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Use of Physical Performance Aids–Enhancement of the Young Athlete
with Steroids, Stimulants, and Dietary supplements
During
the past 2 decades, the use of enhancing physical performance aids
has been steadily increasing. Athletic competition involves
increasingly sophisticated training and conditioning regimens. This
places pressure on young athletes to excel causing many of these
young athletes, their parents and their coaches to try every
conceivable technique to enhance their competitive advantage.
Intense competition and increasingly competitive sporting leagues
across states are adding to the allure of physical performance aids.
What are Steroids?
Steroids are called anabolic-androgenic
steroids because these terms describe their effects on the body.
Anabolic refers to the supporting of the development of skeletal
muscle or muscular hypertrophy. The androgenic effects of steroids
are the initiation of secondary sex characteristics (developing
sexual traits that allow us to distinguish between the two sexes
such as hair growth, development of coarser skin, development of a
lower voice and fatty deposits in the abdominal area for a man.)
Some common female secondary sex characteristics include enlargement
of breasts, development of smoother skin, hip development, and fatty
deposits in the hip and thigh area.
Since the 1950’s, the misuse of steroids is
increasing throughout the athletic world in order to enhance
athletic performance and increase strength through muscular
development. Steroids have been used throughout medicine since the
1950’s. They have been used successfully to treat hypogonadism
(decrease in testosterone production), delayed puberty, and body
wasting (cancer and HIV).
Steroids are being abused by the strength based
athlete and usually not the endurance athlete. Gym doses used by
athletes can vary between 10 and 100 times the suggested medical
dose. Steroid use in adolescents has been increasing in grades 7-12
for the past 10 years for athletes and non-athletes as well.
Steroids are responsible for 400 million dollars in annual retail
sales.
What are some of the types of Physical Performance aids?
Dietary Supplements
The supplements contain protein, nucleic acids,
and amino acid components. These supplements are readily available
for purchase by anyone at a nutrition/drug store without
prescription or parental consent. The manufacturing companies market
these products heavily in youth-oriented media. Endorsements by
professional athletes further encourage their use. The labels on the
outside packaging of supplements are persuasive to the young athlete
and the directions may be confusing.
Research has shown that the incremental gain in
power may be only 5-7% even in professional athletes and in most
cases there is no power enhancement.
Dietary supplements that contain concentrated
protein, nucleic acid, amino acids, and concentrated amounts of
carbohydrate can be a health risk. The high osmotic load
(concentration) of these products can increase the risk of
dehydration and heat-related illness. If you add intense exercise,
intense heat and other factors- an athlete may be at risk for sudden
death from the use of these supplements.
The long term effects of dietary supplement use
is not known.
Stimulants
This is the most commonly used physical
performance aid used by young athletes.
Caffeine
This is the most
pervasive stimulant. Caffeine may be used as a physical performance
product as it is a very powerful diuretic. It can be an effective
product in the short term but because of its effects on metabolism
it is not recommended. Younger athletes are at higher risk
physiologically for dehydration and sudden death from heat-related
illness when compared to more physically matured athletes.
Ephedra
During preseason
training, these products are used to reduce weight in
weight-categorized sports. Young athletes also use ephedra to reduce
body fat and increase mass to enhance their physiques for cosmetic
purposes. Ephedra has been linked with serious injury and death when
combined with heat and/or cardiac arrhythmias. The state of Illinois
has banned the sale of ephedra containing products except FDA
approved ephedrine.
Methamphetamine
This is the most potent
physical performance aid. This compound does improve performance in
the short term period, but unfortunately is very dangerous and is
also readily available. The risk for sudden cardiac death and heat
related injury or death is substantial, moreover the morbidity or
rate of unwanted side effect or injury margin for error is very
small. Young athletes using methamphetamine and related substances
for treatment of attention deficit/hyperactivity disorder ADHD
should also watch for heat related side effects.
Why do young athletes use performance enhancers?
The most common reason steroids are used is to
improve athletic performance. Desire for larger muscles and
decreasing body fat are other reasons. A Kaiser Foundation study
found that more than 70% of youth desire to be like high-profile
athletes and more than half (52%) believe these athletes use
performance-enhancing drugs. Young women and men use physical
performance aids for different reasons it seems. Male use tends
toward striving to be bigger and more athletic, while females tend
to use aids for body shaping and for disordered eating practices.
There is some research that suggests that
muscle dysmorphia may exist- inaccurate beliefs that they are not
sufficiently muscular. Individuals with muscle dysmorphia show
striking parallels with known eating disorders- the “pursuit of
muscles” may be explained by an anorexic’s “pursuit of being thin”.
Is it true that steroids should not be abruptly stopped?
Yes, it is difficult and sometimes dangerous to
stop steroid use suddenly and many abusers will require professional
medical support for this purpose.
What are some signs/side
effects to look for with my child/teen if I suspect
physical performance aid abuse?
Quick weight and muscle gains (when used in a
weight training program)
Aggressiveness and combativeness
Jaundice or yellow tone to the skin
Purple or red spots on the body
Swelling of feet and lower legs
Trembling
Unexplained darkening of the skin
Persistent unpleasant breath odor
Severe acne breakouts and oily skin
Depression or mood swings
Females-irregular menses, increased hair
development and increased muscularity
Males- gynecomastia or enlargement of the
breast tissue
Your child/teen may not have one but many of
the symptoms above. Many changes take place inside the body and may
not be noticed until it is too late. Some of the effects will go
away when the steroid is stopped but some will not. Abuse of these
products might also be difficult if the teen is experiencing
pubertal changes because some of the effects are the same bodily
changes that are expected at this time in development.
