Steroid Nation

The Braun Case: Good clinical practice, steroid (PED) abuse testing, and HIPAA violations

I heard Dan Patrick pontificate on the Ryan Braun situation today. Apparently these sports commentators have Ph.D.s, JDs, and a host of other professional degrees, at least in their own minds.

They also do not need to reveal sources (talk about a slippery slope; what if the source is their dog, ie made up).  Patrick kept referring to "I was told", and "sources".  He made these points:

• Bruan had some huge quantity of synthetic testosterone in his urine.  (actually his T:E as reported was 20:1; 5:1 is usually the cut off for suspicions)
• The issue should not be chain of custody
• Braun should not pursue legal remedies, what what he sue for?  (defamation for a beginning)
• That the chemists are always ahead of the testers (ah he has a Ph.D. in biochemistry now)
• And that big names are enrolling in an MD lead PED program to beat the system (assuredly based on the East German Doping Machine, chuckles)

In medicine laboratory and clinical, the procedure and the processing is vitally important.  If a sample is mishandled, or stored incorrectly, or allowed to warm up (in some cases) the lab values may be in error, and not reliable.  Biologic molecules can decompose, enzymes can metabolize substances, results may be affected.  For experiments, freezers are monitored for constant temperature, labels are clear, and the process is transparent.  If there is a breech, the data is discarded, or should be.

And even then..

Example, I knew of a patient who was told by a physician of standing that he had Hepatitis C, based on high bilirubin.  That was the only value.  I looked at the lab, astonished to hear the conclusions, because nothing else appeared in line with Hep C.  There is a natural variant called Gilbert's Disease where a person walks around with elevated bili.  On retesting that was exactly what the patient manifest - Gilbert's and not Hep C.  So he was given a 'death sentence' based on one lab value.

Thus if there is a breach in protocol, the test is invalid, and it did not happen.  No you cannot reconstruct the results, forget it.  Check out the post on DNA analysis.  Degrdation of lab tests here, here and here.

What is the ideal temp for urin storage?  See below.  The average refergerator is from 35-38C.  And is the household refergerator certified for storage?  BIG OOPS!

But multiple sources said the sample was not shipped for testing as soon as possible, as required by the drug testing policy, and instead was kept in a cool place in the sample collector's home. Sources told ESPN legal analyst Lester Munson that the collector left Braun's sample on a desk in a Tupperware container and left it there for two days.

In retrospect, this was an easy case to arbitrate if the above were true.  Throw out the sample.

So why were Braun's values 'leaked' to the press -- who is going to distort the issue, and hold some kind of kangaroo court on it?  Could this be a HIPAA violation (Health Information Portability Accountability Act)

The Standards for Privacy of Individually Identifiable Health Information (“Privacy Rule”) establishes, for the first time, a set of national standards for the protection of certain health information. The U.S. Department of Health and Human Services (“HHS”) issued the Privacy Rule to implement the requirement of the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).¹ The Privacy Rule standards address the use and disclosure of individuals’ health information—called “protected health information” by organizations subject to the Privacy Rule — called “covered entities,” as well as standards for individuals' privacy rights to understand and control how their health information is used. Within HHS, the Office for Civil Rights (“OCR”) has responsibility for implementing and enforcing the Privacy Rule with respect to voluntary compliance activities and civil money penalties.

A major goal of the Privacy Rule is to assure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public's health and well being. The Rule strikes a balance that permits important uses of information, while protecting the privacy of people who seek care and healing. Given that the health care marketplace is diverse, the Rule is designed to be flexible and comprehensive to cover the variety of uses and disclosures that need to be addressed.

Clearly there was a breach of confidentiality, unless Bruan gave his consent to releaqse information to ESPN.  The issue is 'covered entitiy'.  Is MLB a 'covered entity' testing employees for drug abuse? Sounds like one law firm may answer positively.

The new Health Insurance Portability and Accountability Act rule on privacy scheduled to go into effect on April 14 may reach as far as the disclosure of information about workplace drug testing and substance abuse management. The Standards for Privacy of Individually Identifiable Health Information, known as the Privacy Rule, generally will prevent "covered entities" from disclosing protected health information to non-covered entities without authorization from the subject of the protected health information. The disclosure requirements may apply to many collection facilities, laboratories, Medical Review Officers and other service providers who analyze and review applicants' and employees' drug and alcohol test results.

"Covered entities" under HIPAA must require employers using their services to provide HIPAA-compliant authorization before releasing drug and alcohol test results (i.e., protected health information) for employees and job applicants. Forms currently being used by employers for this purpose may not meet the requirements of the regulations which identify the key components and specifics for the authorization form. Additionally, the forms must be signed by the employees or applicants. As a practical matter, since HIPAA compliance ultimately falls on the shoulders of the "covered entity," the collection facility, laboratory or Medical Review Officer may have its own authorization form for employers.

In addition to the release of test results, other aspects of an employer's substance abuse policy may require use of a HIPAA-compliant authorization form. For example, when an employee enters into substance abuse rehabilitation, an employer may require progress reports from the substance abuse professional who evaluated and treated the employee. If the substance abuse professional is a "covered entity" under HIPAA, the employer may then be required to have the employee sign a specific HIPAA-compliant authorization form permitting the release of the "personal health information", i.e., the substance abuse professional's records, to the employer.

Baseball has cited HIPAA to assure privacy in medical matters before.

The polyps have bothered Rivera recently. Yankees general manager Brian Cashman, citing HIPAA privacy laws, has declined to talk about the issue because it is not baseball-related.

In fact it is reported MLB requires players to sign a HIPAA statement.  Athough this author doesn't think it is a HIPAA violation, I have been on hospital boards that rang up people for far less a HIPAA violation, This might be a MALIGNANT HIPAA violation.

My conclusions:

• If there was a violation in laboratory protocol THIS LAB RESULT, THIS SAMPLE DID NOT EXIST
• Ryan Bruan's attorney's should be looking at defamation and HIPAA violations.  An HIPAA violations not a laughing matter.

I still say Braun should not expose those abs, which are quite unusual for baseball....  ^^

References:

German documentation of tampered doping urine samples.

From this paper:  Detecting the Administration of EndogenousAnabolic Androgenic Steroids
Christiane Ayotte (name sound familiar, she is head of the Montreal Lab)

2.3 Stability of Urinary Steroid Conjugates
Testosterone glucuronide is known to be stable in urine for at least 1 year when the
specimen is stored below –20C (Venturelli et al. 1995; Robards and Towers 1990),
while one study reported the formation of free testosterone and free dihydrotestosterone
in urine samples kept at 18 and 37C (Kjeld et al. 1977). Testosterone and
epitestosterone conjugates are stable for months in sterile urine kept at 4C and
–20C (Jime´nez et al. 2006), while the addition of a bacteriostatic agent was
required to preserve their integrity in urine samples kept at 4C and 37C for a
week (Saudan et al. 2006). Spiked in sterile urine, authentic standards of androsterone,
etiocholanolone, testosterone, epitestosterone sulfates and glucuronides are
stable even upon incubation at 37C; dehydroepiandrosterone-3b-sulfate, like other
sulfoconjugated steroids, is less stable showing partial deconjugation. Since samples
are not collected under sterile conditions, skin bacteria and intestinal microflora
(staphylococci, enterobacteria, E. coli, etc.) are often present. Delays in
delivering the samples to the laboratory and improper refrigeration during transportation and storage may offer good conditions for microbial growth; the effects on the urinary steroids are easily detectable and consist mainly in the hydrolysis of the steroid conjugates and in oxidoreductive reactions leading to
the abnormal presence of steroids in the free form and the accumulation of 5aand
5b-androstan-3,17-dione, the b-isomers being more rapidly altered. Signs of
microbial degradation should obviously be absent to ensure the accurate measure
of the steroid profile (Ayotte et al. 1996, 1997; Hemmersbach et al. 1997).

Harold Connelly dies: Olympic champion and early steroid pioneer

Former Olympian Harold Connolly died at 79 last week.  He died in the gym, with his boots on.

Connolly lived a full and interesting life as documented in the New York Times. He was an Olympic hammer throw champion, a man involved in a huge international controversy based on love, and an early user of anabolic steroids.

In 1991, during a relaxed and lubricated private dinner, I said to Harold Connolly, winner of the 1956 Olympic hammer throw and a perennial world and United States champion: “It’s all timing. If you’d been born later, taken steroids, you could have won a few more gold medals.”

He looked at me incredulously. “You kidding? I was using after 1960. We all were.”

Connolly recognized aggressiveness as a steroids side effect:

When I first met Harold at a Randalls Island track meet in 1966, I didn’t suspect that his crusty demeanor, generally ascribed to fierce competitiveness and self-consciousness about his arm, was probably made even edgier by drugs. Surly that day, he tried to psych out the young hammer thrower who eventually beat him, and he was dismissive when I asked him about reports that he had subverted the youngster’s Olympic training with misinformation.

Twenty-five years later, at that boozy dinner, and then again last October, in a long, sober interview, he admitted that drugs were certainly heightening his “aggressiveness” back then, which he still felt was their only significant downside for older athletes. Harold was against punitive testing, which he thought did no good (“Most of the athletes I have known would do anything short of killing themselves to improve performance”), and he had come around to oppose drugs for youngsters, although I was never sure whether he really thought there were dangers to developing brains and bodies or whether he was finally being politic. 

Connolly relates a day when to achieve at the highest level in the Olympic field events, anabolic steroids was required:

It was after watching American doctors routinely give athletes testosterone injections that Harold decided he could use a little help, too. He started with one or two 10-milligram tablets a day of Dianabol along with proteins. When that had no discernible effect, he moved on to Winstrol and other drugs in “stacking” combinations. It was a standard regimen in the days before testing and prohibition.

As he later told a Senate subcommittee: “I learned that larger doses and more prolonged use increased muscular body weight, overall strength, and aggressiveness, but not speed, flexibility or coordination. My vertical jump went up but so did my blood pressure and cholesterol levels.” 

He had plenty of teammates with whom to compare notes. He remembered that during the 1968 Olympic trials, many athletes “had so much scar tissue and so many puncture holes in their backsides that it was difficult to find a fresh spot to give them a new shot.” 

Although he had some reservations (“Every time I felt unusual physical reactions, a twinge here a twinge there, a headache, disrupted sleep or diminished libido, I retreated from the testosterone or steroids — too apprehensive to take them regularly.”) they were not enough to preclude offering his seven children drug advice in pursuit of their athletic careers. Apparently, they didn’t want to use or they listened to Harold’s second wife, Pat Connolly, a three-time Olympian and coach, whose opposition to drugs has been fierce and unrelenting.

Connolly argued that pro athletes should be allowed to use PEDs.  However like most of these arguments he likely didn't understand the pragmatic issues involved: at what dose, for what period of time, for what indications, and who will pay the malpractice insurance?  (American medicine does not approve medications willy nilly; double blind, controlled research studies are required for EACH indication and EACH compound.  There are not even the preliminary studies on these drugs to begin to delineate the benefits and risks.)

“Pro athletes who can pay for medical guidance should take steroids,” he said. “They can give fans a better performance, a nice luxury. The argument against it is that they are role models and kids will find the black market.

“But the danger factor is ridiculous. How about Nascar and boxers and football players, even without drugs? Maybe some good will come from all this fuss. We’ll find out more about drugs, like we found out more about alcohol and marijuana.”

The romance?  Connolly pursued a Czech discus athlete despite the cold war:

He’s been appropriately celebrated as a role model for disabled athletes (he was born with a withered left arm) and as a lead in one of sports’ most romantic love stories (he married Olga Fikotova of Czechoslovakia, the ’56 Olympic discus winner) but he should also be appreciated as a complex and seminal elder of the Age of Enhancement.

PED using Olympian Antonio Pettigrew found dead at 42; PED use involved?

Forty two year-old former Olympian and admitted PED user/drug cheat Antonio Pettigrew was found dead at age 42.  Pettigrew served as a track coach at The University of North Carolina.

ANTONIO Pettigrew, who was stripped of a 2000 Olympic 4x400m relay gold medal for doping, has been found dead at the age of 42.

There was no word on the exact time or possible cause of death for Pettigrew, whose body was discovered on Tuesday according to a spokesman for University of North Carolina, where Pettigrew was an assistant athletics coach.

Pettigrew, who won the 1991 400 metres world title in Tokyo, was a member of the 4x400 metres American relay team that won the gold medal at the 2000 Sydney Olympics.

But the International Olympic Committee (IOC) stripped Pettigrew and his teammates - including Michael Johnson - of their medals after he admitted, during a trial against former coach Trevor Graham, to doping.

Pettigrew qualifies as a "non-analytic" PED user: He never tested positive for PEDs, however he admitted to use under oath in court.

Pettigrew used at least EPO and HGH. Studies have shown HGH enlarges the heart muscle.  EPO is related to sudden death in cyclists -- it changes hemodynamics.

Could HGH and EPO use have lead to a cardiac problem in Pettigrew produced sudden cardiac death? No one will know exactly, but it's intelligent speculation.

It is reported Victor Conte thought EPO was one of the best PEDs.  Will we now start to see 40+ former athletes drop dead from PED side effects?

Interest turns to Tiger Woods PED use: Links to Canadian doping doctor noted

Anyone who knows PEDs knows one of the side effects of anabolic steroid use is a heightened libido.  Testosterone is the fuel of the sex drive in males and females.  The East German Doping machine produced some very hyper-sexual swimmers.   And when one thinks of recent athletes who appear to have a huge libido...one has to consider the use of an anabolic steroids that may induce such a hyperactive drive.

The athlete clearly in the public eye these days is disgraced pro golfer Tiger Woods.  Today named the athlete of the decade (apparently using exploits only on the golf course as a criterion), Woods appears to sport a prodigious libido.

A Canadian doctor called a 'pioneer' appears to be the go to man in several athletes with questionable physical feats (The New York Times)

A Canadian doctor who has treated many N.F.L. players as well as Olympic medalists like Donovan Bailey and the world’s top golfer, Tiger Woods, is under criminal investigation in the United States. He is suspected of providing athletes with performance-enhancing drugs, according to several people who have been briefed on the investigation.

The F.B.I. investigation of Dr. Anthony Galea, a sports medicine specialist who has treated hundreds of professional athletes across many sports, follows his arrest on Oct. 15 in Toronto by the Canadian police. Human growth hormone and Actovegin, a drug extracted from calf’s blood, were found in his medical bag at the United States-Canada border in late September. Using, selling or importing Actovegin is illegal in the United States.

Dr. Galea is also being investigated by the Royal Canadian Mounted Police for smuggling, advertising and selling unapproved drugs as well as criminal conspiracy. He is tentatively scheduled to appear in a Canadian courtroom on Friday.

Activegin, a calf blood derivative, has been known as a blood doping agent among cyclists.  Gary Wadler says this about the substances activity:

In research studies, Actovegin has been shown to exert insulin-like activity, such as stimulating the transport of glucose in the body, as well as glucose oxidation.

That could be good news for athletes, Wadler says. "Athletes are always looking to get more oxygen to working muscles."

''The idea here was to deliver it therapeutically, to improve the transport and use of oxygen and sugar," he says...

(to the Times:)

The United States Anti-Doping Agency has developed “intelligence” that athletes are using Actovegin to attempt to improve performance, according to a person with knowledge of the matter. Usada asked the World Anti-Doping Agency to ban Actovegin this year but it declined.

Woods consulted with Galea following his knee surgury in 2008.  Galea, who of course claims he is spotless *any professional ever claim to be corrupt?) has a checkered history:

Dr. Galea has developed a reputation among elite athletes for accelerating recovery after surgery or for helping them avoid surgery altogether by using a blood-spinning technique known as platelet-rich plasma therapy, as well as other pioneering procedures, on knees, elbows and Achilles’ tendons.

Although he said he prescribed human growth hormone to some patients in his general practice and had used it himself for 10 years, Dr. Galea, 50, said in an interview that he had never treated professional athletes with H.G.H.

Dr. Galea said Mr. Woods was referred to him by the golfer’s agents at Cleveland-based International Management Group, who were alarmed at the slow pace of Mr. Woods’s rehabilitation after knee surgery in June 2008. The doctor said he flew to Orlando, Fla., at least four times to give Mr. Woods the platelet therapy at his home in Windermere, Fla., in February and March of this year. When asked for comment about Mr. Woods’s involvement with Dr. Galea, Mark Steinberg, of I.M.G., responded in an e-mail message: “I would really ask that you guys don’t write this? If Tiger is NOT implicated, and won’t be, let’s please give the kid a break.”

Dr. Galea’s legal problems began in late September when his assistant was stopped entering the United States from Canada. Her car was searched by border-crossing guards and authorities found Dr. Galea’s medical bag, which contained four drugs, including human growth hormone, Dr. Galea said. “It was for my own use,” he said.

Galea was raided in Canada:

As part of his practice, Dr. Galea said he prescribed human growth hormone to patients 40 and over to improve their stamina when working out and to combat fatigue, among other health benefits.

