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In the Beginning, There Was Androstenedione
Steroids...to be or not to be? Should that Be a Question?
How Much is Too Much?
Too Good to be True?
FDA, DSHEA...Translation Please!
On September 7, 1998, just a few weeks ago,
history was made. Mark McGwire, the St.
Louis Cardinals’ "hot hitter," hit his sixty-second home run of the season, surpassing Roger
Maris’ thirty-seven year legend. Somehow, as with most events in the public’s eye,
controversy surrounding McGwire and his great feat has been brought into the spotlight.
The week before McGwire hit the record-breaking home run, he candidly admitted to the
regular use of the testosterone enhancing supplement androstenedione. Since then, the
controversy encompassing this supplement has been exciting. However, before one can
make an educated decision about androstenedione, one must investigate it more deeply.
These days, everyone has something to say about everything, and a controversial issue
such as androstenedione is no exception. The profound interest surrounding the
supplement has made it an issue recognized world wide; it has become the hot topic of
every newspaper, magazine, and sports broadcast. Through the booming technology
surrounding us, this information is only as far as the keyboard; through the World Wide Web
the world is literally at one’s fingertips.
Androstenedione is a "natural steroid hormone found in all animals
(meat) as well as some
plants (extracts). It is a metabolite of DHEA that serves as a direct precursor (one step
removed) in the bio-synthesis of testosterone. In all mammals, androstenedione is
produced in the gonads and adrenal glands"
(http://www.smartbasic.com/cat.supplements/andro.50.cat.html). It should be noted that this exact definition, word for word, was encountered in every piece of literature researched.
Dehydroepiandrosterone (DHEA) is a hormone made by the adrenal glands used by the
body to make male and female hormones (http://www.getbig.com/glossary/g-nut-1.htm). One
characteristic agreed upon by researchers is its ability to alter the natural levels of
testosterone found in the body’s blood stream, but the degree of which is still in debate. It is
an over-the-counter, entirely legal supplement that can be purchased at almost any nutrition
center or gym. However, androstenedione is not a vitamin, a mineral or a protein; it has yet
to be classified. That much everyone seems to agree on; it is only upon deeper examination
that the picture becomes unclear, controversial, and somewhat muddled. What are the
physical effects when the supplement is taken? Is there more hype surrounding
androstenedione than needs to be? As with much else, there are two sides to every story.
The first view under the magnifying glass is that of the suppliers
and consumers. It has been
dubbed as the hottest "drug free" testosterone booster available
(http://www.propower1.com/androstenedione.htm). For some, androstenedione is a miracle
drug, increasing all of the good and decreasing all of the bad. When "taken prior to physical
activity (body building, sexual activity, etc.), androstenedione will ... produce increased
stamina and endurance, enhance performance (including sexual), and can lead to
increased strength and faster gains in muscle mass." These same suppliers also say that it
increases muscle protein accrual and accelerates recuperation and recovery, which is an
obvious incentive. Identical claims were encountered in every document that encouraged
its use. As already seen, most of the talk about this subject focuses on its effect on
testosterone. Manufacturers claim that these benefits are a direct result of higher levels of
testosterone in the blood stream. Blood levels begin to rise about fifteen minutes after the
oral administration of the supplement and stay elevated for an average of three hours.
Testosterone levels are said to increase between 211-337 percent once the supplement
enters the pituitary gland (where the body’s naturally occurring testosterone comes from)
(http://www.smartbasic.com/cat.supplements/andro.50.cat.html). Because testosterone is the body’s most potent muscle building hormone, a supplement which could fulfill these claims could be very desirable to some people, particularly athletes. Some supporters even claim it is
entirely safe. Another point consistently mentioned by both consumers and manufacturers
alike, is that, as one ages, the natural production of this hormone begins to drop steadily.
