Anabolic Steroid Abuse Research Articles

The dire consequences of doping

Various cases in professional sports have brought the matter of doping—the use of performance-enhancing drugs—to the attention of the broad public. Here, we present a case of doping in a 21-year-old amateur bodybuilder. The man presented to our clinic feeling generally unwell. He was subfebrile and had massive, deep ulcerations, abscesses, and pustules located on his chest and upper back (figure). Persistent questioning revealed a history of continuous abuse of anabolic-androgenic steroids (testosterone enantate 250 mg plus metandienona 30 mg twice weekly), which was consistent with the diagnosis of a severe acne conglobata that was anabolic-androgenic steroid induced.

Reduced activity of monoamine oxidase in the rat brain following repeated nandrolone decanoate administration

Anabolic androgenic steroids (AAS) are known as doping agents within sports and body-building, but are currently also abused by other groups in society in order to promote increased courage and aggression. We previously showed that 14 days of daily intramuscular injections of the AAS nandrolone decanoate (15 mg/kg) reduced the extracellular levels of the dopaminergic metabolites 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in the nucleus accumbens shell using microdialysis. The aim of the present study was to investigate whether the same dose regimen of nandrolone decanoate may affect the activities of the dopamine-metabolizing enzymes monoamine oxidases A and B (MAO-A and MAO-B). A radiometric assay was used to determine the activities of MAO-A and MAO-B in rat brain tissues after 14 days of daily i.m. nandrolone decanoate injections at the doses 3 and 15 mg/kg. Gene transcript contents of MAO-A, MAO-B and cathecol- O-methyltransferase (COMT) were measured with quantitative real-time reverse transcription PCR. 3 mg/kg of nandrolone decanoate significantly reduced the activity of both MAO-A and -B in the caudate putamen. 15 mg/kg of nandrolone decanoate significantly reduced the activity of MAO-A in the amygdala and increased the gene transcript level of MAO-B in the substantia nigra. In conclusion, imbalanced MAO activities may contribute to explain the impulsive and aggressive behaviour often described in AAS abusers. The reduced MAO activities observed are in line with our previously presented findings of decreased extracellular levels of DOPAC and HVA in the rat brain, indicating decreased monoaminergic activity following repeated AAS administration.

Targeting of androgen receptor in bone reveals a lack of androgen anabolic action and inhibition of osteogenesis: A model for compartment-specific androgen action in the skeleton

Androgens are anabolic hormones that affect many tissues, including bone. However, an anabolic effect of androgen treatment on bone in eugonadal subjects has not been observed and clinical trials have been disappointing. The androgen receptor (AR) mediates biological responses to androgens. In bone tissue, both AR and the estrogen receptor (ER) are expressed. Since androgens can be converted into estrogen, the specific role of the AR in maintenance of skeletal homoeostasis remains controversial. The goal of this study was to use skeletally targeted overexpression of AR in differentiated osteoblasts as a means of elucidating the specific role(s) for AR transactivation in the mature bone compartment. Transgenic mice overexpressing AR under the control of the 2.3-kb α1(I)-collagen promoter fragment showed no difference in body composition, testosterone, or 17ß-estradiol levels. However, transgenic males have reduced serum osteocalcin, CTx and TRAPC5b levels, and a bone phenotype was observed. In cortical bone, high-resolution micro-computed tomography revealed no difference in periosteal perimeter but a significant reduction in cortical bone area due to an enlarged marrow cavity. Endocortical bone formation rate was also significantly inhibited. Biomechanical analyses showed decreased whole bone strength and quality, with significant reductions in all parameters tested. Trabecular morphology was altered, with increased bone volume comprised of more trabeculae that were closer together but not thicker. Expression of genes involved in bone formation and bone resorption was significantly reduced. The consequences of androgen action are compartment-specific; anabolic effects are exhibited exclusively at periosteal surfaces, but in mature osteoblasts androgens inhibited osteogenesis with detrimental effects on matrix quality, bone fragility and whole bone strength. Thus, the present data demonstrate that enhanced androgen signaling targeted to bone results in low bone turnover and inhibition of bone formation by differentiated osteoblasts. These results indicate that direct androgen action in mature osteoblasts is not anabolic, and raise concerns regarding anabolic steroid abuse in the developing skeleton or high-dose treatment in eugonadal adults.