“The authorities here and elsewhere have it wrong,” Mr. Greenspan said. “They don’t understand the medical aspects.”

Prescribing human growth hormone is legal in Canada but approved in the United States only for a few specific uses that do not include hastening recovery from surgery or injury. In the world of sports, under World Anti-Doping Association guidelines, H.G.H. is banned though not widely tested for because it requires a blood test. The N.F.L., the N.H.L., the N.B.A. and Major League Baseball do not test for H.G.H.

No, the police may not know unsubstantiated claim, doc, but some professionals do...ethical ones.

However, athletes will do anything they can to obtain an dedge in competition, ethical or not, proved or not.  And Galea apparently has a database of interesting athletes including the 2008 controversial swimmer Dana Torres, who defies gravity with her performances.

“Ten years from now, they are going to say, wow, this guy was a pioneer,” Dr. Lindsay said in a recent phone interview. “That’s the unfortunate thing.”

Dr. Galea blames his current legal problems on his success rate.

“All these athletes come see me in Canada cause I fix them, and I think people just assume that I’m giving them stuff,” he said. “They don’t have to come to me to get H.G.H. and steroids. You can walk into your local gym in New York and get H.G.H.”

The N.F.L. quarterback Chris Simms and wide receiver Javon Walker swear by him. In March, Dr. Galea arranged for Mr. Walker to have cartilage-replacement surgery on his knee in Jerusalem because the procedure is not approved in the United States or Canada. Mr. Walker said the recovery time was half what it would have been if he had had the procedure doctors recommended in the United States.

“He’s a person who just wants to help and heal,” Walker said. “And the world is going to soon know about him.”

The Olympic swimmer Dara Torres said she sought out Dr. Galea to help diagnose the cause of continuing pain in her knee earlier this year. “He found a tear in my quad tendon that was undiagnosed,” Torres said in an e-mail message. “Excluding draining my knee, he has never treated me, but I did see his chiropractor who did soft-tissue work on my leg. That was the extent of my visit with him.”

The Times recounts Galea's treatment of Woods this way:

Dr. Lindsay said he led Mr. Woods’s rehabilitation team after the golfer’s June 2008 surgery to repair his anterior cruciate ligament. In addition to Dr. Lindsay, who is best known for overseeing Alex Rodriguez’s rehabilitation from hip surgery last spring, the Woods team included Dr. Galea and a Vermont-based strength coach named Bill Knowles.

Dr. Lindsay said he worked with Mr. Woods at his home throughout his eight-month rehabilitation. The work included strength training, conditioning and exercises in a swimming pool, Dr. Lindsay said.

In February, discouraged by the lack of progress, Dr. Lindsay asked Dr. Galea to look at Mr. Woods, who was suffering from patellar tendinitis and had scarring in the muscle. “It’s common after the A.C.L. to have tendinitis,” Dr. Lindsay said. “And the P.R.P. helped.”

Dr. Galea said he treated Mr. Woods in his home four or five times with a borrowed centrifuge from an Orlando doctor. Each time, he said he drew blood from Woods, spun it to increase the platelets’ count and then injected a small amount directly into Mr. Woods’s left knee.

Two days after the first treatment, Woods texted him, Dr. Galea said: “He said he couldn’t believe how good he feels. He’d joke and say, ‘I can jump up on the kitchen table,’ and I said, ‘Please don’t.’ ”

Dr. Galea said that Mr. Woods stayed in touch, texting him after the British Open in July that his left knee had begun bothering him again. Dr. Galea said he flew to Orlando in early August and gave Mr. Woods P.R.P. therapy for a final time.

Very interesting, which might be an issue with those who regulate PEDs.  Those with money and connections can obtain these 'treatments'.

So what about Woods' recent troubles in term of 'drive' and we don't mean off the tee.  Look at Woods before and after photos.  Think of the side effects of testosterone and anabolic steroids.  Then consider an athlete who has established ties with a physician who says he pushes HGH and other PED treatments.

It's like hitting over 750 home runs...hitting long off the tee, with the subsequent side effects.

Gene therapy -- myostatin -- Discovered once again

Ongoing research into gene therapies that purport to enhance muscular development, have concerned anti-doping authorities for years.  Such therapies, if successful, would radically alter the playing field of sport.  The haves (athletes who could afford the procedure, or who hijack it) would dominate the games over the half-nots.  Nonetheless medical researchers almost blindly push ahead (or push ahead for economic gain). 

Discover magazine jumps on the controversy with this post.  One commenter laments that holding up gene therapy because of doping cheats would slow down medical progress (although it never hurts to allow the ethics to catch up with the science).

A gene therapy treatment intended to reverse muscle weakness appears to restore muscle mass in monkeys, raising hopes that doctors may soon be able to treat this condition in humans with degenerative diseases like multiple sclerosis and muscular dystrophy. Scientists injected a gene into the monkeys’ thighs that causes cells to produce human follistatin, which interferes with another compound called myostatin. Myostatin breaks down muscle, so in theory adding follistatin should encourage muscles to grow [Reuters].

Frankly medicine marches onward, not slowed by much even ethical concerns.  As medicine becomes 'corporate' one wonders if the 'customers' who demand doping protocols, and who can afford the costs won't be rewarded in the future with out-sized sports achievements.  Kinda like buying the World Series...or buying a gold medal.

Hungarian Olypic class wrestler stung in doping disqualification: Sándor Bárdosi stirs up a hornets nest with doping penalty

Newspapers report Hungarian wrestler Sándor Bárdosi-- once an Olympic wrestling medalist -- lost a recent medal in "Sumo wrestling" following treatment for a wasp sting.

Sumo wrestling world champion Sándor Bárdosi tested positive in a doping test at July's World Games in Taiwan, the National Sports Federation told MTI.

Organisers at the World Games have stripped Bárdosi of his gold medal and fined him €3,000. Former Olympic silver medalist Bárdosi claims that he had been given an injection to treat a wasp sting.

What would cause disqualification?  Usually a sting producing an allergic reaction would be treated with epinephrine, which should be quickly metabolized.  However, it could be that a physician injected prednisone to reduce swelling.

The next report talks about a soccer player with a similar problem,  If these athletes are being harassed for and epi pen, it is ridiculous.  Should the doctor delay treatment for an allergic anaphylactic  reaction before he receives clearance from a bureaucracy?

The organisers of the World Games have decided to strip the wrestler of his gold medal requires him to pay a fine of 3,000 euros, the Hungarian Sumo Federation said.

Bardosi denied the charge, saying that he had been treated for a wasp sting in Kaohsiung.

"The last test I had in Hungary was negative. Just before leaving for Taiwan, however, I was stung by a wasp. Suffering from hand pain, I went to the doctor who gave me an injection and medicine, enabling me to recover by the time of the World Games a week later. Concentrating on the competition, I forgot to mention the affair at the doping test. Anyway, I don't need any doping as I am able to outperform all my opponents," he said.

As a graeco-roman wrestler, Bardosi won a silver medal in the Sydney Olympics nine years ago.

In the Sumo World Games, he triumphed in the under-85 kg, lightweight category.

Italy's world champion soccer player Fabio Cannavaro had a similar wasp bite a few weeks ago. The Italian Olympic Committee (CONI) dropped the charge but his club, Juventus, held out the prospect of some sanction as the player should have consulted with CONI before being treated for a wasp sting.

Ethics of pediatric sports doping

The Sports-Leader carries a short academic piece on the ethics of sports doping.  An excerpt is found below:

The American Academy of Pediatrics (AAP) issued a document in April 2005 on performance-enhancing substance use in sport (1). It inquired about many statements concerning the supposed anti-doping fight and how it may be successful.

The document disputes that children need to be taken into account for a more restrictive moral and ethical anti-doping structure to be effective and recognised that the adolescent group naturally feels indestructible and regularly disregards any implication that performance-enhancing substance use may create a health risk or hamper their suitability for sport (1). Also, adolescents are extremely anxious about their self-image (1)...

The motives for using these substances may be different but a mixture of the above reasons exists in why most athletes take performance-enhancing drugs (2). Doping can be seen as an easy alternative to hard training programmes by some adolescents because the rest of the competitors are in a setting of equal and fair play. However, it is through hard work and perseverance in sport that “the virtues of dedication, perseverance, endurance and self-discipline (4)” help build up an adolescent’s character

Weird 'doping photos' of ex-New York Ranger star Alexei Cherepanov

Last year, budding NHL hockey star Alexei Cherepanov collapsed and died of 'myocarditis' at a hockey game in Russia.  His demise seemed fishy at the time.  Russian news releases were not all that helpful in clarifying the situation.

Now, photos emerged from Russian showing the young hockey star receiving an iv infusion of something.  It is referred as an 'injection' however that is not an injection.  To the National Post:

Remember a few months back when Russian investigators said that New York Rangers draft pick Alexei Cherepanov was taking banned substances before his death during a game with Avangard Omsk last October? Well, now photos on a Russian Web site suggest that those examining the case might have been on the right track.

The photos, which you can see here, depict Cherepanov taking an injection of something, and while it's always best not to jump to conclusions, the events that came after these photos were taken are kind of damning.

Cherepanov died of cardiac arrest on Oct. 13 during a game between KHL teams Omsk and Vityaz.

Here is translated Russian:

Attorney [Cherepanovykh] asked to introduce to the matter of the photo 27.04.2009 15:33 The attorney of the family Of [cherepanovykh] Sergey [Amfiteatrov] sent to the consequence on business of death of the forward of " [Avangarda]" Aleksey Cherepanov three photographs,  reports Sports.ru. " These photographs granted the family Of [cherepanovykh], one of them - the last photo before the game, made on October 13, during the day of death of hockey player. We see on two others how someone carries out the unestablished procedure. I sent to their inspectors with the request to introduce to the materials of [dela]" , he said amphitheatres. The dates of the second and third photographs are unknown. They are named " [Narkomaniya]" and " Addiction of 2" by hockey player himself, who sent to their family.

Steroids ruin Earth Day

Steroids didn't really ruin Earth Day, celebrated by President Obama who flew into Newton Iowa, about an hour from.  However, studies show a significant amount of the drugs in ground water.

It’s been 39 years since the first official Earth Day in 1970. Wisconsin senator Gaylord Nelson founded Earth Day as a protest "to shake up the political establishment and force this issue onto the national agenda.” And, according the Earthday.net, the world of unaddressed pollution being accepted as the “smell of prosperity” would no longer be the norm.

Unfortunately, it seems that the original message has been subtly redefined. Yes, we have made major strides at reducing visible pollution, but our poisoning of our planet continues unabated. We decided that carbon dioxide made our air look bad and worked to curtail its emissions. At the same time, a much more insidious toxin called carbon monoxide became predominant in carbon emissions.

Plants, those green things we count on to provide us with oxygen, take carbon dioxide and turn it into breathable oxygen for the planet and turn the carbon into their own growth. On the other hand, carbon monoxide is highly toxic, although useful in a myriad of chemical application.

We don’t see nearly as much garbage in our rivers and streams as we did 40 years ago, but groundwater contamination from invisible, man made, pollutants is a huge problem. We genetically modify and chemically alter our foods now. We modify animal feed to fatten them up quicker for market purposes. Steroids and antibiotics are also used to fatten up the animals we eat. And we spray our foods with pesticides to improve our crop yields. Is this good for us?

Don't blame us.  We ate some delicious antibiotic free chicken at Panera the other day.  No mention of steroids or not...

British teenage cadet dies after taking anabolic steroids

A 17 year-old British teenager died in hospital after what appears to be ingesting anabolic steroids.  To the Times:

Post-mortem tests will today be carried out on a 17-year-old body builder who is thought to have died after taking steroids to bulk himself up for selection into the Royal Marines.

Matthew Dear of Southend, Essex, had been an Army cadet since the age of 12 and was planning to hea take the grueling selection test for the Marines when he turned 18, in three months' time.

He was admitted to Southend University Hospital eight days ago after becoming seriously ill and died yesterday morning.

"He lived for joining the Armed Forces but fell to pieces before our eyes," his father, Chris Dear, 43, told the Daily Mirror.

We heard other health professionals describe a systemic collapse after using anabolic steroids.  There are cases of teenagers like Taylor Hooton who suicided after anabolic steroid use.  This case, however is physiological and medical collapse.

He was discharged the following morning but was rushed back to hospital that night after losing his sight and was moved into intensive care. The teenager, who had three brothers and a sister, finally died yesterday morning. "They said his brain died and his kidneys packed in," his father told the Mirror.

Police said that tests were being carried out to establish what tablets the teenager had taken, and that a pathologist would examine the youngster’s body.

Those on the inside know about use of PEDs in the military.  Those recruits don't come back all big and bad just from good food.

Illegal cosmetic enhancements prove deadly for women

In the category of 'appearance enhancement' comes this piece from the New York Times.  Many women undergo illegal procedures -- like silicon injection -- that 'enhance their appearance but carry significant and unjustified risks.

Like almost every woman, Fiordaliza Pichardo just wanted to look beautiful, so a few years ago, she began getting silicone injections from a woman she met through a friend in order to plump up her thighs and derriere.

She never expected to pay such a high price for her looks.

In March, a day after receiving an injection,

Ms. Pichardo, 43, died of what the medical examiner later determined was a silicone embolism in her lungs.

Incredible that women (and men) go to these lengths to 'enhance' their appearance.  (listening Sylvester Stallone?)

Nationally, reports of buttock enhancement using silicone and similar thick liquids have surfaced from the Northeast to Miami, and the Food and Drug Administration is also planning to issue a warning on the dangers of such practices, Siobhan DeLancey, a spokeswoman, said Thursday.

“This seems to be kind of an underground occurrence, so it’s difficult to get numbers of actual events and to know exactly what these people are being injected with,” Ms. DeLancey said. “It’s important to note that none of the products that are reportedly being used are approved for this purpose.”

Ms. DeLancey said silicone was not approved for injection into tissues at all, only for use in the eyes and in certain implants where it is contained and cannot leak into tissue. She said the F.D.A. had the ability to conduct criminal investigations, and would encourage victims to come forward “so that we can document the problem.”...

Although side effects are fairly rare, silicone can migrate through the bloodstream, creating potentially fatal clots in the lungs, as it did in Ms. Pichardo’s case, said Dr. Nathan M. Graber, director of environmental and occupational disease epidemiology for the New York City Department of Health and Mental Hygiene. It can also migrate through tissues, leading to ugly lumps and chronic pain

In the personal realm, as well as in the professional world, the artificial enhancement of performance, and beauty, and prominence continues to march on, despite health risks.

Tulsa doctors juicing up Oklahoma pros Another IFBB name: Trudy Ireland-Kline

New details emerged in the Oklahoma steroids bust that netted an IFBB pro.  As often seen, doctors are involved in the distribution and use of the juice.

State drug agents are releasing more information about the arrests of an Oklahoma City firefighter and two Tulsa doctors in a steroid investigation.

Oklahoma Bureau of Narcotics and Dangerous Drugs Control spokesman Mark Woodward says 12 arrest warrants have been issued and five people are in custody.

Among those arrested are Oklahoma City firefighter Sherry Smith for using steroids, Tulsa Dr. Brad Stahlheber for possession of steroids and Tulsa Dr. Gary Lee for improperly prescribing steroids.

Woodward says those involved have ties to competitive bodybuilding.

He says several more people have been indicted on federal charges that are currently under seal and more arrests are expected.

This is not a good career move for a physician.  (the photo shows Dr. Stahlheber when he was a medical student at OSU Osteopathic school). 

It doesn't reflect well on a school to have a recent graduate arrested for illegal drugs.  However, most medical schools are lax in providing ethical guidance...often because the professors are lax in ethics (take a look at recent medical news of fabricated research results; trying not to be preachy about all this).

News 6 says that Dr. Lee developed quite a practice with juicing bodybuilders.

Dr. Brad Stahlheber was arrested at Muskogee Community Hospital where he works.  Agents say he admitted buying steroids over the Internet and using them for cosmetic reasons.

Dr. Gary Lee faces charges of writing more than 30 steroid prescriptions to a couple of  competitive bodybuilders and a power hitter on a national softball team.

And, in Oklahoma City, Darrell Terrell, an amateur bodybuilder who's been featured in national magazines and city firefighter Sherry Smith, both face charges after a search of their home turned up steroids and syringes

Darrell Terrell's (right) secret is now out: he juiced.

And yet one more nationally known bodybuilder who looks less that 'natural'.  According to her website, this bodybuilder is only 51.  She needed to lighten up on the dose!

A nationally recognized competitive bodybuilder from Tulsa, Trudy Ireland-Kline was out of state and promised to surrender when she returns.

Documents show she admitted using steroids, but said she quit because they were causing heart problems.

We don't believe Ms. Ireland had kicked the PED (steroids) habit at the time of this photo.  From her website Ms. Ireland talks about the elements of her success.  She forgot the part about anabolic steroids:

Above all else, I love weight training. I love the gym. I am proud to be more muscular and stronger than I've ever been in my life. Lifting heavy weights and watching my muscles grow bigger and stronger is the ultimate! My training philosophy is train hard, train heavy, eat clean and get big! I love the bodybuilding life style and have been living it for almost two decades. 