Any way to reproduce the short term effects of testosterone is openly welcomed without
second thought to the potential long term consequences in these cases. Another benefit
enticing more users is the claim that the aforementioned benefits can be achieved without
any significant negative feedback response to one’s natural testosterone production. This is
due to the fact that the supplement’s effects only last for a minimal period--so minimal that
the pituitary gland does not have enough time to respond. Therefore, distributors
encourage that androstenedione be taken consistently throughout the day to maintain a
constantly higher level of testosterone than normal. However, the producers fail to present
the basis for argument behind their suggested dosage; there is no scope to the imagination
as to what effect this particular use could result in. Furthermore, the suppliers go on to claim
that these numerous benefits go without the harsh side effects that often accompany steroid
replacement therapy. They also make it quite convenient to purchase their product off the
World Wide Web. One hundred caplets are only $14.95! Over 100 different anabolic
steroids can be found more than 3600 websites (Sullivan et al, 1998). However, if this was
the only side of the story, there would be no controversy. Is this too good to be true? Some
In the Beginning, There Was Androstenedione
A more scientific view can also be researched on the internet. It
all began back in 1935
when androstenedione was first synthesized. Shortly thereafter, and contradictory to
supporters’ statements today, it was shown by Dr. Charles Kochakian, then a known expert
on steroid hormones, that this supplement produced both androgenic and anabolic effects
(http://www.bahnhof.se/~jbartoll/androstenedione.html). Since his research showed that the
anabolic effects were only significant in castrated dogs, androstenedione was consigned to
research limbo. The same article went on toexplain that in the 1970s, it was secretly brought
to the surface once again by East German steroid doctors who began working with the
limited knowledge of the supplement (http://www.musculardevelopment.com/oct/). Today it is known that these doctors enlisted over two hundred elite East German athletes on a steroid program which included androstenedione, but as a nasal spray formulation used immediately before performance as a final booster. They continue to insist that it was used solely as a mental performance booster. However, twenty years later, still not much is known about the short or long term effects of androstenedione.
There have been no formal studies conducted, despite supporters' claims, and no one really knows the true benefits or harmful consequences of this supplement; it is all speculation. It is thought to be highly androgenic, and it is known that the effects are permanent. The effects connected to this supplement include gland enlargement, water retention, impotence, acne, balding, and lower self-pro duction of testosterone. In women, use could lead to permanent changes such as deepening of the voice, development of facial hair, and enlargement of the genitals. In young people, androstenedione may potentially halt growth prematurely because of elevated androgen-levels. The athletes who took these supplements more than twenty years ago now suggest the main side effects were painful sinus headaches and very bad moods. These effects have been linked to those studies involving anabolic steroids and therefore many tend to substitute the two interchangeably. Still, there are other arguments against the use of androstenedione.
Although androstenedione has not been classified as a steroid at this time, a closer look shows the potential for numerous similarities between androstendione and anabolic steroids. Anabolic steroids are synthetic androgens that have greater anabolic activity relative to androgenic activity, when compared to testosterone (Su et al, 1993). They were supposedly first developed as a therapy for a variety of medical conditions. However, it is the common conception today that they increase lean body mass and physical strength while reducing rest time between workouts. It is thought that anabolic steroids were first introduced in 1954 at the Vienna world weight lifting championships (Sullivan et al, 1998). To date, and with earlier discussion in mind, this is the closest element of science that we can relate androstenedione to. In no way is it being said that the effects or benefits of steroids will necessarily be the same as this supplement; however, the case is more likely than any other comparison.
Since they were first introduced almost fifty years ago, anabolic steroids have become very popular. By the late 1960's, 100 percent of the United States power lifters at the Olympic Training camp admitted to have taken some form of steroids (Sullivan et al, 1998). However, the use of these enhancers was not limited to athletes; shortly thereafter the market for these products opened up and "steroid" became a household name. Sullivan's review earlier this year showed that by the mid 1980's the fastest growing population of steroid users had never formally competed in sports (Dezelsky, 1985; Durkin, 1988). The face of the user changed dramatically from a huge muscle bound body builder to an average high school or college student trying to enhance their physique. Sullivan's report showed that as much as 27 percent of adolescents who admitted to use of anabolic steroids explained that they were using the substances to "improve their physical appearance" (Buckley, Yasalis, Friedl et al., 1988; Johnson, 1989; McLain, 1989; Ferry, Anderse, Yates, 19901. In a study of 46 private and public high schools, seven percent of male seniors admitted to having used anabolic steroids (Buckley, Yasalis, Friedl et al., 1988). Of this seven percent, more than two-thirds stated that they began using before they were fifteen. Another realm was added to the spectrum when there was illustration that despite comprehensive education programs about the use of steroids, the attitudes of high school football players toward anabolic steroids were not significantly affected as related in the Sullivan et al report (Goldberg et al, 1990). Is running a four minute mile or hitting sixty-two home runs worth the unknown risks?
