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Garcia JF, Seco-Calvo J, Arribalzaga S, Díez R, Lopez C, Fernandez MN, Garcia JJ, Diez MJ, de la Puente R, Sierra M, Sahagún AM. Online information and availability of three doping substances (anabolic agents) in sports: role of pharmacies. Front Pharmacol 2023; 14:1305080. [PMID: 38111382 PMCID: PMC10725911 DOI: 10.3389/fphar.2023.1305080] [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: 09/30/2023] [Accepted: 11/22/2023] [Indexed: 12/20/2023] Open
Abstract
Background: The Internet has become an important source for easy access to doping substances, where people and athletes may acquire, outside pharmacies and without a (medical) prescription. These online websites do not always offer quality-assured products, and are outside the regular distribution channels of medicines. The aim of this study was to estimate the availability and accessible information on the Internet about the sale of three doping substances (oxandrolone, DHEA, androstenedione). Methods: Cross-sectional exploratory study, being an observation at a point in time of the online availability of these three doping substances (WADA S1 category: anabolic agents), purchased from Spain, Puerto Rico, Canada, United States, Ukraine and Russia. The characteristics of the websites, the countries the webs sold to, the pharmaceutical forms offered and the recommendations for its use were analyzed by using a computer tool designed ad hoc. Results: There were significant differences between countries in the number of webpages that sold the products (Chi-square test, p < 0.05). Oxandrolone was available for purchase mainly when buying from Spain (27.12%) and Ukraine (26.58%), in websites dedicated to sports (77.26%). For DHEA, most of the pages offered it if the search was done from Canada (23.34%) and Russia (21.44%). Products containing androstenedione or DHEA are claimed to enhance sports performance or for sports use without providing details. Compared to the total number of websites checked, the proportion of pharmacies offering these products was low, ranging from 4.86% for DHEA to 15.79% for androstenedione. Conclusion: The three substances selected are easily available without control through the Internet. Only a small number of websites offering them were online pharmacies, and requested a prescription. Most of the doping substances are purchased from the country where they are requested. Product information described benefits for sports performance, but did not do the same with their side effects. It would be advisable for these products to be sold through pharmacies, to guarantee their quality and provide evidence-based information on their safe use, benefits and risks, and only with a prescription. Athletes should be encouraged to consult health professionals about those supplements suitable for their type of training and sports objectives.
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Affiliation(s)
- Juan F. Garcia
- Department of Mechanical, Informatics, and Aerospatiale Engineering, University of Leon, Leon, Spain
| | - Jesús Seco-Calvo
- Physiotherapy Department, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
- Psychology Department, Faculty of Medicine, Basque Country University, Leioa, Spain
| | - Soledad Arribalzaga
- Physiotherapy Department, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Raquel Díez
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Cristina Lopez
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - M. Nelida Fernandez
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Juan J. Garcia
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - M. Jose Diez
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Raul de la Puente
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Matilde Sierra
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
| | - Ana M. Sahagún
- Department of Biomedical Sciences, Institute of Biomedicine (IBIOMED), University of Leon, Leon, Spain
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Psychosocial aspects of sports medicine in pediatric athletes: Current concepts in the 21 st century. Dis Mon 2022:101482. [PMID: 36100481 DOI: 10.1016/j.disamonth.2022.101482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Behavioral aspects of organized sports activity for pediatric athletes are considered in a world consumed with winning at all costs. In the first part of this treatise, we deal with a number of themes faced by our children in their sports play. These concepts include the lure of sports, sports attrition, the mental health of pediatric athletes (i.e., effects of stress, anxiety, depression, suicide in athletes, ADHD and stimulants, coping with injuries, drug use, and eating disorders), violence in sports (i.e., concepts of the abused athlete including sexual abuse), dealing with supervisors (i.e., coaches, parents), peers, the talented athlete, early sports specialization and sports clubs. In the second part of this discussion, we cover ergolytic agents consumed by young athletes in attempts to win at all costs. Sports doping agents covered include anabolic steroids (anabolic-androgenic steroids or AAS), androstenedione, dehydroepiandrostenedione (DHEA), human growth hormone (hGH; also its human recombinant homologue: rhGH), clenbuterol, creatine, gamma hydroxybutyrate (GHB), amphetamines, caffeine and ephedrine. Also considered are blood doping that includes erythropoietin (EPO) and concepts of gene doping. In the last section of this discussion, we look at disabled pediatric athletes that include such concepts as athletes with spinal cord injuries (SCIs), myelomeningocele, cerebral palsy, wheelchair athletes, and amputee athletes; also covered are pediatric athletes with visual impairment, deafness, and those with intellectual disability including Down syndrome. In addition, concepts of autonomic dysreflexia, boosting and atlantoaxial instability are emphasized. We conclude that clinicians and society should protect our precious pediatric athletes who face many challenges in their involvement with organized sports in a world obsessed with winning. There is much we can do to help our young athletes find benefit from sports play while avoiding or blunting negative consequences of organized sport activities.