Detection of anabolic steroid abuse using a yeast transactivation system

The classical analytical method for detection of anabolic steroid abuse is gas chromatography followed by mass spectrometry (GC/MS). However, even molecules with a chemical structure typical for this class of substances, are sometimes not identified in routine screening by GC/MS when their precise chemical structure is still unknown. A supplementary approach to identify anabolic steroid abuse could be a structure-independent identification of anabolic steroids based on their biological activity. To test the suitability of such a system, we have analyzed the yeast androgen receptor (AR) reporter gene system to identify anabolic steroids in human urine samples. Analysis of different anabolic steroids dissolved in buffer demonstrated that the yeast reporter gene system is able to detect a variety of different anabolic steroids and their metabolites with high specificity, including the so-called ‘designer steroid’ tetrahydrogestrinone. In contrast, other non-androgenic steroids, like glucocordicoids, progestins, mineralocordicoids and estrogens had a low potency to stimulate transactivation. To test whether the system would also allow the detection of androgens in urine, experiments with spiked urine samples were performed. The androgen reporter gene in yeast responds very sensitive to 5α-dihydrotestosterone (DHT), even at high urine concentrations. To examine whether the test system would also be able to detect anabolic steroids in the urine of anabolic steroid abusers, anonymous urine samples previously characterized by GCMS were analyzed with the reporter gene assay. Even when the concentration of the anabolic metabolites was comparatively low in some positive samples it was possible to identify the majority of positive samples by their biological activity. In conclusion, our results demonstrate that the yeast reporter gene system detects anabolic steroids and corresponding metabolites with high sensitivity even in urine of anabolic steroid abusing athletes. Therefore we believe that this system can be developed towards a powerful (pre) screening tool for the established doping tests. The system is easy to handle, robust, cost-efficient and needs no high-tech equipment. But most importantly, a biological test system does not require knowledge of the chemical structure of androgenic substances and therefore suitable to detect previously unidentified substances, especially those of the class of so-called designer steroids.

The use of Anabolic Steroids in men’s recreational Fitness Training

Introduction: The aim of this study was to give general overview of using the anabolic steroids among the recre- ational sportsmen and at the same time to analyze other drugs used for immediate help to increase their individual fi tness level. Materials and Methods: The questionnaire has been used to investigate the potential abuse of anabolic steroids among the recreational sportsmen, practicing non-competitive fi tness training at the intermediate level 3 to 4 times per week. Randomly selected 80 men (21.6±3.4 years) from various fi tness centers were asked to fulfi ll the questionnaires anonymously. 80% (64) of question- naires were returned. Results: The most signifi cant fi nding of our study: use of anabolic steroids has been determined by 21% of all respondents; any of anabolic users use the drugs without any professional medical supervision; 36% of present anabolic users are decided to use drugs again in case of harder physical activity or fatigue; 36% of present non-users are decided to use the anabolics in case of physical performance; majority of information on anabolics effects is reached from professional athletes and unoffi cial distributor and common use of anabolics and stimulation drugs without any medical supervision. Discussion: The results of this study should alert to solve the dynamic expansion of anabolics abuse and evaluate the well-known use of anabolics and stimulation drugs to improve physical.

Ischemic Stroke Related to Anabolic Abuse

Anabolic-androgenic steroid (AAS) abuse increased in recent years, and it is associated with numerous adverse effects. Few reports on ischemic stroke related to anabolic steroid abuse have been published. We report a case of a 26-year-old male amateur athlete who suffered a posterior territory ischemic stroke. No abnormalities were found in angiography and echocardiography studies, neither in hemostatic profile. His only significant risk factor was nonmedical use of stanozolol, an anabolic steroid. Anabolic steroids are capable of increasing vascular tone, arterial tension, and platelet aggregation; therefore, they are prone to produce atherothrombotic phenomena. Because of young people's widespread use of anabolic steroids, physicians should be aware of this kind of complication.

アナボリックステロイドの濫用による低ゴナドトロピン性性腺機能低下症の一例

A 32-year-old man complained about a reduction of testicular volume and loss of libido. He had been abusing androgenic anabolic steroids (AAS) for 7 years. Genital examination revealed that both testicular volumes were reduced to 13 ml. Endocrinological investigations showed luteinizing hormone, follicle-stimulating hormone and total testosterone (Total T) levels to be low. The level of free testosterone (Free T) was documented to be high. Later, sex hormone-binding globulin (SHBG) and calculated bioavailable testosterone (cBAT) levels were found to be low. Based on these features, we diagnosed his condition as hypogonadotrophic hypogonadism caused by AAS abuse. We first forbade him to use AAS, but the symptoms and endocrinological features were not improved. Then treatment with injections of human chorionic gonadotropin (hCG) was started. About one month after treatment with hCG started, his symptoms and endocrinological features were not improved. It is well known that AAS abuse induces hypogonadotrophic hypogonadism. It is also reported that normal hormonal function usually recovers after AAS are discontinued, but sometimes the condition is not reversible. In such cases, we should carefully observe the endocrinological features of the patient, and whether the early treatment with hCG injection leads to early recovery of testicular function. It was useful to examine cBAT in this case to understand his endocrinological condition. There are many severe side effects of abusing AAS and thus education about the severe side effects of AAS abuse is necessary.

