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Taoussi O, Bambagiotti G, Gameli PS, Daziani G, Tavoletta F, Tini A, Basile G, Lo Faro AF, Carlier J. In Vitro and In Vivo Human Metabolism of Ostarine, a Selective Androgen Receptor Modulator and Doping Agent. Int J Mol Sci 2024; 25:7807. [PMID: 39063049 PMCID: PMC11277069 DOI: 10.3390/ijms25147807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Revised: 07/05/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Ostarine (enobasarm) is a selective androgen receptor modulator with great therapeutic potential. However, it is also used by athletes to promote muscle growth and enhance performances without the typical adverse effects of anabolic steroids. Ostarine popularity increased in recent years, and it is currently the most abused "other anabolic agent" (subclass S1.2. of the "anabolic agents" class S1) from the World Anti-Doping Agency's (WADA) prohibited list. Several cases of liver toxicity were recently reported in regular users. Detecting ostarine or markers of intake in biological matrices is essential to document ostarine use in doping. Therefore, we sought to investigate ostarine metabolism to identify optimal markers of consumption. The substance was incubated with human hepatocytes, and urine samples from six ostarine-positive cases were screened. Analyses were performed via liquid chromatography-high-resolution tandem mass spectrometry (LC-HRMS/MS) and software-assisted data mining, with in silico metabolite predictions. Ten metabolites were identified with hydroxylation, ether cleavage, dealkylation, O-glucuronidation, and/or sulfation. The production of cyanophenol-sulfate might participate in the mechanism of ostarine liver toxicity. We suggest ostarine-glucuronide (C25H22O9N3F3, diagnostic fragments at m/z 118, 185, and 269) and hydroxybenzonitrile-ostarine-glucuronide (C25H22O10N3F3, diagnostic fragments at m/z 134, 185, and 269) in non-hydrolyzed urine and ostarine and hydroxybenzonitrile-ostarine (C19H14O4N3F3, diagnostic fragments at m/z 134, 185, and 269) in hydrolyzed urine as markers to document ostarine intake in doping.
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Affiliation(s)
- Omayema Taoussi
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Via Tronto 10/a, 60126 Ancona, Italy; (O.T.); (G.B.); (P.S.G.); (G.D.); (F.T.); (A.T.); (J.C.)
| | - Giulia Bambagiotti
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Via Tronto 10/a, 60126 Ancona, Italy; (O.T.); (G.B.); (P.S.G.); (G.D.); (F.T.); (A.T.); (J.C.)
| | - Prince Sellase Gameli
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Via Tronto 10/a, 60126 Ancona, Italy; (O.T.); (G.B.); (P.S.G.); (G.D.); (F.T.); (A.T.); (J.C.)
| | - Gloria Daziani
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Via Tronto 10/a, 60126 Ancona, Italy; (O.T.); (G.B.); (P.S.G.); (G.D.); (F.T.); (A.T.); (J.C.)
| | - Francesco Tavoletta
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Via Tronto 10/a, 60126 Ancona, Italy; (O.T.); (G.B.); (P.S.G.); (G.D.); (F.T.); (A.T.); (J.C.)
| | - Anastasio Tini
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Via Tronto 10/a, 60126 Ancona, Italy; (O.T.); (G.B.); (P.S.G.); (G.D.); (F.T.); (A.T.); (J.C.)
| | - Giuseppe Basile
- Department of Trauma Surgery, IRCCS Galeazzi Orthopedic Institute, Via Riccardo Galeazzi 4, 20161 Milan, Italy;
| | - Alfredo Fabrizio Lo Faro
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Via Tronto 10/a, 60126 Ancona, Italy; (O.T.); (G.B.); (P.S.G.); (G.D.); (F.T.); (A.T.); (J.C.)
| | - Jeremy Carlier
- Section of Legal Medicine, Department of Biomedical Sciences and Public Health, Marche Polytechnic University, Via Tronto 10/a, 60126 Ancona, Italy; (O.T.); (G.B.); (P.S.G.); (G.D.); (F.T.); (A.T.); (J.C.)
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Momoh R, Hassan A. A Case Report of an Acute Severe Tachyarrhythmia Presentation With Underlying Cardiomyopathy in a Patient With Anabolic Androgenic Steroid and Thyroxine Misuse. Cureus 2024; 16:e62806. [PMID: 39044882 PMCID: PMC11262917 DOI: 10.7759/cureus.62806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2024] [Indexed: 07/25/2024] Open
Abstract
A description of an acute hospital presentation with severe tachyarrhythmia requiring multiple direct current cardioversions in a 45-year-old male bodybuilder with underlying cardiomyopathy possibly caused by long-term anabolic steroid abuse and more recent thyroxine misuse is described. A review of the literature regarding the above associations was also done. This case report further adds to the literature regarding the harmful effect of androgenic anabolic steroid misuse (with the added effect of thyroxine misuse in this case) on the heart.
