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Horn J. The dichotomy between health and drug abuse in bodybuilding. NORDIC STUDIES ON ALCOHOL AND DRUGS 2024; 41:212-225. [PMID: 38645972 PMCID: PMC11027851 DOI: 10.1177/14550725231206011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/21/2023] [Indexed: 04/23/2024] Open
Abstract
Aim: The aim of the present study was to investigate the expansion and prevalence of anabolic steroid use by examining the divergent effects between health and drug abuse and to create more awareness around the harmful consequences of these drugs when administered at abusive levels. Methods: A focused and concise literature search was conducted, and 101 high-quality articles were included in the review. Results: The findings underscore the adverse health risks of steroid abuse, emphasizing the stark contrast between health and drug abuse. Conclusions: While steroids and other performance-enhancing drugs can yield muscle growth, strength and even fat loss, abusing these substances can lead to adverse health outcomes. Furthermore, within the fitness subculture, particularly in the realm of bodybuilding, steroid abuse fosters an atmosphere of cheating and deception, frequently downplaying or ignoring the negative and sometimes deadly consequences it brings.
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Cunha GR, Cao M, Derpinghaus A, Baskin LS. Androgenic induction of penile features in postnatal female mouse external genitalia from birth to adulthood: Is the female sexual phenotype ever irreversibly determined? Differentiation 2023; 131:1-26. [PMID: 36924743 DOI: 10.1016/j.diff.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
Female mice were treated for 35 days from birth to 60 days postnatal (P0, [birth], P5, P10, P20 and adult [∼P60]) with dihydrotestosterone (DHT). Such treatment elicited profound masculinization the female external genitalia and development of penile features (penile spines, male urogenital mating protuberance (MUMP) cartilage, corpus cavernosum glandis, corporal body, MUMP-corpora cavernosa, a large preputial space, internal preputial space, os penis). Time course studies demonstrated that DHT elicited canalization of the U-shaped clitoral lamina to create a U-shaped preputial space, preputial lining epithelium and penile epithelium adorned with spines. The effect of DHT was likely due to signaling through androgen receptors normally present postnatally in the clitoral lamina and associated mesenchyme. This study highlights a remarkable male/female difference in specification and determination of urogenital organ identity. Urogenital organ identity in male mice is irreversibly specified and determined prenatally (prostate, penis, and seminal vesicle), whereas many aspects of the female urogenital organogenesis are not irreversibly determined at birth and in the case of external genitalia are not irreversibly determined even into adulthood, the exception being positioning of the female urethra, which is determined prenatally.
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Affiliation(s)
- Gerald R Cunha
- Department of Urology, University of California, 400 Parnassus Avenue, San Francisco, CA, 94143, USA.
| | - Mei Cao
- Department of Urology, University of California, 400 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Amber Derpinghaus
- Department of Urology, University of California, 400 Parnassus Avenue, San Francisco, CA, 94143, USA
| | - Laurence S Baskin
- Department of Urology, University of California, 400 Parnassus Avenue, San Francisco, CA, 94143, USA
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Abstract
Androgens are potent drugs requiring prescription for valid medical indications but are misused for invalid, unproven, or off-label reasons as well as being abused without prescription for illicit nonmedical application for performance or image enhancement. Following discovery and first clinical application of testosterone in the 1930s, commercialization of testosterone and synthetic androgens proliferated in the decades after World War II. It remains among the oldest marketed drugs in therapeutic use, yet after 8 decades of clinical use, the sole unequivocal indication for testosterone remains in replacement therapy for pathological hypogonadism, organic disorders of the male reproductive system. Nevertheless, wider claims assert unproven, unsafe, or implausible benefits for testosterone, mostly representing wishful thinking about rejuvenation. Over recent decades, this created an epidemic of testosterone misuse involving prescription as a revitalizing tonic for anti-aging, sexual dysfunction and/or obesity, where efficacy and safety remains unproven and doubtful. Androgen abuse originated during the Cold War as an epidemic of androgen doping among elite athletes for performance enhancement before the 1980s when it crossed over into the general community to become an endemic variant of drug abuse in sufficiently affluent communities that support an illicit drug industry geared to bodybuilding and aiming to create a hypermasculine body physique and image. This review focuses on the misuse of testosterone, defined as prescribing without valid clinical indications, and abuse of testosterone or synthetic androgens (androgen abuse), defined as the illicit use of androgens without prescription or valid indications, typically by athletes, bodybuilders and others for image-oriented, cosmetic, or occupational reasons.
