Prolonged hypogonadism in males following withdrawal from anabolic-androgenic steroids: an under-recognized problem / Gen Kanayama, James I. Hudson, James DeLuca, Stephanie Isaacs, Aaron Baggish, Rory Weiner, Shalender Bhasin, Harrison G. Pope Jr. . - (Addiction 110 (2015) 5 (May); p. 823-831).

• PMID: 25598171.
• PMCID:PMC4398624.
• DOI:10.1111/add.12850

Abstract

AIMS:
To assess the frequency and severity of hypogonadal symptoms in male long-term anabolic-androgenic steroid (AAS) misusers who have discontinued AAS use.

DESIGN:
Cross-sectional, naturalistic.

SETTING:
Out-patient facility.

PARTICIPANTS:
Twenty-four male former long-term AAS users and 36 non-AAS-using weightlifters, recruited by advertisement in Massachusetts, USA. Five of the former users were currently receiving treatment with physiological testosterone replacement, leaving 19 untreated users for the numerical comparisons below.

MEASUREMENTS:
The Structured Clinical Interview for DSM-IV, questions regarding history of AAS use, physical examination, serum hormone determinations and the International Index of Erectile Function (IIEF).

FINDINGS:
Compared with the 36 non-AAS-using weightlifters, the 19 untreated former AAS users displayed significantly smaller testicular volumes [estimated difference, 95% confidence interval (CI) = 2.3 (0.1, 4.5) ml; P = 0.042] and lower serum testosterone levels [estimated difference: 95% CI = 131 (25, 227) dl; P = 0.009], with five users showing testosterone levels below 200 ng/dl despite abstinence from AAS for 3-26 months. Untreated former users also displayed significantly lower scores on the IIEF sexual desire subscale [estimated difference: 95% CI = 2.4 (1.3, 3.4) points on a 10-point scale; P < 0.001]. In the overall group of 24 treated plus untreated former users, seven (29%) had experienced major depressive episodes during AAS withdrawal; four of these had not experienced major depressive episodes at any other time. Two men (8%) had failed to regain normal libidinal or erectile function despite adequate replacement testosterone treatment.

CONCLUSIONS:
Among long-term anabolic-androgenic steroid misusers, anabolic-androgenic steroid-withdrawal hypogonadism appears to be common, frequently prolonged and associated with substantial morbidity.

Prolonged stimulation of growth hormone (GH) and insulin-like growth factor I secretion by CJC-1295, a long-acting analog of GH-releasing hormone, in healthy adults / Sam L. Teichman, Ann Neale, Betty Lawrence, Catherine Gagnon, Jean-Paul Castaigne, Lawrence A. Frohman. - (The Journal of Clinical Endocrinology & Metabolism 91 (2006) 3 (1 March); p. 799-805) 

• PMID: 16352683
• DOI: 10.1210/jc.2005-1536

Abstract

Context: Therapeutic use of GHRH to enhance GH secretion is limited by its short duration of action.

Objective: The objective of this study was to examine the pharmacokinetic profile, pharmacodynamic effects, and safety of CJC-1295, a long-acting GHRH analog.

Design: The study design was two randomized, placebo-controlled, double-blind, ascending dose trials with durations of 28 and 49 d.

Setting: The study was performed at two investigational sites.

Participants: Healthy subjects, ages 21-61 yr, were studied.

Interventions: CJC-1295 or placebo was administered sc in one of four ascending single doses in the first study and in two or three weekly or biweekly doses in the second study.

Main outcome measures: The main outcome measures were peak concentrations and area under the curve of GH and IGF-I; standard pharmacokinetic parameters were used for CJC-1295.

Results: After a single injection of CJC-1295, there were dose-dependent increases in mean plasma GH concentrations by 2- to 10-fold for 6 d or more and in mean plasma IGF-I concentrations by 1.5- to 3-fold for 9-11 d. The estimated half-life of CJC-1295 was 5.8-8.1 d. After multiple CJC-1295 doses, mean IGF-I levels remained above baseline for up to 28 d. No serious adverse reactions were reported.

Conclusions: Subcutaneous administration of CJC-1295 resulted in sustained, dose-dependent increases in GH and IGF-I levels in healthy adults and was safe and relatively well tolerated, particularly at doses of 30 or 60 microg/kg. There was evidence of a cumulative effect after multiple doses. These data support the potential utility of CJC-1295 as a therapeutic agent.

