Anabolic Steroid Abuse Research Articles

Anabolic-androgenic steroid use and psychopathology in athletes. A systematic review.

The use of anabolic-androgenic steroids (AASs) by professional and recreational athletes is increasing worldwide. The underlying motivations are mainly performance enhancement and body image improvement. AAS abuse and dependence, which are specifically classified and coded by the DSM-5, are not uncommon. AAS-using athletes are frequently present with psychiatric symptoms and disorders, mainly somatoform and eating, but also mood, and schizophrenia-related disorders. Some psychiatric disorders are typical of athletes, like muscle dysmorphia. This raises the issue of whether AAS use causes these disorders in athletes, by determining neuroadaptive changes in the reward neural circuit or by exacerbating stress vulnerability, or rather these are athletes with premorbid abnormal personalities or a history of psychiatric disorders who are attracted to AAS use, prompted by the desire to improve their appearance and control their weights. This may predispose to eating disorders, but AASs also show mood destabilizing effects, with longterm use inducing depression and short-term hypomania; withdrawal/discontinuation may be accompanied by depression. The effects of AASs on anxiety behavior are unclear and studies are inconsistent. AASs are also linked to psychotic behavior. The psychological characteristics that could prompt athletes to use AASs have not been elucidated.

Contemporary Patterns of Anabolic Steroids Abuse and Associated Short Term Side Effects in Athletes

Contemporary Patterns of Anabolic Steroids Abuse and Associated Short Term Side Effects in Athletes

Analytical procedure for steroid profiling valid for Athlete Biological Passport

AbstractAlthough various attempts have been made to eliminate doping in sport, hitherto they all have proved futile. Moreover, the main class of substances that jeopardises the fair play rule remains the same - anabolic androgenic steroids (AAS). To date, longitudinal monitoring of the fluctuations of the endogenous steroids content for a given athlete is regardeded as the most effective approach to the detection of AAS abuse. This is based on the fact that the activity of the steroid biosynthesis pathway may undergo significant changes in response to the AAS administration. This paper presents the entire analytical procedure for quantification of steroids crucial for the Athlete Biological Passport (ABP): testosterone, epitestosterone, dehydroepiandrosterone, androsterone, etiocholanolone, 5-α-androstandiol and 5-β-androstandiol. The procedure consists of a four-step sample preparation process followed by analysis by gas chromatography coupled with mass spectrometry. The limits of quantification for the substances listed above were; 0.44 ng mL

The cutaneous bacterial microflora of the bodybuilders using anabolic-androgenic steroids.

Background:Anabolic-androgenic steroids (AAS) abuse by the athletes has dramatically increased during the recent decades. These substances might increase the skin lipids and enhance the cutaneous microbial proliferation.Objectives:The current study aimed to investigate the potential side effects of AAS on the bacterial microflora colonization of the bodybuilders` skin.Patients and Methods:The skin samples of 94 male bodybuilders (71 AAS users, 23 non-AAS users) and 46 subjects of the control group, with similar gender and age, were cultured and incubated in both aerobic condition to isolate Staphylococcus aureus and anaerobic condition for Propionibacterium acnes. The isolated bacteria were identified by standard microbiological techniques.Results:The skin lesions were more frequent in the body builders than the controls. Moreover, statistically significant differences were also observed in skin lesions among the AAS users and the non-AAS user athletes. The prevalence of S. aureus and P. acnes in the athletes was higher than that of the control group. In addition, there was a significant difference in distribution of P. acnes between the bodybuilders who used AAS and those who did not.Conclusions:A higher number of bacterial flora was found in the bodybuilders particularly those using AAS in comparison to the controls, which might be due to the influence of these AAS on the skin microflora and transmission of the bacteria through the direct contact of the naked skin with the exercise instruments.

Effects of different doses of testosterone on gonadotropins, 25-hydroxyvitamin D3, and blood lipids in healthy men.

