1

Anabolic Steroids

MacGregor Brown & Bryce Inman
Psyc 472
2
History of Performance Drug
Abuse
Greeks reported using certain mushrooms and plant seed to increase
performance.
Romans used drugs to increase performance of horses and gladiators to increase
crowd response.
Steroids first developed in the 1930s
Used by the Germans on their soldiers and animals during WW2 to make up for
a lack of nutrition.
1950s first used for athletic purposes in Russia and Europe.
Primarily for weightlifting.
Mid 1950s it was discovered that testosterone was the driving force behind
increased athletic performance.
Used in all levels of sports, in the 1972 Olympics 68% of athletes reported using
anabolic steroids.
1991 the Federal Anabolic Control Act classified steroids as a schedule 3 drug.
3
Performance Enhancing Drug
Statistics
3.6% of high school students abuse steroids.
Risen nearly 2% in 2002, only drug other than ecstasy to show an
increase.
Men that abuse steroids have a high incidence of some form
of opioid abuse.
Over 3,000,000 people in the USA have reported the use of
steroids.
1997 175,000 women reported steroid use.
15% of NCAA athletes use performance enhancing drugs.
90% of athletes reported have used some form of
performance enhancing drugs during there career.
4
Daily Dietary %
of Protein
(RDA)
Anabolic Steroid
Use
Days for 10lb
muscle mass
gain
400%
None
225-300
400%
Heavy
30-45
300%
None
225-300
300%
Heavy
30-45
200%
None
225-300
200%
Heavy
65-75
100%
None
450-900
100%
Heavy
450-900
5
Testosterone
Produced by Leydigs
cells in testes
Responsible for
secondary sex
characteristics in men
Sex glands, libido,
reduced body fat
percentage, increased
body hair are all results
from elevated levels


6
Estrogen/Aromatase
Estradiol (estrogen) primary
female sex hormone, controls
fertility cycle in women.
Estradiol is beneficial to muscle
growth

Aromatase any enzyme which
removes the 19 methyl from
AAS and forms 3 double bonds
on the A ring.
7
DHT
Through 5-alpha reductase, testosterone is
converted to a hormone 4X as potent,
dihydrotestosterone
DHT binds to receptors much more avidly than
testosterone
5-alpha reductase is present in high amounts in
tissues of the prostate, skin, scalp, liver, and central
nervous system
8
What are steroids?
Fat soluble molecule which contains a system of 4 rings made up of 17
carbon atoms
E.g. cholesterol, estrogen, testosterone, progesterone, cortisol, etc.
Anabolic steroid (DEA) Any hormonal substance, chemically and
pharmacologically, related to testosterone that promotes muscle growth

9
Anabolic/Androgenic
Anabolic building, increased
skeletal muscle mass, bone
density, hemoglobin, nitrogen
retention and protein synthesis

Androgenic androgens are sex
hormones that can induce male
traits (e.g. growth of sex organs,
increased body hair, libido, skin
oil, and change in voice)

Anabolic/Androgenic steroids (AAS) seek to maximize the
anabolic effects while minimizing the androgenic effects.
The ratio of these anabolic/androgenic effects is called the
therapeutic index. Testosterone is the baseline at 1.

10
Therapeutic index of common
AAS
Trade Name Generic name Therapeutic
Index
Androderm Testosterone
1
Deca-Durabolin Nandrolone
Decanoate
11-12
Winstrol Stanazolol 5-20
Primobolan Methenolone 7-16
11
Basic modifications of
Testosterone
17 alpha Remove the H with a methyl or
ethyl group, producing an oral steroid
17 beta Add carbon atoms to this position
and increase solubility in lipids
Other modifications at the carbon 2,3
9, & 19 positions slow receptor
degradation, increase steroids affinity
for binding to receptor sites, inhibit
enzymatic conversion to a weaker
androgen

12
Do anabolic steroids work?
Most research has
shown that anabolic
steroids produce no
effect on muscle
growth. Why?
Fowler (1965) Nibal 20mg/day
Results: No increase in muscle
mass (MM)
Johnson (1968) D-bol
10mg/day. No increase in MM
Casner(1971) Winstrol
6mg/day. No increase in MM
Hervey (1976) D-bol
100mg/day. No increase in MM