Anabolic steroid abuse causing recurrent hepatic adenomas and hemorrhage

Anabolic steroid abuse is common among athletes and is associated with a number of medical complications. We describe a case of a 27-year-old male bodybuilder with multiple hepatic adenomas induced by anabolic steroids. He initially presented with tumor hemorrhage and was treated with left lateral hepatic segmentectomy. Regression of the remaining tumors was observed with cessation of steroid use. However, 3 years and a half after his initial hepatic segmentectomy, he presented with recurrent tumor enlargement and intraperitoneal hemorrhage in the setting of steroid abuse relapse. Given his limited hepatic reserve, he was conservatively managed with embolization of the right accessory hepatic artery. This is the first reported case of hepatic adenoma re-growth with recidivistic steroid abuse, complicated by life-threatening hemorrhage. While athletes and bodybuilders are often aware of the legal and social ramifications of steroid abuse, they should continue to be counseled about its serious medical risks.

The many faces of testosterone

Testosterone is more than a "male sex hormone". It is an important contributor to the robust metabolic functioning of multiple bodily systems. The abuse of anabolic steroids by athletes over the years has been one of the major detractors from the investigation and treatment of clinical states that could be caused by or related to male hypogonadism. The unwarranted fear that testosterone therapy would induce prostate cancer has also deterred physicians form pursuing more aggressively the possibility of hypogonadism in symptomatic male patients. In addition to these two mythologies, many physicians believe that testosterone is bad for the male heart. The classical anabolic agents, 17-alkylated steroids, are, indeed, potentially harmful to the liver, to insulin action to lipid metabolism. These substances, however, are not testosterone, which has none of these adverse effects. The current evidence, in fact, strongly suggests that testosterone may be cardioprotective. There is virtually no evidence to implicate testosterone as a cause of prostate cancer. It may exacerbate an existing prostate cancer, although the evidence is flimsy, but it does not likely cause the cancer in the first place. Testosterone has stimulatory effects on bones, muscles, erythropoietin, libido, mood and cognition centres in the brain, penile erection. It is reduced in metabolic syndrome and diabetes and therapy with testosterone in these conditions may provide amelioration by lowering LDL cholesterol, blood sugar, glycated hemoglobin and insulin resistance. The best measure is bio-available testosterone which is the fraction of testosterone not bound to sex hormone binding globulin. Several forms of testosterone administration are available making compliance much less of an issue with testosterone replacement therapy.

Alteration in [11C]vorozole binding to aromatase in neuronal cells of rat brain induced by anabolic androgenic steroids and flutamide

In a previous study, we demonstrated that androgenic-anabolic steroids increased aromatase expression in the bed nucleus of stria terminalis and preoptic area in rat brain, as evaluated using autoradiography with [11C]vorozole, a potential positron emission tomography tracer for aromatase. In this study, we explored whether the increase in aromatase binding is mediated via androgen receptors and whether this increase occurs in neurons or glial cells. Rats were given nandrolone decanoate (15 mg/kg body weight once every 3 days) and flutamide (20 mg/kg/day) alone or in combination for 20 days. Results indicated a significant increase of [11C]vorozole binding by nandrolone decanoate in the bed nucleus of the stria terminalis and preoptic area, as in our previous study. Flutamide treatment, on the other hand, decreased [11C]vorozole binding in the bed nucleus of the stria terminalis, preoptic area, and medial amygdala. Immunohistochemical examination demonstrated that upregulation of aromatase expression occurred in neurons. Our findings suggest that aromatase is regulated through an androgen receptor-mediated system. This aromatase-specific tracer and the positron emission tomography technique could be useful for exploring the role of aromatase in anabolic androgenic steroids abusers.

Isolation of Gordonia terrae from a patient with catheter-related bacteraemia

A cornyeform bacterium was isolated from a blood culture from a 24-year-old man with familial hypertrophic non-obstructive cardiomyopathy, chronic abuse of anabolic steroids and prior admission to hospital because of clinical signs of sepsis. 16S rRNA gene analysis unambiguously identified Gordonia terrae.