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Affiliation(s)
- Rabiu Momoh
- Critical Care, William Harvey Hospital, Ashford, GBR
| | - Ahmed Hassan
- Anesthesia, William Harvey Hospital, Ashford, GBR
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3
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Thirumalai A, Anawalt BD. Androgenic Steroids Use and Abuse. Urol Clin North Am 2022; 49:645-663. [DOI: 10.1016/j.ucl.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Gunnarsson B, Entezarjou A, Fernández-Aranda F, Jiménez-Murcia S, Kenttä G, Håkansson A. Understanding exercise addiction, psychiatric characteristics and use of anabolic androgenic steroids among recreational athletes – An online survey study. Front Sports Act Living 2022; 4:903777. [PMID: 35979064 PMCID: PMC9376369 DOI: 10.3389/fspor.2022.903777] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
Background The purpose of this paper was to explore maladaptive behaviors among physically active individuals, including exercise dependence and use of anabolic steroids. Both exercise addiction (EA) and use of anabolic androgenic steroids (AAS) correlate to high amounts of exercise and EA have been linked to eating disorders and other mental health problems. Methods An internet survey was spread through fitness-related social media. Inclusion criteria were age ≥ 15 years and exercise frequency ≥ thrice weekly. Exercise addiction inventory identified those at-risk of EA (rEA). Characteristics of rEA were compared to those not at risk. In a separate analysis, AAS users were compared to AAS-naïve individuals. Results In total, 3,029 participants completed the questionnaire. Of these, 11% screened positive for being rEA, and 23% for ED. Factors associated with EA included daily exercise, social phobia, eating disorders and OCD. Risk consumption of alcohol was a negative predictor. Thirty seven participants had taken AAS the last year. These were mainly men, bodybuilders/powerlifters and more often used amphetamines and opioids. Discussion This exploratory study supports EA being strongly associated with eating disorders. Identified associations between EA and compulsive or anxiety disorders warrant further research to clarify if these associations arise prior to, together with, or secondary to EA.
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Affiliation(s)
- Björn Gunnarsson
- Helsingborg University Hospital, Region Skåne, Helsingborg, Sweden
| | - Artin Entezarjou
- Department of Clinical Sciences in Malmö, Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Skåne University Hospital, Region Skåne, Malmö, Sweden
| | - Fernando Fernández-Aranda
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Susana Jiménez-Murcia
- Department of Psychiatry, University Hospital of Bellvitge, Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Programme, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Göran Kenttä
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- Swedish Sport Federation, Stockholm, Sweden
| | - Anders Håkansson
- Clinical Sports and Mental Health Unit, Malmö Addiction Center, Region Skåne, Malmö, Sweden
- Division of Psychiatry, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden
- *Correspondence: Anders Håkansson
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Anabolic-Androgenic Steroid Misuse: Mechanisms, Patterns of Misuse, User Typology, and Adverse Effects. JOURNAL OF SPORTS MEDICINE 2021; 2021:7497346. [PMID: 34926695 PMCID: PMC8683244 DOI: 10.1155/2021/7497346] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/16/2021] [Indexed: 11/17/2022]
Abstract
Anabolic-androgenic steroids (AAS) encompass a broad group of natural and synthetic androgens. AAS misuse is highly prevalent on a global scale, with the lifetime prevalence of AAS misuse in males being estimated to be around 6%, with 15 to 25% of male gym attendees using it at any one time. AAS are associated with sudden cardiac death, neuropsychiatric manifestations, and infertility. The average AAS user is unlikely to voluntarily declare their usage to a physician, with around 1 in 10 actively engaging in unsafe injection techniques. The aim of this paper is to review the current evidence base on AAS with emphasis on mechanisms of action, adverse effects, and user profiles that are most likely to engage in AAS misuse. This paper also reviews terminologies and uses methods specific to the AAS user community.
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Souza CGD. Pharmacological Treatment of Sarcopenia. Rev Bras Ortop 2021; 56:425-431. [PMID: 34483384 PMCID: PMC8405270 DOI: 10.1055/s-0040-1709732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Accepted: 01/27/2020] [Indexed: 11/06/2022] Open
Abstract
Sarcopenia has been acquiring a growing importance in the scientific literature and in doctors' offices. As the population ages, it becomes increasingly essential to know, prevent, and treat this clinical condition. The purpose of the present review is to bring up the current evidence on the diagnosis of this pathology, in a practical way, as well as the main current treatment options.
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Affiliation(s)
- Caio Gonçalves de Souza
- Grupo de Doenças Osteometabólicas, Instituto de Ortopedia e Traumatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Sçao Paulo, SP, Brasil
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7
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Bhasin S, Hatfield DL, Hoffman JR, Kraemer WJ, Labotz M, Phillips SM, Ratamess NA. Anabolic-Androgenic Steroid Use in Sports, Health, and Society. Med Sci Sports Exerc 2021; 53:1778-1794. [PMID: 34261998 DOI: 10.1249/mss.0000000000002670] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This consensus statement is an update of the 1987 American College of Sports Medicine (ACSM) position stand on the use of anabolic-androgenic steroids (AAS). Substantial data have been collected since the previous position stand, and AAS use patterns have changed significantly. The ACSM acknowledges that lawful and ethical therapeutic use of AAS is now an accepted mainstream treatment for several clinical disorders; however, there is increased recognition that AAS are commonly used illicitly to enhance performance and appearance in several segments of the population, including competitive athletes. The illicit use of AAS by competitive athletes is contrary to the rules and ethics of many sport governing bodies. Thus, the ACSM deplores the illicit use of AAS for athletic and recreational purposes. This consensus statement provides a brief history of AAS use, an update on the science of how we now understand AAS to be working metabolically/biochemically, potential side effects, the prevalence of use among athletes, and the use of AAS in clinical scenarios.