Wasn't there someone to help this woman understand she was obviously over-doing the steroids?

Pro wrestler Abismo Negro found dead in Mexican river; Blame goes to steroids

Authorities found (now) ex-pro wrestling legend Abismo Negro ("The Black Abyss") floating down a Mexican river on Sunday.  The story/explanation sounds bizarre.  To Wrestling-Edge:

Andrés Alejandro Palomeque González, better known as Abismo Negro in AAA, was found dead in a river in Mexico yesterday. The lucha wrestler was 37.

No definite cause of death has been determined as of yet, nor has foul play been ruled out.

According to a bus driver who was transporting González and other passengers to Mexico City, González became agitated, almost panicked and demanded to be let off the bus despite it being 1:30 in the morning. After leaving the bus, González found himself lost on the dark hillside, confirmed by a text message he sent to his wife. After receiving the text, his wife contacted local wrestling promoter Vicente Martinez, who organized a search party.

Yesterday morning, González was found floating face down in the river. There has been talk that he may have gotten stuck in mud and was unable to free himself. The body was removed from the river and positively identified as Gonzalez. The local coroner confirmed that the anxiety attack led to the events of his death. He also noted that anabolic steroids being taken by Gonzalez at the time could have caused his anxiety attack.

The steroids/anxiety attack explanation sounds hokey.  Indeed Gonzalez may have taken steroids (appears to go with the pro wrestling profession).  However 'anxiety attack' caused by anabolic steroids leading to confusion and death might be pushing it.

The wrestler might have suffered a heart attack or a stroke, leading to confusion.  Very common.  That confusion could have led to more panic and disorientation.  Or it all could be foul play.

Considering the general cocktail of anabolic drugs pro wrestlers ingest - AASs, HGH, insulin, thyroid hormones, it is a wonder their heart makes it past 40.  Oh yeah, it often doesn't.

Early in his career, González went under the ring name Winners, a masked male dancer, who teamed with former WCW wrestler Super Calo during the early glory days of the AAA promotion. At the TripleMania II-A show in April 1994, Winners formed a trio with Rey Misterio and Rey Misterio, Jr. The following year, he lost his mask in a feud with Calo.

González changed his appearance in 1997 and became Abismo Negro in 1997. He wrestled at the 1997 Royal Rumble in San Antonio at the Alamo Dome by taking part in a "Free-For-All" pre-show match alongside Heavy Metal and Histeria. His team lost to Octagón, Blue Demon, Jr. and Tinieblas Jr. He also made two appearances on Raw in March of that year.

In 2004, Abismo Negro appeared in TNA by taking part in the World X Cup Tournament for Team Mexico.

Lance Armstrong punished syringe man on Amgen ride

The Drunken Cyclist documents a Lance Armstrong shove for 'Syringe-Man' during an Amgen Tour of California outing.

Armstrong may have shoved the guy into the snow, but somehow we think he made

his 'point'...

One comment on the site says this:

Apparently Pharmstrong did not recognize his Oncologist.

Blood doping at the Super Bowl? Platelet Rich Plasma Therapy for the Steelers

Pro cyclists know all about blood doping.  Pro football fans -- and players -- are about to attend a crash course in the technique...sorta.

The New York Times discusses a technique of injury recovery known as 'platelet rich plasma therapy' (PRPT).  Hines Ward and Troy Polamalu used the procedure to recover from injuries.  So how is this medical technique different from outlawed blood doping?

Two of the Pittsburgh Steelers’ biggest stars, Hines Ward and Troy Polamalu, used their own blood in an innovative injury treatment before winning the Super Bowl. At least one major league pitcher, about 20 professional soccer players and perhaps hundreds of recreational athletes have also undergone the procedure, commonly called platelet-rich plasma therapy.

Experts in sports medicine say that if the technique’s early promise is fulfilled, it could eventually improve the treatment of stubborn injuries like tennis elbow and knee tendinitis for athletes of all types.

The method, which is strikingly straightforward and easy to perform, centers on injecting portions of a patient’s blood directly into the injured area, which catalyzes the body’s instincts to repair muscle, bone and other tissue. Most enticing, many doctors said, is that the technique appears to help regenerate ligament and tendon fibers, which could shorten rehabilitation time and possibly obviate surgery.

More of the dope on PRPT after the jump..

Barry Bonds's doctor -- Arthur Ting -- goes roid rage on another doc at hospital

Dr. Arthur Ting, Barry Bonds's physician appears to have gone a bit 'roid rage himself.  The San Francisco By area orthopod might be charged with assaulting a colleague during a confrontation in a hospital.  Good lord, do doctors need to pee for steroids tests 4 times a year now too?

Ting is not a stranger to controverts.  As we noted Ting has been disciplined by the California medical board in the past.  His twin boys quit the USC football team after a reported steroids violation.  And hey, California is a state governed by a former juicer -- Governor Arnold Schwarzenegger. To the San Jose Mercury:

A physician obtained a court restraining order Thursday against former Giants slugger Barry Bonds' orthopedic surgeon, whom he accused of assaulting him last December inside a Redwood City hospital during a fit of rage.

Dr. Arthur Ting, who may be called to testify at the upcoming trial of baseball's all-time home run leader, is accused of attacking Dr. Michael Eiffert during a confrontation at Sequoia Hospital.

Ting has not been arrested and the case has been submitted to the San Mateo County District Attorney's Office to determine whether criminal charges should be filed, Chief Deputy District Attorney Steve Wagstaffe said.

Under the restraining order signed by Superior Court Judge John Grandsaert, Ting must stay 100 yards away from Eiffert, an internal medicine physician and Palo Alto resident, for three years.

During Thursday's brief hearing, Ting's attorney Josh Bentley did not argue against the restraining order, telling the judge he would "not present any evidence at this time." Eiffert represented himself at the hearing.

Bentley declined requests for comment outside the courtroom. Ting did not appear in court and did not return calls seeking comment.

Here is the roid rage episide, which the assualted physiican termed 'roid rage'.  Priceless.

According to a police report on the Dec. 26 incident, Eiffert, 37, said Ting grabbed him by the neck inside a stairwell and pushed him up against a wall. Eiffert told Redwood City police that Ting, 57, was upset because Eiffert refused to do a consultation on one of his surgery patients.

Asked in an interview outside the courtroom whether he saw any connection in his case to Bonds' trial for perjury and obstruction of justice, Eiffert said: "The behavior exhibited by the defendant seems to be reminiscent or consistent with roid rage." The term "roid rage" refers to the intense bouts of anger people on steroids sometimes display.

Pressed to explain whether he believes Ting was using steroids when he allegedly lost his temper Dec. 26, Eiffert said: "I couldn't make a judgment as to that, but certainly the behavior was out of control."

Ting, who is the San Jose Sharks' team physician and has a medical practice in Fremont, performed knee surgery on Bonds several times in 2005. Court documents show federal prosecutors plan to call Ting as a witness in their case against Bonds.

Nandrolone or Winny?  Hmmmmmm, wonder what Ting benches?  Rest of the report:

Ting was placed on probation in 2004 by the state medical board for lax supervision of physician assistants and other subordinates, according to state documents.

Eiffert said he is considering filing a civil lawsuit against Ting but would not elaborate, saying he wants to consult with an attorney.

Redwood City police were dispatched to Sequoia Hospital at about 3:30 p.m. on Dec. 26 to a report of a battery, according to the police report.

Eiffert told police Ting called him to ask for a consultation on one of Ting's surgery patients, who had a history of seizures.

Eiffert said Ting just wanted another doctor to check out his patient on a Friday afternoon because that "unlucky doctor is stuck with the responsibility of caring for the patient" once Ting leaves.

The phone conversation escalated, with Ting saying "something to the effect of, 'Ya know, I had a problem with you a year ago,'" according to Eiffert's statement in the report.

Eiffert said he replied, "Your (sic) the ding dong who was giving alcohol to a patient," according to the report.

Ting had been accused of bringing alcohol into the hospital and making cocktails for a patient Eiffert was treating for alcoholism, Eiffert told police.

Eiffert went on to say he did not know whether Ting was disciplined for the alcohol incident. Sequoia Hospital spokeswoman Joanie Cavanaugh declined to comment on the matter Thursday.

After Ting arrived in person at the small office Eiffert was working in, Eiffert said he had other patients to see and refused to immediately consult with Ting's patient, according to the report.

Eiffert said he eventually left the room and an angry Ting followed him into a stairway, grabbed him by the neck and held him up against a wall, according to the report. Ting let go and grabbed him a second time more forcefully, then "pushed Eiffert hard against the wall," hitting the back of his head.

"I'll kill you. I'll crush you. You don't know who I am. I'll kick your ass. And don't ever call me a ding dong again," Ting said, according to Eiffert's account.

Eiffert said he continued to try to defuse the situation and Ting finally let him go, the report said.

Concussion shows severe damage in NFL player's brain(s)

Everyone knows a football isn't a contact sport; football is a collision sport.  As the players become bigger strong and faster, the collisions become larger, louder, and more frightening.  And who doesn't like it when a player gets lit up on the field?  The player's brain doesn't appreciate too much.  CNN carries the story.

Concussed players describe depression, cognitive troubles, and mood lability.  Add these problems to the mood lability induced by steroids (or brain changes) and you have serious troubles.  About the concussions:

For years after his NFL career ended, Ted Johnson could barely muster the energy to leave his house.

"I'd [leave to] go see my kids for maybe 15 minutes," said Johnson. "Then I would go back home and close the curtains, turn the lights off and I'd stay in bed. That was my routine for two years.

"Those were bad days."

These days, the former linebacker is less likely to recount the hundreds of tackles, scores of quarterback sacks or the three Super Bowl rings he earned as a linebacker for the New England Patriots. He is more likely to talk about suffering more than 100 concussions.

"I can definitely point to 2002 when I got back-to-back concussions. That's where the problems started," said Johnson, who retired after those two concussions. "The depression, the sleep disorders and the mental fatigue."

Until recently, the best medical definition for concussion was a jarring blow to the head that temporarily stunned the senses, occasionally leading to unconsciousness. It has been considered an invisible injury, impossible to test -- no MRI, no CT scan can detect it.

But today, using tissue from retired NFL athletes culled posthumously, the Center for the Study of Traumatic Encephalopathy (CSTE), at the Boston University School of Medicine, is shedding light on what concussions look like in the brain. The findings are stunning. Far from innocuous, invisible injuries, concussions confer tremendous brain damage. That damage has a name: chronic traumatic encephalopathy (CTE).

We have referenced the synergistic effect of concussion with steroids, opiates, and other drugs (like alcohol) in producing bad outcomes...as with Chris Benoit.  The CNN article looks at a wrestler:

In one moment, his dreams of a long career wrestling were dashed by a kick to his chin. That kick, which caused Nowinski to black out and effectively ended his career, capped a career riddled with concussions.

"My world changed," said Nowinski. "I had depression. I had memory problems. My head hurt for five years..." (CTE)

The Steelers appear plagued with concussion problems:

So far, the evidence of CTE is compelling.

The Center for the Study of Traumatic Encephalopathy, along with other research institutions, has now identified traumatic encephalopathy in the brains of late NFL football players John Grimsley, Mike Webster, Andre Waters, Justin Strzelczyk and Terry Long, in addition to McHale.

Grimsley died of an accidental gunshot wound to the chest. Webster, Long and Strzelczyk all died after long bouts of depression, while Waters committed suicide in 2006 at age 44. McHale was found dead last year of an apparent drug overdose.

"Guys were dying," said Nowinski. "The fact of the matter was guys were dying because they played sports 10 or 20 years before."

So far, around 100 athletes have consented to have their brains studied after they die.

Ted Johnson was one of the first to sign up. He said he believes that concussions he suffered while playing football explain the anger, depression and throbbing headaches that occasionally still plague him.

Johnson said he played through concussions because he, like many other NFL athletes, did not understand the consequences. He has publicly criticized the NFL for not protecting players like him.

The NFL's response:

In a statement, the NFL indicated that their staffs take a cautious, conservative approach to managing concussions.

While they support research into the impact of concussions, they maintain that, "Hundreds of thousands of people have played football and other sports without experiencing any problem of this type and there continues to be considerable debate within the medical community on the precise long-term effects of concussions and how they relate to other risk factors."

The NFL is planning its own independent medical study of retired NFL players on the long-term effects of concussion.

"Really my main reason even for talking about this is to help the guys who are already retired," said Johnson. "[They] are getting divorced, going bankrupt, can't work, are depressed, and don't know what's wrong with them. [It is] to give them a name for it so they can go get help."

Studies need to be completed on the effects of concussions, and on the synergistic effects of steroids, PEDs and concussions on the player's functioning.  The players appear to be jacked-up into oblivion as they are knocked silly.

Pro cyclists may be caught doping with blood values, and genetic tests

Our colleague Robin Parisotto, who sits on the UCI (Cycling Union) board of doping reveals that doping charges may be levied by radical changes in pro cyclists's blood indices.  Story at The Australian.

THE first case of a cyclist being charged with doping on the evidence of his blood profile is expected to be prosecuted in the coming months, according to Australian anti-doping expert Robin Parisotto.

The International Cycling Union (UCI) has been building up blood profiles of its professional cyclists by taking thousands of blood samples over the past year.

Canberra scientist Parisotto, who sits on the UCI panel overseeing the anti-doping program, said yesterday more than 30 suspicious samples had been analysed and there was enough evidence to pursue a handful of riders for doping violations.

"We are only collating the results now but I expect in the next few months the UCI will be taking action against some cyclists," Parisotto said.

Sounds like the decisions about whom to prosecute are looming.

The blood profiling is designed to identify any cyclists using banned drugs or methods which manipulate the blood to improve endurance. He said suspicious samples usually contained high haemoglobin levels, or unusually low levels (which would indicate a cyclist was extracting blood to be re-injected during competition).

"There are discussions now about which are the strongest cases to go after," Parisotto said. 

"There's only a handful they can confidently follow up. But I believe in some cases the results are fairly strong and the athlete will have a hard time explaining them."

The first cycling case will be a test for this new method of identifying drug cheats.

Parisotto said there was a smaller number of suspicious samples than he would have expected if the program had been in operation three or four years earlier.

"Now there is more of an effort being made to weed out the cheats and I think some of them are getting scared," he said.

"The risk of getting caught is becoming much greater now that they have to worry about what's in their blood."

Indices to monitor include red blood cell parameters (hemoglobin, and hematocrit), EPO, and other physiological measures, that should be very stable in an individual athlete over time.  Also, Parisotto speaks of monitoring the response of particular genes to doping drugs, a very interesting development.

Parisotto, who developed one of the first tests for the blood booster EPO in the lead-up to the Sydney Olympics, is also working on the next weapon in the anti-doping war, genetic profiling.

"The technology is there now to do gene profiling on blood tests," Parisotto said.

He said any use of blood doping would show up in changes to an individual's gene activity.

The laboratories will just have to chart the abnormal changes that the drugs make to the blood and genes of the athlete.

Surgery for male gynecomastia (man-boobs) goes up in the UK

The Telegraph reports that men's breasts are expanding, as is the surgery to reduce gynecomastia -- the man-boobs often related to anabolic steroid use. (see photo of typical case at left)

Drug specialists are also reporting a rise in the number of young men turning to the illegal use of anabolic steroids to improve their physique.

New figures from the British Association of Association of Aesthetic Plastic Surgeons, due to be published on Monday, are reported to show the number of men opting for breast-reduction procedures last year rose by nearly half.

In the space of five years, the figure has increased from 22 operations in 2003 to 224 in 227.

The Government's official advisers on drugs have noted that anabolic steroids are becoming popular among non-traditional drug-users keen to improve their physique, rather than just athletes.

Anabolic steroid use now ranks among the leading drugs treated in substance abuse treatment centers.  That means an increase in correcting the gynecomastia caused by the estrogenic effects of the drugs.  It also means problems with consequences of the needles used in injectable steroids.

Latest estimates from the British Crime Survey suggest that 179,000 people aged 16-59 have used anabolic steroids but Professor Iverson has previously said the figure might be more than 200,000.

Mike Linnell, of the Lifeline drugs charity in Manchester, said that needle-exchange projects are reporting rising numbers of men injecting steroids for cosmetic reasons.

He said: "What we have seen over the last two years is a growth in people who are not drug-users in the traditional sense. They are coming in because they used anabolic steroids because they wanted to look good. It is all about image, about looking good. This is now right across the board."

Use of anabolic steroids can be for sports advantage, or for simply narcissism, as with the Adonis Complex.

Russian officials ban executives and doctors for Ranger prospect Alexei Cherepanov's death

ESPN reports that Russian hockey officials -- Continental Hockey League KHL -- will ban team executives and doctors following the investigation of New Yok (York) Rangers prospect Alexei Cherepanov.

