Steroid Manifesto

As you might imagine, almost every secret, or even not-so-secret club, gang, pack, or gaggle has a manifesto, a document detailing all the important information that every devotee should possess. The Christian club has the Bible, the US gang has got the Constitution and the Bill of Rights, and even that Bill Phillips, Body For Life pack has a glossy, estrogen- soaked manual that describes how to place your lips directly onto Bill Phillips' butt while sliding your hard earned dollars into the front pockets of his freshly pressed chinos.

This makes me wonder what the world would be like if there were a Book of T, The Word of Testosterone, if you will? Perhaps a book like this might, in some small way, negate the damage caused by years of indelibly stamped images of Richard Simmons's flabby thighs in spandex. Perhaps it might also help erase years of erroneous fitness mythology from the memory centers of fitness trainers and exercisers alike.

If such a book were to be written, I might expect that every full-fledged, card-carrying member of T-Nation would have a copy and this holy book would provide information essential to all T-Nation members. Hence this hypothetical introductory chapter, my vision of what the members of Testosterone Nation should know about their namesake.

Part 1 of this three-part series discussed steroid fundamentals, while part 2 discussed how they're used. This final installment addresses the legal concerns.

Legal, Illegal, Am I Going To Jail?

Since steroids are often sold in locker rooms around the country without a second thought and since the status of steroids has changed over the years, many individuals have no idea as to the true legal status of the drugs or the implications of being caught dispensing or possessing them. If you're gonna play the game, at least know the rules.

Before 1988, steroids were classified as mere prescription drugs by the FDA (Food and Drug Administration). The job of the FDA is to determine which drugs will be classisified as over-the-counter and which will be available only through prescription. In addition, during this time, the Federal Food, Drug, and Cosmetic Act, an act designed to restrict the access of certain drugs to those with "legitimate" medical uses (i.e. with a prescription) by categorizing drugs, determined that steroids could only be distributed with a prescription.

Importantly though, at this time, steroids were not classified as "controlled substances" by the Controlled Substances Act. "Controlled substances" are substances that are more tightly regulated than "uncontrolled" prescription drugs. With tighter control comes a longer paper trail, more intense scrutiny of doctors prescribing these drugs, and more severe penalties associated with illegal dispensation and use.

By the early 80's, due to more frequent reports of steroid use in athletes, especially young athletes, policy makers began to discuss elevating steroids to "controlled" status. Finally, in 1988, the Anti-Drug Abuse Act was passed, putting steroids in a special prescription category, one that carried severe legal penalties for illegal sale or possession with intent to distribute. Remember, before 1988 steroids had always been illegal to sell or possess without a prescription. This new act simply added a very real threat of serious legal penalty (making it a felony, in fact).

Contrary to their attempts to reduce steroid use via legislation, steroid use only accelerated in years following the passage of this act. In response, Congress decided to go ahead and add steroids to the Controlled Substances Act as an amendment (Anabolic Steroid Control Act of 1990), making steroid possession, possession with intent to distribute, and distribution serious offences with penalties similar to those associated with morphine and other scheduled substances.

Interestingly, the transcripts from the Congressional hearings were clear in indicating that health concerns were not the main reason for making steroids controlled substances despite the fact that nearly every other controlled drug was on that list because of associated (and sometimes severe) health risks and dependency. Instead, Congress decided to control these drugs in response to the cries of athletic organizations and in response to a desire to limit adolescent use. Sure, the health risks were considered. But they were not the main motive or force for scheduling these drugs as "controlled." While there are several categories of controlled substances ("schedules"), steroids are placed in Schedule III, along with amphetamines, methamphetamines, opium, and morphine. Buying, possessing, and selling steroids, nowadays, is legally equivalent to buying opium and morphine.

Confused yet? If so, let me break it down. In 1990 steroids were vaulted to an extreme category of highly specialized prescription drugs, drugs that are more difficult to prescribe or obtain, drugs that carry severe penalties for their illegal possession, use, and distribution. This, of course, occurred on a federal level. To add more confusion to the issue, state laws vary with respect to steroid classification and the severity of penalties. All of this legislation, interestingly, occurred without the support of the American Medical Association, the FDA, the DEA, and the National Institute on Drug Abuse! All of these expert agencies actually testified, sometimes vehemently, against the federal and state legislation.

In direct response to the changes in steroid law, many individuals, from big-time black market steroid traffickers to small-time steroid users, have served significant prison sentences for their unlawfulness. Nevertheless, it's clear that these laws have not reduced steroid use in the general public or in athletics, which was their original intent. In addition, with respect to health issues, many believe that the Anabolic Steroid Control Act, rather than protecting the public, created the two biggest health problems associated with steroid use: counterfeit drugs and improper medical supervision.

