Validation of the growth hormone (GH)-dependent marker method of detecting GH abuse in sport through the use of independent data sets

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Growth Horm IGF Res. 2007 Oct;17(5):416-23. Epub 2007 Jun 20.
Erotokritou-Mulligan I, Bassett EE, Kniess A, Sonksen PH, Holt RI.
Endocrinology and Metabolism Sub-Division, School of Medicine, University of Southampton, IDS Building (MP887), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, United Kingdom

CONTEXT: The detection of exogenously administered growth hormone (GH) poses a formidable challenge but a detection method based on the measurement of two GH-dependent markers, IGF-I and type 3 pro-collagen (P-III-P) has been proposed. The measurement of multiple markers in conjunction with discriminant functions can improve the sensitivity and specificity of detection compared with single marker analysis.
OBJECTIVE: To provide further validation of the GH-dependent marker approach.
DESIGN: Analysis of discriminant function scores for GH detection on independent datasets. SETTING: Two independent (GH-2000 and Kreischa) double blind, placebo controlled, hGH administration studies.
SUBJECTS: Healthy active male volunteers.
INTERVENTION: GH-2000 proposed a discriminant function involving IGF-I and P-III- P while the Kreischa function involved IGF-I, P-III-P and IGFBP-3. After adjustment for assay differences the formulae were applied to the other dataset.
OUTCOME MEASURES: Ability to detect GH use in independent datasets using a predefined specificity of approximately 1 in 10000.
RESULTS: The GH-2000 formula was able to detect 90% of those receiving GH in the Kreischa study at one or more time points during the study period. This sensitivity was similar to that obtained on the original GH-2000 dataset. The Kreischa formula correctly identified 41% of individuals receiving GH in the GH-2000 study.
CONCLUSIONS: The study provides further validation that the test proposed by GH-2000 based on IGF-I and P-III-P concentrations can be used to detect subjects receiving exogenous GH.

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Syncope due to Brugada syndrome in a young athlete

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Br J Sports Med. 2007 Mar;41(3):180-1. Epub 2006 Nov 30
Esperer HD, Hoos O, Hottenrott K.
Medical Department, Otto von Guericke University, Magdeburg 39130, Germany.

A 30-year-old male athlete with exercise-related syncopal symptoms spontaneously exhibited a type 1 Brugada ECG and was inducible during electrophysiology study. He was diagnosed with symptomatic Brugada syndrome and deemed at high risk of sudden cardiac death. Thus, he received a cardioverter/defibrillator and was advised to abstain from further competitive sports activities. This case points to a role of the ECG in pre-participation screening. It also demonstrates that, in athletes with Brugada syndrome, repolarisation anomalies may be markedly attenuated during vigorous exercise and considerably increased immediately after exercise. The observed J-wave amplitude dynamics suggests enhancement of pre-existing autonomic dysfunction through heavy exertion.

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Is science killing sport?

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EMBO Rep. 2007 May;8(5):433-5.
Is science killing sport? Gene therapy and its possible abuse in doping.
Filipp F.

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Use, abuse & biomedical detection of anabolic steroids and glucocorticoids in sport

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Articles in French

Ann Endocrinol (Paris). 2007 Sep;68(4):308-14. Epub 2007 Aug 8
Use and abuse of anabolic steroids and glucocorticoids in sport
Duclos M.
Service de medecine du sport et des explorations fonctionnelles, CHU de Gabriel-Montpied, 58, rue Montalembert, 63003 Clermont-Ferrand cedex 01, France
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Ann Endocrinol (Paris). 2007 Sep;68(4):304-5. Epub 2007 Jul 31
Biochemical detection of hormone abuse
Saugy M.
Laboratoire suisse d'analyse du dopage, institut de medecine legale de l'universite de Lausanne, centre hospitalier universitaire Vaudois, 1005 Lausanne, Suisse.
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Ann Endocrinol (Paris). 2007 Sep;68(4):306-7. Epub 2007 Jul 24
hGH-abuse in athletes.
Strasburger CJ, Wu Z, Bidlingmaier M.
Department of Medicine, Division of Clinical Endocrinology, Campus Mitte, Charite Universitatsmedizin Berlin, 1, Chariteplatz, 10117 Berlin, Germany
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Sport's medicalization

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Recenti Prog Med. 2007 Sep;98(9):433-6
Article in Italian
Cristani A, Romagnoli E, Boldrini E.
Unita Operativa di Medicina II, Dipartimento di Medicina Interna e Specialita Mediche, Ospedale Policlinico, Universita degli Studi di Modena e Reggio Emilia, Modena

Medicalization (abuse of sport drinks, supplements and drugs) involves more and more of the sport world, casting doubt on the credibility of results. causes and responsibilities are individuated. Characteristics of two commonly used supplements (creatine, branched-chain amino acids) are analyzed in order to show risks and ambiguities for athletes and the way to come out of it.

