosterone was first chemically
characterized in 1935 more than one thousand
derivative of testosterone have been synthesized,
known as Anabolic-Androgenic Steroids.1
Testosterone and Anabolic-Androgenic Steroids have
been used for a variety of treatments in human and
veterinary medicine, animal husbandry, and most
recently athletics. The first chemical preparations of
testosterone were made available in 1937, and were
initially used in the treatment of involutional
psychoses, melancholia, and depression.2 (This
initial use of Anabolic-Androgenic Steroids is of some
interest due to recent research that has also indicated
an association between Anabolic-Androgenic Steroids
and certain aggressive/psychotic mental illnesses.)
The first use of Anabolic-Androgenic Steroids steroids
as a "performance" enhancing substance was not in
the area
of athletics but during the Second World War when it
was reported that the German SS troops were given
injections of testosterone to increase their
aggressiveness. The first time Anabolic-Androgenic
Steroids were believed to be used in the International
sports arena was to be in the 1950's by Russian
Athletes as was described in the following
observation by Dr. John B. Ziegler:
"The first time I was exposed to anabolic steroid use
was during the 1956 World games. The Russians
were using straight testosterone. What caught my
attention was the young athletes having to get
catheterized, which is a tube they insert into the
urinary tract so they can urinate. This procedure is
usually used for old men who have prostrate trouble.
The Russians were abusing the drugs heavily."3
Shortly after his observation of this new form
of Russian "cheating" Dr. Ziegler returned to the
United States where he joined with Ciba
Pharmaceuticals to create "Dianabol"
(methandrostanolone), the first Anabolic-Androgenic
Steroids. At the time it Dr. Ziegler truly felt it was his
patriotic duty to "help" the American athletes defeat
the Russians in the international sports arena, this
was also the time of the "Cold War." It has also
been reported that as early as the 1950's Anabolic-
Androgenic Steroids use by BodyBuilders and Weight
athletes was beginning to evolve, primarily in
California.4,5 By his own account Dr. Ziegler soon
found out what the athlete's response to this new
ergogenic aid would be:
"I gave them very low dosages (5mg.). A short while
later, I found out they were taking far in excess of
this behind my back and developing all sorts of
medical pathologies. I wanted nothing to do with
IQ's of this level, so I discontinued this area of my
experimentation. The athletes got their hands on the
drugs in the 1960's and in just fifteen to twenty-five
years have turned it into one big mess."6
In a study conducted during the 1972 Olympic
Games, a sample of athletes from 7 countries who
were competing in such diverse activities as
throwing, jumping, vaulting, sprinting, and running up
to 5000 meters, reported that up to 68% admitted to
Anabolic-Androgenic Steroids use.7 The first person
to be disqualified for Anabolic-Androgenic Steroids
use in an Olympic Event was Danuta Rosani of Poland
in the 1976 Summer Olympics.8 The point of
interest was that Danuta was a woman and this was
indicative of just how far the use of Anabolic-
Androgenic Steroids in International athletics had
become. It seems that for every positive drug test for
Anabolic-Androgenic Steroids which is made public
and sensationalized by the press - the spread of
Anabolic-Androgenic Steroids into the general and
recreational athletic population just becomes greater
and greater. As recent as 1988 an American study
has indicated that 6.6% of male, senior level students
who responded to anonymous questionnaire (50%
response rate) reported using Anabolic-Androgenic
Steroids.9 Truly, Anabolic-Androgenic Steroids have
reached what seems to be their peak of popularity,
their availability in gyms, weight rooms, and
disreputable pharmacy's is so well publicized that any
athlete or person who really wants to use Anabolic-
Androgenic Steroids will sooner or later get their
hands on them.
General Description:
The term"Anabolic-Androgenic Steroids"
actually refers to a group of drugs derived from
testosterone, but with some having more anabolic
effect than androgenic effects and others with more
androgenic effects than anabolic effects.
Testosterone is responsible for the formation,
stimulation, and continuation of the characteristic
appearance of the male. The effects of testosterone,
as previously mentioned can be broken down into
two groups of phenotypic effects: androgenic
(producing secondary male sexual characteristics) and
anabolic (mainly increasing muscle size and strength).
Most of the synthetic derivative of testosterone have
attempted to increase either the anabolic effect or the
androgenic effect of testosterone or to increase the
bioavailability of testosterone when taken orally.
There is however no truly anabolic or androgenic
steroid all "anabolic" steroids still retain some
androgenic effects and vice-versa. 10 Metabolism and
Secretion:
Testosterone and dihydrotestosterone are the
only true endogenous androgens in humans. Other
compounds which are called androgens are only
precursors or metabolites of these two compounds
(See Diagram 1), and are only weakly androgenic.
Androgens are produced in the testes, ovaries,
adrenal glands, and in peripheral tissues.