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Affiliation(s)
- Shalender Bhasin
- Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Disa L Hatfield
- Department of Kinesiology, University of Rhode Island, Kingston, RI
| | - Jay R Hoffman
- Department of Physical Therapy, Ariel University, Ariel, Israel
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH
| | | | | | - Nicholas A Ratamess
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ
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8
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Wang F. Theoretical Studies of Some Androgenic-Anabolic Steroid Molecules by Computational Chemistry. RUSSIAN JOURNAL OF PHYSICAL CHEMISTRY A 2021. [DOI: 10.1134/s003602442108029x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Antonio J, Candow DG, Forbes SC, Gualano B, Jagim AR, Kreider RB, Rawson ES, Smith-Ryan AE, VanDusseldorp TA, Willoughby DS, Ziegenfuss TN. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show? J Int Soc Sports Nutr 2021; 18:13. [PMID: 33557850 PMCID: PMC7871530 DOI: 10.1186/s12970-021-00412-w] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 01/28/2021] [Indexed: 01/01/2023] Open
Abstract
Supplementing with creatine is very popular amongst athletes and exercising individuals for improving muscle mass, performance and recovery. Accumulating evidence also suggests that creatine supplementation produces a variety of beneficial effects in older and patient populations. Furthermore, evidence-based research shows that creatine supplementation is relatively well tolerated, especially at recommended dosages (i.e. 3-5 g/day or 0.1 g/kg of body mass/day). Although there are over 500 peer-refereed publications involving creatine supplementation, it is somewhat surprising that questions regarding the efficacy and safety of creatine still remain. These include, but are not limited to: 1. Does creatine lead to water retention? 2. Is creatine an anabolic steroid? 3. Does creatine cause kidney damage/renal dysfunction? 4. Does creatine cause hair loss / baldness? 5. Does creatine lead to dehydration and muscle cramping? 6. Is creatine harmful for children and adolescents? 7. Does creatine increase fat mass? 8. Is a creatine 'loading-phase' required? 9. Is creatine beneficial for older adults? 10. Is creatine only useful for resistance / power type activities? 11. Is creatine only effective for males? 12. Are other forms of creatine similar or superior to monohydrate and is creatine stable in solutions/beverages? To answer these questions, an internationally renowned team of research experts was formed to perform an evidence-based scientific evaluation of the literature regarding creatine supplementation.
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Affiliation(s)
- Jose Antonio
- Department of Health and Human Performance, Nova Southeastern University, Davie, Florida, USA.
| | - Darren G Candow
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Canada
| | - Scott C Forbes
- Department of Physical Education, Faculty of Education, Brandon University, Brandon, MB, Canada
| | - Bruno Gualano
- Applied Physiology & Nutrition Research Group; School of Medicine, FMUSP, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Andrew R Jagim
- Sports Medicine Department, Mayo Clinic Health System, La Crosse, WI, USA
| | - Richard B Kreider
- Exercise & Sport Nutrition Lab, Human Clinical Research Facility, Department of Health & Kinesiology, Texas A&M University, College Station, USA
| | - Eric S Rawson
- Department of Health, Nutrition, and Exercise Science, Messiah University, Mechanicsburg, PA, USA
| | - Abbie E Smith-Ryan
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Trisha A VanDusseldorp
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Darryn S Willoughby
- School of Exercise and Sport Science, University of Mary Hardin-Baylor, Belton, TX, USA
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10
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(Doping, dietary supplements, and cardiovascular system). COR ET VASA 2020. [DOI: 10.33678/cor.2020.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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11
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Yeargin S, Lopez RM, Snyder Valier AR, DiStefano LJ, McKeon PO, Medina McKeon JM. Navigating Athletic Training Position Statements: The Strength of Recommendation Taxonomy System. J Athl Train 2020; 55:863-868. [PMID: 32577741 DOI: 10.4085/1062-6050-240-19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Susan Yeargin
- Department of Exercise Science, University of South Carolina, Columbia
| | - Rebecca M Lopez
- Department of Orthopaedics & Sports Medicine, University of South Florida, Tampa
| | - Alison R Snyder Valier
- Department of Interdisciplinary Health Sciences; School of Osteopathic Medicine in Arizona; Research Support, A.T. Still University, Mesa, AZ
| | | | - Patrick O McKeon
- Department of Exercise Science and Athletic Training, Ithaca College, NY
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12
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Alrabadi N, Jarrah MI, Alzoubi KH. Acute myocardial infarction with cardiogenic shock in a young physically active physician concurrently using the anabolic steroid sustanon: A case report. Biomed Rep 2020; 13:14. [PMID: 32765853 DOI: 10.3892/br.2020.1321] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 02/05/2020] [Indexed: 11/05/2022] Open
Abstract
The association between ischemic heart disease (IHD) and the concurrent use of anabolic androgenic steroids (AASs) is underestimated in clinical settings. The tendency of patients to not disclose AASs use may explain this underestimation. In the present case report, the clinical case of a 26-year-old physically active male, who was a physician, without any classical coronary risk factors, who presented with chest pain that was misdiagnosed by the peripheral care unit as skeletal muscle pain is described. Later, the patient was brought to our central hospital (King Abdullah University Hospital) suffering from a massive acute myocardial infarction with marked ECG changes and cardiogenic shock. Following stabilization of his condition, a detailed history of the patient was taken, during which the patient admitted that he was a chronic user of the anabolic steroid sustanon (250 mg, once/week for 6 months) and amino acid supplements (whey protein isolate, 6 tabs every day for 1 year). Specific cardiac markers were increased and the patient exhibited dynamic ischemic changes in his electrocardiogram. Notably, the coronary angiogram of the patient demonstrated ostial occlusion of the left anterior descending artery, which was associated with mid-right coronary artery embolic obstruction. Other than the anabolic steroids and protein supplementation use, the patient history, examination and lab evaluation were normal. During follow up, the patient continued to suffer heart failure with low ejection fraction. In addition, he developed apical thrombus 2 months after primary admission. The patient developed tachycardia in spite of optimal medical treatment and finally received an implantable cardioverter defibrillator. Physicians should always be aware of the possibility of AASs use in young physically active patients. IHD should always be suspected and investigated with typical chest pain in healthy young patients, even if regular risk factors are not present. Medical professionals should not be excluded as potential AASs users/abusers.