Cherepanov died last year during a hockey match.  Investigating the suspicious death of a 19 year-old professional athlete, generated reports that the young player took stimulants prior to his demise.  However now the Russian officials backtrack on that conclusion to implicate the executives and doctors involved with Cherepanov.  Something seems slippery here.  (ESPN reports)

Russia's Continental Hockey League has banned five team executives and doctors, four of them indefinitely, for at least two years for their roles in connection with the death of New York Rangers prospect Alexei Cherepanov.

The men -- including the former team president and general manager of Avangard Omsk and two team doctors -- were banned following a KHL investigation, which concluded that the parties involved "exhibited criminal negligence" in their duties and knowingly tried to treat Cherepanov's life-threatening heart condition on their own.

The league also clarified earlier media reports that Cherepanov had been using performance-enhancing drugs, explaining that what had been earlier reported as doping was in fact an attempt to treat Cherepanov's heart condition.

Cherepanov, 19, collapsed Oct. 13 while on the bench for the Omsk club Avangard in Russia's Continental Hockey League and died a short time later. The league said Friday that Cherepanov had suffered from chronic myocarditis and that the cause of his death was acute heart failure.

Interesting that the cause of death was acute heart failure.  In the end, everyone dies of 'heart failure'.  However in this case we find it suspicious that a 19 year-old with myocarditis died of heart failure.

We would suspect the athlete died of an arrhythmia, which caused the acute 'heart failure'...inability to pump adequate blood to the tissues. 

We also raises suspicious about the conclusion that the Russian hockey player did not use PEDs; the report says the drug found in the athlete was used to treat his heart condition.  No stimulant would be used to treat myocarditis, unless the drug were something like lidocaine, for severe ventricular arrhythmia.

The Russian report excoriated the doctors treating Cherepanov's condition.  It also addressed the PED issue this way:

Durmanov also addressed media reports last month alleging that Cherepanov had used performance-enhancing drugs.

"The team doctors of Avangard tried to treat Alexei on their own. What the press described as systematic doping, was an attempt to cure Alexei's heart condition," he said.

That's the unusual conclusion that is not believable.

It also appears the emergency crew sent to the hockey meet was not well prepared:

Following Cherepanov's death, prosecutors alleged the arena where Cherepanov was playing failed to coordinate proper emergency medical services before the game. Last month, Russia's federal Investigative Committee alleged a "row of gross violations was committed by the medical brigade" helping Cherepanov.

"Among them, doctors arrived on the scene a full 12 minutes after Cherepanov collapsed, and the battery on the defibrillator to attempt shock Cherepanov's heart back into life was drained," investigators said.

We do not believe the truth has yet emerged about the PED use, and the death of this young hockey star.  Can't the Russians inject some veracity into their reports?

American Gladiator's Nitro confesses that steroids blew up his manboobs

Medically called gynecomastia, and induced by anabolic steroids, former NFL lineman Dan Clark claims anabolic steroids caused his breasts to swell up so much he needed reduction surgery.  However, he looked good in a bikini on muscle beach.

As a side effect of the estrogenic effects of steroids, gynecomastia results when the glands present in male breast tissue reacts with hypertrophy.  Plastic surgeons now find themselves busy reducing the body-builders and athletes who abuse the drugs so much they suffer this side effect, as well as the testicular shrinkage effects.  To the Examiner:

After just 10 weeks of injecting steroids, former Los Angeles Rams defensive lineman Dan Clark gained 32 pounds of muscle. But after 20 years of using the drugs — when he was Nitro on "American Gladiator" — he also got shrunken testicles, major man boobs and dull throbbing pain during sex.

Page Six reports that Dan's tell-all memoir, "Gladiator: A True Story of 'Roids, Rage and Redemption," reveals that his breasts got so big he had to have reduction surgery.  Dan writes in his book:

Bitch tits, man boobs, breast-chesticles is what they're called on the street. Gynecomastia is the scientific name. No matter what you call it, I [had] it. I hate[d] taking off my shirt."

The good news is, Dan finally quit doing steroids, got some therapy, and is now a consultant on the new "American Gladiators."

Amazon.com will ship "Gladiator: A True Story of 'Roids, Rage and Redemption" Feburary 10.

Suppose he could have used a sports bra when he took off his shirt.  Even 'Nitros' plastic fiugure shows some gynecomastia.

Aleksey Cherepanov, Siberian Express derailed: Ranger's Russian hockey prospect death may involve doping and inflammation

An ex-New York Ranger Russian hockey prospect -- Aleksey Cherepanov -- dropped dead at an extraordinarily young age in October.  An inquiry in to the 19 year-old's death revealed 2 pertinent issues (according to RT Sports):

• The report says that Cherepanov 'used stimulants'
• The hockey player suffered from myocarditis

Young ice hockey star Aleksey Cherepanov, who died of a heart attack during a game in October, had been taking performance enhancing drugs. That’s according to a report by the Investigation Committee of the Prosecutor General's Office.     The 19-year-old collapsed during a Continental Hockey League (KHL) game in the Moscow region.

The official statement of the investigation committee says:

"No traces of alcohol or drugs were found in his blood and urine, however, tests for chemicals showed that Aleksey Cherepanov had been using stimulants for several months."
 
It was also discovered that Cherepanov, nicknamed the Siberian Express, was suffering from chronic myocarditis, which meant he should not have been playing sport. According to a post-mortem examination, the sportsman developed the disease approximately a year before his death.

There seems to be confusion in the Western press reportage. The New York Times reports that no drugs were named;  the Russian Times clearly says stimulants.  Stimulants can rarely be involved in cardiac events, in say a vulnerable heart.

The Times also reports that myocarditis 'does not allow enough blood to reach the heart'.  Really? 

Myocarditis means inflammation of the cardiac muscle (which is all of it, as the heart is one large muscle).  The word ending means inflammation, perhaps due to a virus, or even due to a connective tissue disorder.  Myocarditis could be bacterial, or parasitic, or allergic, or...you get it due to something that inflames the heart.  And saying the heart was inflamed says nothing about blood flow.  (where did the Times get this idea?).

To simplify the issue, the heart becomes inflamed, which causes a number of problems.  One would be enlargement of the organ.  When the heart enlarges it actually stretches the fibers that cause contraction.  The heart becomes less effective at pumping thus leading to failure...heart failure.  It is like the apparatus became stretch, flabby, and weak.  This condition often leads to a heart transplant.

The other issue in myocarditis would be electrical changes, reflected in the EKG.  This would cause electrical irritability, and sudden death due to an arrhythmia.  Boula!  A viral myocarditis is a frequent issue in young adult sudden cardiac death.

Investigators in Russia said Monday that Alexei Cherepanov, who was the Rangers’ first-round pick in the 2007 draft, used performance-enhancing drugs for several months before he died during a Russian league game in October.

They also said that Cherepanov, 19, should not have been playing professional hockey because he had myocarditis, a condition that does not allow enough blood to reach the heart...

The federal Investigative Committee in Russia said in a statement that experts concluded from analysis of blood and urine samples that Cherepanov had “engaged in doping” for several months. A spokeswoman for the committee refused to specify which drugs were found in Cherepanov’s system.

We would not be so quick to say that myocarditis absolutely rules out athletic competition.  It's complicated, and one must exert caution, but nothing is absolute...like Lance Armstrong not fathering a child without sperm.

The Russian athlete could have suffered from something as common as a cold which affected his heart.  A Stimulant might have exacerbated the condition.  On the other hand a drug can cause myocarditis.

The Russian press reports other problems:

The investigation also found that: "the paramedics called in for Cherepanov committed a number of gross violations”.

The report says they “arrived 12 minutes after the call and did not have a properly charged defibrillator. In addition, the brigade's chief doctor wrongly diagnosed a ‘natural death’.”
 
The Omsk Avangard forward was one of the most promising hockey stars in Russia. A first-round draft pick of the New York Rangers, Cherepanov was expected to move to National Hockey League.

The Prosecutor General’s Office says they will continue their investigation and warned that  the doctors involved in Cherepanov's treatment may face legal action.

One just cannot emphasize enough that stimulants, and steroids, and HGH, and EPO are DAMN DANGEROUS.   Don't believe the soft peddlers who essentially want an athletes to believe these drugs are like downing jelly-beans.  Dangerous in particular persons.  (that is a diseased heart on the right; it's ugly)

Gene doping is OK? Conference attendees (Dope Now) say yes

Always someone pushing the envelope, or the needle as it were.  The WaPo publishers a piece on the gene doping conference held in Washington.

Gather a roomful of anti-doping experts, administrators, academics and athletes alike _ something a conservative think tank did Thursday _ and there is no consensus as to whether gene doping, thought by some to be the next frontier in Olympic cheating, is at hand.

Indeed, there isn't even consensus on whether it would be a bad thing.

Turns out there is a school of thought _ "pro-doping," it's called _ that suggests anything athletes do to improve performance is OK, even, for example, manipulating DNA or surgically enlarging the webbing between fingers and toes in order to swim faster.

So says Andy Miah, who teaches at the University of the West of Scotland and was among about 10 panelists who participated in Thursday's conference on "The Coming Age of the Uber-Athlete: What's So Bad about Gene Enhancement and Doping?" at the American Enterprise Institute.

According to Miah, academics are taking CERA EPO to be able to rush faster into the Dope Now camp.

Gene doping, which is banned by the World Anti-Doping Agency, is a spin-off of gene therapy, which typically alters a person's DNA to fight diseases.

Miah advocates "celebrating the value of performance enhancement," he said.

"I don't think a public health crisis would arise from enhancement technologies," he added.

Miah said there is a growing group of professors around the world _ "Four years ago, there were half as many people as now," he noted _ who back his "World Pro-Doping Agency" thought experiment. One of his premises is that sports wrongly are thought of as a separate entity, different from other pursuits or professions _ music, art, medicine _ where no one objects to, essentially, doing whatever one can to be the best one can be.

"We are more willing to embrace these enhancements, with the caveat that we need them to be safe enough," he said. "We don't all want to kill ourselves by using these things, but we are interested in exploring the realm of human embodiment that is beyond our current capabilities _ and that might be cognitive, it might be physical. And I think that's where sport isn't quite at yet."

Is Miah qualified to discuss health complications?  No, of course not.  And the rush for the Dope Now organization...probably doubled form 2 to 4.

Ignore the rules.  Ignore sportsmanship.  Ignore the very real threat to morbidity and mortality.  Ignore the science.  Ignore the fact that gene doping has never been researched in an appropriate test group...or any group.  Ignore the costs.  Let's just be cool and hip.  To Edwin Moses:

Other speakers Thursday included Olympic champion hurdler Edwin Moses and U.S. Anti-Doping Agency CEO Travis Tygart, who believe gene doping should be banned, worry what it could do to athletes _ and agree someone is likely to try eventually.

"How do you feel if it's your son or your daughter who wants to be an Olympian? Would you let your kid or your grandchild take what they have to take? Or do what they have to do?" Moses asked.

On the other hand, he acknowledged there are those who will.

"If you have experts saying it's realistic to turn on pieces of your metabolism and it becomes feasible for the athletes to do something without killing themselves and it's not tremendously expensive, someone is going to try it," said Moses, who won gold medals in 1976 and 1984 in the 400-meter hurdles. "There will be someone who can convince an athlete they can get away with it."

An American swimming coach lays it all out:

John Leonard, executive director of the American Swimming Coaches Association, told of conversations he has had with coaches and scientists in China.

"We are really naive if we are to believe that the Chinese at this point are clean or that they are the only country in the world that is experimenting with genetic enhancement as we speak," said Leonard, who was not a panelist but attended the conference and spoke during question-and-answer periods.

"There are lots of countries in the world who couldn't care less about doing it safely, and there are lots of athletes who will take the chance that they will die in order to win medals. ... Will the United States have the same viewpoint when we start losing gold medals?"

Of course athletes will cheat to win.  How about those side-effects?  Enter Theodore Friedman, an actual scientist:

Theodore Friedmann, a professor at the University of California, San Diego, researches human gene therapy and spoke about the risks.

"People are injured. People die," he said. "It should be reserved for treatment of people with serious diseases."

He said he doesn't know whether there are athletes attempting gene doping.

"Nobody knows," he said, before adding: "It wouldn't surprise me."

About one thing Friedmann left no doubt, however: Unlike Miah, he thinks the practice has no place in sports.

"The anti-doping world accepts the notion that rules matter and, in fact, it reflects the wish of most athletes," Friedmann said. "The world of pro-doping is the contrary of all that."

George Mason University professors develop urine HGH test

Remember George Mason's deep run into the 2006 NCAA basketball tournament?  That's not the point here.  The point is Mason professors moved doping tests forward with the development of an HGH urine test.  USA Today says so:

Just as George Mason University's athletics program was overshadowed in the Washington, D.C., region — never mind the nation — until its men's basketball team made a surprising run to the NCAA Final Four two years ago, the school's medical research program had worked in relative obscurity until a major breakthrough this summer.

Two GMU professors whose primary interest had been cancer research developed the first urine test for human growth hormone. Working outside the Olympic movement, outside the traditional research environment of a university-backed teaching hospital, and 20 miles outside the university's main campus in Fairfax, Va., Emanuel "Chip" Petricoin and Lance Liotta moved directly to the forefront of international sports' anti-doping efforts. They also furthered — at least for now — their university's high-risk, high-reward pursuit of national renown and future income.

The Mason technology utilizes nanotraps to grab minute amounts of HGH in the test tube.  Although not specified, the isolated HGH molecules then must be identified as exogenous to the athlete.

It wasn't until earlier this year that they began to alter a test — which they hope one day will be able to detect cancer at its earliest stages — to find HGH in urine. There has been a blood test for HGH for a few years, but it's extremely expensive and its reliability has been questioned within the anti-doping community. The test has been used at the last three Olympics but has failed to identify an athlete using HGH. There is no indication major sports leagues or their players' unions are eager to implement it.

Mixing chemicals that cost less than $100, Petricoin and Liotta created a reaction in the lab that creates millions of nanoparticles tailored to find HGH — and, one day, possibly cancer. The particles, which would be placed in a specimen container before collection, find, trap and preserve the compound so standard testing equipment can detect HGH.

The next step is having their research accepted by the scientific, athletic and legal communities. That process took a step forward last week when their research into the HGH test was published in Nano Research, a peer-reviewed journal specializing in the science of engineering on an atomic and molecular scale.

Ceres, the biotech company, is cooperating with the U.S. Anti-Doping Agency for the next phase: identifying a normal range of HGH in the body. The study will take urine from dozens of adults 18 to 45 who volunteer to give samples at an on-campus athletics facility.

The professors are still early in the approval process, which could take years, according to Frederic Donze, a spokesman for the World Anti-Doping Agency, which approves testing procedures used in Olympic sports.

"There is usually a long way between research and implementation of a methodology for anti-doping purpose," Donze says via e-mail. "A significant element of this process is that the anti-doping community needs to make sure that any detection method can withstand any … scientific and legal challenge."

The most recent incarnation of the test for endurance-boosting EPO — a test that has flagged several cyclists at the Tour de France and a handful of athletes at the Beijing Olympic this summer — took four years, Donze says.

Don Catlin, who founded the UCLA Olympic Analytical Laboratory and is widely viewed as the dean of anti-doping research, spent years seeking this HGH test and has been in constant contact with the professors in hope of getting their test accepted.

"We have made substantial progress," says Catlin, who sat alongside Liotta during a panel discussion at a summit about HGH that Major League Baseball sponsored last month. "I'm excited about it. We have Dr. Liotta, who walks in as a breath of fresh air with a new technology."

The USA Today piece focuses on the entrepeneurial aspect of the Mason research.  We are excited about the anti-doping potential.

For whom the bell tolls: Brother of 'Bigger Stronger Faster' filmmaker -- Mike Bell -- dies at 37

Former WWE wrestler, University of Cincinnati football player, steroid user, and featured personality in the movie documentary 'Bigger Stronger Faster' Mike Bell died in New York state on Sunday.  Bell's brother Chris, wrote and directed the steroid documentary.  Bell was 37. To the Poughkeepsie Journal:

Former pro wrestler Mike Bell, an Arlington High School graduate and Poughkeepsie native, died Sunday afternoon at age 37, the wrestling website Figure Four Online reported late Sunday night.

Bell wrestled for World Wrestling Entertainment in the late 1990s and after that, Extreme Championship Wrestling. He performed at Mid-Hudson Civic Center for both promotions.

He was heavily featured in "Bigger, Stronger, Faster," a critically acclaimed documentary directed and starring his younger brother Chris, which explored steroid use in sports. The movie had candid interviews with both Bell brothers, as well as their parents, Rosemary and Sheldon and brother Mark.

Mike Bell was a football captain at Arlington and later played on scholarship at the University of Cincinnati.

No word on cause of death.  (This blog covers the Bell story)

Injectable Six Packs: HGH for boomers

The AP carries a story today of one of the physicians who looks like he discovered the fountain of youth: Dr. Jeffry Life, a typical Nevada Anti-aging doctor.   These dudes manipulate lax medical boards in Nevada, juice themselves up with HGH (and likely testosterone) then tout their magnificent physiques as the 'Fountain'.