Promoting functional foods as acceptable alternatives to doping : potential for information-based social marketing approach / Ricky James, Declan P. Naughton, Andrea Petróczi. - (Journal of the International Society of Sports Nutrition 7 (2010) 37 (10 November); p. 1-11)

• PMID: 21067611
• PMCID: PMC2994790
• DOI: 10.1186/1550-2783-7-37

Abstract

Background: Substances with performance enhancing properties appear on a continuum, ranging from prohibited performance enhancing drugs (PED) through dietary supplements to functional foods (FF). Anti-doping messages designed to dissuade athletes from using PEDs have been typically based on moralising sport competition and/or employing scare campaigns with focus on the negative consequences. Campaigns offering comparable and acceptable alternatives are nonexistent, nor are athletes helped in finding these for themselves. It is timely that social marketing strategies for anti-doping prevention and intervention incorporate media messages that complement the existing approaches by promoting comparable and acceptable alternatives to doping. To facilitate this process, the aim of this study was to ascertain whether a single exposure knowledge-based information intervention led to increased knowledge and subsequently result in changes in beliefs and automatic associations regarding performance enhancements.

Methods: In a repeated measure design, 115 male recreational gym users were recruited and provided with a brief information pamphlet on nitrite/nitrate and erythropoietin as a comparison. Measures of knowledge, beliefs and automatic associations were taken before and after the intervention with at least 24 hours between the two assessments. The psychological tests included explicit measures of beliefs and cognitive attitudes toward FF and PED using a self-reported questionnaire and computerised assessments of automatic associations using the modified and shortened version of the Implicit Association Test.

Results: The information based intervention significantly increased knowledge (p < 0.001), changed explicit beliefs in specific FF (p < 0.001) and shifted the automatic association of FF with health to performance (p < 0.001). Explicitly expressed beliefs and automatic associations appear to be independent.

Conclusion: Evidence was found that even a single exposure to a persuasive positive message can lead to belief change and can create new or alter existing associations - but only in the specific domain. Interventions to change outcome expectations in a positive way could be a rewarding avenue for anti-doping. Effective social marketing campaigns for drug free sport should follow appropriate market segmentation and use targeted messages via promoting the natural form as opposed to the purified form of the main active ingredient.

Proof of Gene Doping in a Mouse Model with a Human Erythropoietin Gene Transferred Using an Adenoviral Vector / Takehito Sugasawa, Takuro Nakano, Shin-Ichiro Fujita, Yuki Matsumoto, Genki Ishihara, Kai Aoki, Koki Yanazawa, Seiko Ono, Shinsuke Tamai, Lev Manevich, Haruna Ueda, Noriyo Ishibashi, Kenshirou Tamai, Yasuharu Kanki, Yasuko Yoshida, Koichi Watanabe, Tohru Takemasa, Yasushi Kawakami, Kazuhiro Takekoshi. - (Genes 12 (2021) 8 (16 August); 1249)

• PMID: 34440425
• PMCID: PMC8392868
• DOI: 10.3390/genes12081249

Abstract

Despite the World Anti-Doping Agency (WADA) ban on gene doping in the context of advancements in gene therapy, the risk of EPO gene-based doping among athletes is still present. To address this and similar risks, gene-doping tests are being developed in doping control laboratories worldwide. In this regard, the present study was performed with two objectives: to develop a robust gene-doping mouse model with the human EPO gene (hEPO) transferred using recombinant adenovirus (rAdV) as a vector and to develop a detection method to identify gene doping by using this model. The rAdV including the hEPO gene was injected intravenously to transfer the gene to the liver. After injection, the mice showed significantly increased whole-blood red blood cell counts and increased expression of hematopoietic marker genes in the spleen, indicating successful development of the gene-doping model. Next, direct and potentially indirect proof of gene doping were evaluated in whole-blood DNA and RNA by using a quantitative PCR assay and RNA sequencing. Proof of doping could be detected in DNA and RNA samples from one drop of whole blood for approximately a month; furthermore, the overall RNA expression profiles showed significant changes, allowing advanced detection of hEPO gene doping.

Proportionality and the application of the World Anti-Doping Code / Herman Ram. – (International Sports Law Journal (2012) 3-4 : p. 8-11)

Content:
1.) Introduction
2.) The Athlete’s Position
2.1.) Legal Counsel
2.2.) Confidents and Activists
2.3.) Disciplinary Panels
3.) The NADO’s Position
3.1.) The Position of NADO’s in the Code
3.2.) The Position of the Dutch NADO
4.) The Approach of the Dutch Doping Authority
4.1.) Pre-Hearing Information
4.2.) Legal Opinions
4.3.) Right to Appeal
4.4.) Impartial Advice
5.) Conclusions and Discussion

the present World Anti-Doping Code (the Code) offers relevant possibilities for individual assessment of doping cases. This is not always recognized by the general public and, more importantly, it is not always understood by legal counsel, which acts on behalf of the athlete in doping cases. In other words, there is limited but relevant room for flexibility and proportionality proportionality within the Code, but this room is not always used as it could and should be.