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Chen H, Jin Z, Sun C, Santos HO, Kord Varkaneh H. Effects of dehydroepiandrosterone (DHEA) supplementation on cortisol, leptin, adiponectin, and liver enzyme levels: A systematic review and meta-analysis of randomised clinical trials. Int J Clin Pract 2021; 75:e14698. [PMID: 34342920 DOI: 10.1111/ijcp.14698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 07/17/2021] [Accepted: 08/01/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND AIMS Dehydroepiandrosterone (DHEA) supplementation has been investigated in patients with altered cortisol levels and is proposed to ameliorate the metabolic profile related to adipose tissue. However, further research is warranted and evidence is no compelling for liver safety. Hence, we aimed to meta-analyse the effects of DHEA supplementation on circulating levels of cortisol, liver enzymes, and adipokines. METHODS We searched literature published in PubMed, Web of Science, Embase and Scopus, until December 2020. We obtained overall results using the generic inverse of variance method with a random-effects model. RESULTS Through 10 arms, serum cortisol levels decreased significantly after DHEA supplementation [weighted mean difference (WMD): -53.581 nmol/L, 95% confidence interval (CI): -88.2, -18.9, P = .002], without significant heterogeneity (I2 = 36%, P = .117). In contrast, any significance was noted for adiponectin (WMD: -0.045 µg/mL, 95% CI: -0.56, 0.47; P = .865), leptin (WMD: -2.55 µg/mL, 95% CI: -6.2, 1.06; P = .166), aspartate transaminase (AST) (WMD: -3.7 U/L, 95% CI: -10.35, 2.95; P = .276), and alanine aminotransferase (ALT) (WMD: -1.7 U/L, 95% CI: -3.45, 0.06; P = .058). CONCLUSION DHEA supplementation decreased circulating cortisol but did not alter adiponectin, leptin, AST, and ALT levels. Hence, DHEA supplementation could be considered as an adjunct in the management of hypercortisolaemia and is safe for the liver.
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Affiliation(s)
- Hu Chen
- Department of Pharmacy, Yichun People's Hospital, Yichun, Jiangxi Province, China
| | - Zhao Jin
- Department of Pharmacy, Yichun People's Hospital, Yichun, Jiangxi Province, China
| | - Changliang Sun
- Department of Pharmacy, Yichun People's Hospital, Yichun, Jiangxi Province, China
| | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Hamed Kord Varkaneh
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Wang F, He Y, O Santos H, Sathian B, C Price J, Diao J. The effects of dehydroepiandrosterone (DHEA) supplementation on body composition and blood pressure: A meta-analysis of randomized clinical trials. Steroids 2020; 163:108710. [PMID: 32745490 DOI: 10.1016/j.steroids.2020.108710] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/13/2020] [Accepted: 07/27/2020] [Indexed: 12/14/2022]
Abstract
Dehydroepiandrosterone (DHEA) supplementation has been anecdotally considered as a tool to improve body composition and health status. We aimed to verify the impact of DHEA supplementation on traditional measurements of body composition and blood pressure (BP) due to their clinical applicability. A meta-analysis of randomized clinical trials was conducted based on the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Regarding anthropometric characteristics, DHEA supplementation did not change body weight (weighted mean difference (WMD): -0.16 kg, 95% CI: -1.02 to 0.70, p = 0.72) or body mass index (WMD: -0.18 kg/m2, 95% CI: -0.48 to 0.12, p = 0.24), but increased lean body mass (WMD: 0.45 kg, 95% CI: 0.15 to 0.75, p = 0.004) and decreased fat mass (WMD: -0.85%, 95% CI: -1.18 to -0.51, p = 0.000), when compared to control groups. Neither systolic (WMD: 0.98 mm Hg, 95% CI: -2.31 to 4.29, p = 0.56) nor diastolic BP were significantly changed (WMD: -1.62 mm Hg, 95% CI: -5.49 to 2.24, p = 0.49). Our findings demonstrate that DHEA supplementation increased lean body mass and decreased fat mass, but debate persists when translating the results into clinical benefit. Lastly, DHEA supplementation had a neutral effect on BP.
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Affiliation(s)
- Furong Wang
- College of Life Sciences, Northwest University, Xi'an 710069, China
| | - Yanfei He
- Department of Reproductive Health, Women and Children Health and Family Planning Service Center of Decheng District, Dezhou City, Shandong Province 253000, China
| | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Brijesh Sathian
- Deputy Chair for Research, Geriatrics and long term care department, Rumailah Hospital, Hamad Medical Corporation, P. O BOX 3050, Doha, Qatar
| | - James C Price
- Institute of Science and the Environment, University of Worcester, United Kingdom
| | - Jianjun Diao
- Department of Medical Records Management, Central Hospital Affiliated to Shandong First Medical University, Shandong University, No. 105 Jiefang Road, Jinan City, Shandong Province 250013, China.
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