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Dr.Girish S Naik

Anabolic Steroids 1995 poll 198 Olympic level power athletes were given the following scenario: You are offered a banned substance with two guarantees 1. You will not be caught by taking the substance. 2. you will win your event.

Only 3 said no

Same poll, new scenario: 1. The substance will allow you to win every competition you enter over the next 5 years. 2. However the substance will then kill you .

More than 50 % would still use the substance!

This is why performance enhancing drugs remain in the spotlight of sports

Anabolic Steroids

Class of steroid hormones related to the male hormone testosterone. Increase protein synthesis within cells which results in growth of muscle. Also have androgenic properties which include the development and maintenance of male characteristics. Have both medical and sport performance uses.

AS have been modified many times to maximize the anabolic effects and minimize the androgenic affects: 1.Alkylation of the 17-alpha position (oral) 2.Esterfication of the 17beta hydroxyl group (IM)

All AS possess both anabolic and androgenic properties. None are absolutely selective. Testosterone anabolic:androgenicratio 1 Nandrolone10

Stanozolol 30 Anabolic effect : dose dependent (300 mg per week required)

Anabolic Steroids History

1931 male hormone androstenone isolated 1934 androstenone synthesized 1935 testosterone identified and synthesized 1937 clinical trials on humans with testosterone began

Anabolic Steroids History

History WWII German scientist synthesized other anabolic steroids and experimented on concentration camp inmates to treat chronic wasting. It was also given to German soldiers hoping to increase their aggression. Adolf Hitler rumoured to have taken anabolic steroids

Anabolic Steroids History

1940s - Soviet Union and Eastern Block Countries (East Germany) established steroid programs in Olympic and amateur weight lifters. 1958 Dianabol(methandrostenolone) approved in U.S. by the FDA.

Anabolic Steroids History

1972 Study showed no difference in performance enhancement in participants compared to ones given placebo. Remained unchallenged for 18 years owing to poor study with inconsistent controls and insignificant doses. 2001 Studies showed clear increase in muscle mass and decrease in fat associated with high doses of anabolic steroids.

Anabolic Steroids Anabolic Effects

Two different, but overlapping effects : Anabolic promote cell growth. Increased protein synthesis, appetite, bone remodelling ,growth and production of red blood cells.

Increase in the size of muscle fibers (hypertrophy) leading to increase in muscle mass and strength. Decrease the amount of fat in muscle.

Anabolic Steroids Androgenic Effects

Androgenic Effects : Virilising action. Development and maintenance of male characteristics : Increased growth of pubic, beard, chest and limb hair. Enlargement of vocal cords. Increased libido. Enlargement of clitoris & suppression of natural sex hormones

Anabolic Steroids Adverse Effects

Most side effects are dose dependent : Elevated blood pressure (most common). Increase in LDL cholesterol and decrease in HDL cholesterol levels. Increase risk of CV disease : coronary artery disease, arrhythmias, and heart attacks (chronic use).

Anabolic Steroids Adverse Effects

Accelerate the rate of premature baldness (male and female). Acne stimulates the sebaceous glands. Liver damage (cancer) increased demand on liver as oral steroids are changed (increased bioavailability and stability).

Anabolic Steroids Adverse Effects

Tendon rupture has been linked to AS. Stiffer and less elastic tendons. No consistent AS induced ultrastructural or biochemical alterations. Probably tendons do not adapt as fast (weak link).

Anabolic Steroids Gender Specific Effects

Gynecomastia development of breast tissue in males due to conversion of testosterone to estrogen by an aromatase enzyme. Temporary infertility (decreased production of sperm). Testicular atrophy (caused by decreased levels in natural testosterone).

Anabolic Steroids Female - Specific Effects

Increase in body hair. Male-pattern baldness. Deepening of voice (permanent). Enlarged clitoris (permanent). Temporary decrease in in menstrual cycle. Affect fetal development during pregnancy

Anabolic Steroids Adolescent Effects

Stunted growth Premature growth plate shut down as a result of increased levels of estrogen. Premature sexual development. Anabolic steroid use in adolescence has been correlated with poorer attitudes related to health.

Risk of mortality among chronic AS users repoted to be 4.6 times higher than non-AS users. Weekly doses of 600 mg of testosterone or its equivalent for cycles lasting less than 12 weeks appear to cause few side effects during scientific studies. Rule: bigger the dose, the bigger the muscle, the bigger the problem!!

Behavioral Effects Controversial : Mood swings Aggression (roid rage). Mania. Depression. Withdrawal Dependence.

Biochemical Mechanisms : Effect of AS on muscle mass is caused in at least two ways. 1. Increase the production of proteins. 2. Reduce recovery time by blocking the effects of cortisol (promote the breakdown of muscles) AS affect the number of cells that develop into fat storage cells by favouring cellular differentiation into muscle cells.

Steroid hormones mainly interact with cells by binding to proteins called steroid receptors.After binding, proteins move into the cell nucleus and can alter the expression of genes or activate processes in other parts of the cell

Receptors involved with AS are called Androgen receptors. Different types of AS bind with different affinities depending on their chemical structure. This determines the characteristic effects of the AS (anabolic vs androgenic).