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Outcomes of a prospective trial of student-athlete drug testing: the Student Athlete Testing Using Random Notification (SATURN) study

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J Adolesc Health. 2007 Nov;41(5):421-9
Goldberg L, Elliot DL, MacKinnon DP, Moe EL, Kuehl KS, Yoon M, Taylor A, Williams J.
Department of Medicine, Oregon Health & Science University, Portland Oregon 97239-3098, USA

PURPOSE: To assess the effects of random drug and alcohol testing (DAT) among high school athletes. METHODS: This was a 2-year prospective randomized controlled study of a single cohort among five intervention high schools with a DAT policy and six schools with a deferred policy, serially assessed by voluntary, confidential questionnaires. DAT school athletes were at risk for random testing during the full academic year. Positive test results were reported to parents or guardians, with mandatory counseling. Indices of illicit drug use, with and without alcohol use, were assessed at the beginning and end of each school year for the past month and prior year. Potential mediating variables were evaluated. RESULTS: Student-athletes from intervention and control schools did not differ in past 1-month use of illicit drug or a combination of drug and alcohol use at any of the four follow-up periods. At the end of the initial school year and after 2 full school years, student-athletes at DAT schools reported less drug use during the past year (p < .01) compared to athletes at the deferred policy schools. Combining past year drug and alcohol use together, student-athletes at DAT schools reported less use at the second and third follow-up assessments (p < .05). Paradoxically, DAT athletes across all assessments reported less athletic competence (p < .001), less belief authorities were opposed to drug use (p < .01), and indicated greater risk-taking (p < .05). At the final assessment, DAT athletes believed less in testing benefits (p < .05) and less that testing was a reason not to use drugs (p < .01). CONCLUSIONS: No DAT deterrent effects were evident for past month use during any of four follow-up periods. Prior-year drug use was reduced in two of four follow-up self-reports, and a combination of drug and alcohol use was reduced at two assessments as well. Overall, drug testing was accompanied by an increase in some risk factors for future substance use. More research is needed before DAT is considered an effective deterrent for school-based athletes.

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Also see: Comment in J Adolesc Health. 2007 Nov;41(5):419-20.

Dietary Supplementation of High-performance Canadian Athletes by Age and Gender

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Clin J Sport Med. 2007 Nov;17(6):458-464
Erdman KA, Fung TS, Doyle-Baker PK, Verhoef MJ, Reimer RA.
Faculty of Kinesiology; Faculty of Medicine, Department of Community Health Sciences; and Faculty of Medicine, Department of Biochemistry & Molecular Biology at the University of Calgary, Calgary, Canada.

OBJECTIVE:: To determine dietary supplementation practices and opinions, preferred means for dietary supplement (DS) education, and antidoping opinions among elite Canadian athletes varying in age and gender. DESIGN:: A descriptive, cross-sectional survey.
SETTING:: Elite athlete training centers in Calgary, Canada and surrounding area.
PARTICIPANTS:: A total of 582 high-performance athletes (314 male, 268 female). MAIN
OUTCOME MEASURES:: High-performance athletes representing 27 sports with a mean age of 19.96 +/- 3.91 years completed a validated questionnaire assessing DS practices and opinions by recall. Sport categories included varsity, Canadian Sport Centre Calgary (CSCC), and National Sport School (NSS).
RESULTS:: There was extensive DS use, with 88.4% of participants taking >/=1 DS (mean of 3.08 +/- 1.87 DS per user) during the previous 6 months. Overall, sport drinks (22.4%), sport bars (14.0%), multivitamins and minerals (13.5%), protein supplements (9.0%), and vitamin C (6.4%) were most frequently reported. Older athletes were significantly more likely to report greater DS usage; to be advised by teammates, health food store retailers, and magazines; to prefer supplementation education via individual interviews; to claim awareness of anti-doping rules; and to perceive anti-doping compliance. Relative to gender, significant differences were observed for the types of DS reported; supplementation advisors; justifications for DS use; and awareness of anti-doping regulations.
CONCLUSIONS: Utilization of this validated and reliable questionnaire has the potential for broad use and provides insight into the factors that influence DS use in elite athletes.