13
AAS Administration
Oral preparations 17 methyl alklayted to survive acidic
gastric secretions, short half life (e.g. dianabol, winstrol)
Injectable solutions prepared in water or oil. Longer
release times for oil. (e.g. Nandrolone Decanoate)
Patch and gel provides steady and constant testosterone
delivery (e.g. Trenbolone)
Aerosol propellant rapid effects, very hard to detect in
drug tests
Sublingual preparations absorbed directly into blood
stream so avoid digestive system, rapid effects
14
Common AAS Practices
Cycle period of time
ranging from 1 to 4 months
in which AAS user takes
steroids
Stacking combining 2 or
more steroids
Pyramiding a gradual
buildup in dosage, and then
tapering off at the end
Wk Deca(mg) D-bol
1 100 10
2 200 15
3 300 15
4 300 20
5 200 15
6 100 15
7 100 10
15
16
Why AAS produce muscle
Activation of rRNA resulting in protein synthesis
Anticatabolic effect block action of natural
cortisone
Increase free testosterone levels
Stimulates activity of IGF-1 (Insulin-like growth
factor)
17
Positive side effects of AAS
Enhanced muscle mass/strength
Enhanced blood volume and hemoglobin
concentration
Enhanced bone density and strength
Hastened healing of muscular injuries
Decreased body fat
Increased immune response
Elevated mood
18
Clinical Applications
Bone metabolism conditions osteoporosis
Testosterone deficiency conditions male
hypogonadism, andropause
Cardiovascular conditions reduces angina
pectoris, hypertension, coronary artery disease
AIDS reduces AIDS wasting

19
Common AAS
Approved in U.S.
-Testosterone Cypionate
-Nandrolone Decanoate
-Fluoxyymesterone
-Stanozolol
Illegal in U.S.
-Testosterone enanthate
-Methandrostenolone
-Oxandrolone
-Oxymesterone

Veterinary Steroids
-Equipoise (Boldenone undecyclate)
-Trenbolone
20
Deca Durabolin
Nandrolone decanoate -
Long acting ester
Most widely used
Side effects: Water
retention, endogenous test.
suppression, other mild
effects
Detectable for over 1 year
in drug screenings
21
Dianabol (methandrostenolone)
Easy to use, very effective
C17 alpha alkylated
Can show extreme side
effects due to its tendency
to break down into 17alpha
methylestradiol, a form of
estrogen that is much more
active in the body
Short half life (3-5 hrs.)

22
Winstrol (stanozolol)
Not capable of converting
into estrogen due to
modifications at the 9
th
C
position
Prepared in both oral and
injectable forms
Aside from C17
methylation, relatively few
side effects.
23
Side Effects
Hypertension, acne, fluid retention,
hypogonadism, gynecomastia, sleep
disturbances, increased aggression, epistaxis
(nose bleeds), withdrawal depression,
prostate enlargement, heart enlargement,
virilization, abnormal blood clotting, libido
reduction, appetite stimulation, benign
prostate enlargement

24
Acne and hair loss
Acne
Sebaceous glands
(responsible for oil
secretion) are
stimulated by
androgens
Bad acne may develop
on the shoulders, back,
and face
Hair loss
Highly androgenic
steroids that convert to
DHT will aggravate
balding.
DHT chokes the hair
follicle, eventually
killing it
25
Gynecomastia
Female breast tissue resulting from high levels of
estrogen
Estrogen acts upon receptors in the breast and
stimulates the growth of mammary tissue
Removed only by surgery