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Affiliation(s)
- Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Mohamad Ismail Jarrah
- Department of Internal Medicine, Interventional Cardiology Division, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Karem Hasan Alzoubi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
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Akbari Z, Esmailidehaj M, Avarand E, Shariati M, Pourkhalili K. Ischemic Preconditioning Efficacy Following Anabolic Steroid Usage: A Clear Difference Between Sedentary and Exercise-Trained Rat Hearts. Cardiovasc Toxicol 2020; 19:287-296. [PMID: 30535662 DOI: 10.1007/s12012-018-9497-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Previous studies show that anabolic steroids impair innate cardioprotective mechanisms. Here, we investigated the effect of supraphysiological doses of nandrolone on ischemic preconditioning (IPC) as a potent cardioprotective tool against ischemia reperfusion (IR) injury in rat hearts. Male Wistar rats in two experimental settings of sedentary and exercise-trained (60 min/day swimming, 5 days/week, for 8 weeks) were either pretreated with intramuscular injections of arachis oil (Arach, n = 16) as vehicle or nandrolone decanoate (ND, n = 8), 10 mg/kg/week, for 8 weeks. At the end, the hearts were excised and perfused in a Langendorff system. Then, the vehicle-treated hearts subdivided into the IR (30 min of LAD coronary artery occlusion and 120 min reperfusion, n = 8) and IPC (three cycles of 3-min ischemia and 3-min reperfusion before test ischemia, n = 8) groups and nandrolone-treated hearts served as ND + IPC (nandrolone pretreatment before IR and IPC protocols, n = 8) group. Post-ischemic cardiac function and infarct size were assessed. Reperfusion arrhythmias were analyzed using a standard scoring system. In sedentary hearts, ND slightly increased heart-to-body weight ratio and increased baseline cardiac contractile function. In trained hearts, ND markedly increased heart-to-body weight ratio which was also associated with enhanced baseline cardiac function. ND pretreatment enhanced protective effects of IPC in sedentary group; however, abolished these effects in exercise-trained group. The arrhythmia score was not significantly different between nandrolone-treated groups vs. respective preconditioned groups. Our findings show that ND impairs IPC-induced cardioprotection in exercise-trained rat hearts. Cardiac hypertrophy seems to play a crucial role in this response.
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Affiliation(s)
- Zahra Akbari
- Department of Physiology, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mansour Esmailidehaj
- Department of Physiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ebrahim Avarand
- Department of Biology, Islamic Azad University, Kazerun, Iran
| | | | - Khalil Pourkhalili
- Department of Physiology, Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran.
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14
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Jensen AE, Bernards JR, Jameson JT, Johnson DC, Kelly KR. The Benefit of Mental Skills Training on Performance and Stress Response in Military Personnel. Front Psychol 2020; 10:2964. [PMID: 31993011 PMCID: PMC6970970 DOI: 10.3389/fpsyg.2019.02964] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 12/16/2019] [Indexed: 01/13/2023] Open
Abstract
Mental skills training (MST) has been suggested to reduce stress in civilian and athletic populations, however, whether these techniques and practices transfer to a military population are unknown. Therefore, the purpose of this study was to evaluate two MST programs against a baseline condition, training-as-usual (TAU), during an intense, active-duty, military training environment. Two hundred and three Marines enrolled in the United States Marine Corps' Basic Reconnaissance Course participated in this effort (n = 203; age = 22.7 ± 3.3 years; height = 178 ± 6.35 cm; weight = 97.7 ± 8.3 kg; Mean ± SD). Each Marine was assigned to one of three groups, Mindfulness-Based Mind Fitness Training (MMFT), General Mental Skills Training (GMST), or TAU. Operational and cognitive performance measures, as well as, physiological metrics were obtained across three training phases (phase 1-3). Furthermore, phase 3 was sub-divided into pre-ambush, ambush and post-ambush time points. Significant group × time interactions were found for the total number of errors committed on the sustained attention response task (p = 0.004); as well as, plasma cortisol (p < 0.0001) and insulin-like growth factor-1 (IGF-1; p < 0.0001). There were mixed results between groups on operational performance tasks with the MST groups tending to perform better than TAU the more time participants had with MST instruction. During ambush, the differences among groups were especially pronounced for measures of information processing that one would expect MST to enhance: coordinates recall, plot time, and plot accuracy (p < 0.001), with improvements ranging from 24.7 to 87.9% for the MST conditions when compared to TAU. These data demonstrate that independent of the specific type of MST program, the fundamental characteristics of stress regulation embedded within each MST program may enhance performance and cognitive function during time of heightened stress.