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Validation of the growth hormone (GH)-dependent marker method of detecting GH abuse in sport through the use of independent data sets

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Growth Horm IGF Res. 2007 Oct;17(5):416-23. Epub 2007 Jun 20.
Erotokritou-Mulligan I, Bassett EE, Kniess A, Sonksen PH, Holt RI.
Endocrinology and Metabolism Sub-Division, School of Medicine, University of Southampton, IDS Building (MP887), Southampton General Hospital, Tremona Road, Southampton SO16 6YD, United Kingdom.

CONTEXT: The detection of exogenously administered growth hormone (GH) poses a formidable challenge but a detection method based on the measurement of two GH-dependent markers, IGF-I and type 3 pro-collagen (P-III-P) has been proposed. The measurement of multiple markers in conjunction with discriminant functions can improve the sensitivity and specificity of detection compared with single marker analysis.
OBJECTIVE: To provide further validation of the GH-dependent marker approach.
DESIGN: Analysis of discriminant function scores for GH detection on independent datasets.
SETTING: Two independent (GH-2000 and Kreischa) double blind, placebo controlled, hGH administration studies. SUBJECTS: Healthy active male volunteers.
INTERVENTION: GH-2000 proposed a discriminant function involving IGF-I and P-III- P while the Kreischa function involved IGF-I, P-III-P and IGFBP-3. After adjustment for assay differences the formulae were applied to the other dataset.
OUTCOME MEASURES: Ability to detect GH use in independent datasets using a predefined specificity of approximately 1 in 10000. RESULTS: The GH-2000 formula was able to detect 90% of those receiving GH in the Kreischa study at one or more time points during the study period. This sensitivity was similar to that obtained on the original GH-2000 dataset. The Kreischa formula correctly identified 41% of individuals receiving GH in the GH-2000 study.
CONCLUSIONS: The study provides further validation that the test proposed by GH-2000 based on IGF-I and P-III-P concentrations can be used to detect subjects receiving exogenous GH.

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Switch off the light on cycling, switch off the light on doping

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Br J Sports Med. 2007 Nov 5; [Epub ahead of print]
Lippi G, Franchini M, Guidi GC.
Sez. Chimica e Clinica, Dip. Scienze Morfologico-Biomediche, Verona University, Italy

There is rather a long history of fraud in sport competitions, and doping has plagued the Tour de France almost since its beginning in 1903, culminating on July 13, 1967, with the dramatic death of British cyclist Tom Simpson on the climb of the Mont Ventoux, attributed to the use of amphetamines and complicated by the now defunct practice of drinking as little as possible (1). Nearly a year after the 2006 "Tour de Chaos", when nine riders were ruled out of the race suspected to be implicated in an international doping probe based on blood transfusions and the winner of the Yellow jersey tested positive for testosterone (2), a sequel of events have again plagued the 2007 edition. First, a German rider was caught non-negative for testosterone in an out-of-competition antidoping control a few days before the start of the race. Then, an Italian rider was "non-negative" in a doping test for testosterone after stage 11 and a Spanish rider was also found guilty for erythropoietin misuse on the second rest day after stage 15. Later on, a Kazakh top-class rider and Tour contender has tested positive two times in 3 days, after stage 13, an individual time trial, which he won on an "impressive" manner, and after the mountains stage 15. The rider was suspected to have used blood doping by autologous transfusion, since a double red blood cell population was detected during a in-competition antidoping testing. Least but not last, the Danish rider who was wearing the yellow jersey (and already acclaimed as Tour winner) was fired by his team and was forced to withdraw from the race three stages to the end of the race because he has failed to heed several warnings about not informing the his national cycling federation regarding his whereabouts for possible unannounced doping tests (information on the whereabouts is vital for the effectiveness of out-of-competition random testing, to which the UCI attaches great importance). Finally, 2007 yellow jersey winner was formally enquired as a client of blood doping doctor Fuentes, involved in huge doping scandal widely known as "Operacion Puerto" (2). In a immediate reaction on what it is supposed to be the "greatest swindle in sport history", and which came not long after several Tour contenders (including the two riders who won the yellow and green jerseys in 1996) formally admitted to doping, the major German TV channels have decided to stop broadcasting the Tour, a resolution which was supported by most German political parties. Practically, it sounded exactly as "the right point in time to say enough is enough". The disappointing number of cyclists still involved in doping cases clearly attests that the innovative and pervasive strategies adopted by the World Anti-Doping Agency (WADA), the International Cycling Unit (ICU) and several other Sport federations (3) are effective on an analytical basis, but they are probably inefficient to either prevent athletes to dope or modify this upsetting trend towards abuse of doping practices. Several top class athletes have been familiar with doping over the past decade and will probably continue to dope in the years to come, since their inclination to victory, along with the mirage of glory and money, will always overcome the risk of being found guilty. A strategy only based on prosecuting athletes to protect their health is no longer necessary, and it may even turn to be unproductive and costly (4). Therefore, a more radical strategy is needed. Since the enormous economical revenues around the most famous sports events worldwide (Olympics, football Word Championships, Tour de France) is thoroughly linked to sponsors and media coverage, the time has come to draw a line, and stop the media coverage of those events in which doping cases are revealing commonplace. In this perspective, the German TV channels have taken a foremost and audacious resolution. Desolately, little is changed form the 2006 "Tour de Chaos", and the situation has even degenerated (2). Since it is inconceivable that cycling is the only sport where doping is commonplace, the interruption of broadcasting sports competitions where doped athletes participate should be considered an advisable resolution, which should be extended to a variety of other sports events. The time has come to switch off the light on doping.

