Introduction (Magill’s Medical Guide, Sixth Edition)
In the history of sport, athletes have attempted to find a competitive advantage through advanced techniques in training, nutrition, and even in ergogenic aids, such as nutritional supplements and pharmacological aids. The use of these substances—such as anabolic-androgenic steroids (AAS), testosterone precursors (such as androstenedione), and nonsteroidal aids such as human growth hormone (GH) and creatine—have become increasingly popular in recent years, even without thorough scientific data supporting their efficacy and safety.
The population using such performance-enhancing drugs ranges from collegiate to professional athletes to adolescents and high school students. Recent meta-analyses estimate that 3 to 12 percent of adolescent boys have used an anabolic steroid at least once, and 28 percent of collegiate athletes admit to taking creatine. Other studies have suggested that the number may be closer to 41 percent.
Though such ergogenic aids are thought to improve strength, endurance, agility, and overall performance, most athletic improvement is anecdotal at best. Scientific evidence supporting these ideas is scarce and incomplete. Even with aids that may improve strength and/or performance, the safety of these substances has been seriously questioned, such as with the use of AAS, GH, and ephedra.
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Types of Ergogenic Aids (Magill’s Medical Guide, Sixth Edition)
Anabolic-androgenic steroids (AAS) as ergogenic aids in sports are chemical compounds that resemble the structure of testosterone, the naturally occurring male sex hormone that affects muscle growth and strength. “Anabolic” refers to the growth of cells, and “androgenic” refers to the stimulation of the growth of male sex organs and masculine sex characteristics. AAS bind to cells that are used for muscle repair and that can transform into muscle fibers.
AAS has been one of the most studied ergogenic aids, yet many of its mechanisms and adverse effects are still not well understood. Studies have shown that increased doses of testosterone can decrease total body adipose tissue in the body and can increase strength and fat-free mass. Adverse effects of AAS use include hypothalamic-pituitary dysfunction, gynecomastia, severe acne, infection as a result of sharing needles, aggressive and depressive behavior, and a possible association with premature death.
Androstenedione (andro) is a testosterone precursor produced by the adrenal glands and gonads. Its ergogenic effect occurs after it is converted to testosterone in the testes as well as in other tissues. It can also be converted to estrone and estradiol, which are steroid compounds that are primary female sex hormones (found in both men and women). The creation of testosterone is regulated by the amount of testosterone precursors in the body....
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Perspective and Prospects (Magill’s Medical Guide, Sixth Edition)
The use of ergogenic aids in the history of sport has progressively moved from primitive aids to more sophisticated performance enhancers. Crude natural concoctions and stimulants have paved the way for complex pharmacological agents (such as erythropoietin) and designer anabolic steroids (such as tetrahydrogestrinone). Athletes and trainers have utilized any and all means to gain a competitive edge, even if that results in damage to health and even a risk of death.
The biggest problem stemming from the use of such aids is the difficulty in detecting them. This is evident in recent media attention given to ergogenic aids and their popularity, as seen through the 1995 congressional hearings regarding steroid use in Major League Baseball as well as the recent discoveries of abuse by high-profile cyclists and track-and-field athletes. This media attention has also shown the difficulties among investigators, such as the International Olympic Committee (IOC) and United States Anti-Doping Agency, in detecting the use of new designer steroids and new ergogenic aids among elite athletes.
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For Further Information: (Magill’s Medical Guide, Sixth Edition)
Bhazin, S., et al. “The Effects of Supraphysiologic Doses of Testosterone on Muscle Size and Strength in Normal Men.” New England Journal of Medicine 335 (1996): 1-7.
Bohn, Amy Miller, Stephanie Betts, and Thomas L. Schwenk. “Creatine and Other Nonsteroidal Strength-Enhancing Aids.” Current Sports Medicine Reports 1, no. 4 (August, 2002): 239-245.
Foster, Zoë J., and Jeffrey A. Housner. “Anabolic-Andogenic Steroids and Testosterone Precursors: Ergogenic Aids and Sport.” Current Sports Medicine Reports 3, no. 4 (August, 2004): 234-241.
Graham, T. E. “Caffeine and Exercise: Metabolism, Endurance, and Performance.” Sports Medicine 31, no. 11 (November 1, 2001): 785-807.
Juhn, Mark S. “Ergogenic Aids in Aerobic Activity.” Current Sports Medicine Reports 1, no. 4 (August, 2002): 233-238.
Powers, Michael E. “The Safety and Efficacy of Anabolic Steroid Precursors: What Is the Scientific Evidence?” Journal of Athletic Training 37, no. 3 (2002): 300-305.
Shekelle, Paul G., et al. “Efficacy and Safety of Ephedra and Ephedrine for Weight Loss and Athletic Performance: A Meta-analysis.” Journal of the American Medical Association 289, no. 12 (March 26, 2003): 1537-1545.
Singbart, G. “Adverse Events of Erythropoietin in Long-Term and in Acute/Short-Term Treatment.” Clinical...
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