26
Stunted Growth
If taken during adolescence or before, AAS may
halt growth. This occurs because they stimulate
epiphyseal plates on long bones to fuse
prematurely. Once fused, no growing can occur
Stunted growth caused not by AAS, but the
conversion of AAS to estrogen. AAS that do not
convert to estrogen will actually promote height
growth
27
Cardiovascular disease
AAS have a strong effect
on LDL and HDL levels
HDL is the good
cholesterol because it
removes cholesterol
deposits from the arteries
LDL has the opposite
effect
AAS increase LDL levels
and lower HDL levels.
Oral compounds much
more likely to promote this
adverse effect.
28
Testosterone and Aggression
AAS - pronounced effects on
the limbic system
AAS can act as
neurotransmitters
In supraphysiologic doses,
AAS can alter function of
and increase the number of
receptors
Can also modulate other
NT in the brain

Testosterone associated
with social dominance
Test. exacerbates fight or
flight response
Studies indicate an increase
in aggression in animals
treated with AAS
Prison studies, situational
studies
29
Permanent Steroid-Induced
Rage Behavior?
Animal studies show alterations to the test. receptors in the
brain. Theyve also shown modifications to other receptors
The most bothersome alterations in the brain are the increase
in androgen receptors and the increased binding capacity of
these receptors. After cessation of AAS use, these receptors
are thought to be hungry for elevated androgen levels.
Other NTs recognize this deficit and may remain low
(similar to andropause) resulting in depression, self esteem
problems, and a greater tendency to lash out
30
Cancer
AAS are just a
synthetic version of
hormones that are
already present in the
body, so the stress on
organs is not very high.
As such, cancer
resulting from AAS is
extremely rare

The only exception to this
is the use of c17 alpha
alkylated compounds
which are liver toxic.
They have been known
to induce liver damage
and cancer
31
Sexual Dysfunction
Impotence
Male reproductive system
depends largely on the
level of androgenic
hormones. Rebound
effect occurs after AAS
use in which no
androgens are present
in the body.
Testicular atrophy
Production of test. is
turned off (along with
spermatogenesis)
resulting in a
noticeable change in
size of the testicles.
32
Body Dysmorphia
AAS often produce addiction and body image
disorders that have been labeled as
Megorexia or bigorexia
Reverse anorexia
Adonis complex
Muscle dysmorphia
33
Women and AAS
Large amounts of test.
in women can produce
very noticeable side
effects
Virilization
Women develop masculine
characteristics such as a
deepening of the voice,
changes in skin texture,
acne, libido, hair loss, body
hair, and enlargement of
the clitoris
34
35
AAS & the Gateway Phenomenon
After AAS, over 50% used drugs such as:
31% estrogen receptor inhibitors
22% HCG
17% diuretics and/or uppers
15% pain killers


36
Aromatase inhibitors/Estrogen
Blockers
Aromatase Inhibitors
Blocks the aromatase enzyme,
preventing test. from
converting to estrogen
Slows muscle growth,
suppresses HDL
cholesterol, prevents water
retention
e.g. Arimidex (anastrozole)

Estrogen Blockers
Binds to free floating estrogen
molecules, preventing
estrogen from attaching to
androgen receptors
May also stimulate FSH and
LH endogenous test.
production
e.g. Nolvadex (Tamoxifen
citrate)
37
Stimulation of Test. Production
HCG - used clinically to treat
hypo-gonadism. Used post-
cycle to stimulate
endogenous test. by
mimicking LH
Clomid used clinically as a
fertility aid. Acts as an
estrogen antagonist,
opposes negative feedback
of estrogens on
hypothalmus
Hypothalamus: GnRH

Pituitary: LH, FSH

Testes

Testosterone
38
Insulin
Regulates glucose levels in the blood , its role in the body is
to control the uptake, utilization, and storage of amino acids,
carbohydrates, and fatty acids in the body.
Insulin is both anti-catabolic and anabolic because it
stimulates the use and retention of nutrients in muscle cells
(specifically glycogen)
Cannot be detected in drugs tests
Hypoglycemia one possible outcome of use. Can also result
in immediate death, coma, or insulin dependent diabetes.
39
Cutting compunds
Clenbuterol
Beta-2 sypathomimetic,
used as a bronchodilator.
Animal studies indicate
anabolic properties, but
used primarily as a
thermogenic compound by
directly stimulating fat
cells and breaking down
triglycerides. Effects are
temporary due to down
regulation