Throughout the years, since anabolic steroids made their debut, the press for better documentation of their effects has been evident. Evidence for the effects of steroid used is derived from three sources: clinical studies of steroids in treatment, laboratory studies of steroids in normal volunteers, and naturalistic studies of athletes. More than 25 laboratory studies have been used to evaluate the effects of steroids on athletic performance. Naturalistic studies of athletes tend to contradict the subtle findings of the other two studies. Because of their more typical nature, these studies often are weighted more heavily. In the case of anabolic steroids, the naturalistic studies of athletes tended to report marked psychiatric symptoms (Harrison and Katz, 377). Other fascinating evidence within Harrison and Katz's review was that within some groups, certain individuals were described as committing violent and/or criminal acts while using the steroids, including murder and attempted murder (It was documented that these behaviors had never been experienced before within the users) (Conacher, 1989; Choi, 1990; Pope, 1990; Dalby, 1992). As with all studies it must be remembered that these results are indicative of those who volunteered, which may not have been the best representation of the overall population of users.
Still there are more exact drawbacks to the use of anabolic steroids as discussed in the Sullivan et al review. With use of anabolic steroids, systolic pressure increases as much as 10 mmHg and existing hypertension is worsened. Even after discontinued use of six months, studies indicate that 44 percent of the test group was at an elevated risk. Within the Sullivan et al review (1998) it is suggested that sustained increase in heart rate and blood pressure may result in compensatory enlargement of the left ventricular wall (Urhausen et al 1992). This same study indicates that power lifters are more susceptible to atherosclerosis, increased concentrations of low-density cholesterol and decreased concentrations of high-density lipoprotein cholesterol (Sullivan et al 1998)
One of the most frightening concepts involved in the entire realm of anabolic steroids and the supplement androstenedione is dosage. The Sullivan et al review noted that the actual doses taken are usually 10-100 times that of the normal therapeutic dose (Burkett & Faldutto, 1984). Even more stunning is the idea that in some populations (ie weightlifters) the lowest dose was still 350 percent more than the therapeutic dose. Not only are people chancing their health with unknown substances, now they are increasing the unknowns and therefore the inherent risk. The concept that if a little is good than more must be better should be strongly thought out--especially since no one knows if any is good at all.
There are many strong opinions against the use of this supplement. There seems to be no controlled data that would suggest the safe use of oral androstenedione for muscle building. Dr. Charles Yesalis of Penn State University noted, "Androstenedione is no big secret. It's just one of scores of intermediate steroids that have shown no general benefit for health, fitness, or muscle" (http://musculardevelopment.com/oct/andr) Yet others do not classify it as just another hormone precursor. Some worry due to the Dietary Supplement Health Education Act of 1994 (DSHEA), which classifies androstenedione as a food, not a drug, and therefore it cannot be regulated by the Food and Drug Administration (FDA) (http://cgi.pathfinder.com/time/magaz... time.your heal28.html) While the manufacturers cannot claim its effect on curing diseases, they can advertise freely, boasting invalid, exaggerated claims. One manufacturer has gone so far as to say that the supplement found in 250mg pills (androstenedione is usually taken in 50mg increments) can elevate testosterone levels 600 percent (http://www.astresearch.com/a100qa.htm) This, like other inflated claims, remains to be proven. Dr. Yesalis went on to say, "I don't know of any scientific data that shows the efficiency of androstenedione. There are no studies of this supplement." Nothing is concrete and this is what scares doctors most; no one knows exactly what it can do and many users are not willing to wait for studies to be conducted. If the supplement really does increase testosterone in the way the makers claim, users might get more than they bargained for, which, due to its uncertainty, is potentially dangerous.
