Acute Myocardial Infarction in Young Newbie Bodybuilder Using Multiple Steroid and Protein Supplements

4 Dec 2019

Acute Myocardial Infarction in Young Newbie Bodybuilder Using Multiple Steroid and Protein Supplements / Vaibhav Jain, Gajinder Goel. - (Journal of Cardiology Cases 21 (2019) 4 (4 Dec); p. 134-136)

  • PMID: 32256860
  • PMCID: PMC7125384.
  • DOI: 10.1016/j.jccase.2019.11.010


Abstract

Coronary artery disease (CAD), the major reason of deaths worldwide is generally known as a disease of the elderly, however it is grasping the youth too. The most common etiology of young CAD is lifestyle changes, smoking, and development of other comorbid conditions such as diabetes and hypertension at an early age. There has been an upward trend in youngsters regarding consciousness about their body build and thus use of various protein supplements and anabolic steroids for faster results. The present case reports a young patient presenting with severe retrosternal left-sided chest pain for 15-20 min to the emergency department. His electrocardiogram was suggestive of acute anterolateral wall ST segment elevation myocardial infarction for which he underwent urgent coronary angiography and percutaneous coronary intervention. His personal history revealed a significant use of steroids, proteins, and other supplements in supraphysiological doses for instant body building efforts without any other significant past medical, surgical, or family history. He showed good recovery and was strongly recommended to stop steroids and protein supplements. In conclusion, supraphysiological doses of protein supplements, anabolic steroids, and other nutritional products bear a risk factor for CAD.

Learning objective: This is evident from the case report that excessive supplements use by body builders for immediate mass gain and performance enhancement may lead to adverse cardiovascular complications. This is mostly prescribed by peer groups or untrained gym professionals without judging their adverse effects so we recommend a detailed history for steroid use and protein supplements in young patients presenting with acute myocardial infarction without other significant risk factors and need for counselling for use of such substances.

Oxandrolone Augmentation of Resistance Training in Older Women: A Randomized Trial

1 Apr 2015

Oxandrolone Augmentation of Resistance Training in Older Women : A Randomized Trial / Yorgi Mavros, Evelyn O'Neill, Maureen Connerty, Jonathan F. Bean, Kerry Broe, Douglas P. Kiel, David Maclean, Ann Taylor, Roger A. Fielding, Maria A. Fiatarone Singh. - (Medicine & Science Sports & Exercise 47 (2015 11 (November); p. 2257-2267)

  • PMID: 25899102
  • DOI: 10.1249/MSS.0000000000000690


Abstract

Introduction: Sarcopenia is disproportionately present in older women with disability, and optimum treatment is not clear. We conducted a double-blind, randomized, placebo-controlled trial to determine whether oxandrolone administration in elderly women improves body composition or physical function beyond that which occurs in response to progressive resistance training (PRT).

Methods: Twenty-nine sedentary women (age 74.9 ± 6.8 yr; 5.9 ± 2.8 medications per day) were randomized to receive high-intensity PRT (three times a week for 12 wk) combined with either oxandrolone (10 mg·d(-1)) or an identical placebo. Peak strength was assessed for leg press, chest press, triceps, knee extension, and knee flexion. Power was assessed for leg press and chest press. Physical function measures included static and dynamic balance, chair rise, stair climb, gait speed, and 6-min walk test. Body composition was assessed using dual energy x-ray absorptiometry.

Results: Oxandrolone treatment augmented increases in lean tissue for the whole body (2.6 kg; 95% confidence interval (CI), 1.0-4.2 kg; P = 0.003), arms (0.3 kg; 95% CI, 0.1-0.5 kg; P = 0.001), legs (0.8 kg; 95% CI, 0.1-1.4 kg; P = 0.018), and trunk (1.4 kg; 95% CI, 0.4-2.3 kg; P = 0.004). Oxandrolone also augmented loss of fat tissue of the whole body (-1 kg; 95% CI, -1.6 to -0.4; P = 0.002), arms (-0.2 kg; 95% CI, -0.5 to -0.02 kg; P = 0.032), legs (-0.4 kg; 95% CI, -0.6 to -0.1; P = 0.009), and tended to reduce trunk fat (-0.4 kg; 95% CI, -0.9 to 0.04; P = 0.07). Improvements in muscle strength and power, chair stand, and dynamic balance were all significant over time (P < 0.05) but not different between groups (P > 0.05).

