Division between Bodybuilders and Medical-Scientific Community
Many bodybuilders remember the package inserts that proclaimed anabolic steroids “do not enhance athletic performance”, an unfortunate campaign to dissuade athletes from using steroids for a competitive edge. All that was accomplished by this propaganda was a division between athletes and the medical-scientific community.
This division was worsened following the Anabolic Steroid Control Act of 1990. After being voted into law by Congress, this act prevented physicians from providing active guidance in the use of anabolic steroids, and this forced current and potential users of steroids from legally obtaining the drugs from informed physicians and, thus, forcing all of them into the black market.
Incentive from Unlikely Sources
After decades of denial, medical and scientific opinion is finally acknowledging that supraphysiologic courses of anabolic steroids may promote gains in muscle mass and strength. Surprisingly, it was the AIDS epidemic that revitalized steroid research for anabolic therapy. AIDS patients progressively lose weight and lean body mass, leading to greater mortality and morbidity. It was discovered that a variety of anabolic steroids restored muscle mass in men suffering from AIDS-related wasting when supraphysiologic doses are provided, just as steroids build muscle in bodybuilders. There are also a number of Natural Highs and Herbal Drugs available on the market to today sold as Legal Drugs. These are just a few more options available.
Additional incentive for anabolic steroid research came from an equally unlikely direction. Baby boomers, in defiance of the example set by their ancestors, refuse to age gracefully. Instead, they are seeking access to the fountain of youth via multiple cosmetic procedures and therapies. Included among these is the use of anabolic steroids. Rather than accept the natural decline in testosterone levels, which results in many symptoms such as muscle wasting and loss of libido, baby boomers are demanding testosterone therapy to restore their youthful vigor, improve their appearance and at the same time, improve their quality of life.
Hypogonadism is the term used to describe men who produce low levels of testosterone for a variety of reasons. As with otherwise healthy men whose testosterone levels decrease with age, this group of men respond with dose-dependent increased muscle, decreased fat and improved vigor when treated with replacement doses of testosterone.
While studies involving men with AIDS, the elderly, or men with low levels of testosterone are interesting and supportive, they are of limited value for the bodybuilders. In part this is due to the fact that the steroids are provided to these groups to combat the catabolic effect of aging or disease. There are elements of significant value, however. First these studies demonstrate the efficacy of supraphysiologic doses of steroids. More importantly, they provide evidence of safety, at least in the short term. Both issues efficacy and safety, have been challenged by the professional literature. If steroids are safe and effective among afflicted groups, the margin of comfort should be greater with use of similar doses in healthy individuals.
Thus far, the most impressive studies were performed at the Charles R. Drew University of Medicine and Science in Los Angeles, CA. Several papers have been generated by the faculty at this institution, reporting on difference aspects of investigation regarding the use of supraphysiologic doses of testosterone enanthate (TE). The first series of papers was an efficacy study to determine whether supraphysiologic doses of TE, combined with exercise, could increase muscle size and strength in normal, healthy, young adult men. The landmark study published in the New England Journal of Medicine, established that exercise and 600 milligrams of TE provided as weekly injections for ten weeks induced significantly greater increases in muscle size and strength than exercise alone. Importantly, the therapy was well tolerated. Three men developed acne and two complained of breast tenderness, but there were no alterations in liver function or any other metabolic factors. Further, there were no alterations in mood or behavior.
The same investigators have expanded their research, looking at escalating doses of TE in young men, ages 18-35. One series of papers describes the experiences of a group of 61 men, assigned to receive a suppressive drug to prevent any natural testosterone production, then provided with specified doses of TE ranging from 25 milligrams per week (subphysiologic) to 600 milligrams per week (supraphysiologic) for 20 weeks. Findings from this group confirmed the dose relationship between TE dose and muscle size and strength. Supraphysiologic TE increased lean mass and strength and decreased body fat. No significant negative effects were noted at 300 milligrams per week.
HDL (good cholesterol) decreased with the highest dose, but it has been previously established that HDL returns to baseline after discontinuing steroid use. Interestingly, the researchers also proved the increase in muscle size is due to muscle hypertrophy. They demonstrated an increase in satellite cell number and myonuclear number per fiber. Satellite cells merge with muscle cells to increase the number of nuclei per cell. The ratio of nuclei to cell volume appears to be one of the factors involved in the allowance of muscle hypertrophy. This effect, an increase in satellite cell number and myonuclear number, is one of the more potent effects attributed to trenbolone. By increasing the myonuclear number, testosterone therapy permits greater growth in muscle volume than would otherwise be possible.
The researchers compared all the variables involved to determine what factors may have affected the degree of increase in muscle size and strength. Though age and PSA were statistically relate, the primary factor that controlled change in muscle strength and size was TE dose. To summarize, the higher the dose, up to 600 milligrams per week TE, the greater the increase in strength.
Bodybuilders Ahead of the Curve
Though it is gratifying to have a data base of double blind, placebo controlled, university studies published in medical and scientific journals, the results from these landmark studies confirm what has long been known to athletes and bodybuilders. Anabolic steroids, derivatives or esters of testosterone, promote a positive nitrogen balance. Nitrogen balance is a crude measure of protein loss or gain, with most of this change in protein occurring in the skeletal muscle. It has long been known that low testosterone levels, following castration or other disease processes, lead to a loss of muscle. The lost muscle can be restored b restoring testosterone levels to normal. Logic would dictate, and experience has proven, that increasing testosterone levels above normal can increase muscle mass significantly. Bodybuilders have long used supraphysiologic doses of anabolic steroids effectively to increase muscle size and strength.
Obtaining Steroids through a Loophole
A small percentage of anabolic steroid users obtained their drugs by prescription, using the loophole of “androgen deficiency”. Typically, these men were provided with 350 milligrams per week of testosterone esters occasionally, along with an aromatase inhibitor and/or a 5-alpha reductase inhibitor to manage side effects related to the metabolism of testosterone. Though 350 milligrams per week of testosterone ester seems like a very weak cycle, it is roughly two to three times a standard replacement dose, meaning it is double or triple what one would be provided with to replace natural testosterone levels.
It is likely this loophole will soon be closed and, men who previously tried to stay within the law, will be forced to obtain their drugs through the black market industry if they want to continue reaping the benefits of anabolic steroids. In fact, it is possible that men of this group will pursue higher doses of testosterone.
When used by carefully screened, closely supervised, healthy adult men, anabolic steroids may be provided in supraphysiologic doses with a reasonable degree of safety. This appears to be true for doses up to 600 milligrams per week TE for a period of at least 20 weeks. Psychological consequences have been assigned to anabolic steroids, but this appears to be overstated, as well. Excluding the effect of androgens on children or the unborn, there appears to be little risk of adverse psychological events in adult men who do not suffer from mental health disorders.
The arguments against allowing a controlled provision for supraphysiologic testosterone therapy are eroding. It is possible, as further confirmatory studies are published, that physician –guided supraphysiologic testosterone therapy may be allowed in the future.