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Affiliation(s)
| | | | | | | | - Karen R. Kelly
- Naval Health Research Center, San Diego, CA, United States
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15
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Koundourakis NE, Margioris AN. The complex and bidirectional interaction between sex hormones and exercise performance in team sports with emphasis on soccer. Hormones (Athens) 2019; 18:151-172. [PMID: 31256350 DOI: 10.1007/s42000-019-00115-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 01/07/2019] [Indexed: 10/26/2022]
Abstract
A constant topic reported in the lay press is the effect of sex hormones on athletic performance and their abuse by athletes in their effort to enhance their performance or to either boost or sidestep their hard, protracted, and demanding training regimens. However, an issue that it is almost never mentioned is that the athletic training itself affects the endogenous production of androgens and estrogens, while also being affected by them. Among sports, soccer is a particularly demanding activity, soccer players needing to possess high levels of endurance, strength, and both aerobic and anaerobic capacity, with the very great physiological, metabolic, physical, and psychological exertion required of the players being both influenced by sex steroids and, reciprocally, affecting sex steroid levels. This review focuses on the currently available knowledge regarding the complex relationship between athletic training and competition and sex steroid hormone adaptation to the demands of the exercise effort. In the first part of the review, we will examine the effects of endogenous testosterone, estrogen, and adrenal androgens on athletic performance both during training and in competition. In the second part, we will explore the reciprocal effects of exercise on the endogenous sex hormones while briefly discussing the recent data on anabolic androgenic steroid abuse.
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Affiliation(s)
- Nikolaos E Koundourakis
- Lab of Clinical Chemistry-Biochemistry, Department of Laboratory Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece.
| | - Andrew N Margioris
- Department of Clinical Chemistry, School of Medicine, University of Crete, Heraklion, Crete, Greece
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16
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McDuff D, Stull T, Castaldelli-Maia JM, Hitchcock ME, Hainline B, Reardon CL. Recreational and ergogenic substance use and substance use disorders in elite athletes: a narrative review. Br J Sports Med 2019; 53:754-760. [PMID: 31097457 DOI: 10.1136/bjsports-2019-100669] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Substances from various classes may be used for recreational purposes, self-treatment or to boost performance. When substance use shifts from occasional to regular, heavy or hazardous use, positive and negative effects can develop that vary by substance class and athlete. Regular use of recreational or performance enhancing substances can lead to misuse, sanctions or use disorders. OBJECTIVE To review the prevalence, patterns of use, risk factors, performance effects and types of intervention for all classes of recreational and performance enhancing substances in elite athletes by sport, ethnicity, country and gender. METHODS A comprehensive search was conducted to identify studies that compared the prevalence and patterns of substance use, misuse and use disorders in elite athletes with those of non-athletes and provided detailed demographic and sport variations in reasons for use, risk factors and performance effects for each main substance class. RESULTS Alcohol, cannabis, tobacco (nicotine) and prescribed opioids and stimulants are the most commonly used substances in elite athletes, but generally used at lower rates than in non-athletes. In contrast, use/misuse rates for binge alcohol, oral tobacco, non-prescription opioids and anabolic-androgenic steroids are higher among athletes than non-athletes, especially in power and collision sports. Cannabis/cannabinoids seem to have replaced nicotine as the second most commonly used substance. CONCLUSIONS Substance use in elite athletes varies by country, ethnicity, gender, sport and competitive level. There are no studies on substance use disorder prevalence in elite male and female athletes and few studies with direct comparison groups.
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Affiliation(s)
- David McDuff
- Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA .,MD Sports Performance, Ellicott, Maryland, USA
| | - Todd Stull
- Athletics, University of Nebraska-Lincoln University Health Center, Lincoln, Nebraska, USA
| | - João Mauricio Castaldelli-Maia
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil.,Department of Neuroscience, Medical School, Fundação do ABC, Santo André, Brazil
| | - Mary E Hitchcock
- Ebling Library for the Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Brian Hainline
- National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
| | - Claudia L Reardon
- Department of Psychiatry, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
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17
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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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18
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La Vignera S, Condorelli RA, Cannarella R, Duca Y, Calogero AE. Sport, doping and female fertility. Reprod Biol Endocrinol 2018; 16:108. [PMID: 30449281 PMCID: PMC6241032 DOI: 10.1186/s12958-018-0437-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 10/24/2018] [Indexed: 01/02/2023] Open
Abstract
This article is a review that addresses the following topics, divided by paragraphs. The first paragraph investigates the effects of physical activity on ovarian function, analyzing in particular the changes concerning the serum concentrations of follicle-stimulating hormone, luteinizing hormone, prolactin, growth hormone, thyroid hormones, leptin, ghrelin, neuropeptide Y. The second paragraph analyzes the effects of doping on the hypothalamic-pituitary-ovarian axis. Finally, the last paragraph analyzes the PCOS category, evaluating the effects of hyperandrogenism in relation to athletic performance.