The exercise and diet part of the message is good; the anti-aging hormonal treatment is hype.  That hype will cost you 3000.00, which for some baby boomers is money wasted well spent.  And Life's serial photos show that in part exercise is well worth the effort in shaping up the physique.

Life's physique is incredible, but obviously the HGH doesn't regress the effects of aging on the face (there is always plastic surgery for that absolutely fake and phony look.  Wonder if fitness buff Jack Lalane takes HGH -- photo right at 93)

It's one of those photos that make you do a double-take. Dr. Jeffry Life stands in jeans, his shirt off. His face is that of a distinguished-looking grandpa; his head is balding, and what hair there is is white. But his 69-year-old body looks like it belongs to a muscle-bound 30-year-old.

The photo regularly runs in ads for the Cenegenics Medical Institute, a Las Vegas-based clinic that specializes in "age management," a growing field in a society obsessed with staying young. Life, who swears that's his real last name, also keeps a framed copy of the photo on his office wall at Cenegenics.

"He's the man!" patient Ed Detwiler says teasingly, pointing to the photo of the doctor who, in many ways, has become his role model.

Detwiler, 47, has been Life's patient for more than three years. In that time, he has adopted the regimen that his doctor also follows — drastically changing his exercise and eating habits and injecting himself each day with human growth hormone. He also receives weekly testosterone injections.

He does it because it makes him feel better, more energetic, clear-minded.

He does it because he wants to live a long, healthy life.

Except for one of the founders of the hype, Dr. Alan Mintz (really you could not make up these names), who died at age 69 (and not saying that's chopped liver to live to be 69) of a brain hemorrhage during a biopsy.

Dr. Alan Paul Mintz, whose controversial efforts to prolong and improve peoples' lives drew national attention, died Sunday at the age of 69.

"He was a visionary, dedicated to helping people live the most vital lives they could," said his wife of 47 years, Rabbi Yocheved. "He was the most loving husband, father, and grandfather."

Mintz was famous largely because his Cenegenics Medical Institute based in Summerlin promoted the use of steroids and human growth hormone as an anti-aging therapy for some patients, and he showcased his own bodybuilder physique as evidence of the benefits of the regimens he espoused.

Mintz died Sunday from bleeding during a biopsy, Yocheved said. Mintz had been suffering from problems with his brain, possibly because of a stroke, she said.

She said many of his patients were flying in from all over the world for his service today at 10 a.m. at King David Memorial Chapel, 2697 Eldorado Lane, near Eastern Avenue.

So many people are better because for having known him," she said.

Mintz's company, founded in 1998, grew to include offices in Charleston, S.C.; Boca Raton, Fla.; Tokyo; Hong Kong and Seoul, South Korea, and claimed to have more than 12,000 patients.

The anti-aging docs all seem like rich nice old dudes.  However, they certainly come up short when producing scientific evidence of the effectiveness of the HGH and other hormones for anti-aging.  Testosterone can clearly contribute to rippling muscles and less fat in older men; however it can also clearly increase risk of prostrate cancer, and likely stroke and other problems.

The weight training is good stuff.  Weightlifting can increase endogenous testosterone, strengthen bones, and reduce fat.  However, adding the hormones to get that entirely buff look is not only bogus, it could be dangerous.

Who cares when you can life fast, die young, and leave a good looking corpse at 69?

An earlier piece on Life also looked at the HGH Anti-aging medicine phenomenon.

With his six-pack stomach, bulging chest and bull-like shoulders, the muscleman in the newspaper advertisement displays the sort of rippling torso that adorns the cover of men's fitness journals.

But there is one difference. From the neck up, Dr Jeffry S Life is a balding 67-year-old physician.

His physique is the product not of a computer touch-up but a controversial American "ageing management" technique, that often includes a cocktail of human growth hormones and testosterone.

Some 13,000 clients have so far spent thousands of dollars on a technique known as Cenegenics (from the Greek for "new beginning"). As post-war baby boomers enter their 60s, it promises to boost performance from the office to the gym to the bedroom.

The initial one-day $2,995 evaluation at the Cenegenics Medical Institute (CMI) in Las Vegas, has already attracted a handful of unnamed Britons seeking the secret of Dr Life's remarkable torso...

 

After the initial evaluation, clients spend up to $13,000 on exercise and diet regimes, supplemented by vitamins and, in most cases, hormone replenishment such as testosterone.

Approximately 20 per cent are also prescribed injections of human growth hormones if they are diagnosed as demonstrating adult growth hormone deficiency (AGHD).

(The AGHD is fairly bogus, but so what?)

Critics say that it is unproven and potentially dangerous. Tom Perls, a professor of medicine at Boston University, expressed surprise at the number of Cenegenics clients diagnosed with AGHD, as he said the condition normally affects three people in 10,000.

In an interview outlining his philosophy last year, Dr Mintz listed a panoply of positives that he attributed to human growth hormone. They include a decrease in fat and skin wrinkling, an increase in muscle and improved mood.

"Next year does not have to be worse than this year," Dr Mintz said. "How about good sexual activity with your loved one once a week, twice a week, feeling good about it?"

Yeah, you would hate to feel really bad about it...and you're getting all that coin too...

 

20% of Greek kids/young adults would use performance enhancing drugs

In a sample of Greek adolescent and young adults, 20% say they would cheat with PEDs/steroids if the drug would improve their physique; eleven percent of males said they would use PEDs if a coach recommended it.  To Ekathimerini

Almost two in 10 young people who take part in sports would use banned substances if it helped their physique, according to a survey conducted by a new nongovernmental organization.

Neoi questioned 700 people aged between 13 and 28 and found that 3 percent of them admitted to taking banned substances, which included ecstasy, cocaine, creatine and various anabolic steroids.

However, 11 percent of the males who were questioned said that they would take a banned substance if their coach recommended it. Half of all the respondents said that the main danger in taking steroids is that they could cause an early death, while 46 percent said that the media is their main source of information about banned substances.

Greece has had more than 20 athletes in various sports banned this year after they failed drug tests.

This article doesn't make the questions clear, however the 3% of Greeks taking one of a variety of drugs appears low when compared with other surveys.  Perhaps the question was related to athletic achievement?

Myostatin blocking gene therapy to be introduced for dogs; when will the first human athlete abuse it?

Prof Lee Sweeney of the University of Pennsylvania will be behind the introduction of a gene therapy approach to treat aged dogs who suffer muscular weakness.  Apparently elderly dogs who become progressively weaker (this is generally called old age) need treatments so their owners can take the canines on walks.  The therapy involves the injection of a genetically modified myostatin inhibitor that produces incredible muscular hypertrophy; the injection goes into the animal's liver.

Once this gene therapy reaches the public, h ow long will it be before an existing sports record becomes totally obliterated by newly enhanced and genetically modified athletes?

This raises several issues just in the vet use of the technique:

• Isn't aging natural?  Do elderly dogs -- as lovable as they are -- really need to be revitalized so the owners can walk them?  At what cost?
• Might counseling on the normal aging in biology be more effective?  Aging is part of every organism.  Why fight the changes that are inherent in the DNA of the animal, to protect the fragile emotional status of the owner?

To the Telegraph:

An American professor is preparing to market a form of canine gene therapy, which would see dogs injected with substances which switch off the genes that regulate their muscle growth.

Prof Lee Sweeney, from the University of Pennsylvania, has pioneered research into gene transfer technology, a field in which poorly functioning and abnormal genes are manipulated, switched off or replaced.

Ten years ago he created "mighty mice" in the lab with enormous muscles and strength in old age. Now he says experiments on dogs have been so successful that he is preparing to market the treatments to owners of ageing pets across the United States.

He said: "We are now in the final stages of getting all the approvals to offer this through the veterinary hospital as a treatment to try to improve strength in pet dogs.

"As the dogs get weak their owners get upset that they can't walk around any more. So we're hoping that within the next year we will begin the era of genetic enhancement in dogs."

Under the therapy, dogs would be given an injection into the liver of an inhibitor which switches off the gene which produces myostatin, a protein which inhibits muscle growth in animals and humans.

One would hope Sweeney has considered the implications of his genetic enhancement.  The first issue is the economic issue of enhancing an aging dog to mollify the owner.  Obviously an aging animal in the wild gets eaten, which is not a good outcome for a domestic pet.  Domestic pets decline gradually, with the resultant dysfunction experienced by all aging organisms; pet owners keep the animals comfortable until the inevitable sad day when the pet can longer function well.   But does this justify an attempt to allay the aging process in a canine?  At what price? 

Sweeney must consider that if the gene therapy is marketed to vets, that soon, genetically enhanced greyhounds will be winning the dog races.  Once the Schwarzenegger greyhounds win races, human athletes will take notice; actually they already have.  To the Telegraph again:

He (Dr. Sweeney) gets between five and 10 emails a week from athletes, some from Britain, and so many phone calls that his secretary has stopped putting them through.   And that is in a quiet week.

If he publishes an academic paper or does a media interview, a flurry of 50 or   more calls and emails usually follows, as it did 10 years ago when he first   revealed his 'mighty mice' to the world at a meeting of the American Society for Cell Biology – laboratory mice with enormous muscles that retained their   strength and regenerative ability even when the animals reached old age.

Sweeney's super-strong rodents were the product of his pioneering research   into gene transfer technology and the implications were clearly not lost on the athletes and coaches who got in touch, one of whom offered $100,000 for what the mice were getting.

Shockingly, Sweeney also received a request from a high school American football coach for his entire team to be genetically modified.

Sweeney told him what he is still telling everyone a decade later, that bulking up on gene therapy is not yet safe enough for humans and would require heavy-duty immune suppression. He always gets the same response.

"Even if I explain to them that to make it work might require all sorts of heroic measures, they basically say, 'Fine. I'll do it'. And if it's a matter of money, they'll get the money."

Sweeney has never been contacted by a name he recognises – "I don't get Barry Bonds calling me up" – and says most of the would-be guinea pigs appear to be young athletes trying to make the big time.

"Some of them are from Europe," he says. "I get quite a few   from the UK and Germany."

He says he would feel uneasy about passing on their names to the anti-doping authorities but is sufficiently concerned to have accepted a seat on the gene-doping panel of the World Anti-Doping Agency (Wada), who are funding   eight research projects on gene-doping detection in a desperate attempt to stay ahead of the cheats.

Sweeney is bracing himself for another surge of calls and emails next year when his work moves from the laboratory to the commercial world with a muscle-building gene therapy for dogs.

Even though Sweeney knows the illicit demand for the mystatin inhibitor, he will market the drug anyway...ah the power of economic windfalls can outstrip the ethical considerations of the enhancements.

We have a chapter on genetic enhanced performance (GEP) or Performance Enhancing Genetics (PEGs) that looks at the issues. Sweeney has considered the issues too as summed up by the Telegraph:

Sweeney hopes his new canine anti-aging treatment will be just the start.  Humans have the same gene that Sweeney is manipulating in dogs and the nex  step will be to treat people with serious genetic diseases such as muscular dystrophy. Ultimately, he hopes to give the elderly, like the pampered  pooches of Pennsylvania, greater muscle strength and mobility in their final   years.

But any breakthrough will inevitably be seized upon by dope cheats in the same way that clinical drugs such as steroids, human growth hormone and the red blood cell-boosting EPO soon found their way into kit bags. With the prospect of as yet undetectable, lifelong enhancement, how could any drug cheat resist?

As gene transfer technology enters the medical mainstream as a treatment for numerous diseases from blindness to cancer, scientists are agreed it is only a matter of time before it crosses over into sport.

Some predict that London 2012 could be the first genetically modified Olympic Games. Others say the Beijing Games may already have that dubious honour.

Here is a therapeutic enhancement that may render all PEDs obsolete.  The results are shockingly dramatically impressive; the technology undetectable at present; and the technique will soon be available.

Performance Enhancing Drugs are simply amateurs when compared to the potential power of Performance Enhancing Genetics.  Looks like that brave new world of astonishing sports feats will be ushered in very very soon.

Why do sportswriters insist on rewriting medicine: Using bumetanide for weight loss in the NFL

Why do sportswriters insist on rewriting the medical textbooks?  Because athletes decide to take advantage of a drug for their own particular use?  For instance this post which once again identifies a diuretic as a 'weight loss' pill.  The writer even thinks the drug is used to cut weight (as I said, cut off an arm or something to lose weight) rather than as a masking agent.

Just as the underground economy subverts the real economy, the underground medical practice subverts the actual researched indications for these drugs.  And like the honest taxpayer who foots over his fair share to the Govt is cheated by the guy who trades cash under the table, the dishonest athlete cheats the drug free athlete (and I can't believe I defended paying taxes; that may be the dumbest analogy ever written).

Take the diuretic bumetanide (Bumex).  That's a ridiculous generic name, even for this writer who worked with furosemide (Lasix) while in medical school.  A diuretic (known in the press as a 'water pill' which isn't accurate because urine is far more than water) blocks physiological workings of the kidneys which then allow much more urine to flow -- but at a cost.  The cost is the disequilibrium of fluid and electrolyte balance. Such a drug would be 'indicated' for heart failure, kidney disease, and perhaps liver failure where for various reasons the kidneys cannot filter the blood as well as in health.

The side effects?  As mentioned fluid and electrolyte imbalance which can lead to fatal heart rhythms. The heart depends on electrical communications and electro-chemical interactions to keep beating (calcium, sodium, potassium, chloride).  When a diuretic produces the diuresis (fluid output) it pulls those electrolytes with it, thus inducing the electrolyte problems.  There is a reason your grandmother takes potassium (K) with Lasix or HCTZ in the morning.  If not she lands in the hospital as my late mother did often in the past year for K depletion.

When the athletes take a diuretic - for NO MEDICAL reason -- they not only simply abuse the drug, but may produce a dangerous electrolyte imbalance.  That can lead to death as it has with some NFL players in the past.  So Deuce McAllister, for whatever reason he took the drug, risks some major problems with the illicit use.

When you hear of an NFL player taking Bumex, which is a major kick-arse diuretic, the only reason would be to dilute the urine, which would dilute the metabolites of other drugs -- either drugs like steroids, or perhaps other illicit drugs (thus we can suspect but not assume the 'masking' agents are masking anabolic steroids).  None of the NFL player would suffer from heart, kidney, or liver conditions, and maintain an NFL career.

When the press calls Bumex or any diuretic a weight loss' drug, they are rewriting the medical text books.  Any normal person will simply rehydrate in  a matter of minutes (hours) to rebalance fluids and electrolytes (the most guarded physiological parameter in biology).

This reminds me of my cousin who wrestled in high school and college.  He and his friends would try to lose weight by sweating, spilling into pop bottles, cutting their hair, shaving, and any way to reduce some bodily mass as quickly as possible (he once confided to me he was gong to ejaculate to try to lose a few grams; at least that's what he said).  It's all temporary weight.(side effects after the jump)

Dan Dickau: Got your back in doping control...maybe

Ex-Gonzaga star guard Dan Dickau suffered back spasms and anti-doping problems in Europe and America this year.  Dickau, the oft-traveled NBA point guard, journeyed to Europe to play for the Air Avellino italiano team;  however it is reported the medication he takes for back spasms didn't make it through European doping control.  To BallinEurope:

This story about Dan Dickau joining Avellino (Italy)/leaving Avellino and joining the Golden State Warriors was kind of a weird story. Nobody really talked about the “why” and still nobody really knows. Everything we have is rumors from pretty reliable sources so we thought it might be a good idea to post them, since there is no official word - besides back pain.

Dan Dickau was released from Air Avellino, a Euroleague newcomer, because of back problems that prevented him from doing what he gets paid for: play basketball. At first this sounds like a very sad story, but two days later, Dan Dickau signed with an NBA team again: the Golden State Warriors...

Sources say that Dan needed special drugs, that weren’t allowed in Europe but are allowed in the NBA. With the word DRUGS, a lot of confusion ensued. Some web sites reported that Dan refused to get tested for illegal substances, which was the reason for his release. Combine Dan’s back problems with pharmaceuticals he probably had to take and you might think he took substances that are allowed in the US but not in Europe.

It is important to say that you can’t just buy anything in the United States and that we’re talking about pharmaceuticals allowed in within US basketball and just not allowed within FIBA or Euroleague play.

What drug could that be? Maybe cortisone. Use of cortisone requires special permission in Italy and must  be permitted by the Italian league, which for sure would not have been a problem in Dan Dickau’s case.

Another reason why this was probably not the cause: Italian Danilo Gallinari can’t play right now because of back problems while he is in the United States. Dickau is now able to play with two hernias

Or maybe this has nothing to do with doping or doping tests:

So the stories get even crazier all the way to one with Dickau having a gambling problem … well, of course, it has to be something, right?

Interesting report...Dickau, unwilling to pass doping-control because of cortisone.  Doesn't Europe have a Therapeutic Use Exemption (TUE) to allow cortisone?  Or was there something else doping control checks out in the tests?  Note Dickau was credited with 3 'robberies' in this translation:

the base just fichado that seems that antidoping because of medecines was dismissed of the Air Italian Avellino to refuse to pass a control that are taking by back problems which they are legal in the USA but not in Europe, made debut with 8 points, 5 bounces and 4 robberies.