Effects of anabolic androgenic steroids on sleep patterns of individuals practicing resistance exercise

Anabolic androgenic steroid (AAS) abuse has become a public health problem in many countries, and is associated with many psychiatric disorders. Epidemiological studies have also found increasing numbers of sleep disorders reported by individuals using AASs. The purpose of this study was to evaluate sleep patterns and disorders in anabolic androgenic users who practice resistance exercise. The sample comprised 58 males divided into three groups: (1) 20 current AAS users aged 26 +/- 1.2, (2) 21 controls with no history of AAS use, aged 26 +/- 1 and (3) 17 sedentary men with no sleep disorders aged 27.2 +/- 0.34. The volunteers spent a night in the sleep laboratory for polysomnography. Comparing the three groups, the user group showed reduced sleep efficiency and more wakings after sleep onset than the sedentary group (P = 0.001). The sedentary group showed a higher percentage of stage 4 than the non-users group. We suggest that using of anabolic steroids reduced sleep efficiency and alters sleep architecture.

Side Effects of Anabolic Androgenic Steroids Abuse

Long-term side effects of high doses of anabolic androgenic steroids self-administration were evaluated in this study. Twenty male bodybuilders, voluntarily starting steroid self-administration, were followed every 6 months over 2 years. Physical examination, haematological, metabolic and endocrine variables, semen analysis, hepatic and prostate ultrasound and echocardiographic evaluations were performed. LH values (baseline 3.43 +/- 1.75) were suppressed at 18 (1.98 +/- 1.99) (p = 0.026) and 24 (2.43 +/- 2.17) (p = 0.026), and FSH (3.95 +/- 2.01) at 6 (3.01 +/- 2.16) (p = 0.031), 12 (2.45 +/- 2.54) (p = 0.029), 18 (2.02 +/- 2.29) (p = 0.032) and 24 (3.42 +/- 2.64) (p = 0.032) months and SHBG (34.11 +/- 10.88) values significantly lowered at 12 (24.81 +/- 12.49) (p < 0.05), 18 (21.28 +/- 11.15) (p < 0.01), 24 months (25.42 +/- 11.16) (p < 0.01). A significant decrease in spermatozoa count (p < 0.01), and fertility index (p = 0.01) occurred. HDL-cholesterol (baseline 56.94 +/- 13.54) was reduced at 18 (41.86 +/- 14.17) (p < 0.01) and 24 (43.82 +/- 18.67) (p < 0.05) months and Apo A-1 at 12 (p < 0.001), 18 (p = 0.05) and 24 (p = 0.05) months. The most important long-term adverse effects were lower fertility and the impairment of lipid profile associated with an increased cardiovascular risk.

Nandrolone Potentiates Arrhythmogenic Effects of Cardiac Ischemia in the Rat

Anabolic steroid abuse has been associated with thrombosis and arteriosclerosis, both of which predispose to myocardial ischemia and infarction. However, there are reports of sudden cardiac death in the absence of thrombus and atheroma following anabolic steroid use. Although treatment with the commonly abused steroid, nandrolone, has been shown to decrease recovery of systolic function following ischemia in isolated rat hearts, it is unknown whether anabolic steroids can increase the incidence of fatal arrhythmia associated with cardiac ischemia. Anesthetized male Sprague-Dawley rats were administered vehicle or nandrolone (10-160 microg/kg/min iv) 10 min prior to 15-min occlusion of the left anterior descending coronary artery followed by 10-min reperfusion. Nandrolone, in this dose range, did not significantly change heart rate, blood pressure, or cardiac rhythm in the absence of ischemia. However, the fraction of rats surviving ischemia was significantly (p < 0.05) decreased by nandrolone at both 40 and 160 microg/kg/min, while survival time during ischemia was decreased significantly (p < 0.001) by nandrolone 160 microg/kg/min. An increase (p < 0.05) in the duration of ventricular fibrillation was noted at the highest compared to the lowest dose of nandrolone, corresponding to a significant increase in the fraction of rats experiencing ventricular fibrillation (p < 0.01). Nandrolone had no effect on the frequency or duration of ventricular fibrillation or survival time during reperfusion. Although the mechanisms underlying these effects are currently unclear, they indicate that exposure to anabolic steroids in combination with transient reductions in coronary blood flow may explain some reports of sudden cardiac death in anabolic steroid users.