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Affiliation(s)
- David J Handelsman
- ANZAC Research Institute, University of Sydney, Sydney, Australia.,Andrology Department, Concord Hospital, Sydney, Australia
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Tatem AJ, Holland LC, Kovac J, Beilan JA, Lipshultz LI. Nandrolone decanoate relieves joint pain in hypogonadal men: a novel prospective pilot study and review of the literature. Transl Androl Urol 2020; 9:S186-S194. [PMID: 32257859 PMCID: PMC7108994 DOI: 10.21037/tau.2019.11.03] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Testosterone is an archetypal androgenic-anabolic steroid (AAS), while its exogenous administration is considered to be the gold standard for the treatment of male hypogonadism. The benefits are not due to its intrinsic nature alone but are due to the result of its interactions with the androgen receptor (AR). As the management of hypogonadism continues to advance into the modern era, it would be preferable for modern andrologists to have multiple tools at their disposal to influence AR activity. Nandrolone, or 19-nortestosterone, is one such compound. In the following review of the literature, we examine the history, pharmacology, and clinical applications of this medication. We also present the results of our novel pilot study examining the favorable effects of nandrolone on joint pain for hypogonadal men.
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Affiliation(s)
| | - Levi C Holland
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Jason Kovac
- Men's Health Center, Urology of Indiana, Greenwood, IN, USA
| | | | - Larry I Lipshultz
- Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA
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Dreno B, Shourick J, Kerob D, Bouloc A, Taïeb C. The role of exposome in acne: results from an international patient survey. J Eur Acad Dermatol Venereol 2020; 34:1057-1064. [DOI: 10.1111/jdv.16119] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 11/13/2019] [Indexed: 12/26/2022]
Affiliation(s)
- B. Dreno
- Department of Dermato‐Cancerology CHU Nantes‐Hôtel‐Dieu CRCINA Inserm 1232, CIC 1413 University of Nantes Nantes France
| | - J. Shourick
- Bio Informatics/statistics University of Paris Sud Paris France
| | - D. Kerob
- Vichy Laboratoire Internationale Levallois‐Perret France
| | | | - C. Taïeb
- EMMA Fontenay‐sous‐Bois France
- Santé Publique CHU Necker‐Enfants malades Paris France
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Christou GA, Christou MA, Žiberna L, Christou KA. Indirect clinical markers for the detection of anabolic steroid abuse beyond the conventional doping control in athletes. Eur J Sport Sci 2019; 19:1276-1286. [DOI: 10.1080/17461391.2019.1587522] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Georgios A. Christou
- Laboratory of Sports Medicine, Sports Medicine Division, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria A. Christou
- Department of Endocrinology, Medical School, University of Ioannina, Ioannina, Greece
| | - Lovro Žiberna
- Faculty of Medicine, Institute of Pharmacology and Experimental Toxicology, University of Ljubljana, Ljubljana, Slovenia
- Slovenian Anti-Doping Organization (SLOADO), Ljubljana, Slovenia
| | - Konstantinos A. Christou
- Laboratory of Sports Medicine, Sports Medicine Division, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Dréno B, Bettoli V, Araviiskaia E, Sanchez Viera M, Bouloc A. The influence of exposome on acne. J Eur Acad Dermatol Venereol 2018; 32:812-819. [PMID: 29377341 PMCID: PMC5947266 DOI: 10.1111/jdv.14820] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 01/10/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Acne vulgaris is one of the main reasons for dermatological consultations. Severity and response to treatment may be impacted by various external factors or exposome. AIM To assess the impact of environmental factors on acne and to provide a comprehensive overview of the acne exposome. METHODS Two consensus meetings of five European dermatologists and a comprehensive literature search on exposome factors triggering acne served as a basis for this review. RESULTS Acne exposome was defined as the sum of all environmental factors influencing the occurrence, duration and severity of acne. Exposome factors impact on the response and the frequency of relapse to treatments by interacting with the skin barrier, sebaceous gland, innate immunity and cutaneous microbiota. They may be classified into the following six main categories: nutrition, psychological and lifestyle factors, occupational factors including cosmetics, as well as pollutants, medication and climatic factors. Moreover, practical considerations for the dermatologist's clinical practice are proposed. CONCLUSION Exposome factors including nutrition, medication, occupational factors, pollutants, climatic factors, and psychosocial and lifestyle factors may impact on the course and severity of acne and on treatment efficacy. Identifying and reducing the impact of exposome is important for an adequate acne disease management.
