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Doping With Muscle-Building Drugs: FAQ

Why Athletes Risk Using Human Growth Hormone, Anabolic Steroids

What are the risks of abusing HGH?

The short-term risks of rHGH are water gain and swelling, muscle pain, and joint pain. The only really serious short-term risk is an increase of pressure in the brain. This happens to about 1% of children who receive HGH replacement therapy.

In the long term, the risks of abusing rHGH are more serious. Muscles can become weak, there's a higher risk of heart disease, and there's a risk of developing high blood sugar and type 2 diabetes.

Are there tests to detect rHGH?

Yes. The most reliable test looks for evidence of the most common isoform of rHGH, called 22 kDa. This test measures the amount of 22 kDa and the amount of total HGH in the blood. In normal people the ratio of 22 kDa HGH to total HGH is about 0.6. If the ratio is over 1.0, an athlete is considered to be doping with rHGH.

There are drawbacks, however. Some people carry a gene that keeps HGH blood levels low. Even dopers test negative for rHGH if they have this gene.

And the test has to be done no more than 36 hours -- some say 24 hours -- after a person takes rHGH.

Other rHGH tests look for telltale "biomarkers" of body functions that have been altered by rHGH. Such tests have been used and have led to sanctions against athletes, Rogol says.

What are anabolic steroids?

Anabolic steroids are male sex hormones, or androgens. Androgens are the most commonly used performance-enhancing drugs. They account for half of all positive drug tests in the last decade, Bhasin says.

"Use has been growing since the 1980s. Elite athletes actually constitute a very small fraction of use," he says. "Many who use anabolic steroids use intramuscular injections. There are about 30 such compounds, although testosterone, nandrolone, and stanozolol are the most common ones."

Why would athletes use steroids?

Studies show that steroids increase muscle mass and strength. Strenuous exercise doubles these gains, Bhasin says.

"But do bigger muscles and more strength translate into better athletic performance? Athletes believe it does, but we scientists don't understand the mechanisms," he says. "Steroids may promote recovery from injury and allow higher training intensity. It may increase oxygen in the blood. There is some evidence it decreases reaction time and promotes hand-eye coordination."

What are the risks of abusing steroids?

There's a widely held belief that androgens are safe. Nothing could be further from the truth when abusing these drugs, Bhasin says.

He offers a long list of known side effects when misused:

  • Suicidal, homicidal, and sudden unexplained deaths
  • Prolonged shutoff of normal hormones. "All users for any length of time suppress their own testosterone production for months and sometimes for years after they stop using steroids," Bhasin says.
  • Mood disorders and psychiatric disorders
  • Cardiovascular and metabolic problems
  • Liver toxicity
  • Gynecomastia (enlarged breasts in men)
  • Risks associated with injections, such as abscesses or HIV infection
  • Risks of accessory drugs usually taken along with steroids
  • Risks associated with excessive muscle gain
  • Growth retardation in children

"I've been following and tracking steroid-related adverse effects and deaths," Bhasin says. "In one study, Scandinavian power-lifters had a risk of death five times that of matched controls."

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