Extremely difficult to determine what percentage of use in the population Usually middle class, heterosexual men with a median age of 25. 2006 study 78% noncompetitive bodybuilders and non-athletes (cosmetic). 13% reported unsafe injection practices (needle sharing)

Anabolic Steroids Non-medical use: abuse Users often stereo-typed as uneducated or muscle heads 1998 study showed steroid users to be the most educated drug users out of all users of controlled substances. Research their product more than any other group

Anabolic Steroids Administration 3 common forms of AS administration: Oral most convenient (dangerous - liver). Injectable intramuscular not intravenous (HIV and Hepatitis) Transdermal self adhesive skin patches

Athletes who take AS do so typically during the active years of the careers. They combine multiple steroid forms (oral and injectable), a practice called stacking The drug dosage is progressively increased (pyramiding) during a 4 to 18 week cycle, including a drug-free period between drug regimens (4-6 weeks). The drug quantity far exceeds the recommended medical dose (200X) The athlete then progressively reduces the drug dosage in the months prior to competition (to avoid detection)

The cycling of steroids coincides with competition. Many athletes use the training model Periodization : An athlete with a yearly training program (macrocycle) subdivides the year into phases called mesocycles (3 months) As competition nears, training volume gradually decreases while training intensity increases. Steroid use coincides with the mesocycles, with the goal of achieving maximum strength and size at competition.

Oral Anabolic Steroids

Oral Anabolic Steroids 17-alpha methyl testosterone (Android) 17-alpha ethyl testosterone (Maxibolin) 1-methyl testosterone (Primobolan) Androstenediol (Andro food supplements) Androstenedione Dihydroepiandrosterone (DHEA)

Injectable Anabolic Steroids

19-nortesterone ester derivitives (Durabolin) Testosterone ester derivatives (Oreton) Testosterone cypionate derivatives (Virilon):Boldenone Stanozolol (Winstrol) oral form as well Nandrolone.

Minimization of Side Effects

Several techniques to minimize side effects both during cycles and post cycle exists. Increase CV exercise to counter act effects on left ventricle. Estrogen receptor modulators to reduce effect of aromatisation of steroid hormones (tamoxifen) reduce gynecomastia

PCT takes place after each cycle to combat the natural testosterone suppression and restore proper function of numerous glands Typically consists of a combination of the following drugs: Clomiphene or tamoxifen (Primary PCT drug) Anastrozole aromatase inhibitor HCG restore hormonal balance

Anabolic Steroids Post Cycle Therapy Finasteride (Propecia) reduces the conversion of testosterone to DHT (high rate of alopecia) The drug is useless in cases in which the steroid is not converted into a more androgenic derivative

Anabolic Steroids Legal Status

Anabolic Steroids Legal Status Varies from country to country U.S. - Schedule III controlled substance (requires prescription, possession without Rx. federal crime punishable up to 7 yrs) Canada Schedule IV (obtaining or selling punishable for up to 18 mo.,). possession not punishable. Also illegal without Rx. in Australia, Argentina, Brazil and Portugal Legal in Mexico and Thailand.

Anabolic Steroids Prohormones In 1994 , the Dietary Supplement Health and Education Act was signed into law. This act classified substances derived from natural sources as food supplements and made many drugs such as prohormones available over the counter. Thus these substances are not regulated under the same rules and regulations by the FDA. (Loop hole) This can result in the dosages and actual quality of these substances to be in question as they are sold to the consumer Amended in 2004 (Androstenedione)

Anabolic Steroids Status in Sports Anabolic Steroids Status in Sports AS are banned by all major sporting bodies: IOC NBA NHL NFL MLB NCAA

For testosterone the definition of positive depends on an adverse analytical finding (positive result) based on any reliable analytical method (e.g., IRMS,GCMS, CIR) which shows that the testosterone is of exogenous origin, or if the ratio of the total concentration of testosterone to that of epitestosterone in the urine is greater than 6:1, unless there is evidence that this ratio is due to a physiological or pathological condition.

Anabolic Steroids Illegal Trade The majority of AS are obtained illegally through black market trade : Usually manufactured in other countries and smuggled across borders. Smuggling usually done in conjunction with other illegal drugs:Organized crime is involved

Anabolic Steroids Counterfeit Drugs Significant health hazard Computer and scanning technology as made it to copy labels. Product could contain anything (vegetable oil to toxic substances):Users have died of injecting unknown substances in their body. Products are also diluted to maximize profits.

Anabolic Steroids Production and Distribution) AS can be obtained from several sources Sold at gyms and competitions. Illegal drug dealers,Mail order (magazines) , Internet (websites posing as oversea pharmacies).

Proper Training :

Avoid Anabolic Steroids !! Proper Training Sleep,hydration,Stretching, Nutrition (timing,wheyprotein,creatine) Proper form and technique (especially in skeletally immature athletes) Goals

Thank YOU