Dickau signed with the Golden State Warriors in early October, who then cut him yesterday (Solo Basketball):

Chris Mullin announced that Dan Dickau has been waived. Dickau was one of the players that left the NBA to play overseas with Italian LEGA A and Euroleague team Air Avellino. But there he had some problems with his an injury in back and he left to the States after being waived by the Italian club. Air Avellino then signed former Indiana Pacers Travis Best.

Then, Dickau signed almost immediately with the Warriors and all kind of rumors about his departure started to appear. It was said that Dickau needed a special treatment that was not allowed by anti-doping policy in Italy.

Finally, he has been waived again. He just played four preseason games with Golden State, averaging 5 points, 2.5 rebounds and 2 steals in 12 minutes played per game. Dickau is now 30 years old and has already played with Mavericks, Blazers, Hawks, Hornets, Clippers and Celtics in the NBA.

Wonder what is the real Dickau story?

Are doctors using performance enhancing drugs?

An article from the the Sacramental Bee, by Dr. Michael Wilkes, looks at the use of 'stimulants' and PEDs for physicians.

Doctors have long prescribed pills to help people concentrate, stay awake, go to sleep, remember facts, control their moods and enhance endurance in such tasks as flying and studying.

Now, doctors are also using these drugs – not to correct abnormalities but to enhance their abilities.

Advertisements for Provigil and other drugs promise that they will help doctors stay awake.   

The practice of medicine requires long hours, constant learning and a high level of dedication. Physicians work at all hours of the day and night, making life-and-death decisions.

Don't patients benefit if doctors take pills that will help them stay awake during a long overnight shift in the emergency room or provide better concentration to a surgeon doing a 10-hour operation?

Dr. William Cheshire, writing in the journal Virtual Mentor, asserts that the field of medicine has traditionally drawn a line between treatment (to restore or preserve vital functions) and enhancement (to provide abilities that go beyond normal function).

If the practice of medicine has been devoted to treatment, does that preclude doctors from dealing with enhancement? Certainly in some areas, such as plastic surgery, enhancement – not treatment – is the rule.

In some nonmedical fields, enhancement might provide a competitive and selfish advantage – e.g., working longer hours to impress the boss or taking steroids to beat other athletes.

I have spoken with doctors who feel that enhancing pills help protect their patients and society. For example, they ask, what if two patients urgently need surgery? Without a drug to stay awake, the surgeon could perform just one surgery. With medication, he could operate on one patient and then the other.

Wait a minute, though. Do we want doctors operating after they have taken these pills?

I have colleagues who say these pills are no different than a couple of cups of coffee – just a bit stronger. Is that true? What happens when the pills wear off, and what about the side effects?

There is little or no data on how these drugs affect a doctor's performance.

Until we have more data, doctors should not be allowed to take these medicines when on duty.

If doctors are tired, they should sleep. If they can't concentrate, they should explore why. Medicating our physician to work longer, harder and with superhuman concentration is just not in society's interest – at least not without substantial research.

   

As we say, one of the largest challenges in the new science age of the 21st century comes in determining the ethics behind performance enhancement: how far, how much, how moral.  This central question cuts across all ages, professions, and economic groups.

EPO is BMOC in doping world

Erythropoietin (EPO) appears to be assuming larger and more important role in medicine, and in sports doping.  EPO, a natural hormone produced in the kidney stimulates (regulates) the production of red blood cells (RBCs).  RBC, by utilizing hemoglobin, carry oxygen loaded in the lungs to all the 'peripheral tissues' like heart, brain, muscles, gonads, etc..  Hemoglobin then captures CO2 --  a waste product from cellular metabolism -- to be carried back to the lungs where the waste C02 is exchanged for oxygen.

EPO can be abused by cyclists, and track athletes, based on the improvement of oxygen delivery to the muscles, and even the CNS.  However the use of EPO is dangerous, causing blood clots in critical vessels (like heart).

EPO became useful for the treatment of kidney failure.  Kidney failure can be caused by many diseases: hypertension, diabetes, genetic metabolic conditions etc.  Those patients suffered from anemia, treated with EPO.  From Medscape:

The use of erythropoietin (Epo) in treating anemia of chronic kidney disease (CKD) has transformed the lives of millions of individuals.^[1] In the pre-epoetin era, patients had to live with the symptoms of severe anemia, multiple transfusions, and frequent hospitalization. Recombinant erythropoietin (rhEpo) was approved in 1989 for the treatment of CKD anemia. Widespread use of Epo in the management of CKD anemia ensued. Over the past 2 decades, the market for Epo has dramatically increased. It is now estimated that $22 billion worth of Epo has been sold.^[2] This vast market opportunity has not gone without notice in the pharmaceutical industry, and many Epo analogues and derivatives have entered the marketplace. These newer Epos are now grouped under the term erythropoietin-stimulating agents or ESAs. In addition, follow-on epoetins (FOEs), similar to the innovator epoetin, are now commonplace, particularly in emerging countries.

Here is a review of EPO's structure:

Epo is an acidic glycoprotein with a molecular weight of 30.4 kDa (Table ).^[3,4]       

The carbohydrate part of the molecule (approximately 40%) is composed of 3 N-linked and 1 O-linked glycan moieties. N-glycans are key to the biological activity of Epo; the addition of N-glycans into rhEpo increases the carbohydrate content and results in prolonged survival of the molecule. From a structural perspective, Epo has a basic structure like other cytokines (eg, the interleukins). It is composed of 4 amphipathic {alpha}-helical bundles. There are 2 domains located on Helix C and Helix D that are necessary for binding to the Epo receptor (EpoR). Following binding to the EpoR, a JAK2-mediated signal transduction cascade ensues (Figure 1). Epo's binding affinity is also critical to its action. Epoetin-alfa has a high binding affinity, whereas newer derivatives such as continuous erythropoietin receptor activator (CERA) have much lower affinities that are thought to contribute to the longer half-life of these molecules...

In the years following the launch of rhEpo, it became apparent that N-linked glycosylation increased the half-life of the Epo molecule. In 2001, darbepoetin, a longer-acting derivative of epoetin-alfa, was approved. In 2007, CERA, a derivative of epoetin-beta, received regulatory approval. Both darbepoetin-alfa and CERA have a prolonged half life compared with epoetin-alfa or epoetin-beta (Figure 2); these agents have been extensively tested in phase 2 and 3 programs and allow less frequent dosing of Epo in the management of CKD anemia...

If it means something to you, CERA is pegylated EPO:

CERA is a pegylated form of epoetin-beta. CERA is a 60-kDa molecule, approximately twice the molecular weight of epoetin-alfa.^[12,13] A large methoxy-polyethylene glycol polymer is incorporated into the epoetin molecule, essentially doubling its molecular weight compared with epoetin. This modification markedly prolongs CERA's half-life in humans to about 135 hours. In addition, CERA binds to EpoR more slowly than Epo. These 2 attributes result in CERA triggering the JAK2 Epo signal transduction cascade without being internalized. Consequently, CERA has more sustained biologic activity. CERA has been tested extensively and can be used less frequently than epoetin-alfa or darbepoetin-alfa -- it can be administered either once every other week or once monthly.^[14-16]

If you are a anti-doping agency you will not be happy to read that different ways to stimulate EPO are on the way.

Small-molecule Epo mimetic peptides (EMPs) provide a novel paradigm to stimulate Epo. EMPs are peptide sequences that bind and activate EpoR. For example, Wrighton and colleagues^[25,26] have identified a 20-amino-acid peptide (GGTYSCHFGPLTWVCKPQGG) that binds EpoR and has both in vivo and in vitro biologic activity. An example of an EMP that has entered clinical trials with much promise is Hematide (Affymax Inc., Palo Alto, California).^[27] This is a pegylated dimeric EMP that has no sequence homology to Epo but binds and activates EpoR. PEGylation enhances the stability and prolongs the half-life of the molecule (t1/2 of up to 60 hours). Hematide is now being evaluated in phase 2 studies both in renal patients and in patients with cancer.^[28,29] Other EMPs are also in the pipeline.

EPO can be a very effective performance enhancing agent.  Given the advances in the molecular pharmacology of EPO, it will be a formidable task to prevent EPO abuse in sport.

Research shows EPO may improve cognitive functioning...but what about the short memories of doped athletes?

Interesting results from a medical trial at the Max Plank Institute found that cognitive functioning in mice improved with EPO, long abused by athletes for endurance tasks -- especially track and cycling.  EPO stimulates more blood cells allowing a greater capacity of the blood to unload oxygen in the tissues.  Apparently the drug, or a downstream affect of the drug enhances neuronal circuitry of memory functions.  To Barchester Healthcare News:

A drug which has been linked to athletics doping scandals may have positive effects on memory, according to a new study.

Research published in the open-access journal BMC Biology suggests erythropoietin (EPO) may improve memory due to a direct effect on neurons in the brain, as opposed to any effect it might have on blood production in the body.

According to scientists involved in the study, the findings could prove useful in the development of treatments for diseases which affect the brain, such as Alzheimer's and multiple sclerosis.

The researchers revealed that treatment with EPO appeared to "increase the number of inhibitory circuits, which actually increases the efficiency of transmission of excitatory nerve impulses in specific neurons, resulting in greater short-term and long-term plasticity in memory pathways in the hippocampus".

Could the beneficial effects of doping with EPO have also improved the cognitive functioning of athletes who abuse the drug?  Seems their memories fail them at times, especially when they try to recall their drug use.  Must be the hippocampus, huh?

Hannelore Ehrenreich, of the Max Planck Institute, compared the enhanced memory function seen in mice with the dramatic improvement in endurance and muscular performance experienced by athletes who have used the drug.

 

The Lancet reports severe skin acne and scarring due to anabolic steroids

The BBC reports a case study in The Lancet, discussing the worst incident of acne ever seen on the planet (active disease below left).

Anyone considering using steroids to bulk up may want to think again after seeing pictures of the horrific scars suffered by one young bodybuilder.

German doctors were shocked at the extent of the massive, deep ulcerating sores on the chest and back of the 21-year-old man.  After antiseptic and antibiotic therapy the wounds healed but left permanent scars, The Lancet reported.

Experts said steroid-induced acne was usually much milder. Figures from the British Crime Survey put the number of steroid users at 42,000 but some experts believe the true figure could be twice as high.

They have been banned by many sporting bodies, including the International Olympic Committee, because of their danger to health and the potential for competitive advantage.

Known side-effects include potential damage to major organs in the body such as the liver and heart.

Dr Peter Arne Gerber, from the Department of Dermatology at Heinrich-Heine-University in Düsseldorf, Germany, said moderate amounts of the drug could cause big problems.  "Usually in people taking moderate doses of the drug you see some sort of mild acne but in severe cases it can ulcerate.  "The doses this man was taking were within the doses that are used among bodybuilders."

Sounds like the patient wasn't too bright, continuing to use the drugs, even when he looked like a leper, and blasted his genital into oblivion (scarred results below).

Dr Gerber added that the man did not stop taking the steroids once the skin problems developed because he was more concerned with losing muscle mass.

He eventually stopped but by then it was found the steroid abuse had also caused a low sperm count and shrunken testicles.

"There is probably a dose-effect with the steroids but it's also dependent on how the individual reacts," he said.

"It is questionable whether he will be able to start building muscle mass again - he may not be able to perform the exercises due to the scarring."

There is a call for studies at doses of anabolic steroids used on the street.  What IRB (Internal Review Board for ethical studies) would ever approve that?

He added there was a lack of studies examining the side effects of steroid abuse and called for "robust scientific research" to establish exactly what effects anabolic steroids have on heavy users.

Pheonix connecting dots between anabolic steroid use and suicide

Be careful with any interpretation of this, but a Phoenix medical clinic is under investigation following 3 patient deaths given anabolic steroids. ( KNXV-TV)

All three men have at least two things in common, they were taking steroids and they were getting them at Revolution Medical Centers, a Phoenix-based clinic that's currently under state and federal investigation.
 
"We're looking to see if there is a causal relationship between the death and the treatment or therapy they were being given," said Dr. Craig Runbeck, executive director, Arizona Naturopathic Physicians Board of Medical Examiners.
 
"You're hitting your body with a biochemical sledge hammer and you're pushing things way beyond where they were designed to be," Runbeck said.
 
The autopsy reports make no mention of anabolic steroids, but police reports and medical records do.
 
"Patients die everywhere," said Dr. Jeremy Bula, owner of Revolution Medical Centers. "They didn't die as a result of anabolic steroid use."
 
But one patient left behind a note.  "Stop using steroids. They will destroy your life or anyone with you," the note said.  Moments later, Brian Stubstad committed suicide.

A completed suicide is usually a very complicated multi-factorial act.  No one should point a finger at one particular cause.  However, it is true that anabolic steroids can be mood altering -- this is indisputable.  Is the use of anabolic steroids necessary and sufficient to produce an act of violence?  Probably not in most cases.  Can the use of AASs be contributory.  Absolutely....in a vulnerable person.  (Anabolic steroids are now a major drug of abuse; medical clinics are developing withdraw plans for users)

According to documents obtained by ABC15, he was a patient at Revolution Medical Centers for two years.  His chart indicates he had taken trembolin, a powerful steroid that's not approved for human use.

"Anytime you use a drug that's not approved for human use, there are unknown side effects," Runbeck said.

Was Brian Stubstad speaking from the grave?  According to medical records, he was complaining of depression and mood swings shortly after receiving steroids from Revolution Medical Centers.  In the weeks leading up to his suicide, there were police reports, a pattern of violence, and even an order of protection alleging death threats.

"The story sounds very familiar," said Don Hooton, whose son Taylor began using anabolic steroids five years go.  Six months later, 16-year-old Taylor was dead.  "He was going through severe mood swings," Hooton said. "It went far enough that he went upstairs, took two belts and hung himself."

 

Ode Magazine piece misses the mark on doping

A piece in Ode Magazine starts off asking about the role of society vis a vis the Tour de France doping.  Unfortunately by the third paragraph the article drifted astray -- way astray.

If a conclusion is drawn it should be ascertained from the valid data preceding it.  Let's take a look:

I just read the news about the third doping case at this year's Tour de France: Italian rider Riccardo Ricco has tested positive for the banned blood-booster EPO. And of course, as it happens so often with sportsmen who are associated with artificial performance-enhancing measures, Ricco was "booed by spectators when he was taken off the Saunier-Duval team bus by police Thursday," the AP report said.

Poor Ricco! I don't think using drugs was such a great idea, but I do feel we need to ask ourselves some serious questions before we condemn him. After all, in the rest of society, performance-boosters have become increasingly commonplace.

OK, now here it comes, the litany of horrible pharmaceutics:

* People take Prozac so they can better manage psychological pressure. * Students take Ritalin to improve their grades. * Middle-aged men take Viagra to spice up their sex lives. * Shy people take Paxil so they can handle social situations. * Writers, musicians and other artists take other stimulants to stand out in their fields.

Cliche list.  Inaccurate information.

• Prozac is not prescribed 'to manage psychological pressure'.  Fluoxetine is prescribed for mood disorders, anxiety disorders like OCD, Autism, and other medical disorders. The key is 'disorder'. The diagnosis 'psychological pressure' will never be found in a medical record.
• Students do not take Ritalin to improve their grades.  Methylphenidate is prescribed for patients with ADHD to ameliorate inattention, impulsivity, and hyperactivity.  An improvement in grades may be a benefit with the appropriate work effort.
• Middle aged men do not take Viagra 'to spice up their sex lives'  (what an incredibly insensitive remark).  Viagra is used for impotence -- the inability to achieve an erection.  "Spice up".  Yeah, We suppose crutches are used by amputees to beat the airport rush.
• Shy people take Paxil so they can handle social situations.   There's an example of an egregious abuse of drugs. huh?  Patients with social anxiety are clearly cheating the system and should simply stay isolated at home.
• Writers etc. tale stimulants to stand out in their field.   Huh?  Ok, you lost us at 'stand'

Seems this writer distorts medicine, or twists medical treatments to support a illogical argument that EPO abusers like Manuel Beltran is paying for the sins of the Prozac Society.

And Marion Jones took insulin mimicking those horrible diabetes who inject insulin so they can eat pizza...

In modern society, athletes have become heroes. Sports stars aren’t so much role models for society as reflections of it, albeit reflections with exceptional talent. Athletes take performance-enhancing substances mainly as a consequence of our sky-high expectations and the huge commercial interests involved.

Ultimately they are part of the same achievement-oriented society we are, in which he use of stimulants has become normal. The appropriate response is not moral outrage, but a relaxing of the enormous pressure we put on them: Just do your best, kid. That’s all you can do.

OK, we understand the conclusions; however please present preceding arguments developed to support the conclusions rather than a roll call of popular press target medications.

PEDs, and medicines are simply molecules.  Molecules are not evil.  The use or abuse of the molecules is the issue.

Does Dara Torres suffer from a double standard of doping scrutiny?