AimsTo study the effect and time profile of different doses of testosterone enanthate on the blood lipid profile and gonadotropins.Experimental designTwenty-five healthy male volunteers aged 27–43 years were given 500 mg, 250 mg, and 125 mg of testosterone enanthate as single intramuscular doses of Testoviron® Depot. Luteinizing hormone (LH), follicle-stimulating hormone (FSH), blood lipid profile (total cholesterol, plasma [p-] low-density lipoprotein, p-high-density lipoprotein [HDL], p-apolipoprotein A1 [ApoA1], p-apolipoprotein B, p-triglycerides, p-lipoprotein(a), serum [s-] testosterone, and 25-hydroxyvitamin D3) were analyzed prior to, and 4 and 14 days after dosing. Testosterone and epitestosterone in urine (testosterone/epitestosterone ratio) were analyzed prior to each dose after a washout period of 6–8 weeks.Results and discussionAll doses investigated suppressed the LH and FSH concentrations in serum. LH remained suppressed 6 weeks after the 500 mg dose. These results indicate that testosterone has a more profound endocrine effect on the hypothalamic–pituitary–gonadal axis than was previously thought. There was no alteration in 25-hydroxyvitamin D3 levels after testosterone administration compared to baseline levels. The 250 and 500 mg doses induced decreased concentrations of ApoA1 and HDL, whereas the lowest dose (125 mg) did not have any effect on the lipid profile.ConclusionThe single doses of testosterone produced a dose-dependent increase in serum testosterone concentrations together with suppression of s-LH and s-FSH. Alterations in ApoA1 and HDL were observed after the two highest single doses. It is possible that long-time abuse of anabolic androgenic steroids will lead to alteration in vitamin D status. Knowledge and understanding of the side effects of anabolic androgenic steroids are important to the treatment and care of abusers of testosterone.

Prolonged impairment of sexual function associated with anabolic–androgenic steroid abuse: An underrecognized problem

Prolonged impairment of sexual function associated with anabolic–androgenic steroid abuse: An underrecognized problem

Characteristics and outcome of patients with heart failure due to anabolic-androgenic steroids

Objectives. The objective of the study was to analyse the outcome of patients with advanced heart failure due to abuse of anabolic–androgenic steroids. Design. A retrospective chart review of patients admitted or referred for advanced heart failure, due to anabolic–androgenic steroid abuse, in the period 2009–2013 was performed. Results. In 6 of 9 patients (median age: 31, all males) referred in the study period, some potential for recovery of left ventricular (LV) function was seen (P < 0.002), with a maximal improvement in LV ejection fraction reached within 6 months of treatment with angiotensin-converting enzyme inhibitors and beta-blockers. The remaining 3 patients required implantation of a LV assist device (LVAD) and were listed for heart transplantation. No recovery of LV function in the patients treated with assist device was seen. Conclusion. Anabolic–androgenic steroid-induced advanced heart failure is generally not a reversible condition. If diagnosed in the early stages some recovery of ventricular function is possible, but the long-term prognosis is uncertain. Likely, a substantial proportion of patients will eventually require LVADs or cardiac transplantation.