Dihydrotestosterone is formed from testosterone in
peripheral tissues, and is thought to be responsible
for many of the effects of testosterone. Synthesis of
endogenous testosterone occurs primarily in the
testes as a result of stimulation from two hormones
released from the anterior pituitary: Follicle
Stimulating Hormone (FSH) and Luteinizing hormone
(LH). All endogenous androgens and estrogens are
synthesized from cholesterol (See Diagram 2). The
average male will produce only six to seven
milligrams of endogenous testosterone a day. 11
Mechanisms of Action on the Muscle Cell:
All Anabolic-Androgenic Steroids steroids
have a common mechanism of action on the muscle
cell. This involves the binding of the steroid hormone
with a specific receptor in the target tissues. The
androgen passively diffuses through the cell
membrane, where it combines with the receptor in
the cytoplasm of the cell. This hormone-receptor
complex then stimulates production of RNA, which in
turn increases protein synthesis. The number and/or
rate of the hormone-receptor interactions is a
measure of the activity of the hormone. 12
Determining The Effectiveness of Anabolic-
Androgenic Steroids:
There are several methods for determining the
effectiveness and properties of a particular Anabolic-
Androgenic Steroids. The most common method is
the therapeutic index of the drug. With the
therapeutic index method the ratio of androgenic
properties to anabolic properties of the drug is
determined. The determination of this ratio involves
the administration of a particular Anabolic-Androgenic
Steroid to a rat, which after a certain period of time is
dissected (See Diagram 3) and the growth of the rat's
prostrate gland and seminal vesicles (the androgenic
effect) is compared to the growth of the rat's levator
ani muscle (the anabolic effect). For example, in
calculating a therapeutic index, the levator ani muscle
has grown four times the standard, while the seminal
vesicle has grown two times the standard; this would
give us 4/2=2 for the therapeutic
index (TI). Testosterone is generally given a TI value
of 1. Therefore the higher the therapeutic index of a
drug the higher the anabolic qualities of that drug will
be.13
One of the most important aspects of
Anabolic-Androgenic Steroid usage has to do with
nitrogen retention. The use of steroids causes a
marked increase in nitrogen retention along with extra
water retained in the body, which is sometimes
mistaken for weight gain of lean muscle mass. One
method for determining this nitrogen content is to
analyze the intake and balance of nitrogen in the
body. The formula for measurement of the nitrogen
balance is :Steroid Protein Activity Index (SPAI)
NBSP NBCP
SPAI = -------- - -------
- X 100
NISP NICP
Where:
NBSP equals nitrogen balance in steroid period
NISP equals nitrogen intake in steroid period
NBCP equals nitrogen balance in control period
NICP equals nitrogen intake in control period
The ratios in the equation represent the
fraction of dietary protein retained by the body during
the steroid and control periods. The SPAI levels are
effected by the amount of protein and calorie content
of the foods ingested during the two periods. SPAI
results are important in that they help determine the
best dosage of anabolic steroid that could offset the
protein catabolic effects of exercise and training,
while aiding the need for increased biosynthesis of
protein in building muscle tissue.14
It appears that some use can be derived from
the combined us of the TI and the SPAI. If both
indexes are high for a particular Anabolic-Androgenic
Steroid, then that drug may be the safest and most
efficient for that particular subject. However, it may
also be that the unwanted side effects are beyond
what is tolerable for that subject.
Medical/Clinical Uses of Anabolic-Androgenic
Steroids:
Aside from all of the negative publicity about
Anabolic-Androgenic Steroids negative side-effects,
Anabolic-Androgenic Steroids serve an important role
in medicine in the treatment of several illnesses and
pathologies. Anabolic-Androgenic Steroids have been
indicated in a variety of treatments which are listed
below:15
Anemias caused by deficient red blood cell
production
Protein deficient states associated with various
infections (gastritis, colitis, or enteritis)
Assist in the formulation of bone matrix in
Osteoporosis patients
To combat the after effects of radiation therapy
Improve appetite
Cachexia
Diabetic Retinopathy
Kidney Disease
Improve Psychological disposition
Promote Healing (Pre/Post Surgery)
Stimulate growth in adolescents and pituitary
dwarfs
Treatment of Breast Cancer in women
Male impotence of the glandular region (eunuchism,
oligospermia)
Promotion of male secondary sex characteristics
when desired
Clinical studies have shown testosterone and
nandrolone, and others, may be effective male
contraceptives
Positive Side Effects of Anabolic-Androgenic Steroids
in Athletics:
Although these are essentially the primary
athletic uses for Anabolic-Androgenic Steroids, since
they are not the intended medical and
pharmacological uses for Anabolic-Androgenic
Steroids,
I have considered them to be the "positive" side
effects of Anabolic-Androgenic Steroids. I will
attempt to give a brief overview of what side effects
the athletes wish to promote and a brief description
of the mechanism which causes the side effects.
Increased Strength: Anabolic-Androgenic Steroids
owing to their primary function of stimulating protein
synthesis, assist in the increase in size of the
myofibrillar elements (actin and myosin) of the muscle
fiber which are comprised of protein. Strength can
also be gained through "tissue leverage" resulting
from one of or both increases in cellular fluid
(sarcoplasm) and general edema (water retention).
