Poststeroid balance disorder--a case report in a body builder

Int J Sports Med. 1999 Aug;20(6):407-9.

Poststeroid balance disorder--a case report in a body builder.

Bochnia M, Medraś M, Pośpiech L, Jaworska M.

Clinic of Otolaryngology, Medical University in Wroclaw, Poland.

The authors describe a case of poststeroid balance disorder in a 20-year-old
athlete. Previous information of such a doping pathology among sportsmen taking
anabolics was not found. That anabolic steroids had a harm to central activities
and could be suspected especially on the basis of reported psychiatric sequels
and cerebrovascular disorders. The case described is of a patient who had been
given metandienone, oxymetholone, and nandrolone phenyloproprionate in two
courses. Vertigo appeared twice just after introducing doping and persisted in
spite of a 1.5 year break in taking anabolics. In the electronystagmography a
positional nystagmus was detected, the eye-tracking test was distempered, and
abnormal responses in the caloric tests were obtained. In the computed dynamic
posturography the number and length of body sway were increased and,
consequently, the field of the outspread area was enlarged. The moment of
appearance and long-lasting vertigo as well as the results of laboratory
examinations indicate a poststeroid permanent disorder of the central part of the
equilibrium organ. Such a diagnosis seems to be most probable here.

Effect of extended use of single anabolic steroids on urinary steroid excretion and metabolism

J Chromatogr. 1989 Apr 7;489(1):121-6.

Effect of extended use of single anabolic steroids on urinary steroid excretion
and metabolism.

Harrison LM, Martin D, Gotlin RW, Fennessey PV.

Department of Pediatrics, University of Colorado, Denver 80262.

Long-term use of single anabolic steroids by weightlifters and body builders at
dosages greater than or equal to 25 mg per 24 h resulted in reduced excretion of
urinary androgen metabolites, androsterone and etiocholanolone, compared to
values prior to anabolic use. The excretion of major urinary metabolites of
glucocorticoids was not affected by anabolic use. Urinary excretion of anabolic
steroids or anabolic metabolites averaged 20-25% of total anabolic steroid
administered. The major excreted metabolites of methandrostenolone, nandrolone,
oxandrolone and oxymetholone were identified by gas chromatography-mass
spectrometry based on the major mass spectral ion peaks.

Peliosis: a morphologic curiosity becomes an iatrogenic problem.

Hum Pathol. 1978 May;9(3):331-40.

Peliosis: a morphologic curiosity becomes an iatrogenic problem.

Taxy JB.

Peliosis is a morphologic entity describing a condition of blood filled spaces,
most frequently occurring in the liver. In recent years it has evolved from an
anatomic curiosity seen at autopsy to a potential clinical problem in view of its
association with the administration of anabolic steroid hormones. The
pathogenesis and predilection of peliosis for the liver remain unexplained. This
article reports five patients with peliosis, four with splenic involvement, all
but one of whom received an anabolic steroid preparation. One patient died as a
result of rupture of the splenic peliotic spaces. The diagnosis in three cases
was established on the basis of surgical material, i.e., liver biopsy or
splenectomy. An increased awareness of peliosis in patients at risk, as well as
an appreciation for the histopathologic changes in less advanced cases, may
become an important issue for the surgical pathologist.

Plasma fibrinolytic activity following oral anabolic steroid therapy.

Thromb Diath Haemorrh. 1975 Sep 30;34(1):236-45.

Plasma fibrinolytic activity following oral anabolic steroid therapy.

Walker ID, Davidson JF, Young P, Conkie JA.

Six anabolic steroids were assessed for their ability to enhance plasma
fibrinolytic activity in males with ischaemic heart disease. Five
17alpha-alkylated steroids (Ethyloestrenol, Norethandrolone, Methandienone,
Methylandrostenediol and Oxymetholone) were examined and all produced a
significant increase in plasma plasminogen activator as measured by the
euglobulin lysis time. The only non-17alpha-alkylated steroid studied
(Methenolone acetate) failed to enhance fibrinolysis. The 17alpha-alkylated
steroids studied all deserve more detailed evaluation of their long term effects
on plasma fibrinolytic activity.

Induction of premature menstruation with anabolic steroids.

Am J Obstet Gynecol. 1973 Sep 1;117(1):121-5.

