Hoping to gain a competitive edge by taking performance-enhancing drugs? Learn how these drugs work and how they can affect your health. Most serious athletes will tell you that the drive to win is fierce. Besides the satisfaction of personal accomplishment, athletes often pursue dreams of winning a medal for their country or securing a spot on a professional team.
In such an environment, the use of performance-enhancing drugs has become increasingly common. But using performance-enhancing drugs doping has risks. Take the time to learn about the potential benefits, the health risks and the many unknowns regarding so-called performance-enhancing drugs such as anabolic steroids, androstenedione, human growth hormone, erythropoietin, diuretics, creatine and stimulants.
You may decide that the benefits aren't worth the risks. Some athletes take a form of steroids — known as anabolic-androgenic steroids or just anabolic steroids — to increase their muscle mass and strength. The main anabolic steroid hormone produced by your body is testosterone.
Some athletes take straight testosterone to boost their performance. The anabolic steroids used by athletes are often synthetic modifications of testosterone. Why are these drugs so appealing to athletes? Besides making muscles bigger, anabolic steroids may reduce the muscle damage that occurs during a hard workout, helping athletes recover from the session more quickly and enabling them to work out harder and more frequently.
Some athletes, as well as nonathletes, may like the muscular appearance they get when they take the drugs. A particularly dangerous class of anabolic steroids are the so-called designer drugs — synthetic steroids that have been illicitly created to be undetectable by current drug tests. They are made specifically for athletes and have no approved medical use.
Because of this, they haven't been tested or approved by the Food and Drug Administration FDA and represent a particular health threat to athletes. Many athletes take anabolic steroids at doses that are much higher than those prescribed for medical reasons.
Anabolic steroids have serious physical side effects. Taking anabolic-androgenic steroids to enhance athletic performance is prohibited by most sports organizations — and it's illegal. In the past 20 years, more-effective law enforcement in the United States has pushed much of the illegal steroid industry into the black market. This poses additional health risks because the drugs are either made in other countries and smuggled in or made in clandestine labs in the United States.
Either way, they aren't subject to government safety standards and could be impure or mislabeled. Androstenedione andro is a hormone produced by the adrenal glands, ovaries and testes. It's a hormone that's normally converted to testosterone and a form of estrogen estradiol in both men and women.
Andro is available legally only by prescription and is a controlled substance. Its use as a performance-enhancing drug is illegal in the United States. Manufacturers and bodybuilding magazines tout andro's ability to allow athletes to train harder and recover more quickly. Scientific studies that refute these claims show that supplemental androstenedione doesn't increase testosterone and that your muscles don't get stronger with andro use.
In both men and women, andro can damage the heart and blood vessels, increasing the risk of heart attack and stroke. Human growth hormone is a hormone that has an anabolic effect. Athletes take it to improve muscle mass and performance. However, it hasn't been shown conclusively to improve either strength or endurance.
Erythropoietin is a type of hormone used to treat anemia in people with severe kidney disease. It increases production of red blood cells and hemoglobin — the protein that carries oxygen to your body's organs. Taking erythropoietin improves the movement of oxygen to the muscles. Epoetin, a synthetic form of erythropoietin, is commonly used by endurance athletes. Erythropoietin use among competitive cyclists was common in the s and allegedly contributed to at least 18 deaths.
Inappropriate use of erythropoietin may increase the risk of stroke, heart attack and blockage in an artery in the lung pulmonary embolism. Diuretics are drugs that change your body's natural balance of fluids and salts electrolytes , which can lead to dehydration. This loss of water can decrease an athlete's weight, which many athletes prefer. Diuretics may also help athletes pass drug tests by diluting their urine and are sometimes referred to as a "masking" agent.
Diuretics taken at any dose, even medically recommended doses, predispose athletes to adverse effects such as:. Many athletes take nutritional supplements instead of or in addition to performance-enhancing drugs.
Supplements are available over-the-counter as powders or pills. Creatine monohydrate is a supplement that's popular among athletes. Creatine is a naturally occurring compound produced by your body that helps your muscles release energy. Scientific research indicates that creatine may have some athletic benefit by producing small gains in short-term bursts of power.
Creatine appears to help muscles make more adenosine triphosphate ATP , which stores and transports energy in cells, and is used for quick bursts of activity, such as weightlifting or sprinting. But there's no evidence that creatine enhances performance in aerobic or endurance sports. Weight gain is sought by athletes who want to increase their size. But with prolonged creatine use, weight gain is more likely the result of water retention than an increase in muscle mass.
Water is drawn into your muscle tissue, away from other parts of your body, putting you at risk of dehydration. It appears safe for adults to use creatine at the doses recommended by manufacturers. But there are no studies investigating the long-term benefits and risks of creatine supplementation. Some athletes use stimulants to stimulate the central nervous system and increase heart rate and blood pressure. Common stimulants include caffeine and amphetamines.