In this article, the Author will try to shed some light on the positions of athletes (paragraph 2) and Anti-Doping Organizations (paragraph 3), in relation to the proportionality issue introduced above. In the fourth paragraph, he will describe the approach of the Dutch Doping Authority, and the fifth and last paragraph provides some conclusions and input for further discussion.

Proportionality in the World Anti-Doping Code: Is There Enough Room for Flexibility? / Jannica Houben. – (International Sports Law Journal (2007) 1-2 : p. 10-18)

Content:
1.) Stict Liability
2.) Proof and Sanctions
2.1.) Proof of an Anti-Doping Violation
2.2.) Sanctions
2.3.) The limited impact of the question of guilt
3.) Proportionality
3.1.) The principle of proportionality
3.2.) Proportionality cases
3.2.1.) Pre WADC cases
3.2.2.) Post WADC cases
4.) Conclusion

The biggest advantage of the introduction of the World Anti-Doping Code in 2004 is the harmonization, but a disadvantage is that there are still some unclear matters left. The drafters of the WADC opted for a system of strict liability with mandatory (tough) penalties and a possibility of sanction reduction in the case of exceptional circumstances.
The question of fault or negligence only plays a role in the determination of the sanction. In this article, the Author will evaluate this system and the rulings by the CAS. Are the sanctions imposed proportionate to the offenses? Does the Code leave room for the use of the principle of proportionality? If yes, does the CAS use the flexibility in the Code?
In this contribution it is argued that the CAS does not interpret the Code in a correct way. Although the Code can be seen as well drafted, the CAS does not use the flexibility that is incorporated therein.
But there is hope: recently a CAS Panel held in the Puerta case that “in those very rare cases in which Articles 10.5.1 and 10.5.2 of the WADC do not provide a just and proportionate sanction, i.e., when there is a gap or lacuna in the WADC, that gap or lacuna must be filled by the Panel.”

Everyday Memory Deficits Associated with Anabolic-Androgenic Steroid Use in Regular Gymnasium Users / Thomas Heffernan, Lisa Battersby, Patricia Bishop and Terence O’Neill. - (Open Psychiatry Journal 9 (2015); p. 1-6)

Background:

This study compared a group of 47 regular gym users who take androgenic-anabolic steroids (the AAS group) as part of their recreational sport, with a group of 48 regular gym users who do not use AAS (the Non-AAS group) on self-reports of Retrospective memory (RM), executive function (EF) and prospective memory (PM), which are all critical to everyday remembering.

Methods:

All participants were tested using an on-line Survey Monkey method. The Prospective and Retrospective Memory Questionnaire (PRMQ) assessed everyday RM and PM deficits and the Executive Function Questionnaire (EFQ) assessed self-reported problems in EF. A drug-use questionnaire and a mood questionnaire were also administered Results: After observing no between-group differences on alcohol or mood, omitting anyone who drank excessively or had drank recently, smoked or reported using any illegal drug, three one-way ANCOVAs (controlling for age) revealed that the ASS group reported significantly more RM deficits, EF deficits, and PM deficits, when compared with the Non ASS group.

Conclusion:

It was concluded that AAS use in a recreational sports context is associated with RM, EF and PM deficits, indicating that AAS use may damage everyday remembering.

Antonino Bianco, Caterina Mammina, Antonio Paoli, Marianna Bellafiore, Giuseppe Battaglia, Giovanni Caramazza, Antonio Palma, and Monèm Jemni
J Int Soc Sports Nutr. 2011; 8: 25.

Background: It is known that supplement use is a widespread and accepted practice by athletes and people who attend commercial gyms. Little is known about protein supplement amongst people undertaking strength trainingin commercial gyms in Italy when compared to the US.

Objective: The purpose of this study was to examine the use of protein supplementation, alone or in association with other supplements, and dietary behavior amongst regular fitness center attendees in Palermo, Italy.

Design: Resistance training information have been collected from 800 regular fitness center attendees for the initial analysis. A specific questionnaire was generated for the experimentation. Data were collected using a face-toface interview method. Supplement users were then compared to the non users and analyzed using a one-way ANOVA, Kruskall-Wallis, chi-square test or exact test of Fisher when appropriate.