Conclusions: Oxandrolone improves body composition adaptations to PRT in older women over 12 wk without augmenting muscle function or functional performance beyond that of PRT alone.

Octodrine: New Questions and Challenges in Sport Supplements

1 Jun 2020

Octodrine : New Questions and Challenges in Sport Supplements / Valeria Catalani, Mariya Prilutskaya, Ahmed Al-Imam, Shanna Marrinan, Yasmine Elgharably, Mire Zloh, Giovanni Martinotti, Robert Chilcott, Ornella Corazza. - (Brain Sciences 8 (2018) 2 (February); p. 1-13)

  • PMID: 29461475
  • PMCID: PMC5836053
  • DOI: 10.3390/brainsci8020034


Abstract

Background: Octodrine is the trade name for Dimethylhexylamine (DMHA), a central nervous stimulant that increases the uptake of dopamine and noradrenaline. Originally developed as a nasal decongestant in the 1950's, it has recently been re-introduced on the market as a pre-workout and 'fat-burner' product but its use remains unregulated. Our work provides the first observational cross-sectional analytic study on Octodrine as a new drug trend and its associated harms after a gap spanning seven decades.

Methods: A comprehensive multilingual assessment of literature, websites, drug fora and other online resources was carried out with no time restriction in English, German, Russian and Arabic. Keywords included Octodrine's synonyms and chemical isomers.

Results: Only five relevant publications emerged from the literature search, with most of the available data on body building websites and fora. Since 2015, Octodrine has been advertised online as "the next big thing" and "the god of stimulants," with captivating marketing strategies directed at athletes and a wider cohort of users. Reported side-effects include hypertension, dyspnoea and hyperthermia.

Conclusions: The uncontrolled use of Octodrine, its physiological and psychoactive effects raise serious health implications with possible impact on athletes and doping practices. This new phenomenon needs to be thoroughly studied and monitored.

Keywords: DMHA; ambredin; anti-obesity agents; dimethylhexylamine; fitness; novel psychoactive substance; octodrine; performance and image-enhancing drugs; weight loss.

FIM 2019 FIM vs Jeroni Fajardo - Settlement

19 Sep 2019

In January 2019 the International Motorcycling Federation (FIM) has reported an anti-doping rule violation against the Spanish rider Jeroni Fajardo after his sample tested positive for the prohibited substance Heptaminol. After notification a provisional suspension was ordered but not accepted by the Athlete.

The Athlete denied the intentional use of the substance and asserted that he was tested before without issues. He believed that the supplement Nox Pump was the source of the positive test prescribed to him by his personal trainer. The package leaflet of this supplement did not mention any prohibited substance.

After consultation with experts the Athlete demonstrated with evidence that his supplement also contains the Kigelia Africana extract. This plant contains the natural version of Octodrine, and the subsequent metabolic process in the body from Octodrine by hydroxylation resulted into Heptaminol. This option was also mentioned by the Kreischa Lab in the Laboratory Documentation Package (LPD). Analysis of his supplement in a laboratory revealed the presence of Octodrine in the Nox Pump product.

FIM accepts that the Athlete’s violation was not intentional and the result of the use of the Nox Pump supplement. FIM finds that the Athlete bears some fault since he failed to mention his supplement in question on the Doping Control Form and he could have consulted recommended websites in order to reduce the risk of taking supplements that could cause a positive test result. FIM further considers that there were substantial delays in this case not attributed to the Athlete.

The parties in this case reached a settlement agreement and accordingly on 19 September 2019 a 1 year period of ineligibility was imposed on the Athlete starting on the date of the sample collection, i.e. on 16 September 2018.

FIM 2018 FIM vs Christian Craig

29 Jul 2019

In January 2019 the International Motorcycling Federation (FIM) has reported an anti-doping rule violation against the American rider Christian Craig after his A and B samples tested positive for the prohibited substance Heptaminol. After notification the parties in this case were unable to reach a settlement agreement. The Athlete filed a statement in his defence and he was heard for the FIM International Disciplinary Court (CDI).