Multiple Intussusceptions in an Anabolic Steroid Abuser

Introduction: Intussusception is generally associated with mechanical lead points as well as localized inflammation, which serves as a focus for the telescoping of intestine upon itself. Consistent with previous reports, our patient’s use of steroids appears to have contributed to the development of polycythemia, which led to hyperviscosity and intravascular sludging. The subsequent mesenteric ischemia, associated bowel wall thickening, likely resulted in our patient developing multiple intussusceptions. The only potential identified risk factor in our otherwise relatively healthy patient was his chronic use of anabolic steroids. We present the unique case of a 34-year-old recreational body builder who presented with multiple simultaneous small bowel intussusceptions. His past medical history included only hypertension, dyslipidemia, hiatal hernia, and IBS. The patient presented with complaints of severe cramping abdominal pain associated with constipation, nausea, vomiting, and bright red blood per rectum. He admitted to the use of anabolic steroids, and was taking 1,500 mg of testosterone/nadrolone via injection weekly. Laboratory studies revealed a WBC count at 15.0, hemoglobin of 17.9, and hematocrit of 51.2%. A CT scan of the abdomen demonstrated mild diffuse colonic wall thickening with 2 separate areas of short segment, small bowel intussusception, without evidence of obstruction. A colonoscopy demonstrated edema as well as diffuse erythema in the distal ileum and colon, most densely starting in the distal transverse colon and increasing within the rectum. Biopsies were taken from each section of the colon and their pathology indicated acute and chronic colitis from the descending colon forward, as well as changes suggesting ischemic colitis in the rectum. The patient was conservatively medically managed, including aggressive hydration and pain management. A follow-up CT 3 days after presentation demonstrated resolution of the small bowel intussusceptions, and overt colitis was no longer evidenced, clinically. Our patient had no identifiable risk factors for intussusception. The only potential cause was ischemic colitis secondary to polycythemia, attributable to our patient’s supraphysiologic steroid levels. Our case presented a unique diagnostic as well as therapeutic challenge, since its presentation as a complication of anabolic steroid abuse has not been overtly reported.

The anabolic androgenic steroid nandrolone decanoate disrupts redox homeostasis in liver, heart and kidney of male Wistar rats.

The abuse of anabolic androgenic steroids (AAS) may cause side effects in several tissues. Oxidative stress is linked to the pathophysiology of most of these alterations, being involved in fibrosis, cellular proliferation, tumorigenesis, amongst others. Thus, the aim of this study was to determine the impact of supraphysiological doses of nandrolone decanoate (DECA) on the redox balance of liver, heart and kidney. Wistar male rats were treated with intramuscular injections of vehicle or DECA (1 mg.100 g−1 body weight) once a week for 8 weeks. The activity and mRNA levels of NADPH Oxidase (NOX), and the activity of catalase, glutathione peroxidase (GPx) and total superoxide dismutase (SOD), as well as the reduced thiol and carbonyl residue proteins, were measured in liver, heart and kidney. DECA treatment increased NOX activity in heart and liver, but NOX2 mRNA levels were only increased in heart. Liver catalase and SOD activities were decreased in the DECA-treated group, but only catalase activity was decreased in the kidney. No differences were detected in GPx activity. Thiol residues were decreased in the liver and kidney of treated animals in comparison to the control group, while carbonyl residues were increased in the kidney after the treatment. Taken together, our results show that chronically administered DECA is able to disrupt the cellular redox balance, leading to an oxidative stress state.

O uso de esteroides androgénicos anabolizantes e outros suplementos ergogénicos – uma epidemia silenciosa

The abuse of Anabolic Androgenic Steroids (AAS) has become a widespread use among professional and recreational athletes. They are used to improve their physical performance and body image. This article intends to review the Anabolic Androgenic Steroids (AAS) abuse and its clinical management in order to serve as a tool to aid in diagnosis of this potentially serious form of drug abuse. Studies published in Pubmed between 2000‐2013 were included in the review and also from The Journal of Family Practice, American Family Physician, Medicina Desportiva Informa and sites of Autoridade Antidopagem de Portugal and Diário da República. It is important that health professionals be aware, not only for the possible indicators of abuse and its negative health effects, but also its social context. There are other performance‐enhancing drugs that health professionals need to recognize its deleterious health effects.

