De Anabolenpoli : Ervaringen en praktische handvatten / W. (Pim) de Ronde, Lisa Jacobs en Diederik L. Smit. - (Nederlands Tijdschrift voor Geneeskunde (2021) 31 May)

Samenvatting

In Nederland gebruiken naar schatting 20.000 mannen anabole steroïden. De confrontatie met een patiënt die anabole steroïden gebruikt kan emoties en vragen oproepen. Veel artsen voelen daarbij weerstand en afwijzing. Ons advies is om gebruikers van anabole steroïden niet op voorhand te veroordelen, maar om het gesprek aan te gaan over de drijfveren en de inschatting van de risico’s. Daarbij moet u rekening houden met uw eigen aannames en oordelen over dit onderwerp. Mogelijke onderliggende psychopathologische stoornissen moeten worden onderkend en behandeld, mits de gebruiker daarvoor openstaat. Wij adviseren om geen anabole steroïden voor te schrijven zonder medische indicatie. Ook zien wij geen reden om routinematig controles van de gezondheid uit te voeren tijdens het gebruik van anabole steroïden zolang niet vaststaat dat hiermee gezondheidsschade kan worden voorkomen. Als de gebruiker zich meldt met gezondheidsproblemen moet dat als ingang gebruikt worden om het gesprek te openen of heropenen over de voor- en nadelen van het gebruik. Schadelijke effecten van het gebruik van anabole steroïden moeten behandeld worden volgens de geldende richtlijnen.

Consequences of Anabolic-Androgenic Steroid Abuse in Males; Sexual and Reproductive Perspective / Giovanni Corona, Giulia Rastrelli, Sara Marchiani, Sandra Filippi, Annamaria Morelli, Erica Sarchielli, Alessandra Sforza, Linda Vignozzi, Mario Maggi. - (World Journal of Men's Health 39 (2021) e28 (1 June); p. 1-14) 

• PMID: 34169679
• DOI: 10.5534/wjmh.210021

Abstract

The real epidemiology and the possible consequences of anabolic-androgenic steroids (AAS) use still represent a very tricky task due to the difficulties in the quantification and detection of these drugs. Chronic use of AAS, frequently combined with other illicit substances, can induce tremendous negative effects on the reproductive system, but it is also associated with an increased overall and cardiovascular mortality risk. In the present review we summarize and discuss the available evidence regarding the negative impact of AAS on the male reproductive system, providing practical suggestions to manage these problems. For this purpose a meta-analysis evaluating the effects of AAS abusers vs. controls on several hormonal, reproductive and metabolic parameters was performed. In addition, in order to overcome possible limitations related to the combined use of different AAS preparations, we also retrospectively re-analyzed data on animal models treated with supraphysiological dosage of testosterone (T), performed in our laboratory. Available data clearly indicated that AAS negatively affect endogenous T production. In addition, increased T and estradiol circulating levels were also observed according to the type of preparations used. The latter leads to an impairment of sperm production and to the development of side effects such as acne, hair loss and gynecomastia. Furthermore, a worse metabolic profile, characterized by reduced high density lipoprotein and increased low density lipoprotein cholesterol levels along with an increased risk of hypertension has been also detected. Finally sexual dysfunctions, often observed upon doping, represent one the most probable unfavorable effects of AAS abuse.

Declining track and field performance trends in recent years in the Austrian best results 1897-2019 / Bergita Ganse, Hans Degens. - (Journal of Musculoskeletal and Neuronal Interactions 21 (2021) 2 (1 June); p. 196-205)

• PMID: 34059565
• PMCID: PMC8185268

Abstract

Objectives: Plateauing of world records in sports has been suggested to reflect the limits of human physiology. Possible explanations include reduced doping or declining popularity that may even lead to a decrease in human performance. Such a decrease, however, has not yet been observed. We hypothesized that rather than a performance plateau, performance has recently declined.

Methods: Fifteen athletic disciplines of the Austrian annual rankings were analyzed by regression statistics and the average best performance of the last 20 years compared to earlier periods.

Results: The best performances occurred between 1980-1999 and were on average 2.56% (men) and 1.67% (women) better than between 2000-2019. This attenuation was significant in men in 200 m, 800 m, 1500 m, 10 km, long jump, javelin throw (p<0.05), high jump, pole vault, discus throw, shot put and hammer throw (p<0.001); and in women in 400 m, long jump, discus throw (p<0.05) and high jump (p<0.001). The greatest performance declines were observed in the men's shot put (9.11%) and hammer throw (11.44%).