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Affiliation(s)
- Sandro La Vignera
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy.
| | - Rosita A Condorelli
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - Rossella Cannarella
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - Ylenia Duca
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
| | - Aldo E Calogero
- Department of Clinical and Experimental Medicine, University of Catania, Policlinico "G. Rodolico", via S. Sofia 78, 95123, Catania, Italy
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19
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Roman M, Roman DL, Ostafe V, Ciorsac A, Isvoran A. Computational Assessment of Pharmacokinetics and Biological Effects of Some Anabolic and Androgen Steroids. Pharm Res 2018; 35:41. [PMID: 29404794 DOI: 10.1007/s11095-018-2353-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/19/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE The aim of this study is to use computational approaches to predict the ADME-Tox profiles, pharmacokinetics, molecular targets, biological activity spectra and side/toxic effects of 31 anabolic and androgen steroids in humans. METHODS The following computational tools are used: (i) FAFDrugs4, SwissADME and admetSARfor obtaining the ADME-Tox profiles and for predicting pharmacokinetics;(ii) SwissTargetPrediction and PASS online for predicting the molecular targets and biological activities; (iii) PASS online, Toxtree, admetSAR and Endocrine Disruptomefor envisaging the specific toxicities; (iv) SwissDock to assess the interactions of investigated steroids with cytochromes involved in drugs metabolism. RESULTS Investigated steroids usually reveal a high gastrointestinal absorption and a good oral bioavailability, may inhibit someof the human cytochromes involved in the metabolism of xenobiotics (CYP2C9 being the most affected) and reflect a good capacity for skin penetration. There are predicted numerous side effects of investigated steroids in humans: genotoxic carcinogenicity, hepatotoxicity, cardiovascular, hematotoxic and genitourinary effects, dermal irritations, endocrine disruption and reproductive dysfunction. CONCLUSIONS These results are important to be known as an occupational exposure to anabolic and androgenic steroids at workplaces may occur and because there also is a deliberate human exposure to steroids for their performance enhancement and anti-aging properties.
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Affiliation(s)
- Marin Roman
- Department of Biology-Chemistry and Advanced Environmental Research Laboratories, West University of Timisoara, 16 Pestalozzi, 300115, Timisoara, Romania
| | - Diana Larisa Roman
- Department of Biology-Chemistry and Advanced Environmental Research Laboratories, West University of Timisoara, 16 Pestalozzi, 300115, Timisoara, Romania
| | - Vasile Ostafe
- Department of Biology-Chemistry and Advanced Environmental Research Laboratories, West University of Timisoara, 16 Pestalozzi, 300115, Timisoara, Romania
| | - Alecu Ciorsac
- Department of Physical Education and Sport, Politehnica University of Timisoara, Timisoara, Romania
| | - Adriana Isvoran
- Department of Biology-Chemistry and Advanced Environmental Research Laboratories, West University of Timisoara, 16 Pestalozzi, 300115, Timisoara, Romania.
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Abstract
SummaryPatients presenting to psychiatrists frequently have comorbid medical conditions for which they are receiving treatment. A range of medications used for treatment of these conditions can have adverse effects resembling psychiatric symptoms. This article presents the results of our review of the literature on psychiatric adverse effects of various non-psychotropic medications, and discusses the mechanisms of such effects, their assessment and management. Among the commonly prescribed drugs found to have psychiatric adverse effects are corticosteroids, anti-Parkinsonian drugs, anti-epileptics, antiretrovirals, antibiotics, anticancer drugs, analgesics, drugs targeting endocrine and cardiovascular disorders, immunosuppressants, skeletal muscle relaxants and bronchodilators. Some adverse effects are predictable and dose dependent, whereas others are rare and idiosyncratic, and psychiatrists need to be aware of them for accurate diagnosis and appropriate treatment.
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21
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Boyes R, O’Sullivan DE, Linden B, McIsaac M, Pickett W. Gender-specific associations between involvement in team sport culture and canadian adolescents' substance-use behavior. SSM Popul Health 2017; 3:663-673. [PMID: 29349255 PMCID: PMC5769126 DOI: 10.1016/j.ssmph.2017.08.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/02/2017] [Accepted: 08/15/2017] [Indexed: 01/18/2023] Open
Abstract
Canadian adolescents have some of the highest rates of substance use in the world. The etiology of this phenomenon has not been fully explored, and one possible contextual determinant is involvement in sport activities that foster risk-taking behaviors through physical and social mechanisms. Using the 2013-14 Health Behaviour in School Aged Children (HBSC) study we therefore examined this hypothesis in a contemporary national sample of Canadian adolescents. The strength and direction of the relationship between sport and substance use varied by gender and substance, with team sport participation associated with increased binge drinking (RR 1.33 [95% CI 1.13-1.56] for boys, RR 1.21 [1.06-1.38] for girls) and use of smokeless tobacco (RR 1.68 [1.34-2.10] for boys, RR 1.32 [1.01-1.72] for girls), but with lower prevalence levels of cannabis use (RR 0.73 [95% CI 0.61-0.88]) and cigarette smoking (RR 0.79 [95% CI 0.70-0.89]) in girls alone. We also compared team sport athletes with high social involvement (sports team as primary peer group) and physical involvement (higher number of days/week physically active) to those with low involvement. For boys, the combination of high physical and high social involvement was associated with the highest risk, while high social involvement alone was associated with the greatest risk for girls. While team sport participation confers only a small increased risk for substance use, the prevalence of sport participation results in a large population impact. Given this fact, interventions such as education for parents and coaches and policies encouraging engagement in a variety of extracurricular activities should be explored.