Androgens and opiates

Abuse of anabolic androgenic steroids (AAS) and opioids intersects in athletics. Evidence from humans and animals suggests that AAS may act in the brain through opioidergic mechanisms, and may potentiate effects of opioids. To determine whether AAS enhance motivation for opioid intake, in this study, male rats were treated chronically for 6 weeks with high levels of testosterone (7.5 mg/kg) or vehicle subcutaneously, and they were tested for morphine self-administration under fixed-ratio (FR) and progressive-ratio (PR) schedules. Initially, rats received chronic morphine infusion (16.8-50 mg/kg/day) over 7 days. Subsequently, rats were tested for morphine self-administration (3.2 mg/kg) 6 h/day for 3 days under an FR1 schedule, and for 7 days under a PR 9-4 schedule. Under the FR1 schedule, controls self-administered more morphine (95.9±8.5 mg/kg) than testosterone-treated rats (63.2±7.2 mg/kg; P<0.05). Under the PR schedule, there was no effect of testosterone on morphine intake or operant responding (26.7±5.7 responses vs. 30.9±5.9 responses for vehicle; NS). To determine whether testosterone enhances morphine sedation, additional rats were treated with testosterone or vehicle and evaluated for locomotor behavior and rearing activity over 30 min in response to saline or 10 mg/kg morphine. Morphine inhibited locomotor activity and rearing; testosterone selectively reduced rearing behavior, but did not alter locomotor behavior. These results suggest that testosterone does not increase motivation for morphine.

G49 Acne fulminans induced by oral isotretinoin

A 13 year-old male presented with a one year history of acne vulgaris, unresponsive to six months of lymecycline, with comedones, pustules and a few small scarring cysts of his...

Advances in The Detection of Designer Steroids in Anti-Doping

The abuse of unknown designer androgenic anabolic steroids (AAS) is considered to be an issue of significant importance, as AAS are the choice of doping preference according to World Anti-doping Agency statistics. In addition, unknown designer AAS are preferred since the World Anti-doping Agency mass spectrometric identification criteria cannot be applied to unknown molecules. Consequently, cheating athletes have a strong motive to use designer AAS in order to both achieve performance enhancement and to escape from testing positive in anti-doping tests. To face the problem, a synergy is required between the anti-doping analytical science and sports anti-doping regulations. This Review examines various aspects of the designer AAS. First, the structural modifications of the already known AAS to create new designer molecules are explained. A list of the designer synthetic and endogenous AAS is then presented. Second, we discuss progress in the detection of designer AAS using: mass spectrometry and bioassays; analytical data processing of the unknown designer AAS; metabolite synthesis; and, long-term storage of urine and blood samples. Finally, the introduction of regulations from sports authorities as preventive measures for long-term storage and reprocessing of samples, initially reported as negatives, is discussed.

The Anabolic Androgenic Steroid Testosterone Propionate Decreases Recognition Memory in Adult Male Rats

Although there are therapeutic applications of the Anabolic Androgenic Steroids (AAS), the predominant use implies the illicit self-administration by athletes and adolescents. In this respect, AAS abuse is associated with untoward effects on brain and behavior. Exposure to supraphysiological doses of AAS leads to changes in anxiety and aggression, but their effects on cognitive functions are poorly understood. We investigated the effects of the AAS testosterone propionate (TP), acutely or chronically administered in supraphysiological doses, on memory in rats. Experiment I - Adult male Wistar rats were treated once with vehicle (Control group, n = 5) or TP (10 mg/kg, n = 5). Behavioral experiments were performed 60 minutes after the single injection, and included the evaluation of spatial working memory and recognition memory. Experiment II - The rats received repeated daily administration of vehicle (n = 6) or TP (n = 7) for 40 days. Behavioral experiments started 23 hours after the last injection. After behavioral procedures, the animals were euthanized, the blood was collected for biochemical analyses and testicles were removed and weighted. Regarding the behavioral assessment, rats chronically treated with TP presented decreased time exploring the novel object when compared to control group. Rats that were treated acutely showed no significant difference compared with control. Acute or chronic treatments with TP were not effective in promoting changes in spatial working memory. Additionally, chronic treatment with TP induced significantly increases in biochemistry marker the enzyme glutamate pyruvate transaminase (SGPT) and a reduction in testicular weight as compared with control. Even though not interfering with spatial working memory performance, AAS abuse could induce deficit on recognition memory.

