PerformanceEnhancing Substances: Effects, Risks,

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Performance-Enhancing Substances Effects, Risks,
Appropriate AlternativesCh. 11
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• Ergogenic substances- performance-enhancing drugs
  dietary supplements
  
• Majority of these substances are promoted on
  basis of unfounded claims
  
• Any ergogenic substance has some benefit-risk
  trade-off

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Types of performance-enhancing substances

• 2 principle categories
• Naturally occurring hormones drugs that mimic
  their effects
  
• Dietary supplements
• Distinction between a drug dietary supplement
  determines whether or not a product must meet
  Food Drug Administration (FDA) approval for
  safety effectiveness
• If not a drug or does not claim to have
  therapeutic effect, FDA regulations are relaxed
  
• FDA will not investigate for safety or
  effectiveness unless health risk is brought to
  attention

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• Part of FDA definition of a drug is a substance
  that changes bodys structure or function
  
• In 1994 Dietary Supplement Health Education Act
  (DSHEA)
  
• Premarket safety evaluations no longer required
• Can be sold if they do not present significant
  or unreasonable risk of illness or injury when
  used as directed on label or under normal
  conditions
• Can also make claims about effects on bodys
  structure function, as long as not misleading
  

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Definition of products that can be sold as
dietary supplements

• Product intended to supplement diet that contains
  one or more of following dietary ingredients
  
• Vitamin
• Mineral
• Herb or other botanical
• Amino acid
• Dietary substance for use by humans to supplement
  diet by increasing total dietary intake
  
• Concentrate, metabolite, constituent, extract, or
  combination of any ingredient described in a)
  through e)
  
• Product must also be intended for ingestion
  cannot be advertised for use as conventional food
  or as sole item of a meal or diet

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• Ergogenic substances are usually banned from
  athletic competition when consensus is reached
  that they may provide competitive edge
  
• Substance currently banned by International
  Olympic Committee (IOC)
  
• Psychomotor stimulants amphetamine, cocaine,
  methylphenidate
  
• Sympathomimetic amines ephedrine, isoprenaline
• Other stimulants caffeine ( certain levels),
  doxapram, strychnine

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• Anabolic steroids testosterone, stanozolol,
  nandrolone, norethandrolone, methandienone,
  androstenedione
  
• Other hormones growth hormone, erythropoietin
• Narcotic analgesics codeine, heroin,
  hydromorphone, methadone, morphine
  
• Masking agents diuretics probenecid, furosemide

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Anabolic steroids

• Referred to interchangeably as androgens,
  androgenic steroids, or anabolic steroids
  
• Primary androgen is testosterone
• Most of which is synthesized in testes from
  cholesterol
  
• Androgens are primary determinants of male
  physical characteristics

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Results of unnatural use of anabolic steroids

• When administered to women will adopt male
  physical characteristics, increased upper-body
  muscularity decreased body fat deepening of
  voice cessation of menstrual cycles increased
  facial hair
• On adolescent boys primary risk is accelerated
  puberty, rapid growth in size secondary sex
  characteristics
  
• Can produce early closure of growth plates

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Types of Anabolic Steroids Table 11.2

• All appear to work through same receptors in
  body, although effects can differ in various
  tissues because of differences in metabolites
  they form how well they attach to certain
  proteins
• No highly anabolic steroid that helps an
  athlete more than another
  
• High dose of any is likely to achieve
  muscle-binding effect in most people

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• Injectable steroids are more potent than oral
  because of their delivery
  
• Athletes typically take higher doses than men who
  take them for medical treatment
  
• Testosterone enanthate, main injectable steroid
  used by athletes
  
• Readily available in U.S., used clinically
• Wide range of half-lives (how long in body)
• Testosterone propionate remains 1.5 days
• Testosterone buciclate lasts 3 months

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Who uses anabolic steroids?

