User talk:Ryan Griffin

Anabolic Steroids

Anabolic steroids, also known as adrenergic-anabolic steroids, are synthetic hormones that promote protein synthesis.[7] Anabolic steroids have been shown to increase muscle mass.[8] They have also been linked to negative health effects. Anabolic steroids promote increased amounts of acne, aggressive behavior referred to as “roid rage,” male-pattern baldness, a decrease in the rate of growth of adolescents, damage to the testes, erectile dysfunction, and changes to the structure and function of the heart and the liver.

There is evidence that the use of anabolic steroids may cause a form of dependency. Animal studies have shown that male and female hamsters will voluntarily self-administer testosterone and other anabolic steroids, even to the point of fatal overdose. These results have led researchers to conclude that the substances are potentially addictive, "independent of their effects on muscle mass or athletic performance".

History

In the 1930’s, the first synthetic form of testosterone was developed by Adolf Friedrich Johann Butenandt. It was originally used to treat men who had deficient testosterone levels. During World War II, soldiers would be given synthetic forms of testosterone to assist in gaining weight and maintaining strength. During the 1956 Olympics, athletes from the former Soviet Union used synthetic testosterone in order to improve their strength and conditioning. Upon discovery that Soviet athletes had used synthetic testosterone as a supplement, an American physician named John Zeigler developed the first anabolic steroid called methandrostenolone.[8]

In 1975, the International Olympic Committee banned the use of steroids from competition. The United States passed the Anti-Drug Abuse Act in 1988 which introduced penalties for the sale or possession of steroids. The Anabolic Steroid Enforcement Act of 1990 was then passed in the United States which made anabolic steroids a Schedule III substance of the Controlled Substances Act.[8]

Physiological Changes

The prolonged used of anabolic steroids has been linked to damage to different tissues in the human body. Some of the damage is cosmetic while other damage can be life threatening.

Liver

The liver and adipose tissue can convert androgens, such as the anabolic steroid testosterone, into estrogens. The addition of testosterone above normal physiological levels causes the body to change some of the testosterone into estrogens to reduce the amount of testosterone in the body. This causes the development of gynecomastia, resulting in a growth in mammary tissue from the increased amount of estrogens.[7]

Anabolic steroid use can cause hepatic diseases after continued use. 17a-alkylated anabolic steroids have been linked to celestas, peliosis hepatis, hyperplasia, and tumors.[4]

Genitals

Increased levels of anabolic steroids can inhibit the release of follicle stimulating hormone and luteinizing hormone, causing atrophy of the testes and erectile disfunction.[7]

Heart

Anabolic steroids can contribute to structural changes in the heart, specifically in the left ventricle. The left ventricular posterior wall can increase in thickness. The mass of the left ventricle can also increase.[6] The use of anabolic steroids can produce a hypertrophic response by directly acting on cardiac muscle cells. Amino acids are then directly incorporated into proteins, further increasing the mass of the left ventricle.[6] Prolonged anabolic steroid use can cause micro foci of fibrosis to form on the left ventricle wall. Myocardial cells may become segmented. The tissue of the myocardium can become distended and intercalated disks can widen.[4] The myocardial cells in the left ventricle can die as a result of over distension. Contraction band necrosis can occur if many myocardial cells die. [4]

Anabolic steroids may increase the sensitivity of the heart to catecholamines, including epinephrine, that can cause an arrhythmogenic event.[2] At doses above normal physiological levels, anabolic steroids can increase the risk of myocardial ischemia. The increased risk comes from steroid-induced increases in cyclic AMP concentrations and tumor necrosis factor concentrations.[6]

The use of anabolic steroids has been linked to decreased left ventricular ejection fraction, longitudinal strain, radial strain, and peak systolic tissue velocity.[1] Anabolic steroids have also been linked to decreases in flow-mediate dilation, which is associated with lipid alterations and a reduction in the bioavailability of nitric oxide.[5] There have also been links to decreased functions of both E-waves, A-waves, early peak tissue velocity, and peak late diastolic tissue velocity.[1] A lower E/A wave ratio indicates a lower early diastolic function and increased late diastolic function resulting in impaired left ventricle relaxation.[1]

Anabolic steroids can increase low-density lipoprotein cholesterol and decrease high-density lipoprotein cholesterol resulting in an increase to the coronary artery response to the catecholamines norepinephrine and epinephrine.[3]

Androgens, including some anabolic steroids, can alter lipoprotein metabolism increasing the risk for coronary heart disease, myocardial infarction, and sudden cardiac death.[2]

Risk Factors with Weightlifting

Lifting weights can cause activation of platelets, causing an increase in platelet aggregation and a rise in beta-thromboglobulin.[2] After heavy weight lifting, the amount of several substances in the blood can increase, including the number of platelets, platelet crit, mean platelet volume, factor VIII, and vWF antigen. [2] Weightlifting requires that a large volume of oxygen be delivered to muscle cells. Increasing the amount of different substances in the blood inhibits the heart’s ability to transport blood and deliver oxygen. After several years of anabolic steroid use, sub clinical impairments of systolic and diastolic myocardial function can occur, further reducing the hearts ability to function properly. [2]

The sympathetic neurons that help control the heart rate can be affected by anabolic steroid use paired with exercise. Increased levels of testosterone can inhibit the peripheral uptake of neuroamines causing the heart to have an increased response to norepinephrine.[3] Supplementing training with injections of testosterone increases the heart’s response to norepinephrine. The use of anabolic steroids also can increase the average muscle sympathetic burst frequency, causing an increase in the response of the heart to norepinephrine.[5]

References

1. Baggish A, Weiner R, Kanayama G, Hudson J. 2010. Long-term anabolic-androgenic steroid use is associated with left ventricular dysfunction. Circulation: Heart Failure. 472-6.

2. Montagnana C, Lippi G, Franchini M, Banfi G. 2008. Sudden Cardiac Death in YoungAthletes. Internal Medicine 47:1373-8.

3. Fineschi V, Baroldi G, Monciotti F, Reattelli L. 2001. Anabolic steroid abuse and cardiac sudden death. Archives of Pathology and Laboratory Medicine 125:253-5.

4. Fineschi V, Riezzo I, Centini F, Silingardi E. 2007. Sudden cardiac death during anabolic steroid abuse: Morphologic and toxicologic findings in two fatal cases of bodyguilders. International Journal of Legal Medicine 121(1):48-52.

5. Alves M, Santos M, Dias R, Akiho C. 2009. Abnormal neurovascular control in anabolic androgenic steroids users. Medicine and Science in Sports and Exercise 42(5):865-71.

6. Hassan NA, Salem MF, Sayed M. 2009. Doping and effects of anabolic androgenic steroids on the heart: Histological, unltrastructural, and echocardiographic assessment in strength atheletes. Human and Experimental Toxicology 28:273-83.

7. Eugene B A. 2009. Human Physiology. United States: McGraw-Hill. 449 p

8. 2010 [cited 2010 Nov 6].Anabolic Steroids. [Internet]. College Park, MD: Center for Substance Abuse Research, University of Maryland. Available from: http://www.cesar.umd.edu/cesar/drugs/steroids.asp#history.

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