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Affiliation(s)
- Randy Boyes
- Department of Public Health Sciences, Queen’s University, Canada
| | | | - Brooke Linden
- Department of Public Health Sciences, Queen’s University, Canada
| | - Michael McIsaac
- Department of Public Health Sciences, Queen’s University, Canada
| | - William Pickett
- Department of Public Health Sciences, Queen’s University, Canada
- Department of Emergency Medicine, Queen’s University, Canada
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22
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Christou MA, Christou PA, Markozannes G, Tsatsoulis A, Mastorakos G, Tigas S. Effects of Anabolic Androgenic Steroids on the Reproductive System of Athletes and Recreational Users: A Systematic Review and Meta-Analysis. Sports Med 2017; 47:1869-1883. [DOI: 10.1007/s40279-017-0709-z] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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23
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Abstract
Drug abuse occurs in all sports and at most levels of competition. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise untreated mental illness, and to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sport. This review examines the effects of different classes of substances used for doping, side-effects of doping, and treatment of affected athletes. There is variable evidence for the performance-enhancing effects and side-effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions.
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Affiliation(s)
- Shane Creado
- a UW Health Psychiatric Institute and Clinic Ringgold Standard Institution , Madison , WI , USA
| | - Claudia Reardon
- b UW Health Psychiatric Institute and Clinic , Psychiatry , Madison , WI , USA
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24
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Abstract
Performance-enhancing substances (PESs) are used commonly by children and adolescents in attempts to improve athletic performance. More recent data reveal that these same substances often are used for appearance-related reasons as well. PESs include both legal over-the-counter dietary supplements and illicit pharmacologic agents. This report reviews the current epidemiology of PES use in the pediatric population, as well as information on those PESs in most common use. Concerns regarding use of legal PESs include high rates of product contamination, correlation with future use of anabolic androgenic steroids, and adverse effects on the focus and experience of youth sports participation. The physical maturation and endogenous hormone production that occur in adolescence are associated with large improvements in strength and athletic performance. For most young athletes, PES use does not produce significant gains over those seen with the onset of puberty and adherence to an appropriate nutrition and training program.
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25
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Christou GA, Christou KA, Nikas DN, Goudevenos JA. Acute myocardial infarction in a young bodybuilder taking anabolic androgenic steroids: A case report and critical review of the literature. Eur J Prev Cardiol 2016; 23:1785-1796. [PMID: 27184497 DOI: 10.1177/2047487316651341] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 05/04/2016] [Indexed: 11/15/2022]
Abstract
We describe a case report of a 30-year-old bodybuilder suffering acute myocardial infarction (AMI). He had been taking stanozolol and testosterone for two months. The coronary angiogram showed high thrombotic burden in the left anterior descending artery without underlying atherosclerosis. Few case reports of AMI in athletes taking anabolic androgenic steroids (AASs) have been reported so far. AAS-related AMI is possibly underreported in the medical literature due to the desire of the affected individuals to hide AAS use. Physicians should always consider the possibility of AAS abuse in the context of a young athlete suffering AMI. AASs can predispose to AMI through the acceleration of coronary atherosclerosis. Additionally, thrombosis without underlying atherosclerosis or vasospasm is highly possible to cause AMI in AAS users. Complications after AMI may be more frequent in AAS users.
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Affiliation(s)
| | | | - Dimitrios N Nikas
- First Department of Cardiology, University Hospital of Ioannina, Greece
| | - John A Goudevenos
- First Department of Cardiology, University Hospital of Ioannina, Greece
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26
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Mayer KN, Wyder D, Spasic D, Herren T. Severe rhinovirus pneumonia in a young woman taking performance-enhancing drugs. BMJ Case Rep 2016; 2016:bcr-2015-213836. [PMID: 26740273 DOI: 10.1136/bcr-2015-213836] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 22-year-old woman presented to the emergency room of a local hospital with pleuritic chest pain. She regularly worked out and admitted to taking performance-enhancing drugs (PEDs). Clinical findings and further diagnostic work up revealed a diagnosis of perimyocarditis, and adequate therapy was initiated. During the course of the first day, the patient had to be intubated and mechanically ventilated. A diagnosis of bilateral pneumonia and acute respiratory distress syndrome (ARDS) due to an infection by rhinovirus spp was made. A smoking habit, the intense physical training and the use of PED's may have exacerbated the course of the viral pneumonia. After 12 days the patient could be extubated. The length of stay in the intensive care unit was 16 days. After hospital discharge, the patient went to a pulmonary rehabilitation facility for 2 weeks. The outcome was favourable and the patient resumed her strength and endurance training.