• Athletes in many sports have tested positive
• Strength sports more likely FB, wt. lifting
• People outside organized sports use to enhance
  appearance rather than performance
  
• reverse anorexia nervosa- body builders with
  altered self-image
  
• Believe that they look small weak even though
  they are large muscular

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Ergogenic Benefits of Anabolic Steroids

• Muscle mass strength
• Androgens increase body mass in men women,
  including nonfat component
  
• Increase in total body water with increase in
  muscle mass, because water is majority of
  cellular wt.
  
• May explain decrease in wt. when use is stopped
• Increases in muscle protein synthesis muscle
  RNA content
  
• Athletes may derive benefit from use even if they
  stop use long enough before competition to pass
  drug test

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• Athletic Performance
• No enhancement of athletic performance has ever
  been clearly shown
  
• Most studies involved low doses similar to those
  used for medical treatment
  
• Typical end point measure is 1RM which athlete
  was not training for
  
• No studies have examined anaerobic power
• No studies on whether help or hinder aerobic
  endurance
  
• Do not want increase in total body mass, but may
  help prevent muscle breakdown

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Psychological changes with anabolic steroids

• Increased aggressiveness form high-doses
• Most potent hazardous
• Improved motivation feelings of well-being have
  been shown in androgen deficient men

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Potential risks to performance of anabolic
steroids

• Uncontrolled emotional responses directed at
  teammate when teamwork is critical
  
• Unanticipated decline in performance when use is
  suddenly stopped
  
• Undesirable increase in body wt. in aerobic
  endurance athletes
  
• Effects on performance after use is unstudied

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Signs of anabolic steroid use

• Other than positive drug test or direct
  observation of use, there is no way of being
  certain that athlete is using
  
• Most reliable sign is an unexpectedly large
  increase in body size, possibly accompanied by
  substantial strength gain
  
• New acne problem, gynecomastia (male development
  of breasts), or sudden change in behavior
  
• Medical screening may reveal subnormal HDL
  cholesterol level soft, small testes

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Human Chorionic Gonadotropin

• Hormone obtained from urine of pregnant women
  is very close to structure function to
  luteinizing hormone
  
• Injected into men, can cause increase testicular
  testosterone production
  
• Risks receptor desensitization of testes, excess
  estrogen production of testes
  
• Useful in reducing body fat
• No sound evidence of enhancing performance

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Growth Hormone

• Protein secreted by pituitary gland stimulation
  of physical growth
  
• Maintains blood glucose levels, increases uptake
  of glucose amino acids into muscle cells,
  stimulates release of fatty acids from fat cells
  
• Main source is from lab synthesis using
  recombinant DNA technology

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• Increases muscle mass decreases body fat in
  growth hormone deficient individuals
  
• No evidence if same effects occur in normal men
  women or enhances performance
  
• If used for long periods, may produce symptoms of
  acromegaly (disfiguring disease widening of
  bones, organ enlargement, arthritis)

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Erythropoietin

• Can be produced by recombinant DNA
• Naturally produced in kidneys stimulates
  production of new RBCs (carry oxygen)
  
• Levels increase in response to endurance ex.
• Enhanced oxygen-carrying capacity of blood allows
  athlete to work at higher level of oxygen
  consumption

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• Blood doping- athletes reinfused with their own
  RBCs after period of collection storage
  
• Risks
• Additional RBCs may cause blood to be more
  viscous thermoregulatory ability becomes
  compromised
  
• Possibility of sudden death from heart failure

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Beta-Adrenergic Agonists

• Synthetic beta-adrenergic agonists are substances
  chemically related to epinephrine, hormone that
  regulates effects such as lipolysis (breakdown of
  fat) thermogenesis (increased energy
  expenditure for heat production)
• Originally developed for asthma other
  life-threatening conditions

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• May increase lean body mass decrease fat
  storage
  
• Used a lot on livestock
• May cause sleeplessness, nervousness, increased
  heart rate
  