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Affiliation(s)
- B Dréno
- Service de Dermatologie, CIC 1413, CRCINA Inserm 1232, University Hospital Nantes, Nantes, France
| | - V Bettoli
- Department of Clinical and Experimental Medicine, Azienda Ospedaliero-Universitaria di Ferrara, Ferrara, Italy
| | - E Araviiskaia
- Department of Dermatology, First Pavlov State Medical University of St. Petersburg, St. Petersburg, Russia
| | - M Sanchez Viera
- Skin Health, Aging and Cancer, Institute for Dermatology, Madrid, Spain
| | - A Bouloc
- Laboratoires Vichy, Levallois Perret, France
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Perez M, Navajas-Galimany L, Antunez-Lay A, Hasson A. When strength turns into disease: acne fulminans in a bodybuilder. An Bras Dermatol 2017; 91:706. [PMID: 27828663 PMCID: PMC5087248 DOI: 10.1590/abd1806-4841.20165345] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 12/16/2015] [Indexed: 11/22/2022] Open
Affiliation(s)
- Mario Perez
- Pontificia Universidad Católica de Chile - Santiago, Chile
| | | | | | - Ariel Hasson
- Pontificia Universidad Católica de Chile - Santiago, Chile
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9
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Harris VR, Cooper AJ. Modern management of acne. Med J Aust 2017; 206:41-45. [DOI: 10.5694/mja16.00516] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 08/04/2016] [Indexed: 11/17/2022]
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Nieschlag E, Vorona E. MECHANISMS IN ENDOCRINOLOGY: Medical consequences of doping with anabolic androgenic steroids: effects on reproductive functions. Eur J Endocrinol 2015; 173:R47-58. [PMID: 25805894 DOI: 10.1530/eje-15-0080] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 03/24/2015] [Indexed: 01/30/2023]
Abstract
Anabolic androgenic steroids (AASs) are appearance and performance-enhancing drugs (APEDs) used in competitive athletics, in recreational sports, and by body-builders. The global lifetime prevalence of AASs abuse is 6.4% for males and 1.6% for women. Many AASs, often obtained from the internet and dubious sources, have not undergone proper testing and are consumed at extremely high doses and in irrational combinations, also along with other drugs. Controlled clinical trials investigating undesired side effects are lacking because ethical restrictions prevent exposing volunteers to potentially toxic regimens, obscuring a causal relationship between AASs abuse and possible sequelae. Because of the negative feedback in the regulation of the hypothalamic-pituitary-gonadal axis, in men AASs cause reversible suppression of spermatogenesis, testicular atrophy, infertility, and erectile dysfunction (anabolic steroid-induced hypogonadism). Should spermatogenesis not recover after AASs abuse, a pre-existing fertility disorder may have resurfaced. AASs frequently cause gynecomastia and acne. In women, AASs may disrupt ovarian function. Chronic strenuous physical activity leads to menstrual irregularities and, in severe cases, to the female athlete triad (low energy intake, menstrual disorders and low bone mass), making it difficult to disentangle the effects of sports and AASs. Acne, hirsutism and (irreversible) deepening of the voice are further consequences of AASs misuse. There is no evidence that AASs cause breast carcinoma. Detecting AASs misuse through the control network of the World Anti-Doping Agency (WADA) not only aims to guarantee fair conditions for athletes, but also to protect them from medical sequelae of AASs abuse.