Induction of premature menstruation with anabolic steroids.

Bolch OH Jr, Warren JC.

PIP: To determine the mechanism of the effect of certain anabolic steroids on
menstruation induction and to evaluate this effect as an interceptor of early
pregnancy, the luteal phase length was studied in the cycles of women ranging in
age from 21 to 37 years after postovulatory treatment with 7 different anabolic
steroids. Basal body temperature records were kept and endometrial biopsies were
obtained late in the pretreatment control periods to confirm ovulation. 2
steroids which had been proven to shorten the luteal cycle phase were
administered as follows: Nandrolone phenpropionate was given in a daily 50-mg
dose intramuscularly for 3 days. 30 mg of oxymetholone was administered orally
every 6 hours for 4 days. The previously untested steroids were administered
orally in evenly divided doses every 6 hours for 4 days as follows: oxandrolone,
60 mg daily; stanozolol, 28 mg; methandrostenolone, 60 mg; fluoxymesterone, 40
mg; and ethylestrenol, 30 mg. Plasma progesterone and gonadotropins were measured
by radioimmunoassay of blood samples taken 7 days after ovulation. Nandrolone and
oxymetholone were found to significantly shorten cycle and luteal phase lengths
and depress plasma LH and progesterone levels as compared to control cycles.
Nandrolone also significantly depressed plasma FSH levels. Of the 5 new drugs,
only ethylestrenol significantly shortened luteal phase length (p less than
.001). This finding is questioned by the small sample size and thus the use of
this steroid as a menstruation inducer is considered questionable. The mechanism
of the effect of nandrolone and oxymetholone appears to be due to their
antigonadotropic action that only secondarily reduces progesterone levels.
Whether these steroids can affect human chorionic gonadotropin and thus cripple
the corpus luteum and interrupt early pregnancy needs further research.

Impaired vasoreactivity in bodybuilders using androgenic anabolic steroids.

Eur J Clin Invest. 2006 Jul;36(7):483-8.

Impaired vasoreactivity in bodybuilders using androgenic anabolic steroids.

Lane HA, Grace F, Smith JC, Morris K, Cockcroft J, Scanlon MF, Davies JS.

Department of Endocrinology, University Hospital of Wales, Heath Park, Cardiff
CF14 4XW, Wales, UK. laneha@cf.ac.uk

BACKGROUND: Anabolic androgenic steroids are used by some bodybuilders to enhance
performance. While the cardiovascular implications of supraphysiological androgen
levels requires further clarification, use is associated with sudden death, left
ventricular hypertrophy, thrombo-embolism and cerebro-vascular events.

MATERIALS
AND METHODS: To further understand the effect of androgenic anabolic steroid
abuse on vascular function, this study assessed vascular stiffness (pulse-wave
analysis) and cardiovascular risk factors in 28 male, bodybuilding subjects, of
whom ten were actively receiving anabolic agents (group A; 26.4 +/- 7.2 years)
and eight had undergone a 3-month "wash-out" period (group B; 32.1 +/- 7.1
years). The remaining ten bodybuilding subjects (group C; 24.4 +/- 4.4 years)
denied any past use of anabolic steroids or other performance enhancing drugs.
Comparisons were made with ten sedentary male controls (group D, 29.3 +/- 4.7
years).

RESULTS: Endothelial independent dilatation in response to glycerol
trinitrate was significantly impaired in the group currently using anabolic
steroids (group A) compared with the other three groups [A (5.63 +/- 3.24%)
versus; B (11.10 +/- 4.91%), C (17.88 +/- 9.2%) and D (14.46 +/- 3.9%), P <
0.0005, respectively], whereas no significant differences in
endothelial-dependent dilatation were detected between the groups [A (5.0 +/-
3.0%), B (7.4 +/- 3.4%), C (9.6 +/- 4.5%) and D (8.2 +/- 3.3%), P < 0.059,
respectively].

CONCLUSIONS: Previous studies described a decline in vascular
reactivity occurring in bodybuilding subjects which is independent of anabolic
steroid use and may result from smooth muscle hypertrophy with increased vascular
stiffness. This study revealed impaired vascular reactivity associated with
anabolic agents and that improvement in vascular function may occur following
their discontinuation.