This increase in strength is temporary as it will
dissipate with cessation of Anabolic-Androgenic
Steroid use.16
Increased Muscular Size: The myofibrillar growth and
increased sarcoplasmic content (see above) are the
main factors responsible for muscular increases in
size.Reduction in Pain from Arthritis/Tendonitis:
Many athletes claim relief of pain from tendonitis
while on steroid therapy, although this is anecdotal
evidence and lacks scientific research. This pain
relief may also be a result of the anti-catabolic effects
of Anabolic-Androgenic Steroids in the body.17
Anti-Catabolic Effects: Anabolic-Androgenic Steroids
are reported to have a high affinity for glucocorticoid
receptors, thus acting as antiglucocorticoid agents.
Glucocorticoids, such as cortisol, have a primarily
catabolic effect on muscle particularly after exercise.
Therefore if an athlete has high levels of circulating
Anabolic-Androgenic Steroids in their blood the
Anabolic-Androgenic Steroid may suppress the effect
of the circulating cortisol by binding to and blocking
up the available glucocorticoid receptors in the
system. The high levels of Anabolic Androgenic
Steroids may also cause a suppression of ACTH
(adrenocorticotropic hormone) response by mimicking
Cortisol at the pituitary receptors.18
Reduction in Percent Bodyfat: Diet and Training
practices of athletes while using Anabolic-Androgenic
Steroids is highly indicated as a cause in this case.
Anincrease in the percent Lean Body Mass relative to
Body Fat may also cause the perception of a
reduction in Body Fat. In one study involving a
double blind cross over protocol increases in Body Fat
were found in both Anabolic-Androgenic Steroids
users and non-users, however the Anabolic-
Androgenic Steroid users also showed a large
increase in Lean Body Mass.19
Increased Endurance: There are several possible
causes for this effect. The increased number of Red
Blood Cells with the Anabolic-Androgenic Steroids
induced erythropoesis may increase the Oxygen
carrying capacity of the blood. The higher Cortisol
levels inn the blood (explained above)may cause
decreased stress on the working muscles. Increased
aggression and mood changes may cause the athlete
to work harder (See Section on Psychological Side
Effects).Increased Vascularity: Most likely a result of
increased diastolic blood pressure that accompanies
Anabolic-Androgenic Steroid use.20,21 This effect is
a much sought after effect in BodyBuilding
competitions.Improved Recovery Time after Injury or
Training: The fact that Anabolic-Androgenic Steroids
promote protein synthesis and/or retard nitrogen
excretion explains why improvements in recovery
time following injury or surgery, and particularly
following heavy training, is observed. This relates to
less training time lost.
Increased Aggressiveness: Considered to be
extremely beneficial in many anaerobic events as
higher levels of adrenal hormones may improve the
force of muscle contraction. This aspect of Anabolic-
Androgenic Steroids steroids will be discussed further
in the section on Psychological side effects.
Negative Physiological Side Effects:
The negative side effects of Anabolic-
Androgenic Steroids have been well published in
recent years. Many of the side effects may only
appear with extreme Anabolic-Androgenic Steroid
use/abuse with a few of the less serious effects being
the most common such as: acne, water retention,
moodiness, hirsutism, and gynecomastia. Why
Anabolic-Androgenic Steroids cause certain side
effects is not completely understood in some cases,
all that is known is that they do occur. Some of the
side effects (and most dangerous) can be attributed
to the modification of the testosterone molecule in
the creation of oral Anabolic-Androgenic Steroids,
particularly the 17-alpha-alkylated Anabolic-
Androgenic Steroid. The "17-alpha-alkylated" refers
to the part of the Testosterone molecule which was
altered in order to prevent the stomach from digesting
the steroid molecule as a protein. By modify the
testosterone molecule it is able to pass through the
stomach where it is absorbed in the small intestine
and then metabolized in the liver.Liver Disorders:
Nearly all oral Anabolic-Androgenic Steroids cause
alterations in liver function (particularly 17-alpha-
alkylated Anabolic-Androgenic Steroids).
Abnormalities include elevation of plasma levels of
glutamic pyruvic transaminase, glutamic oxaloacetic
transaminase, alkaline phophatase, and bilirubin.
These changes are ordinarily reversed when Anabolic-
Androgenic Steroid use is stopped.22 In severe cases
of Anabolic-Androgenic Steroid induced liver
disfunction, severe disorders have been reported such
as: Cholestatic Hepatitis, Peliosis Hepatitis, Liver
Tumors, and even Leukemia.23 In a 1987 review of
Anabolic-Androgenic Steroid related liver disease
several interesting points in relation to these diseases
and athlete Anabolic-Androgenic Steroid use arose.
None of the 23 cases of peliosis hepatitis reported in
literature involved an athlete. Of the 36 reported
cases of liver tumors only one instance of
hepatocellular carcinoma in a bodybuilder who had
taken multiple oral preparations for four years.