It is needed to develop and maintain male sex characteristics, such as facial hair, deep voice, and muscle growth. Women do have some testosterone in their bodies, but in much smaller amounts. Health care providers use anabolic steroids to treat some hormone problems in men, delayed puberty , and muscle loss from some diseases. But some people misuse anabolic steroids. Some bodybuilders and athletes use anabolic steroids to build muscles and improve athletic performance.
They may take the steroids orally, inject them into muscles, or apply them to the skin as a gel or cream. These doses may be 10 to times higher than doses used to treat medical conditions. Using them this way, without a prescription from a health care provider, is not legal or safe. Misuse of anabolic steroids, especially over a long period of time, has been linked to many health problems, including.
Even though they don't cause a high, anabolic steroids can be addictive. You can have withdrawal symptoms if you stop using them, including. The information on this site should not be used as a substitute for professional medical care or advice.
Unfortunately, this abusive use of anabolic-androgenic steroids has given testosterone replacement therapy a bad rap due to symptoms of too much testosterone and other chemicals in steroids. However, TRT is a legal, prescribed treatment for conditions like low testosterone. There are several differences between using medical testosterone and abusing steroids. Testosterone replacement therapy can be a helpful treatment for low testosterone just like any other medication you may take for health conditions.
There are some other key differences between testosterone replacement therapy and steroids. The main difference between steroid abuse and testosterone injections is the dosage. Testosterone replacement therapy uses smaller doses with the aim of bringing your hormone levels into normal, healthy ranges. This generally means using the smallest dose needed to help increase testosterone levels in your bloodstream.
By contrast, steroid users generally use much higher doses than is recommended by a doctor. In fact, doses can be anywhere between ten and times higher than the maximum dosage a doctor would prescribe. This can increase testosterone and other hormone levels beyond the natural limit and can put your health at risk. Because of the difference in dose and sometimes chemical composition of TRT and steroids, this leads to different potential side effects.
Testosterone replacement therapy is generally safe for most men with hypogonadism. This is because it is approved for treating low testosterone levels. Our physician will sit down with you and review your medical history, overall health, and also discuss risks and benefits to help you decide if testosterone therapy is right for you and also help monitor dosage and side effects to help keep you safe, just like when you start any other medication.
By contrast, because steroid abusers use drugs illegally and without a prescription, there is no medical oversight for safety. In addition, such high doses can cause side effects like paranoid jealousy, aggression, delusions, mania, and impaired judgement. Long-term side effects include organ damage. This is generally attributed to the extreme doses, mixes of other chemicals, and lack of medical guidance when using steroids.
While some steroid users do use their drugs continuously, most use in phases. For example, cycling is using multiple doses for a time, stopping dosage for a while, and then starting again. Plateauing is another common term associated with illegal steroid use. This is where someone constantly changes the dose or type of drug to try to prevent developing a tolerance. By contrast, men using testosterone replacement therapy generally receive continuous doses to keep baseline, optimized levels.
TRT is often a life-long treatment for those with low testosterone to help them continue to feel great and help reduce the effects of hypogonadism. While our physician may adjust your dose, this is only when needed to help you maintain healthy testosterone levels. Testosterone replacement therapy involves working with a physician on an ongoing basis for prescribed testosterone medication.
From a legal standpoint, this is the difference between testosterone therapy and illegal steroids. By contrast, if you need treatment for low testosterone, our team evaluates your hormone levels to diagnose you with hypogonadism and then designs a custom treatment plan to help you feel better.
Then, we offer ongoing monitoring of your hormone levels, symptoms, and health status while receiving hormone injections. It is needed to develop and maintain male sex characteristics, such as facial hair, deep voice, and muscle growth. Women do have some testosterone in their bodies, but in much smaller amounts. Health care providers use anabolic steroids to treat some hormone problems in men, delayed puberty , and muscle loss from some diseases.
But some people misuse anabolic steroids. Some bodybuilders and athletes use anabolic steroids to build muscles and improve athletic performance. They may take the steroids orally, inject them into muscles, or apply them to the skin as a gel or cream. These doses may be 10 to times higher than doses used to treat medical conditions.
Using them this way, without a prescription from a health care provider, is not legal or safe. Misuse of anabolic steroids, especially over a long period of time, has been linked to many health problems, including. Even though they don't cause a high, anabolic steroids can be addictive. You can have withdrawal symptoms if you stop using them, including. The information on this site should not be used as a substitute for professional medical care or advice.
As surprising as it may be, women can also be bothered by symptoms of testosterone deficiency. For example, disease in the pituitary gland may lead to reduced testosterone production from the adrenal glands disease. They may experience low libido, reduced bone strength, poor concentration or depression. There are times when low testosterone is not such a bad thing. The most common example is probably prostate cancer. Testosterone may stimulate the prostate gland and prostate cancer to grow.
That's why medications that lower testosterone levels for example, leuprolide and castration are common treatments for men with prostate cancer. Men taking testosterone replacement must be carefully monitored for prostate cancer. Although testosterone may make prostate cancer grow, it is not clear that testosterone treatment actually causes cancer. Genetic diseases, such as Klinefelter syndrome in which a man has an extra x-chromosome and hemochromatosis in which an abnormal gene causes excessive iron to accumulate throughout the body, including the pituitary gland can also affect testosterone.
