Making the case for steroids

Special to The Times

UNLIKE professional athletes who use anabolic steroids to improve their game, a 27-year-old mortgage broker in Orange County turned to “the juice” for reasons of pure vanity, “as simple as a looking-good thing.”

At the suggestion of a bodybuilder friend, he purchased a round of the drugs -- including oral and injectable steroids, as well as injectable human growth hormone -- for $1,000 in Mexico a few years ago. The drugs helped him buff up in just six months. “My arms went from 15 inches to 17 inches,” said the broker.

But what about side effects? Did his testicles shrink or his hair fall out? Did he suffer a stroke or heart attack? Did he develop ‘roid rage or man-breasts?


Denying them all, he laughed, saying the risks of the drugs have been overblown: “They definitely get a bad rap.”

Doping scandals may be rocking the sports world, but fitness experts say there’s a quiet, yet likely much bigger, trend -- performance-enhancer use among guys who just want to bulk up and have little or no fear about taking illegal and potentially dangerous drugs to do so.

Many exercisers and recreational athletes believe that doctors, public-health experts, politicians and the media have greatly exaggerated the side effects of performance enhancers, especially steroids, the most recognized -- and believed to be the most widely used -- muscle-building drugs.

When combined with strength-training, anabolic steroids, which are synthetic versions of the natural hormone testosterone, promote muscle growth and allow exercisers to train harder and more frequently. Men who start seeing results with steroids may be tempted to “stack” them with other performance-enhancers, such as human growth hormone and clenbuterol.

Steroids are particularly popular because they’re known to yield results, are commonly available at gyms and the Internet and come in various forms such as pills, injections and creams. By comparison, growth hormone, for instance, must be injected and is typically much more expensive.

In sports, the main criticism of doping is that it’s cheating, and athletes’ biggest risk is getting booted from their sports or being stripped of medals and honors if use is detected. But run-of-the-mill gym-goers don’t worry too much about getting busted. Though performance enhancers are illegal when used for nonmedical purposes, the greater risk of getting caught generally lies more with sellers rather than buyers.


There are no solid up-to-date statistics on use of steroids or other performance enhancers in the adult population, but public-health officials, exercise researchers and trainers believe it’s increasing, especially among men wanting to get buff.

A nationwide household survey published in 1993 in the Journal of the American Medical Assn., the most comprehensive population-wide study to date, estimated that more than 1 million people, including teens, had used or were using anabolic steroids.

“I think that’s low-balling it now,” says study author Charles Yesalis, a professor emeritus of exercise and sport science at Penn State and editor of “Anabolic Steroids in Sport and Exercise.”

Many gym-goers who use performance enhancers see them as no riskier -- and perhaps less so -- than surgical cosmetic fixes.

Los Angeles personal trainer Rob Parr describes an acquaintance with a “waistline like Santa Claus” who used steroids over several years to transform himself into a Rambo look-alike. The man, in his 30s, avoided alcohol and ate a healthful diet, Parr says, and simply didn’t think steroids posed a threat. There’s even an attitude in gyms that there is “steroid use” and “steroid abuse,” and that the muscle men are the go-to guys for “safe,” reasonable steroid advice, as opposed to doctors and others in the medical community whom they believe exaggerate the dangers.

The medical community’s credibility gap with gym-goers dates back to the 1970s and ‘80s, when early studies concluded that steroids didn’t boost muscle mass and may be no better than placebos, says Cedric Bryant, chief science officer for the American Council on Exercise, a nonprofit fitness group based in San Diego.


“All the people in the gym knew that was nonsense,” Bryant says. The problem with the studies is they involved medicinal doses, he says, not the amounts athletes and bodybuilders take -- which could be 10 to 100 times higher.

No one knows for certain just how dangerous it is to use high doses of anabolic steroids for extended periods of time.

“There has not been one epidemiological study of the long-term health effects of steroids,” says Yesalis. “But absence of evidence is not evidence of absence.”

Still, anabolic steroids have been used in medicine for decades, for conditions such as muscle wasting and anemia, at lower doses, and doctors and researchers do know the drugs have potential to cause side effects.