Leukemia has also been reported in five non-athlete
cases.24 Most of theses cases most likely resulted
from prolonged oral androgen treatment of anemia,
kidney disorders, and other severe diseases. In one
non scientific publication's editorial it was stated that
all of the deaths associated with Anabolic-Androgenic
Steroid use occurred from the use of one oral
Anabolic-Androgenic Steroid known as Oxymetholone
(Anadrol-50).25
Reproductive Disorders:
Administration of Anabolic-Androgenic
Steroids to male athletes inhibits the release of follicle
stimulating hormone (FSH) and luteinizing hormone
(LH) from the pituitary gland.26 These are the two
hormones responsible for stimulating the release of
testosterone from the testicles as well as stimulating
spermatogenesis in the testicles. Therefore the
inhibition of LH and FSH by exogenous testosterone
may result in testicular atrophy, azoospermia,
oligospermia, or abnormal sperm morphology.27,28
The effects on sperm production and motility appear
to be reversible after Anabolic-Androgenic Steroid use
is discontinued.29 Testosterone levels; however,
may remain low for a prolonged period.30
Anabolic-Androgenic Steroid use by women
can produce severe masculinization effects, after all
Anabolic-Androgenic Steroids are what are used in
pre-sex change therapy for women who want to
become men. These effects may be manifested as a
deepening of the voice, oligomenorrhea, amenorrhea,
clitoromegaly, male pattern baldness, and excessive
growth of superficial body and facial hair. Many of
these effects are similar to those experienced by
young males going through puberty. The changes in
voice, body hair, baldness, and the clitoris usually are
not reversible.31,32
During Pregnancy, Anabolic-Androgenic
Steroids use may have many damaging effects on the
development of the fetus. Anabolic-Androgenic
Steroids can inhibit development of female embryos,
resulting in masculinization of the female fetus.33
Cardiovascular Effects:
Anabolic-Androgenic Steroid use can have
several negative effects on the Cardiovascular
system. Some of these unfavorable side effects are:
a reduction in HDL-cholesterol levels; increased Blood
Pressure; Unfavorable thickening and enlargement of
the left ventricle.
Significant reductions in HDL-cholesterol
levels and an increase in the ration of LDL to HDL
cholesterol, as much as three-fold, have been noted
after Anabolic-Androgenic Steroids use in highly
conditioned weightlifters and bodybuilders.34,35 It
has been indicated that oral steroids may cause a
much greater reduction in HDL cholesterol (33% vs
9%) than injectable steroids because of the alkyl-
groups effects on lipoproteins.36 These low levels of
HDL-cholesterol may increase the risk of
atherosclerosis and heart disease. However,
numerous other risk factors associated with heart
disease have also been identified. Most athletes who
use Anabolic-Androgenic Steroids have few
cardiovascular risk factors and have a normal or low
total cholesterol level during an anabolic steroid
cycle.37 The decrease in HDL cholesterol has also
been shown to be reversible once cessation of
Anabolic-Androgenic Steroids has occurred.38,39,40
Increases in Blood Pressure have also been
linked to Anabolic-Androgenic Steroids use. In a
recent study using Anabolic-Androgenic Steroids
users who self administered their own Anabolic-
Androgenic Steroids, it was observed that after eight
to ten weeks there was only a non-significant rise in
systolic blood pressure. However, the diastolic blood
pressure increased significantly, by approximately 12
mmHg. Six weeks after cessation of Anabolic-
Androgenic Steroids use the diastolic blood pressure
had returned to pre-treatment values. This study
gave the possible explanation for these changes as
being due to the increased blood volume.41 would
also be logical to suspect that the increases in blood
pressure may also be linked to edema and/or a
general increase in body mass, as these are common
factors which have been associated with rises in
blood pressure.
Perhaps one of the most alarming studies I
came across was a recent study of Anabolic-
Androgenic Steroids and their effect on the heart
which indicated the most substantial of the side
effects because it appeared that this particular side
effect may be irreversible. This study involved both
self-administering Anabolic-Androgenic Steroids using
body builders, non-Anabolic-Androgenic Steroids
using body builders, and sedentary individuals. The
findings of this study indicate that Anabolic-
Androgenic Steroids can induce an unfavorable
enlargement and thickening of the left ventricle,
which losses its diastolic properties with the mass
increase. These modifications tend to persist
following a short period of drug withdrawal.42
Effects on Children and Teens:
Due to the fragile hormonal state of the
developing child and teenager, even low dosages of
Anabolic-Androgenic Steroids may have adverse
effects on development. These adverse effects
include the aforementioned as well as several others.
Severe virilization may occur with Anabolic-
Androgenic Steroid use in this age group including
effects such as: phallic/clitoral enlargement, priapism,
increased facial and body hair, male pattern baldness,
deepening of the voice, and severe acne.
Gynecomastia may also occur in young males.
