Anabolic-Androgenic Steroids – Background and History

Every few years, it seems, newspaper headlines blurt out the sad fact that yet another one of our sports heroes has been found guilty of taking some kind of banned performance-enhancing substance. Although there are many such substances available now, especially to a world-class athlete, one important category of performance enhancers is the anabolic-androgenic steroids. These are defined as steroid hormones that increase muscle mass (the anabolic part) and also have masculinizing, or testosterone-like, properties (the androgenic part).

On the street, these substances are usually just called anabolic steroids, but there are no members of the group that aren’t also androgenic. Nevertheless, it is more convenient to use the shorthand term anabolic steroids, and that is the term that we will use in the remainder of this post.

Why are anabolic steroids being brought up in a post on substances of abuse? There is significant evidence that these hormones are abused by some users, and some researchers have theorized that anabolic steroids can produce an addiction-like dependence. Before we discuss these ideas, however, we will present basic information on these substances and how they entered the realm of bodybuilding and athletic competition.

Background and History

Anabolic steroids are structurally related to testosterone

The chemical and trade names of some common anabolic steroids are presented in Table 1. Some of these compounds are taken orally, while others are injected intramuscularly. The latter are formulated for depot injection and maintain their potency for periods ranging from several days to 3 weeks, depending on the steroid. These compounds are all structurally related to testosterone, the principal androgen synthesized by the testes. However, because it is the anabolic rather than androgenic effects that are desired by most users, the chemical modifications that differentiate various synthetic steroids from testosterone are aimed at selectively enhancing their anabolic potency. Because the oral steroids are potentially vulnerable to first-pass metabolism in the liver, these compounds are chemically designed to minimize this problem and thus retain adequate bioavailability.

TABLE 1 Som e Com m on Anabolic Steroids

Generic name Trade name Route of administration
Methandrostenolone Dianabol Oral
Testosterone undecanoate Andriol Oral
Oxandrolone Oxandrin Oral
Oxymetholone Anadrol Oral
Stanozolol Winstrol Oral or injection
Testosterone cypionate Depot-Testosterone Injection
Testosterone enanthate Primotetson Injection
Nandrolone phenylpropionate Durabolin Injection
Nandrolone decanoate Deca-Durabolin Injection
Methenolone enanthate Primobolan Depot Injection

Anabolic steroids were developed to help build muscle mass and enhance athletic performance

American athletes knew little about these compounds before the 1954 World Weightlifting Championships held in Vienna, Austria. Until 1953, American weightlifters had routinely beaten the Soviet team, but the Soviets outscored the Americans in that year and again in 1954. During the Vienna competition, the U.S. and Soviet Union team physicians reportedly went out in the evening for entertainment, and after a few drinks, the physician for the Soviet Union squad confided that some of his men were using testosterone. Dr. John Ziegler, who was the American physician, went back home and began to experiment with testosterone, but he didn’t like the strong “g” androgenic side effects. Ziegler expressed the need for a more g anabolic, less androgenic compound to the giant pharmaceutical company Ciba.

Within a few years, Ciba introduced Dianabol, an orally active compound with enhanced anabolic properties. When Dianabol was administered to elite weightlifters at the famous York Barbell Club in Pennsylvania, the drug produced spectacular results. Once the news got out, many similar compounds quickly followed and strength athletes began to view steroids as the only way to reach the highest level of achievement. According to a 1969 article in the magazine Track and Field News entitled “Steroids: Breakfast of Champions,” these substances were readily available to athletes either from physicians who were willing to write the necessary prescription or even from some pharmacists who dispensed steroids without requiring a prescription (Hendershott, 1969).

However, as we will see later, there is a dark side to anabolic steroids in terms of their potential for serious side effects and possible dependence. Ziegler later recognized the monster that he had helped create, and by the time of his death in 1984 he profoundly regretted that part of his life.