Women may have a testosterone deficiency due to diseases of the pituitary, hypothalamus or adrenal glands, in addition to removal of the ovaries. Estrogen therapy increases sex hormone binding globulin and, like aging men, this reduces the amount of free, active testosterone in the body. Currently, testosterone therapy is approved primarily for the treatment of delayed male puberty, low production of testosterone whether due to failure of the testes, pituitary or hypothalamus function and certain inoperable female breast cancers.
However, it is quite possible that testosterone treatment can improve symptoms in men with significantly low levels of active free testosterone, such as:. However, many men with normal testosterone levels have similar symptoms so a direct connection between testosterone levels and symptoms is not always clear. As a result, there is some controversy about which men should be treated with supplemental testosterone. Testosterone therapy may make sense for women who have low testosterone levels and symptoms that might be due to testosterone deficiency.
It's not clear if low levels without symptoms are meaningful; treatment risks may outweigh benefits. However, the wisdom and effectiveness of testosterone treatment to improve sexual function or cognitive function among postmenopausal women is unclear.
People with normal testosterone levels are sometimes treated with testosterone at the recommendation of their doctors or they obtain the medication on their own. Some have recommended it as a "remedy" for aging. For example, a study from Harvard Medical School in found that even among men who started out with normal testosterone results noted loss of fat, increased muscle mass, better mood, and less anxiety when receiving testosterone therapy.
Similar observations have been noted among women. However, the risks and side effects of taking testosterone when the body is already making enough still discourages widespread use. Testosterone is so much more than its reputation would suggest.
Men and women need the proper amount of testosterone to develop and function normally. However, the optimal amount of testosterone is far from clear. Checking testosterone levels is as easy as having a blood test. The difficult part is interpreting the result. Levels vary over the course of the day. A single low level may be meaningless in the absence of symptoms, especially if it was normal at another time.
We need more research to know when to measure testosterone, how best to respond to the results and when it's worthwhile to accept the risks of treatment. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
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Can wearing contacts harm your vision? Vegan and paleo: Pluses and minuses to watch. Postpartum anxiety is invisible, but common and treatable. Right-sizing opioid prescriptions after surgery. Testosterone's Role Testosterone is the major sex hormone in males and plays a number of important roles, such as: The development of the penis and testes The deepening of the voice during puberty The appearance of facial and pubic hair starting at puberty; later in life, it may play a role in balding Muscle size and strength Bone growth and strength Sex drive libido Sperm production Adolescent boys with too little testosterone may not experience normal masculinization.
These hormones are thought to have important effects on: Ovarian function Bone strength Sexual behavior, including normal libido although evidence is not conclusive The proper balance between testosterone along with other androgens and estrogen is important for the ovaries to work normally. Did You Know? The Perils of Too Much Testosterone Having too much naturally-occurring testosterone is not a common problem among men. Problems associated with abnormally high testosterone levels in men include: Low sperm counts, shrinking of the testicles and impotence seems odd, doesn't it?
Testosterone therapy might seem like the ultimate anti-aging formula. Yet the health benefits of testosterone therapy for age-related decline in testosterone aren't clear. The male hormone testosterone plays an important role in the development and maintenance of typical masculine physical characteristics, such as muscle mass and strength, and growth of facial and body hair.
Testosterone is a hormone produced primarily in the testicles. Testosterone helps maintain men's:. Testosterone levels generally peak during adolescence and early adulthood. For older men, it's important to determine if a low testosterone level is due to normal aging or if it is due to a disease hypogonadism.
Hypogonadism hampers the ability to produce normal amounts of testosterone due to a problem with the testicles or with the pituitary gland that controls the testicles. Testosterone replacement therapy, in the form of injections, pellets, patches or gels, can improve the signs and symptoms of low testosterone in these men. Not necessarily. Men can have many signs and symptoms as they age. Some that might occur as a result of lower testosterone levels can include:.
Some of these signs and symptoms can be caused by other factors, including medication side effects, obstructive sleep apnea, thyroid problems, diabetes and depression. It's also possible that these conditions cause low testosterone levels, so treatment might result in increase of testosterone levels. Testosterone therapy can help reverse the effects of hypogonadism, but it's unclear whether testosterone therapy would benefit older men who are otherwise healthy.
Although some men believe they feel younger and more vigorous if they take testosterone medications, there's little evidence to support the use of testosterone in otherwise healthy men. Guidelines from the American College of Physicians indicate that testosterone therapy might improve sexual function somewhat in some men, but there's little evidence that it improves other functions, such as vitality and energy. Also, some research shows that testosterone therapy can increase your risk of heart disease.
More research is needed. If you wonder whether testosterone therapy might be right for you, talk with your doctor about the risks and benefits. Your doctor will likely measure your testosterone levels at least twice before recommending testosterone therapy. Treating normal aging with testosterone therapy is not advisable. If you don't have a medical condition that's contributing to your decline in testosterone levels, your doctor might suggest natural ways to boost testosterone, such as losing weight and increasing muscle mass through resistance exercise.
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