Premature fusion of the ephiphyses of the long bones
may also cause stunted growth in a child or teens
development. Children and teens are also at a greater
risk of developing hepatic dysfunction.43,44,45
Cosmetic Side Effects:
Perhaps the most notorious of the Anabolic-
Androgenic Steroids side effects are the cosmetic
side effects. These are the side effects that are
perhaps the least serious in their adverse effects on
health but play an important role in the athlete's body
image perception. Some of these side effects
include: headaches, acne, water retention, changes in
libido, and hirsutism.46
Perhaps the most "famous" of the cosmetic
side effects is the development of gynecomastia in
males, known in the gyms and weightrooms as "bitch
tits." In men, endogenously secreted androgens,
such as androstenedione and testosterone, are
converted by aromatization of ring A to estrogens
(estrone and estradiol, respectively) in peripheral
tissues. When large amounts of exogenous Anabolic-
Androgenic Steroids or androgens are present in the
system a significant amount of the androgens will be
converted to active estrogen. Estradiol levels have
been reported as high as five times the average in
Anabolic-Androgenic Steroid using males. Since
active estrogens are responsible for the feminizing
effects in female development it is not uncommon for
males with high levels of active estrogens to develop
breast tissue also known as gynecomastia. It is also
theorized that the high estrogen levels may also
suppress gonadotropin secretion and may have a
direct toxic effect on testicular activity.47
Negative Psychological Side Effects:
The uses of Anabolic-Androgenic Steroids in
clinical psychology since the 30's and 40's should
have been warning enough of the extremely serious
and potentially harmful psychological effects of
Anabolic-Androgenic Steroid use in large quantities.
Recent literature is increasingly forming a solid link
between testosterone and Anabolic-Androgenic
Steroid use with aggression, addiction, and many
other psychological parameters such as euphoria,
aggression, irritability, nervous tension, changes in
libido, hypomania, mania, and psychosis.48
Aggression:
Aggressive behavior and other feelings of
hostility have been demonstrated to be related to
endogenous testosterone levels in a number of
studies using human subjects. Testosterone is
thought to have an activating effect on human
aggressive behavior. The action of testosterone on
the central nervous system apparently contributes to
the elevated aggressiveness of males compared to
females. Many studies have attempted to correlate
levels of testosterone with aggressive behavior in a
variety of subject populations.49 I have attempted to
show some of these correlations in the following
tables:
Anabolic-Androgenic Steroid Withdrawal Symptoms:
Many athletes report a variety of withdrawal
symptoms when stopping the use of Anabolic-
Androgenic Steroids. Often it is these symptoms that
drive the athlete to resume use of Anabolic-
Androgenic Steroids. These withdrawal symptoms
are many and varied; reported symptoms are:
decreased sex drive, fatigue, dissatisfaction with
body image, suicidal thoughts, depression, insomnia,
desire or more steroids, Anhedonia, (inability to
experience pleasure), anorexia, restlessness, and a
general lack of interest.50
Steroid's Addictive Properties:
Recent studies in the British Journal of
Addiction, the American Journal of Psychiatry, and
the Journal of Clinical Psychiatry have all given strong
evidence towards the addictive properties of
Anabolic-Androgenic Steroids. There has been some
speculation that Anabolic-Androgenic Steroids may
affect the endogenous opiod or monoaminergic
systems in the brain to produce dependence.51
Many of the studies often report that the Athletes
feel "high" or extreme pleasure when on Anabolic-
Androgenic Steroids. Anabolic-Androgenic Steroid
dependence may also develop in response to the
positive social reinforcement of having a big muscular
body or inversely be driven by negative reinforcement
- trying to avoid not feeling big.52 Anabolic-
Androgenic Steroid users along with the extreme
body building fanatics have also been linked to body
image disturbances and perceptions much the same
as Anorexia and Bulimia.53
Drug Testing:
The use of urine testing in amateur athletics is
now a common-place phenomenon. The testing of
urine samples involves three basic steps: extraction,
screening, and confirmation. Extraction is the first
step and it involves preparing the urine for analysis.