Understand that regardless of whether on not drug laws are right or wrong, they are still on the books and we are all subject to them. If you choose to use steroids without a prescription, you are choosing to defy the law. In choosing to defy the law, you're accepting the risk of getting caught, serving time in prison, and/or paying some hefty fines and lawyer fees.

I'm An Athlete – What Do I Have To Know?

Whether this is an appropriate view or not, athletics have historically been seen as an endeavor that promotes health and well-being as well as the idea of fair play. Therefore, an embarrassing hypocrisy is present when drug use is rampant at the highest levels of athletics (pro and Olympic level sport).

In an effort to prevent the "tarnishing" of a long-standing athletic ideology, sport-governing bodies, historically, have attempted a two-tiered approach: lobby Congress for more severe drug regulations, and implement mandatory drug testing of athletes. Arguably, neither has produced the desired effect. At the same time though, abandonment of these policies would be an admission of defeat; indirectly condone drug use; and allow athletes who are more pharmaceutically daring to gain a competitive edge over those more conservative athletes. Therefore, governing bodies have remained steadfast in their commitment to their testing programs.

Drug testing in sport began in the late 1950's. However, the first testing for steroids was implemented during the 1976 Montreal Olympic Games after the creation of specific screening procedures (RIA – radioimmunoassay, and GCMS – gas chromatography – mass spectrometry). At this time, the testing consisted of analyzing urine samples (the only permitted testing fluid) using RIA for exogenous steroids. If they were found in urine, GCMS was used to confirm the results. Since this type of testing lacked specificity and since this method could not distinguish between endogenous and exogenous Testosterone, new methods were required.

Later, in 1984, GCMS was used as the main method of analysis. This method could test for more specific steroid metabolites as well as testing the Testosterone to epitestosterone ratio (T/E). This latter method could distinguish whether a person was on Testosterone because endogenous Testosterone is produced in the testis in a 1:1 ratio with epitestosterone. Therefore, if someone were on exogenous Testosterone, this ratio would be out of balance. Due to some natural variations in this ratio it was established that a 6:1 ratio of T/E determined suspicion while a 10:1 ratio established guilt.

This method of testing, however, could be overcome by a variety of methods:

Simply co-administering a cocktail of Testosterone and epitestosterone to maintain the appropriate ratio. This cocktail would also contain other appropriate endogenous steroids since the administration of only T and e would inappropriately elevate these two hormones relative to the other endogenous steroids, thereby raising caution flags. On the other hand, the co-administration of Testosterone and epitestosterone alone, if done in smaller doses, might not be cause for suspicion.
The use of Testosterone patches or gels. These drugs have a slower release and deliver steroids in such a way as to lower peak blood concentration, perhaps allowing athletes to still pass using the 6:1 ratio as the standard. However this use, due to 5 alpha reductase activity in the skin, can lead to elevated blood DHT and the DHT may be detected in the urine.
Having a good lawyer. The T/E ratio is flawed due to the fact that very little is known about individual variation based on diet, gender, training, etc. In addition, there are several scenarios that will raise the T/E ratio without the accused actually taking Tstosterone. As a result, several cases have been thrown out due to inconclusive evidence that drugs were used.

Since there are serious problems with the T/E ratio for detecting steroid use (the current method), a new technique is being proposed for use. This technique uses IRMS (isotope ratio mass spectrometry) to distinguish exogenous Testosterone from endogenous Testosterone. Since Testosterone is made up of carbon atoms and different carbon atoms have different weights, IRMS can figure out how many of the lighter carbons (C12) and how many of the heavy carbons (C13) are around.

Endogenous Testosterone (naturally produced) is made up of 98.9% C12 and 1.1% C13. If any Testosterone shows up in the urine that doesn't contain these percentages, it's suspected that the person is using exogenous Testosterone.

In addition, Testosterone and other steroids can be used without penalty by:

The use of masking agents (drugs designed to mask the metabolites of certain steroids) and/or specially formulated drugs that are not currently detectable.
Monitoring by, what some call, "rogue labs." Many athletes will have their blood and urine monitored regularly in order to ensure that the drugs they are using are not detectible.

As you can see, the drug testing procedures are becoming increasingly more complex in an attempt to keep pace with new drugs and new techniques designed to beat the current tests. Unfortunately, with this complexity comes exponential growth in the expenses associated with testing. Off-season testing can cost up to $1000 per sample. In addition, in competition testing can cost upwards of several million dollars for an event like the Olympic games. Finally, it costs millions of dollars to fund research to keep ahead of drug users. As a result, some experts believe that testing methods are destined to fail.

However, regardless of the outcome, athletes are faced with the choice of avoiding steroids and risking victory or using steroids and risking detection. To the average athlete without advanced drug use and masking techniques, there's a good chance of getting caught.

