Misuse Of Hormones Research Articles

Off-Label Use and Misuse of Testosterone, Growth Hormone, Thyroid Hormone, and Adrenal Supplements: Risks and Costs of a Growing Problem

Over the past few decades, there has been an unprecedented rise in off-label use and misuse of testosterone, growth hormone, thyroid hormone, and adrenal supplements. Testosterone therapy is often promoted to men for the treatment of low energy, lower libido, erectile dysfunction, and other symptoms. Growth hormone is used in attempts to improve athletic performance in athletes and to attenuate aging in older adults. Thyroid hormone and/or thyroid supplements or boosters are taken to treat fatigue, obesity, depression, cognitive impairment, impaired physical performance, and infertility. Adrenal supplements are used to treat common nonspecific symptoms due to "adrenal fatigue," an entity that has not been recognized as a legitimate medical diagnosis. Several factors have contributed to the surge in off-label use and misuse of these hormones and supplements: direct-to-consumer advertising, websites claiming to provide legitimate medical information, and for-profit facilities promoting therapies for men's health and anti-aging. The off-label use and misuse of hormones and supplements in individuals without an established endocrine diagnosis carries known and unknown risks. For example, the risks of growth hormone abuse in athletes and older adults are unknown due to a paucity of studies and because those who abuse this hormone often take supraphysiologic doses in sporadic intervals. In addition to the health risks, off-label use of these hormones and supplements generates billions of dollars of unnecessary costs to patients and to the overall health-care system. It is important that patients honestly disclose to their providers off-label hormone use, as it may affect their health and treatment plan. General medical practitioners and adult endocrinologists should be able to begin a discussion with their patients regarding the unfavorable balance between the risks and benefits associated with off-label use of testosterone, growth hormone, thyroid hormone, and adrenal supplements. Abbreviations: DHEA = dehydroepiandrosterone; FDA = U.S. Food and Drug Administration; GH = growth hormone; IGF-1 = insulin-like growth factor 1; LT3 = L-triiodothyronine; LT4 = levothyroxine; T3 = total triiodothyronine; T4 = thyroxine; TSH = thyroid-stimulating hormone.

Multi-class determination of steroid hormones and antibiotics in fatty hotpot ingredients by pressurized liquid extraction and liquid chromatography–tandem mass spectrometry

Due to the misuse of hormones and antibiotics resulting in drug residues in meat products, serious concerns have arisen regarding to the potential risks for human health. In this paper, a simple and efficient method was developed to simultaneously quantify six steroid hormones and six antibiotics in fatty foods by combining pressurized liquid extraction (PLE) with ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Adsorbents, extraction temperature, extraction time, recycle time and several other parameters were optimized in current investigation. The optimized PLE method was employed by using n-hexane-methanol-acetonitrile (2:1:1, v/v/v) as extraction solvent, silica gel as lipid sorbent, and the optimum parameters were 60 °C, 1500 psi and 10 min, respectively. Under the optimal conditions, the recoveries of spiked samples ranged from 82.2% to 115.0%. The limits of quantifications (LODs) were from 0.4 to 25.0 μg/kg. The developed PLE method was successfully applied to analyze steroid hormones and antibiotics in 27 fatty foods of hotpot ingredients without any additional clean-up steps. The results showed that the residues of estradiol benzoate (EB) and enrofloxacin (EN) in some matrices were much higher than maximum residue limits (MRLs) value, especially EB in fish, which exceeded 176.7 μg/kg. The results demonstrated that the developed method was sensitive and efficient in testing hotpot ingredients, and was an excellent analytical tool for monitoring residues of steroid hormones and antibiotics in fatty foods.

New surveillance concepts in food safety in meat producing animals: the advantage of high throughput 'omics' technologies - A review.

The misuse of anabolic hormones or illegal drugs is a ubiquitous problem in animal husbandry and in food safety. The ban on growth promotants in food producing animals in the European Union is well controlled. However, application regimens that are difficult to detect persist, including newly designed anabolic drugs and complex hormone cocktails. Therefore identification of molecular endogenous biomarkers which are based on the physiological response after the illicit treatment has become a focus of detection methods. The analysis of the ‘transcriptome’ has been shown to have promise to discover the misuse of anabolic drugs, by indirect detection of their pharmacological action in organs or selected tissues. Various studies have measured gene expression changes after illegal drug or hormone application. So-called transcriptomic biomarkers were quantified at the mRNA and/or microRNA level by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) technology or by more modern ‘omics’ and high throughput technologies including RNA-sequencing (RNA-Seq). With the addition of advanced bioinformatical approaches such as hierarchical clustering analysis or dynamic principal components analysis, a valid ‘biomarker signature’ can be established to discriminate between treated and untreated individuals. It has been shown in numerous animal and cell culture studies, that identification of treated animals is possible via our transcriptional biomarker approach. The high throughput sequencing approach is also capable of discovering new biomarker candidates and, in combination with quantitative RT-qPCR, validation and confirmation of biomarkers has been possible. These results from animal production and food safety studies demonstrate that analysis of the transcriptome has high potential as a new screening method using transcriptional ‘biomarker signatures’ based on the physiological response triggered by illegal substances.