Multiple extractions are used because many drugs are
excreted not only in their original form, but also as
by-products resulting from the metabolic breakdown
of the original form.54
The second step, the screening, is a search
for traces of banned substances within the extracted
samples. This involves the use of Gas
Chromatography. Gas Chromatography separates out
individual drugs based on their relative volatility and
solubility, present in urine, one by one, during a time
sequence. Individual drugs or their metabolites are
transported through the chromatographic column
(long thin glass tube coated in a Polymer substance)
by an inert carrier gas (ie. Helium). Different
chemicals will come out of the column end at
different times - known as the "Retention time." If
the sample has the same Retention time as a known
substance it is then analyzed by Mass Spectrometry
in order to confirm the sample.55
The final step for a suspected positive sample
is for the presence of a banned substance to be
confirmed using Mass Spectrometry. This process
identifies a substance by ion bombardment. The
resulting mass spectrogram (or fragmentation
pattern), for any molecule is unique and serves to
identify that molecule. If the molecule is similar to a
banned substance or the metabolites of a banned
substance the test is then considered to be
positive.56
The administration of exogenous testosterone
is unable to be detected by Gas Chromatography or
Mass Spectrometry since it is also a naturally
occurring one in the body. The current method for
detection of exogenously administered testosterone
involves the analysis of the
testosterone:epitestosterone (T/E) ratio, with the
upper limit being set at a ration of 6:1 Testosterone
to Epitestosterone. Epitestosterone is a by product of
the metabolism of testosterone, more specifically it is
the 17-alpha-hydroxy-epimer of testosterone. The
urine usually contains about equal amounts of
testosterone and epitestosterone, with the ration
being normally between one and two in both men and
women. The limits set for this test have been
deliberately set high so that the individual drug-free
steroid profiles easily fall under these levels.57
Masking and "Beating" the tests:
It has long been assumed that as long there
has been drug testing the athletes' have been finding
ways to continue their drug use without being
caught. The most reliable way of beating a "known"
(knowledge of when it is going to occur) drug test is
most likely the cessation of a particular Anabolic-
Androgenic Steroid long enough before the test for
the drug to have cleared the system. In order for the
athlete to know when to stop a particular drug they
would ideally be able to be pre-tested in order to
know what their "clearance time" is (the minimum
amount of time before a contest that the athlete may
continue Anabolic-Androgenic Steroid use up to
without testing positive). Otherwise athletes may
have to make use of books and publications which
recommend which steroids to use and when to stop
using them such as: MuscleMag and Drug Use and
Detection in Amateur Sports. by M. G. Di Pasquale.
The following is an excerpt from M.G. Di Pasquale's
Drug Use and Detection in Amateur Sports:58
Deca-Durabolin and Durabolin (both nandrolone esters
and the cause of many of the countless 19-
nortestosterone positives) are avoided at all times.
Most oil based injectable anabolic steroids are
stopped at least four to five months before the
contest - including:
Equipoise (boldenone)
Primobolan (all methenolone esters except for the
acetate form)
Parabolan/Finaject (trenbolone esters)
Injectable Dianabol (methandrostenelone)
Other injectable anabolic steroids are stopped at least
two months before the drug tested event and include:
Winstrol-V (stanozolol)
Stromba (stanozolol)
Primobolan Acetate
Masterid (dromastanolone proprionate)
Testosterone cypionate, decanoate, and enthanate
A few oral anabolic steroids are stopped at least five
weeks before the contest including:
Dianabol (methandrostenelone)
Primobolan (methelone)
Nilevar (norethandrolone)
A few oral anabolic steroids are used up to within
three weeks of a drug tested event, including:
Anavar (oxandrolone)
Winstrol (stanozolol)
The use of "invisible" Anabolic-Androgenic
Steroids such as Dihydrotestosterone, is the ideal
method for the resourceful athlete to escape
detection. These Anabolic-Androgenic Steroids are
not able to be detected by the Gas Chromatography
or Mass Spectrometry because in order for these
tests to detect a substance or its metabolites they
must have a sample of that substance to identify it
with. There are reportedly over a 1000 different
formulations of Anabolic-Androgenic Steroids.59
Less than one hundred Anabolic-Androgenic Steroids
are currently available commercially in the world. If
an athlete or that athlete's government have access
to the raw chemicals and the organic chemists able to
formulate one of these uncharted Anabolic-
Androgenic Steroids then that athlete may use that
substance without detection.
Athletes also resort to many other methods to
avoid detection, some are successful some are not.
The use of diuretics and chelation therapy to rid the
body of residual traces of banned substances is
common in athletics as the number of positive tests
for furosemide (a diuretic) at the last Olympic games
indicated. The use of diuretics also dilute the urine of
the athlete so there isn't enough of a substance
present in the urine to be identified. The use of
Probenicid, a substance which decreases the urinary
excretion of substances in the body, was also popular
as a means of preventing the excretion of banned
substances into the urine. Both furosemide and
probenicid are now banned substances and their use
can also result in an athlete's disqualification from
competition. The use of soaps, bacteria, or fungus to
contaminate or alter the urine rendering it unusable
have also been proven to be unsuccessful.
SUMMARY:
In this paper I have covered the more popular
topics that have surfaced regarding Anabolic-
Androgenic steroid use in athletics and society. A
brief history of Anabolic-Androgenic steroids was
given in an attempt to show the spread of this
problem in our society. I then gave a brief description
of Testosterone synthesis and metabolism in the
body. The body of this essay was the various side
effects associated with anabolic-androgenic steroids.
These side-effects included: medical uses, athletic
uses, negative physiological uses, and the
psychological side effects. A brief description of the
current drug testing methods used by the I.O.C. and
the athlete's attempts to beat these tests was also
given. The legality of Anabolic-Androgenic steroids in
North America was the final focus of this paper.