Of course, the intensity of these efforts is directed at Olympic and international level athletes. Professional sport tends to treat drug use much differently and therefore avoids much of the controversy associated with Olympic sport.

Summing It All Up

This three-part introduction to steroids has attempted to provide an overview of the T-Nation's namesake by discussing steroid definitions, chemical structures, a brief history of steroids, an overview of how steroids were introduced to sport (part I). In addition, we've provided a brief introduction to modes of steroid delivery, how steroids work, and side effects (both good and bad) (part II). Finally, we've provided some information about legal issues and testing in sport (part III).

While this three part series has contained quite a bit of steroid information, it's barely scratched the surface of steroid knowledge. For more detailed information about steroid physiology, steroids and health, and steroid use for sport or cosmetic reasons, the following references should be of benefit. They represent a sampling of the information that's contributed to our knowledge on steroids.

Online Articles:

Steroids and Side Effects (positive and negative):

Steroid Basics and Steroid Cycle Construction

Steroids For Dummies by Cy Willson
The Never Ending Cycle by Cy Willson

Testosterone and Environment

The Big T (Parts 1 and 2) by John M Berardi

Books

Bhasin, S., et al. Pharmacology, Biology, and Clinical Applications of Androgens. New York, NY: Wiley-Liss, Inc. 1996.
Di Pasquale, M. Anabolic Steroid Side Effects. Warkworth Ontario: MGD Press. 1990.
Dorfman, R.I., Shipley, R.A. Androgens: Biochemistry, Physiology and clinical significance. New York: J Wiley, 1956: 53.
Francis, C. Speed Trap. New York: St Martins Press. 1990.
Kruskemper, H. Anabolic Steroids. New York: Academic Press. 1968.
Kerr, R. The Practical use of Anabolic Steroids with Athletes. San Gabriel, CA. 1982.
Mainwaring, W.I.P. et al. The Mechanism of Action of Androgens. Verlag New York, 8-10, 1977.
Nieschlag, E. and Behre, H.M. In Testosterone Action, Deficiency, and Substitution. Springer-Verlag, New York, 1-31, 1998.
Philips, W.P. Anabolic Reference Guide. Golden, CO: Mile High. 1991.
Vida, J.A. Androgens and Anabolic Agents, Chemistry and Pharmacology. Academic Press, Inc, New York, 77-91, 1969.
Wright, J. Anabolic Steroids and Sport 2. Natic, MA: Sports Science Consultants, 1982.
Yen, S., Jaffe, R. Reproductive Endocrinology. Philadelphia: Saunders Co., 1986.
Yesalis, C.E. Anabolic Steroids in Sport and Exercise. Windsor Ont., Human Kinetics: 2000.

