Gynecomastia: A Dude Grows Breasts – Estrogen Side Effects of Male Anabolic Steroid UseA steroid are testosterone and estrogen steroids is a steroid that acts as a hormone. Steroid hormones can be grouped into two classes: Within those two classes are five types according to the receptors to which they bind: Vitamin D derivatives are a sixth closely related hormone system with homologous receptors. They have some of the characteristics of true steroids as receptor ligands. Steroid hormones testosgerone control metabolism, glenn jacobs mayorimmune functionssalt and water balancedevelopment of sexual characteristicsand the ability to withstand illness and injury.
Steroid hormone - Wikipedia
Anabolic steroid precursors have gained widespread popularity as ergogenic supplements. Advertisements for these supplements claim that they increase endogenous testosterone production and protein synthesis, resulting in increased lean body mass and strength during training.
At this time scientific support is limited, but the potential for serious side effects exists and the popularity of these supplements continues to grow.
This review provides rationales for the ergogenic claims regarding steroid precursors and compares claims with data from scientifically controlled investigations.
Although fairly new to the athletic community, steroid precursors have been used as ergogenic or anabolic agents for quite some time.
Suggested gains in strength and lean body mass are attributed to an increase in the endogenous production of testosterone and enhanced protein synthesis. Most of the scientific data, however, do not support manufacturers' ergogenic claims, and the potential for serious side effects, such as decreased high-density lipoprotein cholesterol and increased estrogen concentrations, has been associated with precursor use.
Thus, the safety and efficacy of these supplements must be questioned. It appears that the risks associated with the use of anabolic steroid precursors outweigh any possible ergogenic benefits. Furthermore, these supplements are banned by most athletic organizations. Thus, it is extremely important that athletic trainers are able to educate athletes on these issues so they can continue to perform at an optimum level in a safe and healthy manner.
Anabolic-androgenic steroids AAS are synthetic derivatives of testosterone that have been used by athletes for decades to increase lean body mass, strength, and overall athletic performance. It is currently illegal to possess AAS without a prescription from a licensed physician. The result has been an increase in the popularity of nutritional supplements marketed as natural testosterone enhancers or steroid precursors.
Although bodybuilders have been using steroid precursors for some time, it was home-run hitter Mark McGuire's well-publicized use that first brought them to the attention of the athletic community and the public. While there are numerous precursor products on the market, the most popular are those containing dehydroepiandrosterone DHEA and the various forms of androstenedione A'dione and androstenediol A'diol.
Dehydroepiandrosterone, A'dione, and A'diol are androgenic hormones produced primarily by the adrenal glands and gonads that act as precursors in the endogenous production of testosterone and estrogen. This natural process begins in the adrenal cortex where DHEA is secreted and eventually converted to either A'dione or A'diol, which are both immediate precursors to testosterone.
Testosterone production is not the only pathway for these precursors, as A'dione and testosterone can also be aromatized to estrone and estradiol Figure. Like testosterone, the production of DHEA and A'dione peaks in the midtwenties and then declines steadily with age after the third decade of life. Thus, original research in precursor supplementation focused on its role in replacement therapies to compensate for the age-related decline in their endogenous production.
However, the A'dione and testosterone levels in women reached levels above sex-specific young adult ranges, while no changes were observed in men. Significant increases in estrone and estradiol were also observed. The changes in hormone levels were not associated with any change in lean body mass; however, the subjects did not perform any type of physical training. It is important to note that significant decreases in high-density lipoprotein HDL cholesterol were observed in 2 of the previously mentioned studies.
Increased levels of testosterone have been shown to increase protein synthesis, muscle strength, and lean body mass. Results from earlier studies involving an older population have led to the marketing of these products as ergogenic or anabolic supplements capable of increasing testosterone levels and, consequently, lean body mass, strength, and overall athletic performance.
As described, the increases in testosterone had only been observed in older women; however, these products are marketed toward young athletic men. One of the initial studies cited in support of precursor supplementation was published by Mahesh and Greenblatt 21 in The subjects in that study consisted of 4 women ages were not reported , 2 of whom ingested DHEA while the other 2 ingested A'dione.
Although the authors did not perform a statistical analysis, they concluded that ingestion of these supplements increased testosterone levels, with A'dione causing the greater increase. Obviously, with such a small sample, the results are not reliable. A second study commonly cited in support of these supplements involved ovariectomized rats.
These levels were regained in a dose-responsive manner when the rats were fed A'dione. These are just 2 examples of what has become common practice among supplement manufacturers, as results from deficiency studies and animal studies and animal deficiency studies are generalized to a young, healthy, and athletic population. When young, healthy men were recruited as subjects, results similar to those previously observed in older women have not been reproduced.
Thus, only higher dosages were able to achieve increases in testosterone. Similarly, a significant increase in testosterone was observed in young men after a mg dose. It must be noted that acute increases in estradiol have also been observed in young men after A'dione ingestion. When DHEA and A'dione were administered daily to young men using protocols ranging from 2 days to 8 weeks, no changes in resting before ingestion testosterone, regardless of dose, have been observed.
However, plasma A'dione did increase more than 3-fold. Similar to the acute changes after A'dione ingestion, significant increases in estradiol have been observed in young men after chronic ingestion. Because of concerns regarding the increases in estrogens observed in men after DHEA and A'dione ingestion, there has been an increase in the number of products containing A'diol. Unlike A'dione, A'diol cannot be directly converted to estrogen, as it must first be converted to testosterone, which can then be converted to estradiol.