Thyroid hormone
Used to treat thyroid
deficiency, obesity, and
other metabolic disorders
Synthetic version of T3
which stimulates thyroid
gland resulting in;
acceleration of cellular
reactions, increase in
metabolism &
cardiovascular functions.
Rebound effect
40
Steroid Precursors/Prohormones

Androstenedione
Androstenediol
Dehydroepiandrosterone
(DHEA)
41
Androstenedione
Produced by the adrenal glands
17alpha-hydroxyprogesterone & DHEA.
Once produced it is one step away from
testosterone and estrogen
Missing the a hydrogen atom in the 17
th

position.
Processed by the liver where the hydrogen
atom is added.


42
Steroid Chart
43
Estrogen or Testosterone?
Testosterone
Androstenedione is converted into testosterone
by 17beta-hydroxysteroid dehydrogenase, which
is activated by luteinizing hormone secreted by
the hypothalamus and pituitary gland
Estrogen
Androstenedione may also be converted to the
estrogen, by the enzyme aromatase.
44
Estrogen or Testosterone?
45
Androstenediol
Similar to Androstenedione
Lacks a 3-keto group that enables the
conversion into estrogen
A much more androgenic compound
(produces much more male based effects)
46
Why Androstenediol?
Has higher conversion rates to testosterone.
Doesnt convert into estrogen.
Does not convert into DHT (cause of
balding).

47
DHEA
2 steps away
A precursor to testosterone that is produced
in the adrenal glands.
Aids in producing Androstenedione which
produces testosterone and estrogen
DHEA>Andro>Testosterone/Estrogen
48
Why Take a Steroid Precursor
Increase lean muscle mass?
Decrease body fat?
Increase strength ?
Increase libido?
Only temporarily increases blood levels of
testosterone, does not cause body to naturally
produce testosterone.
49
Negative Side Effects
Balding
Acne
Enlarged prostate
Reduced sperm count
Increased aggression
Kidney & Liver damage
Disrupt the menstrual cycle
Decrease levels of HDL cholesterol

50
Creatine
51
What is Creatine?

An amino acid taken into the body through
meats and animal products.


52
What does Creatine do in the
body?
Once ingested creatine is synthesized into
phosphocreatine in the kidneys, liver, and the
pancreas.
Creatine is synthesized by the three amino acids
arginine, glycine, and methionine.
Once synthesized into phosphocreatine it is
transported to skeletal muscles, the heart, and the
brain for energy usage.


53
What Does Creatine do in the
Body Cont.?
Assists with the production of ATP, which is
used for short term energy exertion.

54
What is ATP?
Adenosine triphosphate (ATP).
ATP is used during short-term high intensity
energy output.

55
56
How Does Creatine Assist with
the Production of ATP?
When ATP is broken down during exercise, energy
is produced with the loss of a phosphate ion.
During high intensity exercise, ATP is constantly
broken down to ADP and Phosphorous and
reproduced to provide maximum energy output.
When this occurs, phosphocreatine donates one of
its phosphate ions to facilitate the resynthesis of
ATP.
57
Results of this Process.
Reduced muscle fatigue - the rate at which
ATP is broken down does not exceed the rate
at which it can be resynthesized.
Decreased Lactic Acid
Faster Recovery

58
Side Effects
There is no pure evidence that creatine causes
actual physical harm.
Possible Risks
Weight gain of 1-2kgs, due to the increase of fluid stores.
Increased risk for muscle cramps, and tears due to the
increased water retention
Damage to kidneys.
Usage may lead to cancer causes cancer.
Excessive use may decrease the bodies natural ability to
produce creatine.
59
How is Creatine Taken?
Powder form
Pill
Serum
60
Typical Dosage
5g daily regular usage
20g daily During loading period to build up
creatine supply in the body

61
Growth Hormone (GH)
A naturally occurring hormone in the body.
Signaled release from the hypothalamus.
Release from the pituitary gland regulated by two
hormones.
Somatostatin (SS) decreases GH output.
Growth Hormone-Releasing Hormone (GHRH)
Increase GH output.
Can also be regulated by the amount of GH and Insulin
Like Growth Factor 1 (ILGF-1) that is circulated back
through the body.