Journal Articles

Alen, M. Suominen, J. Effect of androgenic and anabolic steroids on spermatogenesis in power athletes. Int. J Sports Med. 1984: 5 (Oct): 189-92.
Alen, M. Androgenic steroid effects on liver and red cells. Br J Sports Med. 1985: 19 (1): 15-20.
Albert, J, et al., Prostate Concentrations of endogenous androgens by radioimmunoassay. J Steroid Biochem 7:301 (1976).
Arnold, A., Potts, G.O., & Beyler, A.l. Evaluation of the protein anabolic properties of certain orally active anabolic agents based on nitrogen balance studies in rats. Endocrinology. 1963. 72: 408-417.
Bergink, E.W., Janssen, P.S., Turpijn, E.W., & Van der Vies, J. Comparison of the receptor binding properties of nandrolone and testosterone under in vitro and in vivo conditions. Journal of Steroid Biochemistry. 1985: (22): 831-836.
Bhasin, S., Woodhouse, L., Sorer, T.W. Proof of the effect of testosterone on skeletal muscle. Journal of Endocrinology. 2001: (170): 27-38.
Bhasin, S. et al. Testosterone dose-response relationship in healthy young men. American Journal of Physiology. 2001: vol. 281, (6): E1172-E1181.
Brodsky, I.G., Balagopal, P., & Nair, N.S. Effect of testosterone replacement on muscle mass and protein synthesis in hypogonadal men-a clinical research center study. Journal of Endocrinology and Metabolism. 1998: (81): 3469-3475.
Catlin, D.H., & Halton, C.K. Use and abuse of anabolics and other drugs for athletic enhancement. Advances in Internal Medicine. 1991: (36): 399-424.
Cowart, V. Steroids in sports: After four decades time to return these genies to the bottle. JAMA. 1987: 257: 421.
Diekerman RD, McConathy WJ, Zachariah NY. Testosterone, sex hormone-binding globulin, lipoproteins and vascular disease risk. J Cardiovasc Risk 1997 : 4(5-6):363-366.
Frankle, M.A., Eichberg, R., & Zachariah, S.B. Anabolic androgenic steroids and a stroke in an athlete: Case report. Arch. Phys. Med. Rehab. 1980: (69): 632-634.
Glazer, G. Atherogenic effects of anabolic steroids on serum lipid levels. Arch Intern Med. 1991: (151): 1925-33.
Goldstein, P. Anabolic steroids: An ethnographic approach. NIDA Res. Monogr. 1990: (102): 74-96.
Haupt, H., Rovere, G. Anabolic steroids: A review of the literature. Am Journal of Sports Med. 1984: 12(6): 469-84.
Hervey, G.R. et al. Effects of methandienone on the performance and body composition of men undergoing athletic training. Clin Sci. 1981: 60(4): 457-61.
Lamb, D.R. Anabolic steroids in athletics: How well do they work and how dangerous are they? Am J Sports Med. 1984: 12(1): 31-38.
Marin, P., Krotkiewski, M., & Bjorntrop, P. Androgen treatment of middle-aged obese men: effects on metabolism, muscle, and adipose tissue. European Journal of Medicine. 1992: (1): 329-336.
Potts, G.O., Arnold, A., & Beyler, A.L. Dissociation of the androgenic and other hormonal effects of steroids. 1976.
Sader MA, Griffiths KA, McCredie RJ, et al. Androgenic anabolic steroids and arterial structure and function in male bodybuilders. J Am Coll Cardiol 2001;37(1):224-230.
Seidell, J., Bjorntrop, P., Sjostrom, L., Kvist, H., & Samerstedt, A. Visceral fat accumulation in men is positively associated with insulin, glucose and c-peptide levels, but negatively with testosterone levels. Metabolism. 1990: (39): 897-901.
Shapiro J, Christiana J, Frishman WH. Testosterone and other anabolic steroids as cardiovascular drugs. Am J Ther 1999;6(3):167-174.
Sitteri, PK, Wilson, JD, DHT in Prostatic Hypetrophy. J Clin Invest, 49:1737 (1970).
Snyder, P.J., et al. Effect of testosterone treatment on body composition and muscle strength in men over 65. Journal of Clinical Endocrinology and Metabolism. 1999: (84): 2647-2653.
Street, C., Antonio, J., & Culdip, D. Androgen use by athletes: A reevaluation of the health risks. Can. J. Appl. Physiol. 1996: 21(6): 421-440.
Taylor, W., Black, A. Pervasive anabolic steroid use among health club athletes. Ann Sports Med. 1987: 3(2): 155-9.
Urban, R.I. et al. Testosterone administration to elderly men increases skeletal muscle strength and protein synthesis. American Journal of Physiology. 1995: (269): E820-E826.
Wang, C. et al. Effect of testosterone replacement therapy on mood changes in hypogonadal men. Endo. Soc. 1995: June p2-122.
Webb, O.L., Laskarzewski, P.M., Glueck, C.J. Severe depression of high-density lipoprotein cholesterol levels in weight lifters and body builders by self-administered exogenous testosterone and anabolic androgenic steroids. Metabolism. 1984: (33): 971-975.
Wilson, JD, The intranuclear metabolism of Testosterone in the accessory organs of reproduction. Recent Prog Horm Res 26: 309 (1970)
Wilson, J.D., Griffen, J.E. The use and misuse of androgens. Metabolism. 1980: 29(12): 1278-95.
Wilson, J.D. Androgen use by athletes. Endo. Rev. 1988: (9): 181-199.
Windsor, R., Dumitru, D. Anabolic steroid use by athletes. Post Grad Med. 1988: (84): 37-49.
Wright, J. Anabolic steroids and athletics. Exerc Sport Sci Rev. 1980: (Sep): 140-202.
Wu, F.C.W. Endocrine aspects of anabolic steroids. Clinical Chemistry. 1997: (43): 1289-1292.
Yeager, D., Bamberger, M. Over the edge: Aware that drug testing is a sham, athletes seem to rely more than ever on banned performance enhancers. Sports Illustrated, April,14, 1997.
Yesalis, C.E., Bharke, M.S. Anabolic-androgenic steroids. Sports Med. 1995: 19(5): 326-340.
Zgliczynski S, Ossowski M, Slowinska-Srednicka J, et al. Effect of testosterone replacement therapy on lipids and lipoproteins in hypogonadal and elderly men. Atherosclerosis 1996;121(1):35-43.
Zmuda JM, Cauley JA, Kriska A, et al. Longitudinal relation between endogenous testosterone and cardiovascular disease risk factors in middle aged men. A 13 year follow-up of former Multiple Risk Factor Intervention Trial participants. Am J Epidemiol 1997;146(8):609-617.