What are some health consequences of steroids?
In boys and men, reduced sperm production,
testicular shrinkage, impotence, difficulty or pain in urination,
baldness and irreversible breast enlargement.
In girls and women, development of more
masculine characteristics, such as decreased body fat and breast
size, deepening of the voice, excessive body hair but loss of scalp
hair can occur. Females may experience alterations in their hormones
that may lead to an altered menstrual cycle (commonly irregular
anyway for the first 2 years beyond the onset of the first menstrual
cycle).
In both male and female teens there may be
premature termination of the adolescent growth spurt so that for the
rest of their life, abusers may remain shorter than they would be
without the drugs.
In males and females, blood clotting,
cholesterol changes, potentially fatal liver cysts and liver cancer,
and hypertension, heart attack and stroke. Sometimes aggression
manifesting itself as fighting or physical and sexual abuse can
happen.
Injectors of steroids can contract HIV/AIDS and
Hepatitis B and C.
Some side effects can show up rather quickly
while others may take years to materialize.
Why
are steroids linked to tendon injuries?
Athletes using performance aids are carrying
more muscle and bulk than their frames can support. A mild injury
can cause such trauma to a tendon that more injuries to muscles
built by performance aids are career-threatening. Steroids cannot
improve an athlete’s agility or skill they merely build muscle that
is too bulky. Steroids also cause tendon degeneration by altering
collagen synthesis or strength, causing sclerosis and fibrosis
in the tendon, fatty degeneration, necrosis, or calcification
all of which can lead to injury or irreversible damage. Sometimes
injections straight into the muscle can lead to tendon injury or
cell death.
What are the laws? Why are performance aids for sale and so readily
available?
Steroid use dates back to the 1930’s however it
was not until the 1970’s or 1980’s that they came under the Food and
Drug Administration’s (FDA) jurisdiction. In 1990, Congress elected
to schedule anabolic steroids as Schedule III controlled substances
under Title 21 of the U.S. Code that regulates foods and drugs. This
is the same class as amphetamines, opium and morphine. It has
classified anabolic steroids as “any drug or hormonal substance,
chemically and pharmacologically related to testosterone that
promotes muscle growth”. However it was the phrase “promotes
muscle growth” that provided a loophole enabling androstenedione
and others related to this substance to avoid the label “anabolic
steroids” because of the lack of knowledge known about the
substance. The 1994 federal Dietary Supplement and Health Education
Act (DSHEA) provided a legal framework to classify androstenedione
and other substances as dietary supplements – akin to foods which
require no prescription. DSHEA does not enforce manufacturers to
demonstrate premarket purity, safety, and efficacy to treat or cure
any illness or condition. To summarize, most of the supplements that
are on the market should be strictly regulated but are not
because they are labeled with government agencies as foods. The
government is working on federal grants that may be available for
elementary, middle, and high schools for steroid prevention and
education programs via the Anabolic Steroid Control Act of 2004.
What are some physical performance aids? You may see these names on
the bottle.
α-lipoic acid
Anabolic steroids
Androstenedione
Antioxidants (vitamin C, Vitamin E, β-carotene)
in large amounts
Amphetamines
Bee Pollen
Beta blockers (propanolol)
Beta-Hydroxy-beta-methylbutyrate (HMB)
Blood
Caffeine
Calcium (in large amounts)
Carnitine
Choline
Chrysin
Chromium
Clenbuterol
Coenzyme Q-10
Creatine
Dehydroandrostenedione
Dimethyl sulfoxide (DSMO)
Diuretics (furosemide, spirinolactone,
hydrochlorothiazide)
Engineered dietary supplements
Ephedrine
Erythropoietin (EPO)
Folic Acid
Ginkgo biloba
Ginseng
Glycerol
Human Growth Hormone
Inosine
Insulin-like growth factor (IGF-1)
Iron
Methandrostenolone (Dianobol)
Minerals (boron, chromium, vanadium, iron,
selenium, zinc)
Niacin
Nicotine
Nonsteroidal anti-inflammatory drugs
Omega-3 fatty acids
Oxandrolone (Anavor)
Oxymetholone (Anadrol-50)
Oxygen
Pantothenic Acid
Phosphorus
Pyridoxine (Vitamin B6)
Plant steroids (phytosteroids, У-oryzanol,
ferulic acid (FRAC)
Protein supplements
Sodium Bicarbonate
Sport Drinks
Stanozolol (Winstrol)
Tribulis terrestris
Vitamin supplements
Vitamin B12-cyanocobalamine
Vitamin B15 dimethylglycerine (DMG)
Yohimbine (yohimbe)
Talk to your doctor if you hear your athlete or teen say these
words…
A
Glossary of terms:
Blending- Mixing different drugs in
order to achieve an effect
Bulking up-Increasing muscle mass
through steroids
Cycling-Taking multiple doses of
steroids over a specified period of time, stopping for a time and
then starting again
Doping- Using drugs and other nonfood
substances to improve athletic performance
Ergogenic drugs- physical performance
enhancers such as steroids
Megadosing- Taking massive amounts of
steroids by injection or pill
Plateauing- When a drug becomes
ineffective at a certain level
Roid Rages-Uncontrolled outbursts of
anger, frustration, or combativeness that may result from using
anabolic steroids
Shotgunning-Taking steroids on a
hit-or-miss basis
Stacking-Using a combination of anabolic
steroids often in combination with other drugs
Tapering-Slowly decreasing steroids
intake
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