The Athlete accepted the test result and denied the intentional use of the substance. He assumed that the positive test was likely the result of a contaminated supplement he had used. Because he was notified of the anti-doping rule violation 10 months after the sample collection it was impossible for him to test the supplements he ingested from the original batch. He was only able to recreate these supplements with the ingredients from other batches of the same manufacturers. However all 3 recreated supplements analysed in a Laboratory tested negative for prohibited substances.

FIM contended that the Athlete’s violation was not intentional, does not accept that the source of Heptaminol is from contaminated products and holds that the Athlete had to demonstrate how the prohibited substance entered his system to establish grounds for a reduced sanction.

The CDI finds that the presence of the prohibited substance has been established in the Athlete’s sample, that the Athlete accepted the test result and accordingly that he committed an anti-doping rule violation. The CDI accepts that the violation was not intentional but deems that the Athlete failed to demonstrate with evidence that his supplement in question was contaminated nor how the prohibited substances entered his system.

The CDI concludes that there are no grounds for Significant Fault of Negligence but considers that there were substantial delays in this case not attributed to the Athlete.
Therefore the CDI decides on 29 July 2019 to impose a 2 year period of ineligibility on the Athlete starting on the date of the sample collection, i.e. on 10 March 2018.

FIM 2017 FIM vs Cade Clason - Settlement

21 Jun 2019

In June 2017 the International Motorcycling Federation (FIM) has reported an anti-doping rule violation against the America rider Cade Clason after his sample tested positive for the prohibited substances Amfetamine and Dexamphetamine (d-amphetamine, dextroamphetamine). After notification a provisional suspension was ordered.

The Athlete demonstrated with medical information that he suffered from Attention Deficit Hyperactivity Disorder (ADHD) and used prescribed Adderall medication as treatment. Previously in March 2015 the FIM TUE Board had denied the Athlete’s TUE application for the use of Adderall because of the lack of relevant and supporting evidence. Hereafter in March 2019 the FIM TUE Board granted the Athlete a TUE for Adderall after it had received sufficient medical evidence of his practitioners. However WADA did not agree that the Athlete was permitted to apply for a retroactive TUE.

FIM accepts that the violation was not intentional and caused by using Adderall medication as treatment for the Athlete’s ADHD problems. FIM considers that meanwhile a TUE application for the use of Amfetamine was granted in March 2019 but that the Athlete failed to mention his medication on the Doping Control Form.

The parties in this case reached a settlement agreement and accordingly on 21 june 2019 a 2 year period of ineligibility was imposed on the Athlete starting on the date of the provisional suspension, i.e. on 21 June 2017.

FIM 2018 FIM vs Broc Tickle

7 May 2019

In April 2018 the International Motorcycling Federation (FIM) has reported an anti-doping rule violation against the American rider Broc Tickle after his A and B samples tested positive for the prohibited substance Methylhexaneamine (dimethylpentylamine). After notification a provisional suspension was ordered. The Athlete filed a statement in his defence and he was heard for the FIM International Disciplinary Court (CDI).

The Athete denied the intentional use of the substance, asserted that he was tested before without issues and requested to lift the provisional suspension. The Athlete argued that FIM only had insufficient evidence of his anti-doping rule violation and that the found substance 5-methylhexan-2-amine was not listed in the WADA 2018 Prohibited List.

FIM contended that the Athlete failed to provide any evidence that shows that he acted with a low level of Fault or Negligence and that his supplements he used were pre-apporoved by a medical specialist. On the contrary FIM finds that the evidence shows that the Athlete acted with gross negligence because he had used supplements without taking any precautionary measures.

Considering the reports of WADA and the Cologne Lab the CDI concludes that 5-methylhexan-2-amine is a prohibited substance, that the presence of this substance had been established in the Athlete’s samples and accordingly that he committed an anti-doping rule violation.

The CDI holds that the FIM not even tried to demonstrate that the Athlete’s violation was not intentional and that the Athlete was warned by his doctor to use caution in taking over-the-counter medications. The CDI deems that the Athlete failed to provide a witness statement from his doctor, failed to establish how the prohibited substance entered his system and that he acted with significant fault or negligence. Finally the CDI considers that there were substantial delays in this case not attributed to the Athlete.