Results: 30.1% of the respondents use dietary supplements during their training as a believe it is the “way to gain muscles and strength”. Whey protein shakes (50.0%) mixed with creatine and amino-acids (48.3%) were the most frequent choices amongst the users. A majority of the subjects (34.0%) appeared to rely on their gym instructors’ advice for their intake; a lower proportion (13.0%) consulted physicians, while none of them consulted nutritionists.
A high consumption of milk has been noticed in both users (67,7%) and non-users (52,8%); supplement non-users consumed significantly more snacks and bakery products than users per week (P < 0.001), while users consumed significantly more protein-rich foods (P < 0.01) with a particular preference for meat (48.0%).

Conclusions: A considerable number of regular strength training adepts consume protein supplements mixed with other products (mainly creatine and amino-acids). Limited numbers consult “dietary specialists” and rely mainly on their instructors. We emphasize on the importance of the dissemination of scientifically based
information about supplementation in this environment and the promotion of updated educational programs for the instructors.

Pseudoephedrine enhances performance in 1500-m runners / Kate Hodges, Sarah Hancock, Kevin Currell, Bruce Hamilton, Asker E. Jeukendrup. - (Medicine & Science in Sports & Exercise 38 (2006) 2 (February); p. 329-333)

• PMID: 16531903
• DOI: 10.1249/01.mss.0000183201.79330.9c

Abstract

Pseudoephedrine is an over-the-counter drug to relieve nasal and sinus congestion. Although it has been suggested that pseudoephedrine could be a stimulant and ergogenic aid, pseudoephedrine was recently removed from the banned substance list by the International Olympic Committee and placed on the monitoring program (from January 2004). It was felt that evidence was lacking for an ergogenic effect, although few studies have investigated the effects of pseudoephedrine on exercise performance. This study, therefore, aimed to investigate the effects of pseudoephedrine on 1500-m running performance.

Methods: In a double-blind, randomized crossover design, seven male athletes completed two 1500-m running trials on an outdoor track after having completed a familiarization trial. All trials were 7 d apart. After a 12-h overnight fast, subjects reported to the laboratory and received a standardized breakfast (energy asymptotically equal to 500 kcal 50% CHO). Subjects were given either 2.5 mg.kg(-1) bw pseudoephedrine or 2.5 mg.kg(-1) bw maltodextrins (placebo) in gelatin capsules 70 min before the start of the warm-up, which started 20 min before they ran 1500 m all-out. Pre- and postexercise blood samples were collected and analyzed for lactate and glucose concentrations, partial pressure of oxygen (PO2) and carbon dioxide (PCO2), and percent oxygen saturation.

Results: Pseudoephedrine significantly decreased time to completion of 1500-m time trials in the present study by 2.1% (from 279.65 +/- 4.36 s with placebo to 273.86 +/- 4.36 s with pseudoephedrine) with no reported side effects. No changes in the measured blood parameters were found, suggesting a central effect of pseudoephedrine rather than a metabolic effect.

Conclusion: The finding was that 2.5 mg.kg(-1) bw pseudoephedrine ingested 90 min preexercise improves 1500-m running performance.

Psychiatric and hostility factors related to use of anabolic steroids in monozygotic twins / Thomas A. Pagonis, Nikiforos V. Angelopoulos, George N. Koukoulis, Christos S. Hadjichristodoulou, Paraskevi N. Toli

• European Psychiatry 21 (2006) 8 (December); p. 563-569
• PMID: 16529916
• DOI: 10.1016/j.eurpsy.2005.11.002

Abstract

Introduction: Anabolic androgenic steroids (AAS) are derived by chemical manipulation of the testosterone molecule. The specified category of drugs produces anabolic, androgenic and psycho-active effects including elevated aggressive, hostile, violent and anti social behavior.

Objective: The objective of this case report observational study was to evaluate the possible psychological consequences of AS use in the twin user of each pair, compared with the non-user twin.

Methodology: We studied two pairs of male monozygotic twins: one pair 24 years old and the other 31 years old, with absolute genome and phenotype similarity. One of the twins of each pair used AAS while the other did not. Both pairs lived in Hellenic provincial towns and followed a common training and nutrition regime. The psychometric instruments used were the Symptoms Check List-90 (SCL-90) and the Hostility and Direction of Hostility Questionnaire (HDHQ). The psychometric evaluations took place within a time interval of 6 months.

Results: The study found high levels of aggressiveness, hostility, anxiety and paranoid ideation in the twins who used AS. The non-user twins showed no deviation from their initial status.

Conclusion: The use of AAS induced several important psychiatric changes in monozygotic twins which were not present in the twin who did not use AAS.