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Updated: Jun 2 2021

Steroids & Stimulants


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Images steroids.jpg
  • Anabolic steroids
    • Introduction
      • cause increase in muscle strength
      • increase aggressive behavior
      • increased erythropoiesis
      • side effects
        • hypertension
        • liver tumors
        • increased LDL
        • decreased HDL
        • hypercholesterolemia
    • Intake
      • either oral or injection routes possible
    • Evaluation
      • an abnormally low high-density lipoprotein level should alert the physician to the possibility of steroid use in an athlete.
      • blood testing examines for testosterone to epitestosterone ratio of > 6:1
    • Physical exam
      • increased body weight
      • testicular atrophy
      • irreversible deepening of female voice
      • alopecia (irreversible)
      • reduction in gonadotropic and sex hormones (estrogen and testosterone)
        • can lead to decreased bone mineral density
        • oligospermia or azoospermia
      • growth retardation
      • gynecomastia
    • Type of steroids
      • Human Growth hormone (HGH)
        • the most abundant substance produced by the pituitary gland. Growth hormone has a direct anabolic effect by accelerating the incorporation of amino acids into proteins. It is becoming an increasingly popular anabolic steroid substitute;
        • similar effects from insulin-like growth factor (IGF-1)
        • increased muscle size but not strength
        • Side effects:
          • myopathic muscles development
          • carpal tunnel syndrome
          • insulin resistance
      • Androstenedione
        • an androgen produced by the adrenal glands and gonads
        • acts as a potent anabolic steroid and is converted in the liver directly to testosterone with a resultant increase in levels after administration.
      • DHEA
        • is a naturally occurring hormone made by the adrenal cortex.
        • it is converted to androstenedione, which in turn is converted to testosterone.
        • the beneficial and adverse effects of DHEA can be correlated directly with those of testosterone.
      • Erythropoietin (EPO)
        • stimulates hemoglobin production and increases O2 carrying capacity
        • side effects
          • increased blood viscosity which can lead to stroke or myocardial infarctions
      • Somatotropin
        • a growth hormone that causes hypertrophy of type 1 muscles and atrophy of type 2 muscle
  • Catabolic Hormones
    • Glucagon
      • has a catabolic effect on skeletal muscle
  • Supplements
    • Creatine
      • Introduction
        • derived from glycine, arginine, and methionine
        • a muscle and power building supplement (not an anabolic steroid)
        • mechanism is that creatinine is converted to phosphocreatine, which acts as a source of ATP for muscle
          • studies have shown although it can increase work in anaerobic trials, it cannot increase peak force
        • widely used in conjunction with off-season weight lifting programs
      • Outcomes
        • studies show mixed results with regard to enhanced sports performance
      • Risks
        • pulls water from blood vessels into cells, creating a theoretical risk of dehydration 
      • Reports of
        • increased muscle injury
        • renal insufficiency (rare)
  • Stimulants
    • Includes
      • caffeine
        • doses of 2 to 3 mg/kg have been shown to improve performance
        • works by reducing fatigue and increasing alertness
        • previously banned by the International Olympic Committee (IOC)
          • now allowed up to 12 micrograms per milileter of urine
      • ephedra
      • ephedrine
      • "ma huang"
        • often included in energy drinks
      • amphetamines
    • Risks include
      • dehydration
      • impaired heat management
      • high blood pressure
      • nervous system impairment
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