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Performance Enhancing Drugs in Sports

Performance Enhancing Drugs in Sports. Joseph Kenny, MD Saturday, Dec 3, 2011. A little about the history, use, abuse, side effects and folklore of --. Anabolic steroids Stimulants Human Growth Hormone Erythropoietin. Full disclosure. I have no financial conflicts to report

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Performance Enhancing Drugs in Sports

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  1. Performance Enhancing Drugs in Sports • Joseph Kenny, MD • Saturday, Dec 3, 2011

  2. A little about the history, use, abuse, side effects and folklore of -- • Anabolic steroids • Stimulants • Human Growth Hormone • Erythropoietin

  3. Full disclosure • I have no financial conflicts to report • All images used are either in the public domain, images that I created, or subject to the fair use exception • All opinions expressed are my own

  4. This presentation will have about as much FOLKLORE as it does SCIENCE

  5. Objectives • Learn a little about the history of the four major classes of performance enhancing drugs • Know the main physiologic effects of these drugs • Understand the adverse effects of these drugs • Review common and not-so-common excuses for failing a drug test in light of the physiology of the drugs

  6. "Because they are banned substances in sports, and because they are dangerous substances that can cause irreversible harm, it's not ethical to do true scientific studies of these medications as they actually are being used. So we are kind of stuck on the anecdotal experiences as far as what's going on with illicit use.“ • Marc Safran, Sportsmedicine, UCSF

  7. Anabolic Steroids • The Brown Sequard elixir 1889 • May 1935, Testosterone is isolated • Dianabol 1958 • The cream and the clear, 1999

  8. Main effects of anabolic steroids • Increase protein synthesis – build muscle • All have virilizing effects to some degree • Most popularly used steroids have a relatively high anabolic:androgenic ratio • There is clearly a psychological effect as well – increased aggression, appetite for competition and hard training

  9. 1889 – the Brown-Sequard Elixir

  10. Pud Galvin

  11. Dianobol 1958

  12. Victor Conte • Bay Area Laboratory Cooperative (Balco) • Formerly bass player for the Tower of Power • Developed “the cream” and “the clear” • Pioneered “informational” drug testing

  13. The cream and the clear • The cream – A transdermal steroid preparation of testosterone and epitestosterone designed to evade detection • The clear (tetrahydrogestrinone) was a new steroid designed by chemist/bodybuilder Patrick Arnold, also designed explicitly to evade detection

  14. Anabolic Steroids side effects • Men: Testicular shrinkage, oligospermia, impotence (HCG) • Gynecomastia: tamoxifen • Women: Facial hair, deepening of voice, shrinkage of breasts, menses disrupted • Both: Acne, hypertension, elevated cholesterol, hypercoagulabillity

  15. Chris Benoit • Professional wrestler who killed his wife and son, 2007, then hung himself. He was using alprazolam, hydrocodone, and testosterone at the time.

  16. Steroids for Cosmesis

  17. Arnold Schwarzenegger

  18. Debbie Clemens

  19. Sylvester Stallone

  20. Hulk Hogan

  21. What do these three have in common?

  22. Benzedrine inhaler, 1928

  23. Main effects of amphetamine • Lessened fatigue • Perception of more energy • Better ability to concentrate • Improved reaction time • Euphoria

  24. Here I sitAll alone with a broken heartWell, I took three benniesNow my semi truck won’t startNeed to be in Cincinnati Monday morning to draw my pay!

  25. Take three more benniesThen PULL truck to Cincinnati

  26. Side effects of amphetamine • Aggression • Anxiety • Tachycardia, arrhythmia • Hallucinations, psychosis

  27. Can you identify this individual?

  28. He was an emergency room doctor • Practiced in Fort Bragg, North Carolina, 1970 • Graduate of Northwestern Medical School • Married, father of two daughters • Daily user of amphetamine, which was available in “candy bowls” to be taken ad lib by emergency room personnel

  29. Human Growth Hormone • Originally harvested from cadaver pituitary glands • Recombinant HGH 1981 • Creutzfeldt-Jacob Disease in cadaver-derived GH recipients in 1985; product removed from the market • There are now at least six different manufacturers of recombinant HGH

  30. Growth Hormone and Athletic Performance • There is a stunning paucity of evidence that Growth Hormone helps athletic performance • Nonetheless, anecdotal data suggest use is fairly widespread • Goal is reduced fat and increased muscle • Testing is difficult; to date, very few positives in testing

  31. Side effects of HGH • Arthritis • Diabetes • Big Jaw • Big Hands and Feet • Cardiomyopathy • Atherosclerosis

  32. Andre Roussimoff

  33. Blood Doping • Can be done via homologous or autologous transfusion • More commonly done via erythropoietin, darbopoietin, or CERA (PEGylatedepo) • High performance endurance athletes can likely tolerate very high hematocrit, nonetheless occasional death due to hyperviscosity

  34. Tour of California

  35. The Vengeful Massage Therapist

  36. Justin Gatlin

  37. Photosynthesis • My carbon signature is plant - like

  38. Floyd Landis

  39. It was my oral contraceptive • That’s why my testosterone to epitestosterone ratio is 400:1

  40. Mary Decker

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