Besides the Soviet Union, the German Democratic Republic (GDR, or East Germany) began secretly giving anabolic steroids to its elite athletes in the 1960s (Franke and Bere- donk, 1997). The most commonly used compound in the GDR was chlordehydromethyl-testosterone, known as Oral-Turinabol. The East Germans had especially great success with their female athletes, who won many Olympic and world championships with the aid of anabolic steroids. The increased performance of a female shot-putter over an 11- week period of Oral-Turinabol treatment. Unfortunately, as we will see later, these competitors paid a high price for their achievements due to the powerful side effects of anabolic steroids in women.

By the mid-1980s, there were increasing reports of rampant anabolic steroid use not only in professional sports but also reaching down into colleges and even high schools. In response, the U.S. Congress held a series of hearings between 1988 and 1990 that culminated in the Anabolic Control Act of 1991. This legislation classified 27 specific anabolic steroid preparations as Schedule III controlled substances, thus making their use illegal without a medical prescription. In addition, these substances are banned by many amateur and professional sports organizations, including the National Collegiate Athletic Association, the International Olympic Committee, the National Football League, the National Basketball Association, and most recently Major League Baseball.

Although users had long touted the beneficial effects of anabolic steroids on muscle mass and strength, many researchers remained unconvinced by these anecdotal reports because properly controlled scientific studies were lacking and arguments could be made that placebo effects, increased training motivation, or other confounding factors might be responsible for the enhanced performance of anabolic steroid users. However, a series of recent studies by Shalender Bhasin and his colleagues at the Charles R. Drew University of Medicine and Science have shown that giving high doses of testosterone to healthy young men leads to muscle fiber hypertrophy (increased size), increased muscle mass, and enhanced strength (Bhasin et al., 1996, 2001; Sinha-Hikim et al., 2002).

The subjects were given weekly injections of testosterone enanthate at different doses for a period of 20 weeks. They also received another drug at the same time to suppress endogenous testosterone secretion so that their testosterone levels would depend solely on the exogenous treatment. The lowest doses (25 and 50 mg per week) produced subnormal circulating testosterone concentrations, the 125 mg-dose produced concentrations in the normal range, and the 600mg dose produced testosterone levels that were at least 4 times the average pretreatment concentration. Anabolic steroid administration caused dose-dependent increases in muscle volume and strength. In contrast, sexual function was unchanged, indicating that this aspect of androgen action is not influenced by testosterone level within the dose range used and over the time period of testing. The findings of Bhasin’s group are very important because they were obtained under carefully controlled conditions. However, it is worth noting that even greater effects may be obtained by users taking still higher doses of steroids and combining the treatment with intensive strength training.

Anabolic steroids are taken in specific patterns and combinations

Anabolic steroids are taken in a variety of different doses, patterns, and combinations (Mottram and George, 2000). Endurance athletes (for example, marathon runners) and sprinters tend to take relatively low doses of steroids, whereas bodybuilders and strength athletes like weightlifters may take up to 100 times the therapeutic doses of these hormones. Anabolic steroids are often used in patterns called cycling. Cycles are typically 6 to 12 weeks in duration, with periods of abstinence between successive cycles. Athletes use cycling for the following reasons:

1. To minimize the development of tolerance to the drug

2. To reduce the occurrence of adverse side effects

3. To maximize performance at an athletic competition; and

4. To avoid detection of a banned substance

Cycling is sometimes combined with pyramiding, in which the steroid dose is gradually increased until the midpoint of the cycle and then gradually decreased as the cycle is completed. Pyramiding is thought to reduce possible withdrawal effects resulting from sudden termination of steroid use. It is important to note, however, that many of the reasons offered for cycling and pyramiding are based on anecdotal information rather than controlled scientific studies.

One additional feature of steroid use is stacking. This refers to the simultaneous use of two or more anabolic steroids. Stacking is often done by combining a short-acting oral steroid with a long-acting injectable preparation. While users may believe that stacking enhances the effectiveness of these compounds, again there is little research available to bolster such beliefs.

Jean-Paul Marat

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