Troubled social background of male anabolic-androgenic steroid abusers in treatment

BackgroundThe aim of this study was to investigate the social background and current social situation of male abusers of anabolic-androgenic steroids (AAS).MethodsWe compared thirty-four AAS-abusing patients from an Addiction Centre (AC) with two groups, 18 users and 259 non-users of AAS from a public gym in Orebro, Sweden. The study is based on semi-structured interviews and questionnaires.ResultsHistories of a troubled childhood as well as current social disadvantage were both more frequent among the AAS users. Users also reported poor relationships with their parents and almost half of them had experienced physical or mental abuse. The AC group's experiences from school were mostly negative, and included concentration problems, boredom and learning difficulties. Their current circumstance included abuse of other drugs, battering of spouses and other criminality such as assault, illegal possession of weapons and theft.ConclusionIn conclusion, this study shows that abusers of AAS often have a troubled social background. This underlines the importance of making a thorough social assessment as a part of the treatment programme. The results of the study may help in directing appropriate questions relevant to the abuse of AAS.

Population-based reference values for bone mineral density in young men

Population-based reference values for peak bone mass density in Danish men. BMD of total hip (1.078 +/- 0,14 g/cm2) differed significantly from values from National Health and Nutrition Examination Survey III and of total lumbar spine ((1.073 +/- 0.125 g/cm2) differed significantly from Hologic values. Geographic, ethnic, and socio-economic factors are known to affect bone mineral density (BMD) and peak bone mass significantly. Reference values for male peak bone mass are scarce, and the diagnosis of male osteoporosis often relies on values provided by producers of dual-energy X-ray absorptiometry (DXA) equipment. The aim of the present study was 1) to establish population-based reference values for BMD in young men and 2) to study subgroups based on variables with suspected impact on bone metabolism. We included 783 young Caucasian men aged 20 to 30 years in the Odense Androgen Study (OAS). Peak BMD was attained within the third decade. Obesity (BMI > 30 kg/m2) was associated with higher BMD. Abuse of anabolic steroids as well as chronic illness was associated with lower BMD. Our population-based reference values for BMD of the total hip (1.078 +/- 0.14 g/cm2) differed significantly from published values from National Health and Nutrition Examination Survey III for non-Hispanic white men, while BMD of total lumbar spine (1.073 +/- 0.125 g/cm2) differed significantly from Hologic reference values. Locally derived reference values are important to avoid false positive or false negative findings during work-up in patients evaluated for osteoporosis.

Severe laryngitis following chronic anabolic steroid abuse

The effects of anabolic steroids on the quality of voice have been well documented; however, no study has established significant structural changes in the larynx as a direct result of anabolic steroid use. We report a unique case of a 47-year-old male smoker and professional body builder who presented with progressive stridor and hoarseness following abuse of anabolic steroids over a period of two years. Conservative management failed to resolve his symptoms and a planned tracheostomy was performed to secure his airway. Subsequently he was treated with multiple laser resections and eventually decannulated. No case of severe laryngitis in association with anabolic steroid usage has been reported previously in the literature.

Anabolic steroid abuse: psychiatric and physical costs.

The psychiatric effects of anabolic-androgenic steroids (i.e., testosterone and its derivatives) have been less well studied than their physical effects but are reported to include depression, mania, psychosis, and aggression. Dependence can also occur, with withdrawal involving psychiatric and physical symptoms. Adverse effects of steroid abuse should be managed by discontinuing the drugs-by tapering if necessary-and by treating the symptoms.

Structural sperm and aneuploidies studies in a case of spermatogenesis recovery after the use of androgenic anabolic steroids

Azoospermia may sometimes be related to the use of androgenic anabolic steroids. We report the case of an azoospermic man who had abused androgenic anabolic steroids and who recovered spermatogenesis six months after cessation of abuse and the administration of hormonal therapy. An azoospermic 34-year-old man came to Regional Referral Center for Male Infertility. The recovery of spermatogenesis was observed after the cessation of abuse of steroids and the administration of hormonal therapy. Ultrastructural analysis of sperm was carried out by transmission electron microscopy, and the meiotic segregation of chromosomes 1, 9, 18, X, Y was investigated. Mathematically elaborated transmission electron microscopy data highlighted seminal features close to normal fertility. Fluorescence in situ hybridisation showed a high frequency of XY disomy in sperm. Our findings confirm the recovery of spermatogenesis but suggest a possible relationship between altered meiotic segregation and the abuse of androgenic anabolic steroids.

Atrial fibrillation and anabolic steroid abuse

Atrial fibrillation (AF) is the most common sustained arrhythmia to occur in humans. Several predisposing substrates such as increasing age, heart failure, hypertension and valvular heart disease have been identified. The use of illicit drugs as the substrate for AF is not frequently recognized.