Society loves a winner and top
reap large social and monetary rewards. It is
not surprising that some will grasp at anything
that might increase their
including “juice,” or anabolic
These drugs are variants of the male
by pharmaceutical companies. They were
introduced in the 1950s to treat anemia
and certain muscle-wasting diseases and
to prevent muscle atrophy in patients
immobilized after surgery. Testosterone is
responsible for the increase in muscle and
bone mass and other physical changes
that occur during puberty and converts
boys into men.
Convinced that megadoses of steroids
could produce enhanced masculinizing
effects in grown men, many athletes and
bodybuilders were using them by the early
1960s, a practice that is still going on.
Investigations have stunned sports fans
with revelations of steroid use by many elite
athletes including Barry Bonds, formerly of
the San Francisco Giants; Mark McGwire,
formerly with the St. Louis Cardinals; and
Marion Jones, one of the most celebrated
women athletes of all time.
However, steroid use is not conﬁned to
professional athletes. It is estimated that
nearly one in every 10 young men has
tried them, and their use is also spreading
among young women.
It is difﬁcult to determine the extent
of anabolic steroid use because most
international competitions ban the use of
drugs. Users (and prescribing physicians
or drug dealers) are naturally reluctant to
talk about it, and users stop doping before
the event, aware that evidence of drug
use is hard to ﬁnd a week after they stop.
Additionally, “underground” suppliers
of performance-enhancing drugs keep
producing new versions of designer steroids
that evade standard antidoping tests. The
Olympic Analytical Laboratory in Los Angeles
rocked the sports world when it revealed
that a number of elite athletes tested positive
for tetrahydrogestrinone (THG), a designer
steroid not previously known or tested for.
There is little question that many
professional bodybuilders and athletes
competing in events that require muscle
strength (e.g., shot put, discus throwing,
and weight lifting) are heavy users.
Football players have also admitted using
steroids as an adjunct to training, diet, and
psychological preparation for games. These
athletes claim that anabolic steroids enhance
muscle mass and strength, and raise oxygen-
carrying capability owing to greater volume
of red blood cells.
Typically, bodybuilders who use steroids
combine high doses (up to 200 mg/day)
via injection or transdermal skin patches
with heavy resistance training. Intermittent
use begins several months before an
event, and commonly entails taking many
anabolic steroid supplements (a method
called stacking). They increase doses
gradually as the competition nears.
Do the drugs do all that is claimed?
Research studies report increased isometric
strength and body weight in steroid
users. While these are results weight
lifters dream about, for runners and
others requiring ﬁne muscle coordination
and endurance these changes may not
translate into better performance. The
“jury is still out” on this question.
Do the alleged advantages of steroids
outweigh their risks? Absolutely not.
Anabolic steroids cause: bloated faces
(Cushingoid sign of steroid excess), acne
and hair loss, shriveled testes and infertility,
liver damage that promotes liver cancer, and
changes in blood cholesterol levels that may
predispose users to heart disease.
In addition, females can develop
masculine characteristics such as smaller
breasts, enlarged clitoris, excess body hair,
and thinning scalp hair. The psychiatric
Athletes Looking Good and Doing Better
with Anabolic Steroids?
hazards of anabolic steroid use may
be equally threatening: Recent studies
indicate that one-third of users suffer
serious mental problems. Depression,
delusions, and manic behavior—in which
users undergo Jekyll-and-Hyde personality
swings and become extremely violent
)—are all common.
Another recent arrival on the scene,
sold over the counter as a “nutritional
performance-enhancer,” is androstenedione,
which is converted to testosterone in the
body. Though it is taken orally (and the liver
destroys much of it soon after ingestion),
the few milligrams that survive temporarily
boost testosterone levels. Reports of athletic
wannabes from the ﬁfth grade up sweeping
the supplement off the drugstore shelves are
troubling, particularly since it is not regulated
by the U.S. Food and Drug Administration
(FDA) and its long-term effects are unknown.
A study at Massachusetts General
Hospital found that males who took
androstenedione developed higher levels
of the female hormone estrogen as
well as testosterone, raising their risk of
feminizing effects such as enlarged breasts.
Youths with elevated levels of estrogen
or testosterone may enter puberty early,
stunting bone growth and leading to
shorter-than-normal adult height.
Some people seem willing to try almost
anything to win, short of killing themselves.
Are they unwittingly doing this as well?
C L O S E R
the contractile ﬁbers, and inﬂammatory cells (macrophages and
lymphocytes) accumulate in the surrounding connective tissue.
As the regenerative capacity of the muscle is lost, and damaged
cells undergo apoptosis, muscle mass drops.
Tere is still no cure for DMD. Current treatments are aimed
at preventing or reducing spine and joint deformities and helping
those with DMD remain mobile as long as possible. Tus far the
only medication that has improved muscle strength and func-
tion is the steroid prednisone, but other immunosuppressant
drugs may delay muscle deterioration.
One initially promising technique,
myoblast transfer therapy
(injecting healthy myoblast cells that fuse with diseased my-
oblasts) has been disappointing. Newer experimental therapies
have reversed disease symptoms in dystrophic animal models.
One of these involves injection of adeno-associated viruses car-
rying pared-down microdystrophin genes. A diﬀerent approach