• May impair certain types of athletic performance
  involving fine motor skills

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Drug Testing

• Can be reliable effective means of maintaining
  level playing field for all athletes
  
• Testers always trying to develop improve
  methods to catch those who think they can beat it

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Methods of testing

• Key elements of effective drug program include
  year-round, random, unannounced testing
  
• Tests must be performed by competent lab
  certified in this type of work
  
• Tests can usually be developed for any substance
  that does not occur naturally in the body

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Problems in drug testing

• Substances used to mask illicit ergogenic
  substances are now banned can be detected
  
• Most masking agents are diuretics, which dilute
  urine specimen make it harder to obtain
  positive test

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Dietary Supplements

• Useful primarily to athletes who have specific
  nutritional deficiency or who do not take in
  adequate vitamins mineral in their normal diet
  
• Many advertised supplements do not serve any
  useful purpose
  
• Most products are not tested for safety or
  efficacy unless questions about its health risks
  are brought about

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• People can protect themselves against fraud by
  carefully reading the labels claims associated
  with a product
  
• Want to by products made according to established
  manufacturing standards (labeled U.S.P) from
  nationally known food drug manufacturers
  
• natural has no meaning in terms of safety

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Vitamins

• Reduction in physical performance is observed in
  chronic vitamin deficiencies
  
• Especially deficiencies in some B vitamins
• Recent studies have shown no performance benefit
  from greater-than-normal vitamin intake
  
• Antioxidants- reduce tissue damage caused by
  oxidative stress vitamin C E
  
• May help speed up recovery, minimize illness or
  injury, sustain immune function

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Steroid Replacers

• Substances that may increase testosterone levels
  either through stimulation of testosterone
  production by the body or by acting as precursors
  for steroid production
• None are known to be effective performance
  enhancers
  
• Androstenedione, sapogenins

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Growth Hormone Releasers

• Intravenous infusion of amino acid arginine
  produces relatively consistent increase in growth
  hormone secretion in normal subjects
  
• Has not been shown if oral application produces
  same effect or if any performance-enhancing
  effect
  
• One of best GH releasers is resistance exercise
  or perhaps any exercise that produces large rise
  in lactic acid
  
• Can produce same levels as arginine infusion
• Do not waste money on

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L-Carnitine

• Essential for transport of certain types of fats
  into mitochondria for energy production
  
• Synthesized in body stored in skeletal
  cardiac muscle
  
• Theory is that if muscle carnitine levels can be
  increased, there will be greater utilization of
  fat saving of glycogen during exercise
  
• No evidence of performance enhancing effects

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Creatine

• Found in high concentration in meat
  theoretically increases energy substrate
  availability
  
• Supplementation clearly increases intramuscular
  concentrations of creatine phosphate boosts
  performance
  
• CP maintains high concentration of ATP in muscle
  during periods of muscular exertion
  
• Critical at start of sprint or other
  high-intensity activity
  
• Supplementation would be expected to delay fatigue

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• Taken in form of creatine monohydrate to be able
  to pass through cell membranes
  
• Creatine is not retained by all people, these
  people would not benefit from it
  
• Reported wt. gains may or may not be related to
  changes in hydration
  
• No reported risks, but some may emerge in future

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Caffeine other stimulants

• Effects of stimulants includes
• Reduced fatigue
• Increased alertness
• Increased confidence
• Even euphoria
• By delaying fatigue producing euphoric effects,
  the risk that an athlete will be pushed beyond
  safe physiological limits could suffer serious
  consequences
• Development of drug dependence

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• Caffeine can benefit prolonged endurance
  performance
  
• Primary benefit is glycogen-sparing effect
  through increased availability of fatty acids
  
• Glycogen-sparing does not occur in all
  individuals appears most consistently in
  well-trained individuals
  
• Principal drawback is potential diuretic effect
• From inconvenience to performance-threatening
  dehydration
  
• Individual responses vary with use, each person
  should find out for themselves whether it works
  for them