Multifocal β-catenin activated hepatocellular adenomas (HCA) with malignant transformation in hepatocellular carcinoma (HCC) after abuse of anabolic steroids

Multifocal β-catenin activated hepatocellular adenomas (HCA) with malignant transformation in hepatocellular carcinoma (HCC) after abuse of anabolic steroids

Nandrolone decanoate inhibits gluconeogenesis and decreases fasting glucose in Wistar male rats

The use of anabolic-androgenic steroids to improve physical performance or appearance has increased notably. The doses used are 10- to 100- fold higher than the therapeutic dose (TD), and this abuse can cause several side effects. Glucose metabolism is significantly affected by anabolic-androgenic steroid abuse, but studies about glycemic regulation during fasting are scarce. There are some evidences showing that testosterone can antagonize glucocorticoids action, which are crucial to glucose production during fasting. Thus, the aim of this study was to determine the impact of supraphysiological doses (SDs) of nandrolone decanoate (DECA) on rat glucose metabolism during fasting. Male Wistar rats were treated with i.m. injections of vehicle, a low TD (0.016 mg/100 g b.w.-TD group) or a high SD (1 mg/100 g b.w.-SD group) of DECA, once a week for 8 weeks. After 12 h fasting, we evaluated glucose and pyruvate tolerance tests, liver glycogen content, serum levels of gluconeogenic substrates, insulin and corticosterone, glucose uptake and hexokinase (HK) activity in skeletal muscle, and the adrenal catecholamine content. SD group had increased serum insulin levels and a blunted response to insulin regarding glucose uptake in skeletal muscle. Fasting serum glucose decreased significantly in SD group, as well as the pyruvate tolerance test and liver glycogen content. Moreover, serum levels of glycerol were increased in SD group. Our data indicate that SDs of DECA exert effects on different regulatory points of glucose metabolism, resulting in defective gluconeogenesis and decreased skeletal muscle glucose uptake in response to insulin.

Can appearance conversations explain differences between gay and heterosexual men’s body dissatisfaction?

Men's body dissatisfaction is prevalent and a serious health concern as it is associated with negative outcomes including depression, disordered eating, and anabolic steroid abuse. Gay men are particularly vulnerable to body dissatisfaction, perhaps due to heightened sociocultural appearance pressures experienced in gay subculture. Appearance conversations represent an underresearched, but potentially potent, mechanism of appearance pressures. The current study explored whether differences in the frequency of engaging in appearance conversations accounted for differences in body dissatisfaction and associated risk factors among gay and heterosexual men. A purposeful sample of gay (N = 77, Mage = 32.57) and heterosexual (N = 78, Mage = 25.30) men were recruited from community organizations in the United Kingdom. Participants completed an online questionnaire assessing appearance conversations, body dissatisfaction, appearance orientation, and internalization of appearance ideals. Gay men reported more frequent engagement in positive and negative appearance conversations and greater body dissatisfaction, appearance orientation, and general internalization than heterosexual men. Moreover, frequency of appearance conversations mediated the relationship between sexuality and the majority of study variables, including body dissatisfaction (ps<.05). These findings suggest that appearance conversations are an important sociocultural influence on male body image and that they are important in understanding the differences between gay and heterosexual men's body dissatisfaction and associated risk factors. © 2013 American Psychological Association.

Abstract 18278: Anabolic-Androgenic Steroid Use is Associated With Systolic and Diastolic Left Ventricular Dysfunction