Therefore the CDI decides on 7 May 2019 to impose a 2 year period of ineligibility on the Athlete starting on the date of the sample collection, i.e. on 10 February 2018.

FIM 2016 FIM vs Anastasiy Nifontova - Settlement

13 Mar 2919

In November 2016 the International Motorcycling Federation (FIM) has reported an anti-doping rule violation against the Russian rider Anastasiy Nifontova after her sample tested positive for the prohibited substance Meldonium. After notification a provisional suspension was ordered.

The Athlete demonstrated with medical evidence that the violation was not intentional because she underwent treatment for her health problems and had used prescribed medication which she mentioned on the Doping Control Form.

FIM accepts that the violation was not intentional due to the prescribed medication for a legitimate medical condition but deems that there are no grounds for No Significant Fault or Negligence.

The parties in this case reached a settlement agreement and accordingly on 13 March 2019 a 2 year period of ineligibility was imposed on the Athlete starting on the date of the provisional suspension, i.e. on 14 November 2016.

FIM 2018 FIM vs Anthony West

28 Jan 2019

In September 2018 the International Motorcycling Federation (FIM) has reported an anti-doping rule violation against the Australian rider Anthony West after his A and B sample tested positive for the prohibited substance Cocaine. After notification a provisional suspension was ordered. The Athlete filed a statement in his defence and he was heard for the FIM International Disciplinary Court (CDI).

Previously on 22 November 2013 an 18 month period of ineligibility was imposed on the Athlete by the CAS Tribunal (CAS 2012/A/3029) after WADA had appealed the 1 month sanction imposed by FIM.

The Athlete denied the intentional nor the recreational use of Cocaine and argued that several procedural irregularities had been occurred as departures of the the Standards and that the test results should be set aside. Further he explained that in 2015-2018 he suffered from a number of setbacks, had relational problems and a depression with suicidal intent. He was drinking excessive amounts of alcohol but he denied that he was addicted to drug or alcohol.

He testified that in July 2018 he was drinking in a club with a good friend and to help his agitation, anxiety and insomnia his friend had added Cocaine into his drink without his knowledge. Only after the notification he was told what had happened and that this was not the first time that his friend had laced his drink. The Athlete's friend testified and confirmed that he had spiked the Athlete's drink. The Athlete accepted during the proceedings that the postive test results were valid and admitted the violation due to spiking of his drink.

The CDI finds that the presence of Cocaine has been established in the Athlete's samples and accordingly that he committed an anti-doping rule violation. Considering the evidence the CDI established well beyond the balance of probability that the Athlete's drink had been spiked by his friend.

The CDI concludes that the Athlete had not intentionally used the prohibited substance and that he bears No Significant Fault or Negligence for a reduced sanction.
Since this is the Athlete's second anti-doping rule violation the CDI holds that the reduced 1 year period of ineligibility is increased to 2 years under the Rules.

Therefore the CDI decides on 28 January 2019 to impose a 2 year period of ineligibility on the Athlete starting on the date of the provisional suspension, i.e. on 14 September 2019.

UKAD 2020 RFU vs Max Drage

19 May 2020

In January 2020 the Rugby Football Union (RFU) reported an anti-doping rule violation against the player Max Drage after his sample tested positive for the prohibited stubstances Anastrozole, Clomifene, Etiocholanolone and Testosterone including its adiols.

After notification a provisional suspension was ordered. The Athlete failed to respond to the RFU communications, he only posted a #UKAD #FuckYou message on Instagram. The case was settled by the RFU Anti-Doping Tribunal based on the written submissions of the parties.

RFU contends that the Athlete's Instagram post showed that he was aware of the notification but failed to respond to the communications. As a result he failed to demonstrate that the violation was not intentional nor how the substances entered his system.

The Tribunal finds that the presence of prohibited substances has been established in the Athlete's sample and accordingly that he committed an anti-doping rule violation. There are no grounds for a reduced sanction since the Athlete failed to establish that the violation was not intentional nor how the substances entered his system.

Therefore the RFU Anti-Doping Tribunal decides on 19 May 2020 to impose a 4 year period of ineligibility on the Athlete starting on the date of the provisional suspension, i.e. on 10 January 2020.

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