Medical studies, for instance, have found that, in men, anabolic steroids can cause acne, testicular shrinkage, infertility, breast enlargement, reduced “good” cholesterol, elevated “bad” cholesterol and liver tumors when used as a contraceptive, hormone replacement or anemia treatment. Case reports have linked high doses of anabolic steroids to stroke, heart attacks and cancer, though these associations aren’t proven.

The effects can vary dramatically according to the type of steroid taken, the dose, duration of use, the age the person began using and other factors.


“They are clearly not harmless,” Yesalis says.

He and others believe the risk of side effects generally increases as the dose increases. Competitive athletes who take steroids generally follow an on/off schedule, in which they may take three to five steroids for six to 12 weeks, then go off the drugs for several weeks and then back on them, and so on, in an effort to maximize the benefits and minimize the risks.

But bodybuilders and other users seeking the cosmetic effects may skip the breaks, taking the drugs continuously and stacking them with human growth hormone and other performance enhancers in their quest for a superhuman physique.

“Soon their goal is to be the 300-pound gorilla,” Yesalis says.

Jay Hoffman, professor and chairman of the department of health and exercise science at the College of New Jersey in Ewing, believes steroids are safer when cycled.

Hoffman, who took steroids himself for three years while attending NFL training camps in the early ‘80s, says steroids were widely used in professional football before they were banned. “If they were so dangerous, we’d be seeing a lot of people in their 50s dropping dead and we’re not seeing that,” he says.


Words of caution

Medical doctors aren’t so quick to dismiss the potential for dire consequences.

“There is a line in here that no one can draw -- who’s going to get the serious side effects, who’s going to commit hara-kiri and who’s going to get really aggressive and punch someone out?” says Dr. Don Catlin, one of the world’s leading anti-doping authorities who until earlier this month was the director of UCLA’s Olympic Analytical Laboratory, which performs doping tests for the Olympics, the NCAA, the NFL and minor league baseball. In 2003, Catlin identified the designer steroid tetrahydrogestrinone (THG), which is at the heart of the Bay Area Laboratory Cooperative (BALCO) scandal, where the drug was supplied to professional athletes.

“You can’t get me to say in any way it’s OK to use them,” he says.

Dr. Linn Goldberg, a professor of medicine and head of the division of health promotion and sports medicine at Oregon Health and Science University in Portland, says the risks are amplified when users stack steroids with other performance enhancers and dietary supplements, some of which may contain steroid-like agents themselves.


“All of a sudden you’re taking pill after pill after pill,” says Goldberg, who is involved with programs to keep high school athletes off performance enhancers. “When you fool with these types of medicines, especially when you’re not under a doctor’s care, you don’t know what you’re getting into.”

Making matters worse, drugs on the black market may be contaminated, he says.

As for the risks of other performance enhancers, high doses of human growth hormone can cause bones to thicken and grow, particularly those of the hands, feet and face. Doctors know this from observing what happens to patients, most notably former wrestler Andre the Giant, who died in 1993 and who had a condition called acromegaly, which causes the pituitary gland to pump out excess growth hormone. Patients may also experience various other health problems, including an enlarged heart, diabetes and premature death.

Another popular performance enhancer used among bodybuilders is clenbuterol, which helps burn fat and boost muscle. It mimics adrenaline, and high doses can cause insomnia, nervousness, muscle cramps, heart palpitations and arrhythmias. Overdoses could potentially be deadly.

One point that all the experts interviewed for this article agree on is that anabolic steroid use may be particularly dangerous in teens and women. The influx of hormones could wreak havoc with adolescents’ development and already raging hormones and cause permanent masculinizing effects in women.

They also say it’s unlikely that any long-term study will ever be done on performance enhancers. “No one is going to study anabolic steroid use when it’s given at 100 times the normal dose,” Goldberg says.

Regardless of the potential risks, people who use performance enhancers generally don’t see immediate adverse effects, not in the way one might with drugs such as meth or heroin.


The mortgage broker took one round of the drugs and is considering another. He experienced no side effects other than feeling a “little more aggressive” -- which he views as an unexpected perk because he also races cars. “When I go out on a racetrack, it’s like being a gladiator and going to battle,” he says. “If you hesitate you’re dead.”

He adds: “I liked the competitive edge.”