Rich Piana's Mysterious Death Raises Questions About Insulin and Bodybuilding

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The medical examiner's office says it hasn't finalized Piana's cause of death—but the rumors still point to a dangerous trend

fter collapsing and spending two weeks in a medically induced coma, celebrity bodybuilder Rich Piana died in August at the age of 46.The exact cause of his death has yet to be determined, but that certainly hasn’t stopped people from speculating about potential causes. First, there were reports that an overdose might have been to blame. Now, there are rumors that Piana might have died from using insulin, the hormone that regulates your body's blood sugar. People who inject insulin and who already produce the hormone naturally can see their blood glucose levels drop dangerously low—and if they don't ingest additional sugar to bring their blood glucose back up, the consequences can be fatal.


But first things first: It's important to note that the medical examiner's office tells us it hasn't yet determined how and why Piana died.
“We have not finalized a cause and manner of death, so it sounds like the insulin issue is just a rumor,” Florida’s District Six Medical Examiner’s Office, which is currently conducting Piana’s autopsy, told Men’s Health.
Though the rumors about Piana's death remain wholly unverified, it's true that insulin use is on the rise among bodybuilders, according to Dr. Harrison Pope, M.D., a psychiatry professor at Harvard Medical School who's conducted extensive research on substance abuse amongst bodybuilders. Piana himself was vocal about his use of insulin, going into detail about the practice in a posted four years ago. He acknowledged that taking insulin can be “dangerous,” but said the danger is easily avoidable if you take the right amount of sugar.


Why would a bodybuilder be taking insulin, a hormone commonly associated with type I diabetes? In addition to regulating blood glucose levels, insulin also has anabolic properties, meaning it helps to grow your muscles.
“Insulin is widely used for its anabolic properties that, like steroids, aid in muscle growth,” Pope told Men’s Health. “Furthermore, it is undetectable in testing because insulin is already present in the body.”
Related: A Big-Muscle Workout Plan for Skinny Guys
Another reason insulin is so appealing is because of its apparent lack of side effects. He added that it wouldn't "cause those hormonal changes you see with traditional anabolic steroids,” which include a deepening of the voice and extra body hair growth for females and the development of breasts, testicle shrinkage and loss of hair in males.