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Affiliation(s)
- Eberhard Nieschlag
- Centre of Reproductive Medicine and AndrologyUniversity of Münster, 48129 Münster, GermanyCenter of Excellence in Genomic Medicine ResearchKing Abdulaziz University, Jeddah, Saudi ArabiaCentre of EndocrinologyDiabetology and Rheumatology, Dortmund, Germany Centre of Reproductive Medicine and AndrologyUniversity of Münster, 48129 Münster, GermanyCenter of Excellence in Genomic Medicine ResearchKing Abdulaziz University, Jeddah, Saudi ArabiaCentre of EndocrinologyDiabetology and Rheumatology, Dortmund, Germany
| | - Elena Vorona
- Centre of Reproductive Medicine and AndrologyUniversity of Münster, 48129 Münster, GermanyCenter of Excellence in Genomic Medicine ResearchKing Abdulaziz University, Jeddah, Saudi ArabiaCentre of EndocrinologyDiabetology and Rheumatology, Dortmund, Germany
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Zomorodian K, Rahimi MJ, Taheri M, Ghanbari Asad A, Khani S, Ahrari I, Pakshir K, Khashei R. The cutaneous bacterial microflora of the bodybuilders using anabolic-androgenic steroids. Jundishapur J Microbiol 2014; 8:e12269. [PMID: 25789120 PMCID: PMC4350042 DOI: 10.5812/jjm.12269] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 07/10/2014] [Accepted: 08/05/2014] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Kamiar Zomorodian
- Basic Sciences in Infectious Diseases Research Center, Shiraz University Of Medical Sciences, Shiraz, IR Iran
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
- Corresponding author: Kamiar Zomorodian, Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel/Fax: +98-7112305291, E-mail:
| | - Mohammad Javad Rahimi
- Basic Sciences in Infectious Diseases Research Center, Shiraz University Of Medical Sciences, Shiraz, IR Iran
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Mohammad Taheri
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Ali Ghanbari Asad
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Soghra Khani
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Iman Ahrari
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Keyvan Pakshir
- Basic Sciences in Infectious Diseases Research Center, Shiraz University Of Medical Sciences, Shiraz, IR Iran
- Department of Medical Mycology and Parasitology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Reza Khashei
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
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Loraschi A, Galli N, Cosentino M. Dietary supplement and drug use and doping knowledge and attitudes in Italian young elite cyclists. Clin J Sport Med 2014; 24:238-44. [PMID: 24184855 DOI: 10.1097/jsm.0000000000000018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To explore use and attitudes toward drugs and dietary supplements (DS) and knowledge concerning doping in cycling. DESIGN Retrospective cross-sectional study. SETTING Professional cycling. PARTICIPANTS Elite under-23 male cyclists. INTERVENTION Anonymous semistructured questionnaire administered during race periods. MAIN OUTCOME MEASURES Use and attitudes toward DS and drugs, and doping knowledge. RESULTS Forty cyclists aged 19 to 23 years and practicing for 14 to 30 h/wk were interviewed. Previous use (last 3 months) of drugs or DS occurred in 33 of 40 (82.5%) and 39 of 40 (97.5%) cyclists, respectively. Almost all the subjects named at least 1 doping agent (range, 1-10). Within a fixed list of 18 substances (among which only 14 were doping agents), participants recognized 3 to 18 of them as doping agents. They recognized tramadol and sildenafil as doping agents, which are not doping agents, and failed to recognize probenecid and albumin, which actually are. Doping knowledge correlated with drug use (r2 = 0.1614; P = 0.01). Participants deemed doping prevalence high among cyclists in general but not in their own team (P < 0.0001). CONCLUSIONS Use of prescription drugs and DS was a common occurrence. Doping knowledge was poor and biased, and its relationship with drug use deserves consideration. Educational interventions are needed to improve knowledge and awareness about prescription drugs and DS use, as well as about doping.
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Affiliation(s)
- Anna Loraschi
- Center for Research in Medical Pharmacology, University of Insubria, Varese, Italy
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Injection site infections and injuries in men who inject image- and performance-enhancing drugs: prevalence, risks factors, and healthcare seeking. Epidemiol Infect 2014; 143:132-40. [PMID: 24713416 DOI: 10.1017/s0950268814000727] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
People who inject drugs are vulnerable to infections and injuries at injection sites, but these have rarely been studied in those injecting image- and performance-enhancing drugs (IPEDs). This study examined the factors associated with reported symptoms of injection site infections and injuries in IPED injectors. Of the 366 male IPED injectors surveyed, 42% reported ever having redness, swelling and tenderness (36% in the preceding year), and 6·8% had ever had an abscess or open wound at an injection site. Having these symptoms was associated with a range of factors related to drug use and healthcare utilization. One sixth (17%) of those reporting redness, tenderness and swelling had ever sought treatment, as had the majority (76%) of those reporting an abscess, sore or open wound. Most common sources of advice were emergency clinics and General Practitioners. Interventions are needed to support access to appropriate injecting equipment and provide targeted harm reduction advice.
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Kersey RD, Elliot DL, Goldberg L, Kanayama G, Leone JE, Pavlovich M, Pope HG. National Athletic Trainers' Association position statement: anabolic-androgenic steroids. J Athl Train 2013; 47:567-88. [PMID: 23068595 DOI: 10.4085/1062-6050-47.5.08] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE This manuscript summarizes the best available scholarly evidence related to anabolic-androgenic steroids (AAS) as a reference for health care professionals, including athletic trainers, educators, and interested others. BACKGROUND Health care professionals associated with sports or exercise should understand and be prepared to educate others about AAS. These synthetic, testosterone-based derivatives are widely abused by athletes and nonathletes to gain athletic performance advantages, develop their physiques, and improve their body image. Although AAS can be ergogenic, their abuse may lead to numerous negative health effects. RECOMMENDATIONS Abusers of AAS often rely on questionable information sources. Sports medicine professionals can therefore serve an important role by providing accurate, reliable information. The recommendations provide health care professionals with a current and accurate synopsis of the AAS-related research.