Interesting column from the normally logical Gwen Knapp today.  She wonders why a 40 year-old male like Barry Bonds received a free pass when he belted a home run every time he spit, meanwhile a successful 41 year-old female swimmer -- Dara Torres --  comes under the intense scrutiny of the doping-suspicions crowd. (Torres simply delivered a baby at age ~39, then records 5% faster times in her postpartum swimming years than she did in her college competitions; maybe she cut down on that college drinking).

We are going to suffer from the fallout after we deliver our opinion, however it is obvious where this is going: a double standard of men receiving the pass and women receiving grief.  Knapp might have added in the double standard between Euro and African genes -- some say African-American athletes suffer discrimination and thus are accused of doping more often than Euro athletes.  We can't keep up with all the double standards...

A 41-year-old woman did the impossible. Dara Torres swam faster than she ever did before, making her fifth Olympic team. As a result, she faced questions about doping, suspicions she fully expected and completely deserved.

But when Barry Bonds, at age 37, suddenly went from a great hitter to a supernatural one, increasing his home run output by nearly 50 percent, the media didn't put him on the defensive about steroids. It would take a lot more than 73 home runs in a single season to make that happen.

When Lance Armstrong returned from cancer treatment and transformed himself from a cyclist who barely could get through a Tour de France into the imperial master of the event, no American reporter dared challenge the authenticity of his accomplishment.

We've come a long way since the BALCO investigation schooled us on performance-enhancing drugs. But how far have we really come? Olympians are still held to higher standards than better-known jocks, and women somehow keep paying higher prices for doping awareness than their male peers.

A great deal of water flowed under the doping bridge since Barry Bonds lit up the night with steroid-fueled home runs in 2001.  BALCO. Operation Puerto.  The Mitchell Report. The Carolina Panther Superbowl Scandal.  More Tour de France scandals involving luminaries like Floyd Landis.  Of all these various doping and steroid scandals, only several women trickled out of the predominantly male scandals: Marion Jones, Chryste Gaines,  and cyclist Tammy Thomas to name several of BALCO fame.  Jones and Thomas exacerbated part of their plights: the simple doping truth would have saved their souls and actually their careers.  (And why is BALCO-linked swimmer Amy Van Dyken less notorious than Jones or Thomas?  Gender bias?)

Point is that the sporting public is much much more aware of steroids and HGH and insulin and modafinil now than in 1998 when McGwire and Sosa set personal bests in home run totals, not in the 50 freestyle.

Performance alone rarely triggers widespread suspicion in the media, but it sufficed for accusations against Torres and, 20 years ago, Florence Griffith-Joyner. The same scrutiny does not apply to men until they have a failed test on their record, federal investigators on their tails or a member of their entourage under indictment.

Oh really? Roger Clemens comes to mind.  How many dope tests did Roger Clemens fail?  The Rocket suffered more scrutiny than anyone since Bill Clinton over the past year.  Time and time again fans referred to Clemens rather mundane pitching numbers in his last years with Boston, and the sudden revitalization of the 34 year (that's right 34, not 41) at Toronto.  No doping positives there either.  Clemens doesn't even live with an endocrinologist, although wife Debbie is expert in HGH use.

Need some other names who never failed a test, yet are mentioned in doping: Brady Anderson and Luis Gonzalez come under scrutiny for storybook -- but unusually dubious -- sporting achievements.  None is admitting to cooking the books (or their looks), nor are Internet pharmacy receipts found for these males, yet the steroids-scrutiny continues on.

Is there some belief in male athletic accomplishment, perhaps its confirmation of masculinity, that does not surrender as easily to the realities of doping? Or is it simply that the most prominent women tend to be Olympians, and we expect greater purity from athletes who represent our country? Whatever the reason, men get to spin their fairy tales with less resistance.

Fairly tales with less resistance?  How about Usain Bolt, a young athlete setting the world record in the 100M?  In his 3rd or 4th 100M he was under scrutiny for doping, with nothing much known about the guy.  The Y chromosome sure didn't save his butt from the hot spotlight of doping suspicion.  Every remarkable achievement in sports henceforth will come under 'PED scrutiny'; such is modern life post-pharmacology.

(more controversy after the jump)

NFL prospect Heath Benedict died of irregular heartbeat; enlarged heart and drugs (Viagra) noted

Heath Benedict, a small college big time football player found dead at his home last March, appears to raise many questions.  At 6-6 and 320 pounds, any NFL prospect draws attention to possible steroid use, An early death compounds the concerns.  At the time this was said (USA Today)

Heath Benedict, a two-time Little All-American offensive lineman at Newberry College in South Carolina, was found dead on a couch in his Jacksonville home.

Jacksonville police said no foul play is suspected in the death of the 24-year-old Benedict, a 6-6, 326-pounder who finished up his senior season in the fall and left school to train for next month's NFL draft. He was nine hours short of a business degree.

Benedict took part in the Senior Bowl in January, the first Division II player to do so since 2004, and was invited to last month's NFL combine.

"He was a big, tough man, but he had a very gentle heart," Newberry president Mick Zais said. "He was a teddy bear."

Benedict, who redshirted at Tennessee in 2002 before moving to Newberry, was a native of the Netherlands. He played high school football at the Peddie School in Hightstown, N.J.

More than a gentle heart - an enlarged heart with an irregular heartbeat.  What might cause cardiac hypertrophy?  A congenital condition, or drug use.  Drugs like anabolic steroids or more notoriously HGH can enlarge the heart, thus causing major problems.  And what was found at Benedict's house?  These drugs (The State):

Former Newberry College football standout Heath Benedict died of an irregular heartbeat caused by an enlarged heart, according to the Duval County Medical Examiner’s Office in Jacksonville, Fla.

The report also reveals a syringe and three bottles were found near his body on March 26. One of the bottles contained water, but the other two were labeled “L-Via” and “L-Dex,” liquid forms of the drugs Viagra and Arimidex.

Deputy chief medical examiner Jessie Giles made it clear Benedict’s death was caused by dilated cardiomyopathy, a heart-muscle disease that leads to a fatal irregular heartbeat. However, Giles said the role Viagra, an erectile dysfunction medication, and Arimidex, an anabolic steroid used by post-menopausal breast cancer patients to reduce estrogen levels, could not be determined.

“The role, if any, of anabolic steroid or other similar drug/preparation use ... is unknown and beyond the scope of this office,” Giles wrote in the report.

The newspaper distorted the facts somewhat.  Arimidex (anastrozole) is not an anabolic steroid, however is a masking agent or an anti-estrogen drug.  It acts by inhibiting conversion of androgenic steroids to estrogen, thus reducing side effects like enlarged breasts.

Injections of Viagra and Arimidex is somewhat bizarre.  Was this player attempting to maximize his NFL potential, yet trying to avoid detection at dope testing?

Stories recently centered on Viagra as PED, apparently used by big time drug-cheat Roger Clemens.  (Sporting News).  Listen to this quote attributed to Clemens:

Roger Clemens, among other athletes, used Viagra to improve their athletic performance, according to a report in the New York Daily News.

Clemens got the pills -- which are not banned by Major League Baseball -- from a teammate and kept them in a GNC vitamin bottle in his locker, according to an anonymous source cited by the newspaper. He also reportedly told a friend that the drug made him feel flushed and made his heart race. 

The newspaper also quotes BALCO founder Victor Conte as saying, "All my athletes took it," in reference to a Viagra-like drug.

The drug and its over-the-counter substitutes reportedly have numerous off-label uses. These include helping build endurance and delivering oxygen, nutrients and performance-enhancing drugs to muscles more efficiently.

Researchers at universities across the country are now trying to determine whether anecdotal evidence that Viagra aids in training and improves performance is based in scientific fact.

Heart racing?  Perhaps leading to cardiac arrhythmias in an athlete who might have primed his heart with anabolics?  This isn't good.  More on the topic later...

Add#1We added a continuation of the State article which stated that Benedict showed "two puncture wounds in his arm, which isn't consistent with anabolic steroids.

Add#2:  We found a research study where Arimidex increased testosterone in 'elderly men' from about 375 to 575.  Not a bad increase.  The mechanism appears to be by blocking the negative feedback from estrogen on LH/FSH or GNRH release in the pituitary.

 

Growth Hormone: New biomarkers, and calls for more regulation

First we go to News-Net Medical for a report on the search for new biomarkers, that may be useful in the anti-doping crusade.  Investigators have been looking at proteins that change when exogenous HGH is administered.  Biomarker detection would aid a regulatory agency like WADA when trying to detect drug cheats l ike Marion Jones, who abused HGH on the way to her discredited Olympic medals.  (Update: The debate about the performance enhancing effectiveness of HGH continues on)

Researchers have found potential new biomarkers for growth hormone, which they say could help the sports community in detecting growth hormone abuse. The results of the animal study will be presented at The Endocrine Society's 90th Annual Meeting in San Francisco.

Many athletes are misusing recombinant human growth hormone, a drug intended for people who are growth hormone deficient, because of its supposed ability to decrease fat and increase muscle. However, detection remains a challenge. The growth hormone drug appears only briefly in blood and is identical to the growth hormone that the body naturally makes, said study coauthor John Kopchick, PhD, of Ohio University.

"Variability is a problem with current testing for growth hormone doping," Kopchick said. "It is gender and age-sensitive. We're looking for a test that will give standard results for everyone."

The authors are attempting to identify proteins in the blood that could be biomarkers for growth hormone action. A biomarker is a substance that can be detected in higher-than-normal amounts in the blood, urine, or body tissues and thus could be used for screening.

A bookmarker would alert authorities that doping has occurred.  For instance the decrease in LH seen when testosterone is administered would be considered a biomarker.

Kopchick's group injected six male mice with growth hormone once a day for a week and also injected six male mice with saline, to serve as controls. On the eighth day they determined the protein changes in the blood of all mice.

Several proteins or their isoforms (genetic variants or protein sub-populations that are modified differently) greatly increased or decreased in the growth hormone-treated mice, compared with controls, the authors reported. They included transthyretin, clusterin, albumin, and apolipoprotein A-1 (apoA1).

If the results translate to humans, these proteins have the potential to be new biomarkers for growth hormone action, according to Kopchick. Regulatory agencies could use new biomarkers for growth hormone in their attempts to halt the abuse of this drug among athletes, he said.

"Extension of these results to humans is of paramount importance, and these studies are ongoing," he said.

The second report originated with a paper in the Journal of the American Medical Association, where Dr. Thomas Perls describes the huge anti-aging industry's use of HGH.  Dr. Perls will point out that HGH use in Anti-aging is entirely unresearched, and potentially dangerous.  To Science Daily:

Since their previous article in the Journal of the American Medical Association (JAMA) in 2005 on the clinical and legal aspects of growth hormone for anti-aging, in which researchers from Boston University School of Medicine, Boston Medical Center and the University of Illinois at Chicago alerted the medical community and lay public to the deceptive mass marketing and illegal distribution of growth hormone for anti-aging and athletic enhancement, the authors provide new evidence demonstrating that these deceptive and dangerous activities have grown worse.

Remarks Dr. Thomas Perls, Director of the New England Centenarian Study and an associate professor of Medicine at Boston University School of Medicine, who has monitored the anti-aging industry for over the past ten years, "despite the overwhelming evidence that the risks and dangers of growth hormone far outweigh the clinically demonstrated insignificant benefit in normally aging individuals, the prescribing, distribution and sale of hGH for alleged anti-aging aesthetic and athletic enhancement has dramatically grown over the past few years. Clearly, the coordinated and aggressive marketing campaigns of the anti-aging and age-management industries are highly and most unfortunately effective."...

Contrary to published claims, neither long-term safety nor health benefits have been demonstrated in normally aging individuals taking hGH. A review of clinical studies among healthy, normally aging individuals found that hGH supplementation does not significantly increase muscle strength or aerobic exercise capacity. However, documented adverse effects include soft tissue edema, arthralgias (joint pains), carpal tunnel-like syndrome, gynecomastia (enlarged breasts) and insulin resistance with an elevated risk of developing diabetes. Increasingly more and more animal and laboratory studies suggest an increased cancer risk.

Dr Perls came up with the following recommendations:

The authors suggest that several measures need to be taken to address the inappropriate distribution and use of hGH.

Among their recommendations:

• The public must be accurately informed by physicians and scientists who do not have a vested interest in hGH, about health risks, fraudulent marketing and illegal distribution of this drug.
• Organizations that promote or indirectly profit from the medically inappropriate and illegal distribution of hGH that have been accredited by the Accreditation Council for Continuing Medical Education (ACCME) to offer American Medical Association Physician Recognition Award (PRA) category 1 CME credits or other categories of CME credit should, at a minimum, have their accreditation revoked.
• U.S. manufacturers of hGH must be more effective in, and held accountable for, controlling the distribution of the drug to companies providing the drug for illegal uses.
• Congressional hearings and media attention surrounding hGH should focus less on athletes and prominent entertainers who are also victims of deceptive marketing and pushing of hGH, and much more on the distributors who are violating federal and state laws by making the drug available for non-approved uses.

Daily Steroid Briefing

1.  Is Bowser or Spot ingesting steroids in pet food?  (Natural News)

2.  Interesting story from India:  Renegade doctor disguised steroids as 'turtle blood'; patients felt immediate boost.  (MedIndia.com)

3.  Researchers find that old muscle cells inhibit cell regeneration by producing a chemical called "TGF-beta".  Modulating stem cells reversed aging on older muscle.  (Technology Review)

4.  More animal stories: Don't give those Greyhounds any more anabolic steroids. (AzStarNet.com)

5. Steroid user (along with meth, coke, maryjane, and other drugs) wanted to kill OKlahoma prosecuting DA.  (News Examiner-Enterprise)

Dissociative Identity Disorder keeps altering Herschel Walker Walker Walker Walker

Ex-UGA Bulldog great, and ex-NFL running back Herschel Walker says that he exhibited multiple personalities, known as 'Dissociative Identity Disorder" (DID).  Walker (apparently the main one) writes about his 'alters' in his new book "Breaking Free", out now.

Walker makes it clear that he did not suffer physical or sexual abuse during childhood.  Interesting because abuse is considered the causal factor of DID. Kinda like manifesting 'strep throat' without exposure to the streptococcus bacteria.

Walker opens the book with an anecdote in which he became enraged about a botched Mercedes delivery.  He attributes this rather mundane episode to DID.  We would attribute it to a temper tantrum.  Whatever, you can't write a book about your rather common anger control problems; you can write a book about your multiple personalities.  Apparently every mood a Walker feels belongs to a different personality.  Terrell Owens must harbor a few hundred personalities.

Walker also mixes in a good bit of Christian theology in the mix, along with the prejudice experienced in the South when he grew up.

Walker explains relatively mundane chapters of his life -- such as anxiety about having his wisdom teeth pulled -- as a manifestation of DID.  Sounds like he was simply anxious about needles.

Walker relates a number of behavior problems throughout his career --attributed to DID -- and complaints about teams and coaches.  It is unclear which personality messed up the famous Viking-Cowboy trade.  Walker can't remember a number of life events including threatening his wife.

Walker would be better off seeing a competent psychiatrist for a better diagnosis.  Then again, that might not be a best-seller.  However, he could no longer form his own personal multi-personality football team.

Daily Steroid Briefing

1.  Texas man nailed with internet steroids sales. (Media Newswire)

2. Tailored workout for heart problems?  No juicers allowed.  (CBS News)

3.  Feel bad about Marion Jones's teammates stripped of Olympic medals? Contribute to the defense fund so they can sue.(Bloomberg)

Focusing attention on baseball's ADHD anti-deficit

The Los Angeles Times focused on the ADHD (Attention-deficit Hyperactivity Disorder) epidemic in baseball.  It appears that with the initiation of serious drug testing in MLB, the number of therapeutic use exemptions for ADHD, has mushroomed. (photo is the Pirate's Adam LaRoche, diagnosed with ADHD)

In 2006, the major leagues granted exemptions for attention deficit disorder medication to 28 players. In 2007, that number jumped to 103...

...attention deficit disorder, a condition that for one day last winter overshadowed steroids on Capitol Hill. In the wake of the Mitchell Report, in a hearing that otherwise resembled a Washington victory lap for baseball's oft-beleaguered leadership, Rep. John Tierney (D-Mass.) broke off a wicked curve.

George Mitchell had wanted to know how many medical exemptions had been granted so players could use banned substances -- "a significant loophole in some drug-testing programs," the former U.S. senator had written in his report. Baseball had refused to hand that data to Mitchell, citing the confidentiality in its testing program.

Tierney wanted to know too, and this time baseball provided the figures rather than risk a subpoena from Congress. And Tierney read the numbers aloud, live on television: In 2006, baseball granted exemptions for ADD drugs to 28 players. In 2007, that number jumped to 103.

From 28 to 103, about a 3.5 times increase in TUEs.  However, we would think that the '28' figure might be an artificially low number -- new procedure produces an artificial base.  There are about 1400 players in MLB.  If the prevalence of ADHD is about 7% (low estimate), then about 105 players should exhibit ADHD.  Except the figures lie.  The usual prevalence numbers consider males and females.  MLB obviously plays males only.  So expect slightly under doubling the prevalence (as some of the number would be females).  Fourteen percent would be 196 players with ADHD.  The number quoted above makes more sense now.

