Fuck it, I think you guys will be interested in this,
Int J Sports Med 2008; 29: 679-687
DOI: 10.1055/s-2007-96580
Side Effects of Anabolic Androgenic Steroids Abuse
A. Bonetti1, F. Tirelli1, A. Catapano2, D. Dazzi3, A. Dei Cas3, F. Solito1, G. Ceda3, C. Reverberi4, C. Monica5, S. Pipitone5, G. Elia6, M. Spattini1, G. Magnati3
Long-term side effects of high doses of anabolic androgenic steroids self-administration were evaluated in this study. Twenty male bodybuilders, voluntarily starting steroid self-administration, were followed every 6 months over 2 years. Physical examination, haematological, metabolic and endocrine variables, semen analysis, hepatic and prostate ultrasound and echocardiographic evaluations were performed. LH values (baseline 3.43 �± 1.75) were suppressed at 18 (1.98 �± 1.99) (p = 0.026) and 24 (2.43 �± 2.17) (p = 0.026), and FSH (3.95 �± 2.01) at 6 (3.01 �± 2.16) (p = 0.031), 12 (2.45 �± 2.54) (p = 0.029), 18 (2.02 �± 2.29) (p = 0.032) and 24 (3.42 �± 2.64) (p = 0.032) months and SHBG (34.11 �± 10.88) values significantly lowered at 12 (24.81 �± 12.49) (p < 0.05), 18 (21.28 �± 11.15) (p < 0.01), 24 months (25.42 �± 11.16) (p < 0.01). A significant decrease in spermatozoa count (p < 0.01), and fertility index (p = 0.01) occurred. HDL-cholesterol (baseline 56.94 �± 13.54) was reduced at 18 (41.86 �± 14.17) (p < 0.01) and 24 (43.82 �± 18.67) (p < 0.05) months and Apo A-1 at 12 (p < 0.001), 18 (p = 0.05) and 24 (p = 0.05) months. The most important long-term adverse effects were lower fertility and the impairment of lipid profile associated with an increased cardiovascular risk.
Other important parts from discussion,
RE: insulin sensitivity
Decrease in plasma glucose and insulin levels with the consequent reduction of insulin resistance (HOMA) is not consistent with the reported anti-insulin effects of AAS. Such a reduction of insulin resistance cannot be due only to the well-known effects of physical exercise [8] as training loads remained unaltered during the whole follow-up period. A possible explanation for the improved insulin sensitivity may be due to the increased muscle mass and decreased adipose mass. Peripheral glucose uptake is directly correlated to lean mass [4], [25] and steroids play a fundamental role in regional adipose tissue redistribution.
RE: liver health (you guys will love this one)
Even considering the possibility of ultra-structural hepatic modifications not associated with abnormal liver function tests, AAS hepatotoxicity is probably overestimated [7], [16]. In our study, liver ultrasound examination was negative for peliosis, hepatocellular adenomas or carcinomas. Hepatomegaly and steatosis revealed at the first visit was unchanged during the study, and it may be compatible with the very high protein intake. No clinical study has yet demonstrated a conclusive link between AAS use and increased incidence of liver cancer and many reports of AAS-associated hepatoma have been anecdotic cases [3], [7], [28], [50].
Study limitations
Methodological limitations are necessarily linked to the experimental conditions and to the study design: recruitment criteria and heterogeneity of study sample; diversity in the compounds used, doses, duration, treatment (cycling and staking), and route of administration; possible interactions with other commonly-used drugs. Moreover, we took for granted the information on the drugs disclosed by manufacturers; no quality control to check if the products were actually in their announced concentration and on their purity was performed. Despite the limitations imposed by the experimental conditions, the study offers as novel elements the recruitment of a considerable number of subjects and the rather long follow-up.
Conclusions
This study is an on-the-field examination of drugs being introduced into a muscle-enhancing programme. Our investigation peers into the world of gyms and bodybuilding, which has often been investigated, but about which it is difficult to gather information because of the conspiracy of silence surrounding the use of illegal substances. Most researches conducted to date have generally been concerned with a limited sample size and/or the use of low doses of AAS or high doses but for a short time period.
The main issues arising are:
risks associated with pharmacological interactions due to a wide combination of self-administered drugs;
atherogenic modifications in the lipid profile. These changes are asymptomatic and therefore do not constitute a disincentive to the use of these substances, despite fatalities among bodybuilders who used AAS, together with life-threatening arrhythmias;
sexual changes (hypogonadism associated to testicular atrophy and low sperm count, gynaecomastia), although affecting 80 % of subjects, were less severe than those reported in the literature. This is possibly explained by the method of AAS self-administration (cycling) and to chorionic gonadotropin use.
The picture emerging is one of a knowledgeable population of users integrated into a subculture of clandestine use of drugs, able to manipulate substances in order to maximise the advantages and minimise the disadvantages.