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Tobias HJ, Zhang Y, Auchus RJ, Brenna JT. Detection of synthetic testosterone use by novel comprehensive two-dimensional gas chromatography combustion-isotope ratio mass spectrometry. Anal Chem 2011; 83:7158-65. [PMID: 21846122 DOI: 10.1021/ac2015849] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We report the first demonstration of comprehensive two-dimensional gas chromatography combustion-isotope ratio mass spectrometry (GC×GCC-IRMS) for the analysis of urinary steroids to detect illicit synthetic testosterone use, of interest in sport doping. GC coupled to IRMS (GCC-IRMS) is currently used to measure the carbon isotope ratios (CIRs, δ(13)C) of urinary steroids in antidoping efforts; however, extensive cleanup of urine extracts is required prior to analysis to enable baseline separation of target steroids. With its greater separation capabilities, GC×GC has the potential to reduce sample preparation requirements and enable CIR analysis of minimally processed urine extracts. Challenges addressed include online reactors with minimized dimensions to retain narrow peak shapes, baseline separation of peaks in some cases, and reconstruction of isotopic information from sliced steroid chromatographic peaks. Difficulties remaining include long-term robustness of online reactors and urine matrix effects that preclude baseline separation and isotopic analysis of low-concentration and trace components. In this work, steroids were extracted, acetylated, and analyzed using a refined, home-built GC×GCC-IRMS system. 11-Hydroxyandrosterone and 11-ketoetiocolanolone were chosen as endogenous reference compounds because of their satisfactory signal intensity, and their CIR was compared to target compounds androsterone and etiocholanolone. Separately, a GC×GC-quadrupole MS system was used to measure testosterone (T)/epitestosterone (EpiT) concentration ratios. Urinary extracts of urine pooled from professional athletes and urine from one individual that received testosterone gel (T-gel) and one individual that received testosterone injections (T-shots) were analyzed. The average precisions of δ(13)C and Δδ(13)C measurements were SD(δ(13)C) approximately ±1‰ (n = 11). The T-shot sample resulted in a positive for T use with a T/EpiT ratio of >9 and CIR measurements of Δδ(13)C > 5‰, both fulfilling World Anti-Doping Agency criteria. These data show for the first time that synthetic steroid use is detectable by GC×GCC-IRMS without the need for extensive urine cleanup.
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Affiliation(s)
- Herbert J Tobias
- Division of Nutritional Sciences, Cornell University, Savage Hall, Ithaca, New York 14853, United States.
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Soolari A, Soolari E, Shumaker ND. Palatal Tissue Enlargement After Subepithelial Connective Tissue Graft Harvest Associated With Anabolic Steroid Abuse. Clin Adv Periodontics 2011; 1:23-28. [PMID: 32698551 DOI: 10.1902/cap.2011.100004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Accepted: 01/27/2011] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Healing complications associated with androgenic anabolic steroid (AAS) abuse have received minimal attention in the periodontal literature. This case report describes an adverse healing event after palatal subepithelial connective tissue graft (SECTG) harvest associated with AAS abuse. CASE PRESENTATION A 35-year-old white male was treated with an SECTG procedure to address gingival recession on the facial aspect of teeth #24 and #25. Donor tissue was harvested from the left hard palate via a single incision technique. The procedure was completed without complication. One week postoperatively, the patient presented with a large asymptomatic overgrowth of tissue from the palatal harvest site. Over the following 5 weeks of continued observation, the lesion demonstrated progressive, spontaneous resolution. Investigation of possible etiology revealed the subject was a recreational bodybuilder with admitted AAS abuse. CONCLUSIONS Post-surgical healing can be influenced by AAS abuse. Alterations in connective tissue metabolism and fibroblast activity are known sequelae of AAS abuse; however, patients may be reluctant to admit to steroid abuse during the presurgical interview. Surgeons should suspect the possibility of AAS abuse when postoperative complications present in a patient of muscular body type.
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Affiliation(s)
- Ahmad Soolari
- Private practice, Silver Spring, MD.,Department of Periodontics, Naval Postgraduate Dental School, Bethesda, MD
| | - Ehsan Soolari
- College of Chemical and Life Sciences, University of Maryland, Adelphi, MD
| | - Nicholas D Shumaker
- Currently, private practice, Fort Collins, CO; previously, Naval Health Clinic Quantico, Quantico, VA, and Department of Periodontics, Naval Postgraduate Dental School
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