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Detraining and tapering effects on hormonal responses and strength performance

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J Strength Cond Res. 2007 Aug;21(3):768-75.
Izquierdo M, Ibanez J, Gonzalez-Badillo JJ, Ratamess NA, Kraemer WJ, Hakkinen K, Bonnabau H, Granados C, French DN, Gorostiaga EM.
Studies, Research and Sport Medicine Center, Government of Navarra, Navarra, Spain.

This study examined the impact of 4 weeks of either complete cessation of training (DTR) or a tapering period (TAP; short-term reduction of the strength training volume, while the intensity is kept high), subsequent to 16 weeks of periodized heavy resistance training (PRT) on strength/power gains and the underlying physiologic changes in basal circulating anabolic/catabolic hormones in strength-trained athletes. Forty-six physically active men were matched and randomly assigned to a TAP (n = 11), DTR (n = 14), or control group (C; n = 21), subsequent to a 16-week PRT program. Muscular and power testing and blood draws to determine basal hormonal concentrations were conducted before the initiation of training (T0), after 16 weeks of training (T1), and after 4 weeks of either DTR or TAP (T2). Short-term DTR (4 weeks) results in significant decreases in maximal strength (-6 to -9%) and muscle power output (-17 and -14%) of the arm and leg extensor muscles. However, DTR had a significant (p < 0.01) larger effect on muscle power output more than on strength measurements of both upper and lower extremity muscles. Short-term (4 weeks) TAP reached further increases for leg (2%) and arm (2%) maximal strength, whereas no further changes were observed in both upper and lower muscle power output. Short-term DTR resulted in a tendency for elevation resting serum insulin-like growth factor (IGF)-1 concentrations, whereas the corresponding TAP experienced elevation in resting serum insulin-like binding protein-3 (IGFBP-3). These data indicated that DTR may induce larger declines in muscle power output than in maximal strength, whereas TAP may result in further strength enhancement (but not muscle power), mediated, in part, by training-related differences in IGF-1 and IGFBP-3 concentrations.

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Mass spectrometric determination of insulins and their degradation products in sports drug testing

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Mass Spectrom Rev. 2007 Nov 13; [Epub ahead of print]
Thevis M, Thomas A, Schanzer W.
Institute of Biochemistry and Center for Preventive Doping Research, German Sport University Cologne, Carl-Diem Weg 6, 50933 Cologne, Germany.

Insulins' anabolic and anti-catabolic properties have supposedly led to its misuse in sport. Hence, doping control assays were developed to allow the unequivocal identification of synthetic insulin analogs and metabolic products derived from human insulin and its artificial counterparts in urine and plasma specimens. Analyses were based on immunoaffinity purification and subsequent characterization of target analytes by top-down sequencing-based approaches, which were conducted with hybrid tandem mass spectrometers that consisted of either quadrupole-linear ion trap or linear ion trap-orbitrap analyzers. Diagnostic product ions and analytical strategies are presented and discussed in light of the need to unambiguously identify misused drugs in urine and plasma specimens for doping control.

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Screening for 2-quinolinone-derived selective androgen receptor agonists in doping control analysis

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Rapid Commun Mass Spectrom. 2007;21(21):3477-86
Thevis M, Kohler M, Maurer J, Schlorer N, Kamber M, Schanzer W.
Center for Preventive Doping Research-Institute of Biochemistry, German Sport University Cologne, Carl-Diem Weg 6, 50933 Cologne, Germany.