Many of the studies used in this paper were
conducted in the clinical or laboratory setting or the
athletes were asked about there anabolic-androgenic
steroid use in their everyday lives. This is not how
Anabolic-Androgenic steroids are used in the "real"
world of the weightrooms in North America. Steroid
use in the weightrooms often involves dealers who do
not only deal in steroids but more than likely
marijuana and cocaine also. The black market is
becoming increasingly controlled by organized crime
and the infiltration of fake Anabolic-Androgenic
steroids has taken over the market. No longer does
the athlete only have to worry about the side effects
of steroids but they also have to worry about
whether or not that clear oil they are sticking into
their muscles came from the pharmaceutical plant,
the petroleum plant, of the Mazola plant. The current
laws have forced the legitimate sources of real
Anabolic-Androgenic steroids to stop supplying them
to the athletes and as the law of supply and demand
dictates the underworld has found a new demand to
supply.
ENDNOTES:
1. Barhke et al. "Psychological and Behavioural
Effects of Endogenous Testosterone Levels and
Anabolic-Androgenic Steroids Among Males: A
Review." Sports Medicine 10 (5), 1990. p. 304
2. Barhke et al. "Psychological and Behavioural
Effects of Endogenous Testosterone Levels and
Anabolic-Androgenic Steroids Among Males: A
Review." Sports Medicine 10 (5), 1990. p. 305
3. Goldman, B. Death In The Locker Room.
Icarus Press. ⌐1984. p. 1
4. Barhke et al. "Psychological and Behavioural
Effects of Endogenous Testosterone Levels and
Anabolic-Androgenic Steroids Among Males: A
Review." Sports Medicine 10 (5), 1990. p. 305
5. Davies and Thomas, Science and Sporting
Performance: Management or Manipulation?
Clarendon Press. ⌐1982. p. 104
6. Goldman, B. Death In The Locker Room.
Icarus Press. ⌐1984. p. 2
7. Barhke et al. "Psychological and Behavioural
Effects of Endogenous Testosterone Levels and
Anabolic-Androgenic Steroids Among Males: A
Review." Sports Medicine 10 (5), 1990. p. 306
8. Donohoe and Johnson, Foul Play: Drug Abuse
In Sports. Basil Blackwell Ltd. ⌐1988. p. 13
9. Bass, F. "Anabolic Steroid use: An
Epidemiological Perspective." BC Medical Journal
Vol.
32 (7) July 1990. p. 299
10. DiPasquale, M. Drug Use & Detection In
Amateur Sports. M.G.D. Press ⌐1985 p.41
11. DiPasquale, M. Drug Use & Detection In
Amateur Sports. M.G.D. Press ⌐1985 p.45
12. DiPasquale, M. Drug Use & Detection In
Amateur Sports. M.G.D. Press ⌐1985 p.47
13. Goldman, B. Death In The Locker Room.
Icarus Press. ⌐1984. p. 220
14. Goldman, B. Death In The Locker Room.
Icarus Press. ⌐1984. p. 221
15. Di Pasquale, M. G. "Clinical Uses of Anabolic
Steroids." Drugs in Sport. Decker Periodicals ⌐1991.
Premier Issue. p. 3.
16. Hatfield, F. Anabolic Steroids: What Kind and
How Many? Fitness Systems. ⌐1982. p. 11
17. Hatfield, F. Anabolic Steroids: What Kind and
How Many? Fitness Systems. ⌐1982. p. 12
18. Boone, J. et al. "Resistance Exercise Effects
on Plasma Cortisol, Testosterone, and Creatine
Kinase Activity in Anabolic Androgenic Steroid
Users." International Journal of Sports Medicine. Vol
11, 1990. pp. 293-297
19. Kuipers, H. et al. "Influence of Anabolic
Steroids on Body Composition, Blood Pressure, Lipid
Profile and Liver Functions in Body Builders"
International Journal of Sports Medicine. Vol 12,
1991. pp. 413-418
20. Kuipers, H. et al. "Influence of Anabolic
Steroids on Body Composition, Blood Pressure, Lipid
Profile and Liver Functions in Body Builders"
International Journal of Sports Medicine. Vol 12,
1991. pp. 413-418
21. Hatfield, F. Anabolic Steroids: What Kind and
How Many? Fitness Systems. ⌐1982. p. 12
22. Katz, S. "Anabolic Steroid Use: Adverse
Effects." BC Medical Journal Vol. 32 (7) July 1990.
pp. 295-6
23. Katz, S. "Anabolic Steroid Use: Adverse
Effects." BC Medical Journal Vol. 32 (7) July 1990.
pp. 295-6
24. Bierly, J. "Use of Anabolic Steroids by
Athletes." PostGraduate Medicine. Vol 82 (3) Sept.
1987. p. 73
25. Phillips, W. "Steroids Kill??" Anabolic
Reference Update, July-August 1988. p. 1
26. Katz, S. "Anabolic Steroid Use: Adverse
Effects." BC Medical Journal Vol. 32 (7) July 1990.
p. 295
27. Katz, S. "Anabolic Steroid Use: Adverse
Effects." BC Medical Journal Vol. 32 (7) July 1990.
p. 295
28. Windsor, R.E. & Dumitru, D. "Anabolic
Steroid Use by Athletes." Post-Graduate Medicine.