Conclusions: The Austrian track and field annual best results show a performance decline following a peak, instead of a plateau. Future studies should address the causes and whether this also applies to other sports and countries.

Broadening the Horizon of Antidoping Analytical Approaches Using Dried Blood Spots / Mario Thevis. - (Clinical Chemistry (2021) 1 June; p. 1-3)

• PMID: 34060612
• DOI: 10.1093/clinchem/hvab074

Steroidgebrauch bei Freizeit-Bodybuildern = Steroid Use in Free Time Bodybuilders / Felicitas Michels-Lucht, Jan Schirmer, Thomas Klauer, Harald Freyberger, Michael Lucht. - (Psychotherie Psychosomatik Medizinische Psychologie 61(2011) 12; 512-517)

• DOI: 10.1055/s-0031-1295454

Abstract

A sample of 74 male bodybuilders was analyzed for relationships between steroid abuse (abuse n=31; no abuse n=43) and self-esteem (Multidimensionale Selbstwertskala MSWS), body-image (Body-Image Questionnaire FK-ASA) as well as teasing (Physical Appearance Related Teasing Scale PARTS). In a logistic regression analysis age (p=0.001), low values for body expression (p=0.036) and high self-esteem (p=0.024) predicted steroid intake; training frequency or teasing experiences showed no effect. Contrary to earlier findings high and not low self-esteem was associated with steroid abuse. Because of the overlap between constructs narcissism and self-esteem further studies should disentangle the role of narcissism and self-esteem for steroid abuse in bodybuilders.

In 2016, Professor Richard McLaren issued two reports about systemic doping in Russia. These reports identified a significant number of Russian athletes who were involved in, or benefitted from, the doping schemes and practices that he uncovered.

Hereafter in January 2019 the World Anti-Doping Agency (WADA) recovered the internal database of the Moscow Laboratory (LIMS). Following investigation of allegations of organized doping practices, and in particular of the LIMS, WADA provided international federations with investigation reports on the athletes implicated in these organized doping practices.

As a result in March 2021 the International Football Federation (FIFA) reported an anti-doping rule violation against the football player Dariya Meshcheryakova for the use of the prohibited substance Furosemide in April 2013. After notification the Athlete failed to respond and the case was referred to the FIFA Disciplinary Committee.

Considering the evidence in this case the Disciplinary Committee establishes that the Athlete had used a prohibited substance and accordingly had committed an anti-doping rule violation. Without her response the Committee deems that the Athlete failed to demonstrate that the violation was not intentonal, nor grounds for a reduced sanction.

Therefore the FIFA Disciplinary Committee decides on 3 June 2021 to impose a 2 year period of ineligibility on the Athlete, starting on the date of the notification of this decision, i.e. on 19 July 2021.

In 2016, Professor Richard McLaren issued two reports about systemic doping in Russia. These reports identified a significant number of Russian athletes who were involved in, or benefitted from, the doping schemes and practices that he uncovered.

Hereafter in January 2019 the World Anti-Doping Agency (WADA) recovered the internal database of the Moscow Laboratory (LIMS). Following investigation of allegations of organized doping practices, and in particular of the LIMS, WADA provided international federations with investigation reports on the athletes implicated in these organized doping practices.

As a result in March 2021 the International Football Federation (FIFA) reported an anti-doping rule violation against the football player Ivan Knyazev for the use of the prohibited substance Metandienone in May 2013. After notification the Athlete failed to respond and the case was referred to the FIFA Disciplinary Committee.

Considering the evidence in this case the Disciplinary Committee establishes that the Athlete had used a prohibited substance and accordingly had committed an anti-doping rule violation. Without his response the Committee deems that the Athlete failed to demonstrate that the violation was not intentonal, nor grounds for a reduced sanction.

Therefore the FIFA Disciplinary Committee decides on 3 June 2021 to impose a 2 year period of ineligibility on the Athlete, starting on the date of the notification of this decision, i.e. on 19 July 2021.

Related case:

ADAK 2018 ADAK vs Purity Jerono Talam
February 20, 2019

On 20 February 2018 the Panel of the Kenya Sports Disputes Tribunal decided to impose a 4 year period of ineligibility on the Athlete Purity Jerono Talam after she tested positive for the prohibited substance Oxandrolone.

Hereafter the Anti-Doping Agency of Kenya (ADAK) established that the Athlete had participated in 5 competitions in China between April 2018 and May 2019 during her suspension.