Selective androgen receptor modulators (SARMs) represent a class of emerging drugs with high potential for misuse in sports, and therefore members of this group are banned as anabolic agents by the World Anti-Doping Agency. Preventive approaches to restrict their use include early implementation of target analytes into doping control screening assays and evaluation of the mass spectrometric behavior of these drugs to allow their unequivocal identification as well as the characterization of structurally related compounds and metabolic products. Four model SARMs with the 6-alkylamino-2-quinolinone structure, including the advanced drug candidate LGD-2226, were synthesized. Fragmentation pathways after positive electrospray ionization and collision-induced dissociation were studied using an LTQ Orbitrap mass analyzer, and diagnostic product ions and common dissociation pathways were employed to establish a screening procedure targeting intact quinolinone-based SARMs as well as putative metabolic products such as dealkylated analogues. Therefore, features of a triple quadrupole mass analyzer such as multiple reaction monitoring and precursor ion scanning were utilized. Sample preparation based on commonly employed liquid-liquid extraction and subsequent liquid chromatographic/tandem mass spectrometric measurement allowed for detection limits of 0.01-0.2 ng/mL, and intra- and interday precisions between 3.2 and 8.5% and between 6.3 and 16.6%, respectively. Recoveries varied from 81 to 98%, and tests for ion suppression or enhancement effects were negative for all analytes.

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Performance enhancement with supplements: incongruence between rationale and practice

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J Int Soc Sports Nutr. 2007 Nov 12;4(1):19 [Epub ahead of print]
Petroczi A, Naughton DP, Mazanov J, Holloway A, Bingham J.

BACKGROUND: Athletes are expected to consider multiple factors when making informed decision about the nutritional supplement use. Besides rules, regulations and potential health hazards, the efficacy of different nutritional supplements in performance enhancement is a key issue. The aim of this paper was to find evidence for informed decision making by investigating the relationship between specific performance-related reasons for supplement use and the reported use of nutritional supplements.
METHODS: The 'UK Sport 2005 Drug Free Survey' data (n = 874) were re-analysed using association [chi-square] and 'strength of association' tests [phi] to show the proportion of informed choices and to unveil incongruencies between self-reported supplement use and the underlying motives. Results: Participants (n = 520) reported supplement use in the pattern of: vitamin C (70.4%), creatine (36.1%), whey protein (30.6%), iron (29.8%), caffeine (23.8%), and ginseng (8.3%) for the following reasons: strength maintenance (38.1%), doctors' advice (24.2%), enhancing endurance (20.0%) ability to train longer (13.3%), and provided by the governing body (3.8%). Of thirty possible associations between the above supplements and reasons, 11 were predictable from literature precedents and only 8 were evidenced and these were not strong (phi < .7). The best associations were for the ability to train longer with creatine (reported by 73.9%, chi-square = 49.14, p < .001; phi = .307, p < .001)], and maintaining strength with creatine (reported by 62.6%, chi-square = 97.08, p < .001; phi = .432, p < .001) and whey protein (reported by 56.1%, chi-square = 97.82, p < .001; phi = .434, p < .001).
CONCLUSION: This study provided a platform for assessing congruence between athletes' performance enhancing reasons for supplement use and their actual use. These results suggest that a lack of understanding in supplement use. There is an urgent need to provide accurate information which will help athletes make informed choices about the use of supplements.

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Exercise-related menstrual dysfunction: implications for menopausal health

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Menopause Int. 2007 Jun;13(2):88-9
Speed C.
Rheumatology and Sports and Exercise Medicine, Addenbrooke's Hospital, Cambridge, UK

Physical activity is a well recognized approach to the enhancement of general health and wellbeing in both healthy and diseased populations. However, excessive activity can result in exercise-related menstrual dysfunction (ERMD), which can adversely affect bone health and increase the risk of infertility and cardiovascular events in later life. Physicians should maintain a high awareness of EMRD in assessing health risks in the menopausal woman.

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The world anti-doping program and the primary care physician

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Pediatr Clin North Am. 2007 Aug;54(4):701-11, x-xi
Hilderbrand RL
United States Anti-Doping Agency, 1330 Quail Lake Loop, Suite 260, Colorado Springs, CO 80906, USA

The presence of a prohibited substance in an athlete's urine (or blood, when applicable) or the use of a prohibited method constitutes a doping offense, even if the substance is a pharmaceutical and is properly prescribed. To avoid a doping offense for the therapeutic use of a prohibited substance or method the International Standard for Therapeutic Use Exemptions (TUE) must be followed. When the TUE is required, the appropriate process must be completed before testing under conditions where the substance or method is prohibited. This article describes the World Anti-Doping Code and the International Standards, which are part of the Code. In addition, the procedures for the proper preparation and submission of TUE requests are presented along with the manner in which the requests are considered by the Therapeutic Use Exemption Committees.