Vol. 84(4) Sept. 1988. p. 47
29. Windsor, R.E. & Dumitru, D. "Anabolic
Steroid Use by Athletes." Post-Graduate Medicine.
Vol. 84(4) Sept. 1988. p. 47
30. Katz, S. "Anabolic Steroid Use: Adverse
Effects." BC Medical Journal Vol. 32 (7) July 1990.
p. 295
31. Holden, S.C. et al. "Anabolic Steroids in
Athletics." Texas Medicine. Vol. 86, March 1990. p.
35
32. Couch, R. M. "Anabolic Steroid use:
Endocrinological Aspects." BC Medical Journal Vol.
32 (7) July 1990. p. 297
33. Katz, S. "Anabolic Steroid Use: Adverse
Effects." BC Medical Journal Vol. 32 (7) July 1990.
p. 295
34. Katz, S. "Anabolic Steroid Use: Adverse
Effects." BC Medical Journal Vol. 32 (7) July 1990.
p. 295
35. Couch, R. M. "Anabolic Steroid use:
Endocrinological Aspects." BC Medical Journal Vol.
32 (7) July 1990. p. 298
36. Holden, S.C. et al. "Anabolic Steroids in
Athletics." Texas Medicine. Vol. 86, March 1990. p.
35
37. Windsor, R.E. & Dumitru, D. "Anabolic
Steroid Use by Athletes." Post-Graduate Medicine.
Vol. 84(4) Sept. 1988. p. 49
38. Holden, S.C. et al. "Anabolic Steroids in
Athletics." Texas Medicine. Vol. 86, March 1990. p.
35
39. Katz, S. "Anabolic Steroid Use: Adverse
Effects." BC Medical Journal Vol. 32 (7) July 1990.
p. 295
40. Kuipers, H. et al. "Influence of Anabolic
Steroids on Body Composition, Blood Pressure, Lipid
Profile and Liver Functions in Body Builders." Int. J.
Sports Med. Vol. 12. 1991. p.413
41. Kuipers, H. et al. "Influence of Anabolic
Steroids on Body Composition, Blood Pressure, Lipid
Profile and Liver Functions in Body Builders." Int. J.
Sports Med. Vol. 12. 1991. p.413
42. De Piccoli, B. et al. "Anabolic Steroid Use in
Body Builders: An Echocardiographic Study of Left
Ventricle Morphology and Function." Int. J. Sports
Med. Vol. 12. 1991. p.408
43. Katz, S. "Anabolic Steroid Use: Adverse
Effects." BC Medical Journal Vol. 32 (7) July 1990.
p. 295-6
44. Holden, S.C. et al. "Anabolic Steroids in
Athletics." Texas Medicine. Vol. 86, March 1990. p.
35-6
45. Windsor, R.E. & Dumitru, D. "Anabolic
Steroid Use by Athletes." Post-Graduate Medicine.
Vol. 84(4) Sept. 1988. p. 47
46. Holden, S.C. et al. "Anabolic Steroids in
Athletics." Texas Medicine. Vol. 86, March 1990. p.
35
47. Couch, R. M. "Anabolic Steroid use:
Endocrinological Aspects." BC Medical Journal Vol.
32 (7) July 1990. p. 297
48. Brower, K. J. et al. "Evidence for Physical and
Psychological Dependence on Anabolic Androgenic
Steroids in Eight Weight Lifters" Am. J. of Psychiatry
Vol. 147 (4) April 1990. pp. 510
49. Barhke et al. "Psychological and Behavioural
Effects of Endogenous Testosterone Levels and
Anabolic-Androgenic Steroids Among Males: A
Review." Sports Medicine 10 (5), 1990. p. 310
50. Brower, K. J. et al. "Evidence for Physical and
Psychological Dependence on Anabolic Androgenic
Steroids in Eight Weight Lifters" Am. J. of Psychiatry
Vol. 147 (4) April 1990. pp. 510-512
51. Brower, K. J. et al. "Symptoms and
correlates of anabolic androgenic steroid
dependence." British Journal of Addiction. Vol. 86,
1991. p. 766.
52. Brower, K. J. et al. "Symptoms and
correlates of anabolic androgenic steroid
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1991. p. 766.
53. Tonkin, R. & Manley, R. "Anabolic Steroid
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Journal Vol. 32 (7) July 1990. p. 292.
54. DiPasquale, M. Drug Use & Detection In
Amateur Sports: Update 4. M.G.D. Press ⌐1987 p.
7
55. DiPasquale, M. Drug Use & Detection In
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7
56. DiPasquale, M. Drug Use & Detection In
Amateur Sports: Update 4. M.G.D. Press ⌐1987 p.
8
57. DiPasquale, M. Drug Use & Detection In
Amateur Sports. M.G.D. Press ⌐1985 p. 55-6
58. DiPasquale, M. Drug Use & Detection In
Amateur Sports: Update 4. M.G.D. Press ⌐1987 p.
3-4
59. Barhke et al. "Psychological and Behavioural
Effects of Endogenous Testosterone Levels and
AnabolicAndrogenic Steroids Among Males: A
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