However, as in the previous investigations, a single mg dose of A'diol failed to increase serum testosterone levels in young men. As mentioned previously, ergogenic claims are based on the theory that precursor ingestion will result in increased testosterone levels, which would then stimulate an increase in muscle protein synthesis.
However, at this time, there is no scientific support for this theory, as both DHEA 31 and A'dione 30 ingestion have failed to increase protein synthesis in groups of young men. Thus, the conversion of A'dione to testosterone may not be necessary to have an anabolic effect. However, this theory also lacks support, as A'dione ingestion failed to affect muscle protein synthesis or muscle-fiber cross-sectional area, even though significant increases in serum A'dione were observed.
If precursor supplementation elevated testosterone levels, increases in muscle strength and lean body mass, such as those observed after testosterone administration, would be expected. However, strength measures were not performed, and diet and physical activity were not controlled or recorded. Thus, the authors' conclusions must be questioned. Other than the previously mentioned study, the ergogenic claims regarding precursor supplementation have not been supported.
For example, 4 weeks of DHEA supplementation failed to increase lean body mass in a group of young, healthy men. However, the same supplementation protocol also failed to affect lean body mass in a group of postmenopausal women. It is possible that 4 weeks of ingestion were insufficient to observe remarkable body-composition changes, although changes have been observed after just 4 weeks of testosterone administration.
Again, no changes in strength or lean body mass were observed in a similar age group after 8 weeks of DHEA ingestion and resistance training. Longer supplementation and training protocols have also failed to support ergogenic claims.
The failure to increase strength or lean body mass further suggests that exogenous DHEA and A'dione must first be converted to testosterone to achieve an anabolic effect. Thus, it is possible that long-term supplementation could have serious side effects similar to those associated with AAS use, such as suppressed testosterone production, liver dysfunction, cardiovascular disease, testicular atrophy, male-pattern baldness, acne, and aggressive behavior.
In women, precursor-induced increases in testosterone concentrations could cause lowered voice pitch, hirsutism changes in hair growth patterns, including facial hair , increased abdominal fat accumulation, and general virilization. The Anabolic Steroid Control Act of defines an anabolic steroid as any drug or hormonal substance chemically and pharmacologically related to testosterone, other than estrogens, progestins, and corticosteroids, that promotes muscle growth.
Under that act, testosterone and anabolic steroids are classified as Schedule III drugs and cannot be sold over the counter or possessed without a prescription. Although DHEA, A'dione, and A'diol are structurally and pharmacologically related to testosterone, they have not been proven to promote muscle growth and are, therefore, not classified as Schedule III drugs. Furthermore, the Dietary Supplement Health and Education Act of has allowed these products to be sold legally over the counter as natural supplements in the United States.
Over-the-counter availability and unrestrained self-medication with steroid precursors create a heightened potential for serious side effects, and the safety of these products must be questioned, as there are no human studies in the medical literature on their long-term safety. Unfortunately, most companies that manufacture and sell nutritional supplements are profit driven and are often misleading with their advertising.
One of the primary concerns is that manufacturers are not required to list the ingredients on the labels of natural supplements; thus, the consumer does not always know the true contents of the product. Thus, these men were ingesting a supplement and urinating a drug. Whenever an athlete is considering using steroid precursors or any ergogenic supplement, 3 questions must be asked: At this time, scientific support for the ergogenic or anabolic use of steroid precursors does not exist.
However, numerous studies provide evidence of the possible dangers associated with them, including increased risk of heart disease and increased estrogen concentrations in men. Thus, it appears that the risks far outweigh the benefits. It is also important to note that the International Olympic Committee, the National Collegiate Athletic Association, and the National Football League have banned the use of steroid precursors, and the use of these supplements can be detected in drug tests.
National Center for Biotechnology Information , U. Journal List J Athl Train v. University of Florida, Gainesville, FL. Powers, PhD, ATC, CSCS, provided conception and design; acquisition and analysis and interpretation of the data; and drafting, critical revision, and final approval of the article. Address correspondence to Michael E. Address e-mail to mpowers hhp. This article has been cited by other articles in PMC. Steroid Precursors Dehydroepiandrosterone, A'dione, and A'diol are androgenic hormones produced primarily by the adrenal glands and gonads that act as precursors in the endogenous production of testosterone and estrogen.
Open in a separate window. Original Research Like testosterone, the production of DHEA and A'dione peaks in the midtwenties and then declines steadily with age after the third decade of life. Ergogenic Claims Increased levels of testosterone have been shown to increase protein synthesis, muscle strength, and lean body mass. Research Involving Young Men When young, healthy men were recruited as subjects, results similar to those previously observed in older women have not been reproduced.
Chronic Hormonal Changes When DHEA and A'dione were administered daily to young men using protocols ranging from 2 days to 8 weeks, no changes in resting before ingestion testosterone, regardless of dose, have been observed. Protein Synthesis As mentioned previously, ergogenic claims are based on the theory that precursor ingestion will result in increased testosterone levels, which would then stimulate an increase in muscle protein synthesis. Lean Body Mass and Strength If precursor supplementation elevated testosterone levels, increases in muscle strength and lean body mass, such as those observed after testosterone administration, would be expected.
Anabolic Steroids in Sport and Exercise. Anabolic steroids, bodybuilding, and the law: J Clin Endocrinol Metab. Felig P, Frohman L A, editors. In vivo 4-androstene-3,dione and 4-androstene-3beta,17beta-diol supplementation in young men. Eur J Appl Physiol. Conversion of blood androgens to estrogens in normal adult men and women. Endocrine disorders of the breast. Wilson J D, editor. Williams Textbook of Endocrinology.