Consequently ADAK reported a violation of the prohibition of participation during the imposed ineligibility. After notification the Athlete filed a statement in her defence and she was heard for the Sports Disputes Tribunal.

The Athlete admitted that she had participated in the 5 competitions in China at instigation of her manager who also failed to pay her for these marathons. She asserted that she was unaware that she was sanctioned for 4 years and that she not had received the Decision of the Tribunal. She acknowledged that prior in February 2018 after notification a provisional suspension was ordered.

The Panel deems that the Athlete indeed was sufficiently aware that a provisional suspension was ordered and despite she intentionally had participated in 5 competitions in China. Since the Athlete had filed an appeal against the Decision of 20 February 2019 the Panel dismiss the Athlete's assertion that she was unaware that she was banned due to she had not received the Decision of the Tribunal.

The Panel concludes that the Athlete had breached the provisional suspension, thereupon the period of ineligibility and accordingly she had committed a second anti-doping rule violation.

Therefore the Kenya Sports Disputes Tribunal decides on 3 June 2021 to impose an additional 4 year period of ineligibility on the Athlete, starting on the date the current period of ineligibility shall end, i.e. on 12 February 2022.

Investigation of the urinary excretion of prednisolone and metabolites after nasal administration : relevance to doping control / Koen Deventer, Michael Polet, Wim Van Gansbeke, F. Hooghe, H. Van Hoecke, P. Van Eenoo. - (Drug Testing and Analysis (2021) 3 June)

• PMID: 34081842
• DOI: 10.1002/dta.3105

Abstract

Glucocorticosteroid (GC) use in sport is restricted to non-systemic (nasal/ophtamological/dermatological/intra-articular) use. Systemic use is prohibited because of strong inflammatory suppressing effects. Prednisolone is a GC proven to be very effective in the treatment of nasal congestions and allergic rhinitis and its therapeutic use is allowed. To establish normal urinary concentration ranges for nasally administered prednisolone, an excretion study was performed with Sofrasolone® (nasal-inhaler). 6 volunteers were administered a high dose (4.5 mg prednisolone in 4 gifts over a 9 hour period). Samples were analysed using a validated LC-MS/MS method monitoring prednisolone (PRED) and the metabolites prednisone (PREDON), 20β-dihydroprednisolone (20βPRED) and 20β-dihydroprednisolone (20βPRED) in the total fraction (glucuroconjugated and free). Maximum concentrations were 266, 500, 350 and 140 ng/ml for PRED, PREDON, 20βPRED and 20βPRED, respectively. These results show that the current reporting limit of 30 ng/ml in urine can be easily exceeded after therapeutic use. Hence, to avoid false-positive findings related to nasal application, this limit should be increased. To investigate the degree of glucuronidation of PRED and its metabolites also the free fraction was investigated. This shows that PREDON has the highest glucuroconjugation (50%). PRED, 20βPRED and 20βPRED only show less than 20% conjugation.

Applying insights from implementation and intervention science to improve the evidence base on image and performance-enhancing drugs (IPEDs) interventions / Geoff Bates, Anders Schmidt Vinther

• Performance Enhancement & Health  9 (2021) 2 (August), 100193
• DOI: 10.1016/j.peh.2021.100193

Abstract

Recent decades have seen increased public attention devoted to the use of image and performance-enhancing drugs (IPEDs). As research into the epidemiology and aetiology of IPED use has grown substantially, so has interest amongst scholars and policy makers in developing and implementing a variety of public health interventions that target potential and current IPED users. However, the evidence base on IPED interventions remains underdeveloped and few firm conclusions can be made about their impact. In short, we know very little about whether IPED interventions are appropriate, effective, ineffective, or even harmful, or why and how this is the case. In this article, we make the case for applying recent insights from intervention and implementation science to better assess the problems that require intervention, enhance the development, implementation and evaluation of IPED interventions, and improve the quality and size of the evidence base. This is necessary if we are to develop evidence-based IPED interventions that support good health and avoid the potential to do harm. We begin by discussing the different types of IPED interventions that have been introduced and what we know about their impact from the limited evaluations that have been published to date. We then discuss how methods and frameworks from intervention and implementation science can provide important insights that will greatly enhance the development, implementation, and evaluation of these interventions. Drawing on examples of IPED interventions implemented in a variety of countries we explore how these methods can be applied by those working in this field and identify guidance and tools that support their uptake. We conclude by proposing five key priorities to support the development of a more robust evidence base of IPED interventions that will, ultimately, support an evidence-based public health response to IPED use.