Background: Illicit anabolic-androgenic steroid (AAS) abuse is a worldwide public health problem. While several small recent human studies suggest that AAS abuse leads to left ventricular (LV) dysfunction, this association remains incompletely explored. We therefore examined LV function in long-term AAS users (≥2 years of lifetime AAS) and age-matched, non-user comparison men. Methods: All participants underwent a structured clinical interview to obtain a detailed medical history, prior use of AAS and other illicit drugs, and exercise exposure followed by standard 2-dimensional transthoracic echocardiography. LV systolic function was assessed by LV ejection fraction (bi-plane method) and LV diastolic function was assessed using early LV relaxation velocity (E’). Groups were compared by linear regression with adjustment for traditional cardiovascular risk factors and lifetime use of other drugs. Results: We evaluated 33 weightlifting current AAS users (mean [SD] age 44.0 [5.7] years), 18 weightlifting prior AAS users with &gt; 3 months of abstinence (42.4 [4.2] years), 19 non-AAS-using weightlifters (43.2 [5.2] years), and 18 non-AAS-using non-weightlifting men (42.4 [5.2] years). Current AAS users had significantly lower LV ejection fractions than non-AAS-using weightlifters and non-weightlifting men (Table). Similarly, current AAS users showed impaired diastolic function compared to non-AAS-using weightlifters and non-weightlifting men (Table). Of note, prior AAS users showed no significant difference from the two non-AAS comparison groups, and were significantly better than current users on both indices of LV function. Conclusions: Current AAS use is associated with statistically and clinically significant impairment of LV function. Although further confirmatory study is required, these findings suggest that AAS-induced LV dysfunction is a serious but potentially reversible pathology that regresses with AAS abstinence.

Chronic nandrolone administration induces dysfunction of the reward pathway in rats

Data in animal models and surveys in humans have revealed psychiatric complications of long-term anabolic androgenic steroid abuse. However, the neurobiochemical mechanisms behind the observed behavioral changes are poorly understood.The aim of the present study was to investigate the effects of nandrolone decanoate on emotional behavior and neurochemical brain alterations in gonadally intact male rats.The behavioral reactivity to the elevated plus maze and the social interaction test was used to assess anxiety-related symptoms, and the sucrose preference test was used to evaluate anhedonia. Dopaminergic, serotonergic and noradrenergic transmissions were also evaluated in selected brain areas.The chronic administration of nandrolone, at 5mgkg−1 injected daily for 4weeks, induced the loss of sweet taste preference, a sign of anhedonia and dysfunction of the reward pathway. The behavioral outcomes were accompanied by reductions in the dopamine, serotonin and noradrenaline contents in the nucleus accumbens. Alterations in the time spent in the open arms and in the social interaction test were not found, suggesting that nandrolone did not induce an anxiogenic profile. No differences were revealed between the experimental groups in the amygdala in terms of the neurotransmitters measured.Our data suggest that nandrolone-treated rats have a depressive, but not anxiogenic-like, profile, accompanied by brain region-dependent changes in dopaminergic, serotonergic and noradrenergic neurotransmission. As anabolic androgenic steroid dependence is plausibly the major form of worldwide substance dependence that remains largely unexplored, it should be highlighted that our data could contribute to a better understanding of the altered rewards induced by nandrolone treatment and to the development of appropriate treatments.

Androgenic Anabolic Steroid, Cocaine and Amphetamine Abuse and Adverse Cardiovascular Effects

Introduction:Anabolic-androgenic steroids (AAS), a synthetic derivate of testosterone, have become a popular drug among athletes and bodybuilders to enhance muscle mass and improve the athletic performance. Many pathological effects such as hepatic and endocrine dysfunction, behavioural changes and cardiovascular complications have been reported.Case Report:Within these ast ones, we find an increase in left ventricular muscle mass, concentric myocardial hypertrophy, left ventricular diastolic dysfunction, arterial hypertension, prothrombotic effects, changes in the concentration of cholesterol levels, particularly a reduction in HDL cholesterol concentration, myocardial infarctions in relation to endothelial dysfunction, vasospasms or thrombosis and sudden cardiac death.Discussion:We report the case of a 32-year-old patient with a history of arterial hypertension, depressive syndrome and consumption of cocaine, amphetamines and AAS who developed severe left ventricular systolic dysfunction and myocardial hypertrophy with signs of heart failure and peripheral arterial embolism.