Another important complication to consider is whether or not the use of testosterone enhancers will inhibit the body's natural production of the hormone. Although makers say no, some doctors have doubts. Dr. Karlis Ullis, a Santa Monica Sports Medicine doctor mentioned, "One of the potential problems is that tissue levels (of testosterone) can build for a long time" (http://musculardevelopment.com/oct/andr) . The brain cannot tell the difference between naturally produced testosterone and that made artificially and therefore reads the artificial as natural. It then signals the body to stop producing its own testosterone for fear of excess. An article recently apprearing in Time Magazine suggested that high testosterone levels may stimulate the premature development of cancerous tumors in the prostate. (http://cgi.pathfinder.com/time/magaz... time.your heal28.html) Doctors caution that because testosterone is eventually converted into estrogen, high levels may also cause men to develop gynecomastia (the excessive development of the male breasts). They strongly warn that androstenedione should not be used in those who wish to have a family later in life. These warnings, like the manufacturer's promises, have no concrete evidence in their favor either. However as Dr. Ullis noted, "absence of evidence is not evidence of absence...We just don't know what it does." The main problem is this absence of evidence. John Troup, vice president for scientific affairs at General Nutrition Centers, ordered franchises to stop the distribution of the supplement saying that they were not yet satisfied with the safety of the product, as reported by Time Magazine (http://cgi.pathfinder.com/time/magaz... time.your heal28.html) It seems as though a thick cloud of fog surrounds androstenedione. A statement issued by the assumed creditable St. Louis Cardinals' medical staff disputed the attacks on Mark McGwire and the supplement stating that there have yet to be any significant side effects found (http://espnet.sportszone.com:80/mlb/new) Should someone remind them that as of yet, there is no concrete proof of any effects of androstenedione?
With the passage of the Dietary Supplement Health and Education Act of 1994 by Congress, the Food and Drug Administration's hands are tied. After an industry-financed campaign aimed at scaring health-minded individuals convinced the public that the FDA was close to banning all supplements and the like the act was passed leaving the supplement market entirely unregulated. It weakened the FDA's ability to regulate the safety of thousands of new products on the supermarket shelves every year. Before the act was passed a company had to withhold a product from the market until it was proven to be safe and effective; now that burden of proof is shifted to the FDA. Now a company can market any product without regard to its safety or effectiveness (http://horc.orgifaqs/dldsheal.html). The manufacturers can make any claim imaginable short of a cure for a particular disease. However, before a substance can be removed from the market, the FDA must show evidence that someone was hurt and then they can take their case to court. Recently an Associated Press analysis of FDA records found over 2500 reports of side effects from dizziness to 79 deaths (Porter np). Because the supplement industry has such a powerful lobby regulatory restraints look to be slow in coming.
The controversy surrounding androstenedione body building enhancers is far from over. If it is not androstenedione, it will be something else, such as 19-Norandrostenedione, which is another supplement rumored to enhance athletic performance even more so than androstenedione. It is quite evident that much is unclear about this hormone precursor. Can it really do the wonderful things the suppliers claim? If it can, will users get more than they asked for, which may not all be positive? Should we be more cautious about the unknown until it proves to be safe? The questions continue and will only be answered once studies are conducted and the long term effects can be analyzed. The "experts" for and against this wonder drug are adamant in voicing their predictions of the benefits or harm androstenedione will incur. It is in the careful deciphering of these contradictory messages that makes us astute and conscientious consumers in today's unpredictable marketplace.
Pope, H. G., & Katz, D. L. (1994). Psychiatric and Medical Effects
Androgenic Steroid Use. Archives General Psychiatry, 51, 375-382.
Porter, R. (1998). Supplements supply dietary danger, as FDA looks on.
Washington. Oct. 1998, 1-4.
Su, T., Pagilaro, M., Schmidt, P. J., Picar, D., Wolkowitz, O., & Rubinow, D. R. (1993).
Neuropsychiatric Effects of Anabolic Steroids in Male Normal Volunteers. JAMA,
Sullivan, M. L., Martinez, C. M., Gennis, P., & Gallagher, E. J. (1998). The Cardiac Toxicity of Anabolic
Steroids. Progress in Cardiovascular Diseases, 41(1), 1-15.
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