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By Mark Bloom
HealthDay Reporter
SATURDAY, Jan. 29 (HealthDay News) -- While Major League Baseball owners and the players' union have agreed on a stricter policy to combat the use of performance-enhancing steroids, scientists are exploring the potential dangers posed by these drugs.
Intuitively, steroids seem to put athletes in harm's way. But they also seem to give those who use them an unfair advantage over those who don't.
The problem is the scientific community has little data to back up either assertion.
"There has been a tremendous disconnect between the conviction of athletes that these drugs are effective and the conviction of scientists that they aren't," said Cynthia M. Kuhn, a Duke University professor of cancer biology and pharmacology.
"In part, this disconnect results from the completely different dose regimens used by scientists to document the correction of deficiency states and by athletes striving to optimize athletic performance," she added.
There are some documented cases in professional sports that, at the very least, indicate some links between steroid use and declining health.
Lyle Alzado, who during the best years of his 15-year pro football career weighed 254 pounds at 6' 3", died from brain cancer in 1992 at the age of 43. He told Sports Illustrated that he began taking anabolic steroids in college in 1969. After he became ill, Alzado wrote, "If you're on steroids or human growth hormone, stop. I should have."
Ken Caminiti was a Major League Baseball player who won the National League Most Valuable Player award in 1996. He died from a heart attack in October 2004 at the age of 41. And while his death has been linked to cocaine use, Caminiti was another athlete who told Sports Illustrated that he used steroids during his MVP season, when he had career-high statistics.
A more recent example is Jason Giambi, the New York Yankees first baseman whose admission that he used steroids was revealed by the San Francisco Chronicle. The newspaper cited grand jury minutes in which Giambi reportedly talked about the various substances he ingested or injected. Giambi's body essentially broke down during the 2004 season. He was a pale imitation of the slugger the Yankees obtained two years earlier from the Oakland Athletics.
Were Giambi's orthopedic woes the result of his abuse of performance-enhancing drugs? Did the benign tumor he developed -- reportedly a pituitary growth -- arise from a female fertility drug called clomiphene (Clomid) he reportedly told the grand jury he took to bulk up? There's no way to prove that either condition was caused by performance-enhancing drugs. Yet steroids can have orthopedic side effects and clomiphene can exacerbate a pituitary tumor.
From the standpoint of health risks, the best evidence of how dangerous anabolic steroids can be comes from once-secret East German medical reports dating to the 1970s and 1980s, when athletes from that country, particularly women, were setting astonishing records in track and field and swimming. Some of those records of a generation ago still stand.
Werner W. Franke, of the German Cancer Research Center in Heidelberg, reported in 1997 in the journal Clinical Chemistry that for years the East Germans gave anabolic steroids to several thousand athletes of both sexes, including minors. "Special emphasis was placed on administering androgens to women and adolescent girls because this practice proved to be particularly effective for sports performance," he wrote. "Damaging side effects were recorded, some of which required surgical or medical intervention."
These side effects resulted in some irreversible damages, like virilization, increased growth of body hair, voice changes and disturbances in libido. "The effect on the sexual drive was relatively strong in some women," he wrote. There were also cases of enlarged liver.
Today it's all much subtler, with newer "designer" steroids on the scene that can defy testing, even though they are just as risky as the old-fashioned variety. There is also the addition of recombinant human growth hormone (hGH), which enhances muscle growth, and erythropoietin (EPO) "blood doping," which increases oxygen delivery to the muscles. Both are extremely difficult to detect.
"Human growth hormone is a potentially dangerous drug, which when used by adults can lead to diseases having significant mortality rates," according to the U.S. Justice Department. "Its misuse in adults poses a wide array of serious side effects, including significant cardiovascular disease, irreversible enlargement of the heart, and development of polyps and malignancies of the colon."
So far, the Justice Department has offered no significant studies to back up this assertion. And human growth hormone was approved by the Food and Drug Administration for use in children to increase short stature. It is also used in cases of AIDS wasting.
These days, the idea for athletes is to gain an edge -- not too much of an edge to risk their health, but enough to achieve their athletic goals -- with the financial rewards that follow. The trouble is that no one knows which athletes' bodies will get away with a little cheating and not cause their bodies to fail them.
Giambi's medical troubles and his ensuing performance drop-off may have been a coincidence. Yet when he showed up at spring training last year, after his name emerged in the now-infamous BALCO probe and he presumably halted his use of the drugs, sports writers were shocked at how his body shape had changed -- almost as if a weightlifter had stopped working out. BALCO Labs was a small California company that manufactured a variety of strength-enhancing substances, including a testosterone supplement.
Giambi's grand jury testimony reportedly contained a reference to taking "the clear," a street name for tetrahydrogestrinone, the "designer" drug known as THG. It was the chance discovery of that drug that spurred the investigation of BALCO, which led to the grand jury being convened. Presumably, THG is called "the clear" because until a year ago the steroid was undetectable by standard testing.
According to a report in the May 2004 Journal of Clinical Endocrinology & Metabolism, THG is closely related to gestrinone, a 19-nor progestin, and resembles trenbolone. Trenbolone, popular among body builders, is a veterinary drug used to bulk up cattle and it is banned by the National Collegiate Athletic Association. Gestrinone, used to treat endometriosis, acts on the pituitary. It is not approved for adult males.
Giambi also reportedly testified he used an agent he called "the cream." This, too, is a "designer" steroid, said to be a mixture of the male hormone testosterone and epitestosterone.
According to the National Institute on Drug Abuse, the statistics on health effects from the long-term abuse of anabolic steroids on humans are based on anecdotal reports -- not formal epidemiological reports -- and certainly not randomized clinical trials, which would be unethical, if not illegal.