62
GH in the Body
63
Other Factors that Increase GH

Decreased blood glucose during exercise and sleep
trigger the release of GH.
High protein increase small amounts GH release.
Some amino acids such as L-arginine can increase
GH by decreasing the release SS from the
hypothalamus.
Niacin has been shown to increase exercise induced
GH release by 300- 600% (Murray, 1995).
64
Theories about GH
Somatomedin hypothesis (Daughaday,
1972).
1. GH is released from the pituitary gland.
2. Travels to the liver where it is converted
into ILGF.
3. ILGF enters the blood stream and
stimulates muscle growth.
65
Theory 2
Dual Effector Theory - Similar to the
Somatomedin hypothesis except it is
believed that GH alone has anabolic effects
without ILGF.
Studies in mice have shown that mice
injected with GH are significantly larger than
those that were solely injected with ILGF.
66
How does GH Cause Muscle
Growth?
Once converted into ILGF, ILGF stimulates
the production of, and the conversion of
satellite cells into muscle cells.
Satellite cells Cells that lie dormant around
muscle tissue until stimulated by ILGF.
Have the ability to replicate the genetic
makeup of muscle cells.
67
Side Effects
One of the most common side effects of GH
abuse is acromegaly.
overgrowth of bone and connective tissue which
leads to a change in physical appearance such as
a protruding jaw and eyebrow bones.
Metabolic dysfunction
Glucose intolerance
68
How is GH Administered
Must have a prescription.
IM injections.
Dosage - A weekly dosage of 0.30 mg/kg of
body weight.
Very expensive!
Can be over $20,000 for an annual supply of
Growth Hormone.
69
Beta Blockers
Medically used to:
Reduce blood pressure
Migraine headaches
Heart arrhythmia
Alcohol withdrawals
Anti-anxiety
70
Athletic Uses
Reduces anxiety, jitters, and slows the heart rate.
Commonly used in sports that require a steady
hand.
Golf
Archery
Bowling
Pool
Biathlon
Rifle shooting

71
Physiological Effects
1. During heightened arousal adrenaline is
produced
2. Heart rate increases and blood pressure is
increased
3. Beta Blockers block the beta receptor on
the muscles of the heart which reduces
these effects.


72
Side Effects
Impotence
Low Blood Pressure
Insomnia
Cardiac failure
Poor circulation
May reduce performance capacity
73
Diuretics
Increase the amount of urine formation and the rate
at which it is excreted.
Used in sports that require reduced weight such as:
Wrestling
Horse racing
Bodybuilding
Boxing
Also used to mask the use of other performance
enhancing drugs.
74
Side Effects
Dehydration
Decreased circulation of blood volume
Muscle cramps
Renal disorders
Dizziness
Disrupted Heart rhythm
75
Blood Doping/Erythropoietin
Blood Doping
Adding additional blood to the system to
increase the amount of red blood cells in the
system.
Increased red blood cells increases the amount of
oxygen that the body can carry.
Thus, increasing the performance during endurance
sports.
Illegal, but hard to detect!
76
Erythropoietin
A naturally occurring hormone released from
the kidneys.
Causes increased production of red blood
cells.
Increased oxygen capacity
Increased tolerance to lactic acid.
77
Side Effects
Can be very dangerous
Bacterial infection
Induce shock
Hypertension
Stroke
May receive the wrong blood type
Increased blood viscosity
Increased workload
Increased risk for blood clots
Increased risk for heart attack
78
Additional Performance
Enhancing Drugs
GHB
Enables athlete to reach deeper state when
sleeping
Body produces more growth hormone
Highly abused among athletic community as a
recreational drug because it produces similar
intoxication to alcohol without the caloric intake
and hangover.
79
Additional Performance
Enhancing Drugs
GHB
Enables athlete to reach deeper state when
sleeping
Body produces more growth hormone
Highly abused among athletic community as a
recreational drug because it produces similar
intoxication to alcohol without the caloric intake
and hangover.