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Anabolic-androgenic steroids: use and abuse in pediatric patients

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Pediatr Clin North Am. 2007 Aug;54(4):771-85, xii
Kerr JM, Congeni JA.
Northeastern Ohio Universities College of Medicine, 4209 State Route 44, PO Box 95, Rootstown, OH 44272, USA

The "win at all costs" mentality fuels athletes to seek performance-enhancing substances, such as anabolic-androgenic steroids, to gain an advantage over their opponents. Nonathletes espouse this same attitude to "win" the battle of attractiveness. An enhanced understanding of anabolic-androgenic steroids and the motivations behind their abuse will arm pediatricians with the ability to engage their patients in a balanced discussion of the benefits and costly risks of anabolic-androgenic steroids and successfully deter further use.

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Beyond sports-doping headlines: the science of laboratory tests for performance-enhancing drugs

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Pediatr Clin North Am. 2007 Aug;54(4):713-33, xi
Hatton CK
UCLA Olympic Laboratory, University of California at Los Angeles, 2122 Granville Avenue, Los Angeles, CA 90025, USA

This primer on urine analysis in sports-doping control is an overview with an emphasis on the main analytical chemistry technologies in use: gas chromatography-mass spectrometry (GC-MS), liquid chromatography-tandem mass spectrometry (LC-MS-MS), isotope ratio mass spectrometry detection of exogenous testosterone use, and isoelectric focusing detection of recombinant erythropoietin (EPO) use. Included are graphic examples of GC-MS selected ion monitoring and full scan, LC-MS-MS, and EPO test electropherogram data; a list of common acronyms; and answers to questions frequently asked about tampering and test accuracy.

DJ note: Make sure one can not rule out that the science behind isoelectric focusing detection of recombinant erythropoietin by this and other labs is faked. Learn more

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Creatine and other supplements

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Pediatr Clin North Am. 2007 Aug;54(4):735-60, xi
Lattavo A, Kopperud A, Rogers PD.
Department of Medical Education, Grant Medical Center, 285 East State Street, Suite 670, Columbus, OH 43215-4354, USA

Ergogenic dietary supplement use is highly prevalent among adolescent and collegiate athletes, and use is increasing. To make appropriate recommendations for or against use by individual athletes, physicians who work with adolescent athletes should be knowledgeable about the most commonly used supplements and be able to access high-quality information about others. This article first discusses the legal and regulatory environment of dietary supplements. Several of the most commonly used supplements are then discussed in detail, including creatine, beta-hydroxy-beta-methylbutyrate, protein, amino acids, stimulants, alkalotic agents, glycerol, vitamins, and minerals. Finally, the "Gateway Theory" as it may relate to adolescent supplement and other drug use is discussed.

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Sports medicine: performance-enhancing drugs

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Pediatr Clin North Am. 2007 Aug;54(4):797-806, xii
Gregory AJ, Fitch RW.
Vanderbilt University Medical Center, MCE-South Tower, Suite 3200, Nashville, TN 37232, USA

Performance-enhancing drugs, ergogenic aids, or sports supplements have been a part of sports since sporting competition began and likely always will be. Considered cheating by purists and necessary by some athletes, we must accept the fact that they are used, understand why they are used, and study how to prevent their use to institute change. This article summarizes current information regarding the use of performance-enhancing drugs in young athletes and provides proven prevention strategies for instituting a program in your local schools.

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The history of the development of anabolic-androgenic steroids

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Pediatr Clin North Am. 2007 Aug;54(4):761-9, xi
Dotson JL, Brown RT
Department of Pediatrics, Columbus Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA

The history of anabolic-androgenic steroids (AASs) is an interesting tale that has its roots in ancient "endocrinology." More than 6000 years ago, farmers noted enhanced domestication of animals after castration. The development of AASs, and, later, their artificial synthesis, have remained a hot topic in scientific research and pharmaceuticals. Over the years, AASs have been used as a proposed treatment for a wide variety of ailments, despite deleterious side effects. Unfortunately, they have been, and still are, abused by body builders, athletes, and teens.

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