Use and misuse of hormones in sport

Use and misuse of hormones in sport

Residues of synthetic hormones in pork, Madagascar

In Madagascar, little information is available on drug residues in animal products. Official veterinary services have been recently informed about the misuse of human injectable contraceptives in pig farms. Farmers and local animal health workers have been suspected of treating pigs for growth promotion and of using human progestins, especially medroxyprogesterone acetate (MPA), as a chemical alternative method for castration of sows that are then fattened before culling. Indeed, MPA may arrest the onset of farrowing and induce post-lactational anestrus in sows.Because the use of synthetic hormones in pig husbandry is consid­ered a fraud by the Malagasy legislation, an exploratory study was carried out to confirm these suspicions and investigate the main molecules concerned.We investigated 80 pigs slaughtered in seven Malagasy abattoirs and raised in eight (out of 22) Malagasy regions (i) to confirm the contamination of carcasses by anabolic hormones by liquid chromatography coupled to mass spectrometry (LC-MS/MS), (ii) to identify the concerned molecules, and (iii) to explore consumers’ exposure to hormone residues. Only adult sows were sampled con­sidering that chemical castration with progestogens was the most common hypothesis of misuse of synthetic hormones in the field.The screening of the 80 kidney-fat samples did not reveal residues of progestogens other than MPA. MPA-positive samples were detected in 10 out of 15 districts (66.7%), and in all eight surveyed regions except one (87.5%), Diana Region in Northern Madagascar. Our results revealed heavy contamination of pork products by synthetic hormone residues; its prevalence was high considering that such residues are not supposed to occur accord­ing to the Malagasy legislation. Investigations by Malagasy vet­erinary services revealed that farmers and animal health workers purchased syringes of progestogens (Confiance™, Pfizer). These low-price progestins are easily available in private local dispen­saries and basic health centers (public sector).Without any control, farmers can easily administer MPA to pigs. It has thus become urgent to launch public-awareness campaigns and improve control within the sectors of animal production and public health over the entire country.

Fatal aconitine intoxication or thyroid storm? A case report

The case of a female in the latter half of her teens found dead in her father’s apartment is reported. A glass containing liquid and plant remnants was found at the death scene. There were no indications of any intervention or the application of force by a third party.Autopsy showed unremarkable findings. Toxicological investigations revealed lethal doses of aconitine, a highly poisonous alkaloid and the major active compound of Aconitum napellus, in all specimens. Plant remnants were identified as A. napellus leaves by a botanist and toxicological examination of the liquid in the glass on site showed extremely high concentrations of aconitine.Additionally, laboratory results revealed that the young female was suffering from thyrotoxicosis factitia, an uncommon form of hyperthyroidism caused by misuse or overdosing of thyroid hormones in order to loose weight. A rare but serious and often fatal complication of hyperthyroidism is thyroid storm.Eventually the condition of thyroid storm due to thyrotoxicosis factitia could have contributed to the woman’s death from aconitine poisoning.

Application of Stable Carbon Isotope Analysis to the Detection of Testosterone Administration to Cattle

The use of anabolic substances is prohibited in food-producing animals throughout the European Union. No method is available to reliably detect the misuse of natural hormones in cattle. A method was developed to detect the abuse of testosterone in cattle fattening. Synthesized testosterone is rather depleted in the (13)C/(12)C ratio. Hence, the method is based on gas chromatography/combustion/isotope ratio mass spectrometry (GC/C/IRMS) analysis of urine. To select testosterone metabolites and endogenous reference compounds (ERC), the concentration of urinary steroids of cattle was investigated. Dehydroepiandrosterone and androst-5ene-3beta,17alpha-diol were chosen as ERCs to show endogenous (13)C/(12)C ratios. Etiocholanolone and 5alpha-androstane-3beta,17alpha-diol were chosen as the most important testosterone metabolites. Other metabolites known from literature like epitestosterone were less promising. In principle, GC/C/IRMS is a nonspecific method because finally carbon dioxide is analyzed. Therefore, a dedicated cleanup procedure for the selected steroids was developed. By means of proposed confidence intervals in the isotopic composition of ERCs and metabolites, the administration of testosterone to cattle could be detected reliably. Differences of up to 11 per thousand on the delta-scale between ERC and testosterone metabolites were found after testosterone administration, whereas endogenous differences did not exceed 2 per thousand.

Application of high-performance thin-layer chromatography and gas chromatography-mass spectrometry to the detection of new anabolic steroids used as growth promoters in cattle fattening

The misuse of natural and synthetic hormones as growth promotors in cattle fattening, although forbidden within the European Community, is well known. Frequently these hormones are injected into the animal as highly concentrated mixtures (the so-called “hormone cocktails”), which usually stay locally at the site of injection from where they are distributed by a slow diffusion process. The analysis of these injection sites by an HPTLC method following a simple and unselective extraction yields a good picture of the compounds which are misused. Although almost 40 hormone reference standards are run with the sample, unknown spots regularly appear on the HPTLC plates, demonstrating that attempts are continuously made to bypass the laboratory controls by introducing new products on the black market. By continuously gathering HPTLC data for a broad range of hormones which were not yet known to be used in cattle fattening, it was possible to elucidate quickly the identities of two new spots that appeared on the chromatogram in the period between the end of 1992 and early 1993. These new compounds that were found in injection sites were the gestagens delmadinone acetate and algestone acetophenide. Their identities were confirmed by GC-MS analysis.

The use and misuse of hormones in veterinary practice: some recent developments in steroid therapy.

The use and misuse of hormones in veterinary practice: some recent developments in steroid therapy.