Side effects of the drug:

The drugs are not without risk, said Julie Dopheide, associate professor of clinical pharmacy at USC. As stimulants, she said, they could improve concentration even in people without ADD, but side effects could include irritability and anxiety. The drugs also could increase pulse rate and blood pressure, she said, particularly dangerous to anyone with an underlying heart condition.

Those side-effects named above are significant but usually mild. In the hands of a good doctor side effects are minimized.

As the Times article continues it isn't easy to obtain the TUE for a stimulant, thus we doubt that MLB players abuse the diagnosis of ADHD to obtain amphetamines,

Studies suggest anabolic steroids produce long term changes in muscle structure

The Wall Street Journal dug up an interesting study from Umea University.  The study from the Department of Integrative Medical Biology at Umea (Sweden) demonstrated long term muscle changes in anabolic steroids users -- despite current abstinence.   The WSJ related these changes to MLB stats. (here)

In the study, which was completed in October 2006 by the Department of Integrative Medical Biology at Sweden's Umea University, researchers took muscle biopsies from 26 elite powerlifters who have competed at the sport's highest levels. Ten of the volunteers said they were not steroid users, but the other 16 had either admitted using these drugs in the past or said they were currently using them. Not only is it unusual for scientists to study elite athletes of any kind, it's almost impossible to study top athletes who are using steroids in competition.

When the researchers looked at the subjects' muscles through a microscope, they made a surprising discovery: Rather than returning to their original proportions, the muscles of the steroid users who'd stopped taking the drug looked remarkably similar to those of the subjects who were still using. They also had larger muscle fibers and more growth-inducing "myonuclei" in their muscle cells than the nonsteroid users.

The Journal says the study was published at the U of Umea's website, however this may be the journal abstract.

Interesting that anabolic steroid use increases muscle fiber size, and increases myonuclei number.  Perhaps this priming effects on muscle cells produces not only acute effects to enhance strength, but also enhances the use of HGH later in 'abstinent steroid users' (or concurrent users) as noted in this study.

Strength, peak power output and IGF-I significantly increased and total protein, albumin and free tetra-iodothyronine significantly decreased compared to controls (p < 0.05) and within the GH group (p < 0.017). Fat-free mass index and VO₂ peak significantly increased, while body fat and thyroid-stimulating hormone significantly decreased within the GH group (p < 0.017). Conclusions: Short-term rhGH increased strength and power. Of therapeutic value is the possibility that muscle bulk and strength could be increased in patients with muscle-wasting conditions.

Thus, one of the reasons administering HGH to college students does not enhance strength -- their muscle cells are not previously primed with AASs.  Charles Yesalis understands this:

Charles Yesalis, a former strength coach and professor emeritus of health policy and administration at Pennsylvania State University, says athletes who continue to train can retain as much as 85% of their gains from using drugs. This isn't based on muscle biopsies or peer-reviewed research, he says, but on 30 years of experience with athletes. He says he has talked privately with hundreds of dopers, some of them champions, and has seen the permanent benefits of performance-enhancing drugs. "These things are like rocket fuel," he says.

Review from Stanford says HGH no benefit as PED

In a comprehensive review of HGH used as a PED (performance enhancing drug) a team at Stanford says that current evidence suggests no anabolic effect for the hormone.  (although this paper is called a study, it isn't; it is a review or meta-analysis of past papers)

Athletes who take human growth hormone may not be getting the boost they expected. While growth hormone adds some muscle, it doesn't appear to improve strength or exercise capacity, according to a review of studies that tested the hormone in mostly athletic young men.

"It doesn't look like it helps and there's a hint of evidence it may worsen athletic performance," said Dr. Hau Liu, of Santa Clara Valley Medical Center in San Jose, Calif., who was lead author of the review.

Growth hormone, or HGH, is among the performance enhancers baseball stars Roger Clemens and Andy Pettitte were accused of taking in the blockbuster Mitchell Report. Clemens denies using the hormone, while Pettitte admits using it.

Will there be new studies of HGH as a PED?  Maybe, maybe not.

But the new research has some limitations and sheds no light on long-term use of HGH. The scientists note their analysis included few studies that measured performance. The tests also probably don't reflect the dose and frequency practiced by athletes illegally using the hormone. Experiments like that aren't likely to be conducted.

"It's dangerous, unethical and it's never going to be done," said Dr. Gary I. Wadler, a member of the World Anti-Doping Agency and a spokesman for the American College of Sports Medicine.

There were significant differences noted with HGH, in the analysis.  Lean body mass increased in the HGH subjects.  Strength (measured in the studies) did not increase in the HGH subjects.  However side effects became more prominent with HGH use -- edema (tissue swelling) and and joint aches (like carpel tunnel syndrome).

As we pointed out in the Huffington Post, HGH by itself may not be anabolic.  There is evidence that the hormone is synergistic with anabolic steroids (or insulin or T4), which means that the effects of these hormones add to each other.  Further, we don't know the effects of the drugs on the most genetically gifted athletes - professionals.

However, a study is a study.  HGH by itself in these doses used in young healthy men does not appear to be an impressive anabolic drug.

 

Catching-up: gene doping, Florida steroids and more

Here are a few commentaries from last week we need to note:

1.  in 'Designing Improved Humans', Henry Miller, M.D., discusses performance enhancement's march to gene doping:

The well-publicized use by athletes of performance-enhancing drugs including androgenic steroids and human growth hormone has gotten more people than ever before thinking and talking about the subject. But the issue is neither new nor limited to a small number of people...

Technology will soon offer even more extreme possibilities for enhancement. Scientists, using gene therapy to increase the levels of a single enzyme, recently created a strain of mice with increased physical abilities by genetically altering a gene that affects metabolism. By injecting an active form of the gene PEPCK-C into an embryo, the scientists found that the mouse more efficiently burns body fat for energy and produces less lactic acid during exercise...

These experiments have reinvigorated a long-running debate about the ethics of creating designer humans. “We’re in an era when breakthroughs in biology and intelligence are outpacing the culture’s capacity to deal with the ethics,” said Joe Tsien, Ph.D., the Princeton University molecular biologist who directed the development of a “smart mouse” almost a decade ago. “There will be issues of access and who can afford it and whether the social wealthy class will have the intellectual advantage over poor people.” As though attending M.I.T. instead of Florida A&M doesn’t confer an intellectual advantage.

Artificial enhancement was also addressed in the Sports Illustrated article here.

2:  The Broward-Palm Beach New Times looks at the HGH-promoting Anti-aging clinics in Florida.  The article begins idyllically:

Grass doesn't get any greener than on major-league baseball's spring training fields. It's the annual dawn of each season, when vivacious young hopefuls play catch with millionaire all-stars. That was the scene on a February morning at Roger Dean Stadium in Jupiter, spring training home of the St. Louis Cardinals.

Then turns incongruously ironic:

One year ago, this citadel of major-league baseball wasn't so serene. Investigators contend that South Florida is not just a popular spring training destination but also the epicenter of a nationwide network distributing illicit prescription steroids and human growth hormones.

To follow a minor league player, juicing through an Anti-aging clinic.

J says he paid about $1,000 per stack. A "stack" is a combination of steroids and HGH that comes as a package. It's generally used for a one-month workout cycle. When his first stack arrived, he says, he called a number he had for Palm Beach Rejuvenation Center to figure out how to use it. "I didn't want to inject the wrong thing — this into that or in the wrong order or whatever, and have something bad happen." The conversation was awkward initially, but he got the information he needed.

Near the television in his apartment, J has a photo of himself and two friends posing in a weight room. He was a late-round draft pick out of high school only a few years ago. The signing bonus offered to him was less than $100,000, but it was enough for him to decide to forgo college (and scholarship eligibility) and move straight into rookie-league ball, the bottom of the minor leagues. He had mild success his first season but got hurt halfway through. He was injured again early into his second season.

Reminds us of the story yesterday documenting a minor league draftee testing positive for a PED.

This is a very well researched piece; it should go into the reference bank of Anti-aging clinic performance-enhancement doping.

Sports Illustrated takes a look at HGH and anti-aging

In a well-written Sports Illustrated piece, Jack McCallum looks at how enhancement pervades American culture, in sports, in the arts -- in almost all aspects of life.  A nation on dope.  A Steroid Nation.

We are a juiced nation.

We are a nation on dope.

We are a nation looking for enhancement, a way to age gracefully, perform better and longer, and, at the outer edge, vanquish what was once considered that alltime undefeated opponent known as aging. We do that by Botoxing our wrinkles, lifting our faces, reconstructing our noses, despidering our veins, tucking our tummies, augmenting our breasts and taking a little pill to make sure we're ready when, you know, the right time presents itself. We also do it by injecting human growth hormone (HGH) and testosterone, America's new golden pharmaceutical couple...

The truth is, sports do not define the culture -- they reflect it. Society's image of the ideal body is shaped largely by forces outside the chalked lines. And the belief that life can be improved, even extended, by drugs comes not from sports but from the burgeoning field known as antiaging medicine.

This is good stuff.  We should take the time to analyze this article, however right now, we can only point you to the SI site to read the work.

We point out that the steroids/PED/HGH aspect may only be the tip of the iceberg on this issue.  How far will enhancement - drug, hormonal, cosmetic, surgical, silicone -- take humans?  Will we be cyborgs in the future, part man, part machine, part materials, part hormones?

(and by the way, we have a small quote in the article, but by far the most profound quote -- OK not all that profound...but it is small)

 

 

Bobby Murcer confesses to steroid use...for treatment

Yankee great Bobby Murcer, now battling 'brain cancer' says he takes steroids.  Hey, but these are therapeutic steroids.

Murcer's battle with cancer is well known.  Treatment for the tumor consisted of chemotherapy and radiation therapy last winter.  Murcer resumed activites as Yankee broadcaster recently, however his doctors noted an ominous shadow on a brain MRI.  Story in the NY Daily News:

After getting the good news Wednesday that the ominous spot on his brain was not the return of cancer, an "ecstatic" Bobby Murcer expressed thanks to all his fans and well-wishers for their answered prayers.

"I just want everyone to know how grateful I am for their prayers," Murcer told the Daily News from his home in Oklahoma City. "It was a pretty scary thing and I didn't realize how complex this whole thing was going to be, but the good news is the spot turned out to be scar tissue and not a new tumor. I'm ecstatic."

The 61-year-old Murcer, who is battling a particularly aggressive form of brain cancer, is in a special experimental program at M.D. Anderson Hospital in Houston.

After six weeks of chemotherapy and radiation last winter, he was able to resume his broadcasting duties with the Yankees. But last week a routine MRI revealed a spot in the same area of his brain from which the initial tumor was removed in December of '06, prompting doctors to order a biopsy. Yesterday, the biopsy revealed the spot to be only scar tissue and not another tumor.

As Murcer related, the procedure was almost as intense as the original surgery.

"I didn't know they were going to have to go back in there with a needle into my brain to take the tissue out," he said. "The whole thing took about three hours and I'm pretty wiped out right now. Wiped out, but ecstatic. I thank the Good Lord for looking over me."

Murcer said he plans to spend the rest of the spring at home in Oklahoma City resting up, but vowed, as he did last year, to be back in the booth for Opening Day.

Murcer then 'admitted' to steroids.  Actually these would be corticosteroids, used to prevent reflex brain swelling.

"Tell everyone I'll see them then," he said. "And, oh yes, tell them to forgive me, but I'm on steroids now! I know they don't want to hear this, but that's what the doctors have me taking."

See, there is a place for steroids in medicine, when used properly.  And no one will ask Murcer to testify before Congress...let's keep Bobby Murcer in our thoughts.

 

New book on gay health targets steroid abuse

A new book on health care issues in gay men lists steroid use as problematic. The Windy City Media Group looks at a new book on gay health by Dr. Frank Spinelli.

Dr. Frank Spinelli never saw any books that directly focused on current, wide-ranging health issues affecting gay men, so he wrote one.

The result is The Advocate Guide to Gay Men's Health and Wellness ( Alyson Books; $18.99 ) , a first-of-its-kind resource for life-enhancing holistic medicine. Informational and inspirational, the book provides an in-depth, easy-to-read look at the issues that affect the emotional, mental, spiritual and physical well-being of gay men...

Spinelli stresses the importance of a good physical exam annually, one geared to a gay man.

The book itself is geared for the 40-and-over crowd, “but there's something in it for everyone,” he said, pointing out sections about gay sex and STDs.

“Being gay has a lot to do with how you see your health, how you talk to your doctor, including what you talk to your doctor about,” Spinelli said.

Dr. Spinelli says anabolic steroid and HGH use needs to be addressed in the gay community:

The book also addresses steroid and recreational drug use within the gay community—and, yes, both are a major problem, he said.

“When I moved to New York, I had never even heard of a circuit party, let alone knew what went on at them, including the amount of drugs consumed at them,” Spinelli said. “I really see crystal meth as a major problem in the gay community. I can't even begin to imagine how much we've underestimated its use. It's probably much higher than its given statistically.

“Anabolic steroids definitely are a problem within the gay community. They definitely are having an impact in the community. Same for human growth [ hormone ] .”

The book also offers information about gay man's physical exams and tips to avoid contracting a new bacterial skin disease that has been silently plaguing the gay community since 2002. Also, Spinelli writes about eating disorders, among other topics.

We would suspect of "Appearance Enhancement" as the root of the steroid and HGH use in this population.  Certainly a topical subject.

Teenage steroid use is alive and not so well

We were recently asked by a major news magazine if teenage steroid and PED use constitutes a significant health problem.  The answer: a resounding yes.

Like health problems such as child abuse, elder abuse and date rape, adolescent steroid use exists underground and sometimes undetectable.  Most physicians, parents, teachers, and others in contact with teens do not understand the issue.  How many doctors, for instance, work out at Gold's Gym (or 1 on 1 Elite Personal Fitness in Deer Park, TX) to understand the culture of covert PED use?

At our hospital -- the University of Iowa -- the lab tests to detect steroid use (detection of nandrolone, T:E ratio etc.) are not offered.  Clinicians and lab personnel do not appreciate the appropriate labs to detect the problem.  Therefore, when a 'bulked-up' teen athlete presents with unusually aggressive behavior, the possibility of steroid use is not considered or not investigated.  (Following a recent presentation on steroid use, this author was criticized because the issue was not clinically relevant.)

However, the International Herold Tribune points out that teen 'roid abuse exists, and can be deadly (also Boston Globe).

She just wanted six-pack abdominal muscles. So in the summer of 2003, Dionne Passacantando, a 17-year-old high school cheerleader, gymnast, and vice president of her Allen (Texas) High School class, made a decision she regrets. She bought anabolic steroids from a boy on the school football team.

"Nobody frowned upon it," she said. "It was easier for me to get those than it probably was to buy beer."

But after injecting herself with Winstrol every other day for five weeks, she became suicidal.

"I was the last person in the world you'd think would use anabolic steroids," she said.

There are those who argue that steroid abuse does not induce behavioral changes.  There are those who argue the drugs do not produce significant side effects.  Any story that purports those claims should be either regarded with skepticism, or perhaps treated with disdain (you decide).

There are those who say that steroid and PED use be treated like Lasik surgery, as an aid to performance improvement.  Anyone ever see a patient who underwent Lasik surgery murder his son, and his wife, then kill himself as Chris Benoit did?

The young lady from Texas (cheerleaders now use 'roids) knew about Tyler Hooton:

he July 2003 suicide of 17-year-old Taylor Hooton has haunted her.

Hooton and Roberts never met, though their schools are rivals just north of Dallas.

"We probably knew the same people and probably got our stuff from the same people," Roberts said.

Hooton was a 6-foot-2-inch, or 1.88-meter, 180-pound, or 82 kilogram, pitcher for his Plano, Texas, high school team. According to the Hooton family, Taylor was told by his coach that "he needed to be bigger" for his senior year. Taylor used steroids, became depressed, and hanged himself from his bedroom door on July 15, 2003.

His father, Don Hooton, started the Taylor Hooton Foundation to fight steroid abuse...

The week Taylor Hooton died was the week Dionne Roberts started using steroids, she said. She said at least half the Allen football team was on steroids.

"A lot of parents and coaches were OK with the fact that this was going on," she said. "I feel it was even encouraged to a point."

The school's athletic director, Steve Williams, disputes that.

"I'd have a hard time believing that's the truth," he said. "We have no knowledge of that. Are we naive to say steroids don't exist here? No."

Unfortunately the AD is wrong: physicians nurses, coaches, AD, and principals are not well educated about teen steroid use, and often unaware (in other cases coaches promote it).  While adolescent PED abuse is not public health problem #1, it is as not insignificant as some will tell you.

It won't be long until American teen females suffer the same problems the girls from the East German doping machine suffered: short term problems including voice changes, genital hypertrophy, and long term problems including mood changes and birth defects.  Then maybe someone will believe.