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Affiliation(s)
- Kristina Nadine Mayer
- University of Zürich, Zürich, Switzerland Department of Internal Medicine, Hospital Limmattal, Zürich, Switzerland
| | - Daniel Wyder
- Department of Anesthesia and Intensive Care Unit , Spital Limmattal, Zürich, Switzerland
| | - Danijela Spasic
- Emergency Department, Hospital Limmattal, Zürich, Switzerland
| | - Thomas Herren
- Department of Internal Medicine, Hospital Limmattal, Zürich, Switzerland
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27
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Nieschlag E, Vorona E. Doping with anabolic androgenic steroids (AAS): Adverse effects on non-reproductive organs and functions. Rev Endocr Metab Disord 2015; 16:199-211. [PMID: 26373946 DOI: 10.1007/s11154-015-9320-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Since the 1970s anabolic androgenic steroids (AAS) have been abused at ever increasing rates in competitive athletics, in recreational sports and in bodybuilding. Exceedingly high doses are often consumed over long periods, in particular by bodybuilders, causing acute or chronic adverse side effects frequently complicated by additional polypharmacy. This review summarizes side effects on non-reproductive organs and functions; effects on male and female reproduction have been recently reviewed in a parallel paper. Among the most striking AAS side effects are increases in haematocrit and coagulation causing thromboembolism, intracardiac thrombosis and stroke as well as other cardiac disturbances including arrhythmias, cardiomyopathies and possibly sudden death. 17α-alkylated AAS are liver toxic leading to cholestasis, peliosis, adenomas and carcinomas. Hyperbilirubinaemia can cause cholemic nephrosis and kidney failure. AAS abuse may induce exaggerated self-confidence, reckless behavior, aggressiveness and psychotic symptoms. AAS withdrawal may be accompanied by depression and suicidal intentions. Since AAS abuse is not or only reluctantly admitted physicians should be aware of the multitude of serious side effects when confronted with unclear symptoms.
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Affiliation(s)
- Eberhard Nieschlag
- Centre of Reproductive Medicine and Andrology, University of Münster, Münster, Germany.
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Elena Vorona
- Centre of Endocrinology, Diabetology and Rheumatology, Dortmund, Germany
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28
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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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29
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Nogueira FRDS, Brito ADF, Vieira TI, Oliveira CVCD, Gouveia RLB. Prevalência de uso de recursos ergogênicos em praticantes de musculação na cidade de João Pessoa, Paraíba. REVISTA BRASILEIRA DE CIÊNCIAS DO ESPORTE 2015. [DOI: 10.1016/j.rbce.2013.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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30
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Pomara C, Neri M, Bello S, Fiore C, Riezzo I, Turillazzi E. Neurotoxicity by synthetic androgen steroids: oxidative stress, apoptosis, and neuropathology: A review. Curr Neuropharmacol 2015; 13:132-45. [PMID: 26074748 PMCID: PMC4462038 DOI: 10.2174/1570159x13666141210221434] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 09/30/2014] [Accepted: 10/25/2014] [Indexed: 12/25/2022] Open
Abstract
Anabolic-androgenic steroids (AAS) are synthetic substances derived from testosterone that are largely employed due to their trophic effect on muscle tissue of athletes at all levels. Since a great number of organs and systems are a target of AAS, their adverse effects are primarily on the following systems: reproductive, hepatic, musculoskeletal, endocrine, renal, immunological, infectious, cardiovascular, cerebrovascular, and hematological. Neuropsychiatric and behavioral effects as a result of AAS abuse are well known and described in the literature. Mounting evidence exists suggesting that in addition to psychiatric and behavioral effects, non-medical use of AAS carries neurodegenerative potential. Although, the nature of this association remains largely unexplored, recent animal studies have shown the recurrence of this AAS effect, ranging from neurotrophin unbalance to increased neuronal susceptibility to apoptotic stimuli. Experimental and animal studies strongly suggest that apoptotic mechanisms are at least in part involved in AAS-induced neurotoxicity. Furthermore, a great body of evidence is emerging suggesting that increased susceptibility to cellular oxidative stress could play a pivotal role in the pathogenesis of many neurodegenerative disorders and cognitive impairment. As in other drug-evoked encephalopathies, the key mechanisms involved in AAS - induced neuropathology could represent a target for future neuroprotective strategies. Progress in the understanding of these mechanisms will provide important insights into the complex pathophysiology of AAS-induced neurodegeneration, and will pave the way for forthcoming studies. Supplementary to abandoning the drug abuse that represents the first step in reducing the possibility of irreversible brain damage in AAS abusers, neuroprotective strategies have to be developed and implemented in future.
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Affiliation(s)
- Cristoforo Pomara
- Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
- Department of Anatomy, University of Malta. Msida, Malta
| | - Margherita Neri
- Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Stefania Bello
- Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Carmela Fiore
- Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Irene Riezzo
- Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Emanuela Turillazzi
- Institute of Legal Medicine, Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
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31
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Abstract
Drug abuse occurs in all sports and at most levels of competition. Athletic life may lead to drug abuse for a number of reasons, including for performance enhancement, to self-treat otherwise untreated mental illness, and to deal with stressors, such as pressure to perform, injuries, physical pain, and retirement from sport. This review examines the history of doping in athletes, the effects of different classes of substances used for doping, side effects of doping, the role of anti-doping organizations, and treatment of affected athletes. Doping goes back to ancient times, prior to the development of organized sports. Performance-enhancing drugs have continued to evolve, with “advances” in doping strategies driven by improved drug testing detection methods and advances in scientific research that can lead to the discovery and use of substances that may later be banned. Many sports organizations have come to ban the use of performance-enhancing drugs and have very strict consequences for people caught using them. There is variable evidence for the performance-enhancing effects and side effects of the various substances that are used for doping. Drug abuse in athletes should be addressed with preventive measures, education, motivational interviewing, and, when indicated, pharmacologic interventions.
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Affiliation(s)
- Claudia L Reardon
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Shane Creado
- Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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32
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Poussel M, Renaud P, Gambier N, Didelot A, Favre A, Chenuel B. Dopage sportif à la méthandiénone : intérêt des antennes médicales de prévention du dopage. Therapie 2014; 69:249-50. [DOI: 10.2515/therapie/2014023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 12/23/2013] [Indexed: 11/20/2022]
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