HealthDay Reporter
SATURDAY, Jan. 29 (HealthDay News) -- While Major League Baseball owners and the players' union have agreed on a stricter policy to combat the use of performance-enhancing steroids, scientists are exploring the potential dangers posed by these drugs.
Intuitively, steroids seem to put athletes in harm's way. But they also seem to give those who use them an unfair advantage over those who don't.
The problem is the scientific community has little data to back up either assertion.
"There has been a tremendous disconnect between the conviction of athletes that these drugs are effective and the conviction of scientists that they aren't," said Cynthia M. Kuhn, a Duke University professor of cancer biology and pharmacology.
"In part, this disconnect results from the completely different dose regimens used by scientists to document the correction of deficiency states and by athletes striving to optimize athletic performance," she added.
There are some documented cases in professional sports that, at the very least, indicate some links between steroid use and declining health.
Lyle Alzado, who during the best years of his 15-year pro football career weighed 254 pounds at 6' 3", died from brain cancer in 1992 at the age of 43. He told Sports Illustrated that he began taking anabolic steroids in college in 1969. After he became ill, Alzado wrote, "If you're on steroids or human growth hormone, stop. I should have."
Ken Caminiti was a Major League Baseball player who won the National League Most Valuable Player award in 1996. He died from a heart attack in October 2004 at the age of 41. And while his death has been linked to cocaine use, Caminiti was another athlete who told Sports Illustrated that he used steroids during his MVP season, when he had career-high statistics.
A more recent example is Jason Giambi, the New York Yankees first baseman whose admission that he used steroids was revealed by the San Francisco Chronicle. The newspaper cited grand jury minutes in which Giambi reportedly talked about the various substances he ingested or injected. Giambi's body essentially broke down during the 2004 season. He was a pale imitation of the slugger the Yankees obtained two years earlier from the Oakland Athletics.
Were Giambi's orthopedic woes the result of his abuse of performance-enhancing drugs? Did the benign tumor he developed -- reportedly a pituitary growth -- arise from a female fertility drug called clomiphene (Clomid) he reportedly told the grand jury he took to bulk up? There's no way to prove that either condition was caused by performance-enhancing drugs. Yet steroids can have orthopedic side effects and clomiphene can exacerbate a pituitary tumor.
From the standpoint of health risks, the best evidence of how dangerous anabolic steroids can be comes from once-secret East German medical reports dating to the 1970s and 1980s, when athletes from that country, particularly women, were setting astonishing records in track and field and swimming. Some of those records of a generation ago still stand.
Werner W. Franke, of the German Cancer Research Center in Heidelberg, reported in 1997 in the journal Clinical Chemistry that for years the East Germans gave anabolic steroids to several thousand athletes of both sexes, including minors. "Special emphasis was placed on administering androgens to women and adolescent girls because this practice proved to be particularly effective for sports performance," he wrote. "Damaging side effects were recorded, some of which required surgical or medical intervention."
These side effects resulted in some irreversible damages, like virilization, increased growth of body hair, voice changes and disturbances in libido. "The effect on the sexual drive was relatively strong in some women," he wrote. There were also cases of enlarged liver.
Today it's all much subtler, with newer "designer" steroids on the scene that can defy testing, even though they are just as risky as the old-fashioned variety. There is also the addition of recombinant human growth hormone (hGH), which enhances muscle growth, and erythropoietin (EPO) "blood doping," which increases oxygen delivery to the muscles. Both are extremely difficult to detect.
"Human growth hormone is a potentially dangerous drug, which when used by adults can lead to diseases having significant mortality rates," according to the U.S. Justice Department. "Its misuse in adults poses a wide array of serious side effects, including significant cardiovascular disease, irreversible enlargement of the heart, and development of polyps and malignancies of the colon."
So far, the Justice Department has offered no significant studies to back up this assertion. And human growth hormone was approved by the Food and Drug Administration for use in children to increase short stature. It is also used in cases of AIDS wasting.
These days, the idea for athletes is to gain an edge -- not too much of an edge to risk their health, but enough to achieve their athletic goals -- with the financial rewards that follow. The trouble is that no one knows which athletes' bodies will get away with a little cheating and not cause their bodies to fail them.
Giambi's medical troubles and his ensuing performance drop-off may have been a coincidence. Yet when he showed up at spring training last year, after his name emerged in the now-infamous BALCO probe and he presumably halted his use of the drugs, sports writers were shocked at how his body shape had changed -- almost as if a weightlifter had stopped working out. BALCO Labs was a small California company that manufactured a variety of strength-enhancing substances, including a testosterone supplement.
Giambi's grand jury testimony reportedly contained a reference to taking "the clear," a street name for tetrahydrogestrinone, the "designer" drug known as THG. It was the chance discovery of that drug that spurred the investigation of BALCO, which led to the grand jury being convened. Presumably, THG is called "the clear" because until a year ago the steroid was undetectable by standard testing.
According to a report in the May 2004 Journal of Clinical Endocrinology & Metabolism, THG is closely related to gestrinone, a 19-nor progestin, and resembles trenbolone. Trenbolone, popular among body builders, is a veterinary drug used to bulk up cattle and it is banned by the National Collegiate Athletic Association. Gestrinone, used to treat endometriosis, acts on the pituitary. It is not approved for adult males.
Giambi also reportedly testified he used an agent he called "the cream." This, too, is a "designer" steroid, said to be a mixture of the male hormone testosterone and epitestosterone.
According to the National Institute on Drug Abuse, the statistics on health effects from the long-term abuse of anabolic steroids on humans are based on anecdotal reports -- not formal epidemiological reports -- and certainly not randomized clinical trials, which would be unethical, if not illegal.
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