Management of male sterility in patients taking anabolic steroids

 Arch Esp Urol. 2005 Apr;58(3):241-4.

[Management of male sterility in patients taking anabolic steroids]

[Article in Spanish]

de la Torre Abril L, Ramada Benlloch F, Sánchez Ballester F, Ordoño Domínguez F,
Ulises Juan Escudero J, Navalón Verdejo P, López Alcina E, Ramos de Campos M,
Zaragoza Orts J.

Servicio de Urología, Consorcio Hospital General Universitario, Valencia, España.
Luitorrr@hotmail.com

OBJECTIVES/METHODS: To review the incidence of male infertility secondary to
intake of anabolic products and our experience and outcomes with treatment. There
is a variety of such substances (testosterone, nandrolone, stanozolol, etc.) in
their intake may be unique or combinations, both orally or parenterally.
Comparisons between patients and case series are difficult because of the hiding
of this practice and various consumption practices and doses employed.
RESULTS/CONCLUSIONS: Most of the patients recover normal spermatogenesis does by
stopping intake of anabolic substances. The period of time until recovery is 6.35
months. Patients not recovering after six months were given tamoxifen 20
mg/24-hour, if having a normal or inhibited hypothalamus-hypophysis axis.
Duration of abuse, doses, and anarchical consumption maderesponse to treatment
with antiestrogen drugs or gonadotropins unpredictable in patients not responding
to conservative treatment.

Hepatocellular adenomas associated with anabolic androgenic steroid abuse in bodybuilders: a report of two cases and a review of the literature.

Br J Sports Med. 2005 May;39(5):e27.

Hepatocellular adenomas associated with anabolic androgenic steroid abuse in
bodybuilders: a report of two cases and a review of the literature.

Socas L, Zumbado M, Pérez-Luzardo O, Ramos A, Pérez C, Hernández JR, Boada LD.

Department of Radiology, Cajal Clinical Centre, Las Palmas de Gran Canaria,
Canary Islands, Spain.

Anabolic androgenic steroids (AAS) are used illicitly at high doses by
bodybuilders. The misuse of these drugs is associated with serious adverse
effects to the liver, including cellular adenomas and adenocarcinomas. We report
two very different cases of adult male bodybuilders who developed hepatocellular
adenomas following AAS abuse. The first patient was asymptomatic but had two
large liver lesions which were detected by ultrasound studies after routine
medical examination. The second patient was admitted to our hospital with acute
renal failure and ultrasound (US) studies showed mild hepatomegaly with several
very close hyperecogenic nodules in liver, concordant with adenomas at first
diagnosis. In both cases the patients have evolved favourably and the tumours
have shown a tendency to regress after the withdrawal of AAS. The cases presented
here are rare but may well be suggestive of the natural course of AAS induced
hepatocellular adenomas. In conclusion, sportsmen taking AAS should be considered
as a group at risk of developing hepatic sex hormone related tumours.
Consequently, they should be carefully and periodically monitored with US
studies. In any case, despite the size of the tumours detected in these two
cases, the possibility of spontaneous tumour regression must also be taken in
account.

The anti-doping hot-line, a means to capture the abuse of doping agents in the Swedish society and a new service function in clinical pharmacology.

Eur J Clin Pharmacol. 2003 Nov;59(8-9):571-7. Epub 2003 Sep 12.

The anti-doping hot-line, a means to capture the abuse of doping agents in the
Swedish society and a new service function in clinical pharmacology.

Eklöf AC, Thurelius AM, Garle M, Rane A, Sjöqvist F.

Department of Clinical Pharmacology, Huddinge University Hospital, 14185
Stockholm, Sweden.

With the support of the Swedish National Institute of Health a national
information service was started in 1993 aiming to capture the abuse of doping
agents in the general public. It was organized as a telephone service, called the
Anti-Doping Hot-Line, from our department and managed by trained nurses
co-operating with clinical pharmacologists. Important information collected about
all callers (anonymous) was: date of call, its origin, category of caller, doping
experience and main question being asked. Abusers were asked about their age,
sex, affiliation, abused drug(s), duration of abuse, habit of administration and
adverse reactions (ADRs). Between October 1993 and December 2000 25,835 calls
were received with a peak during spring and autumn. Most calls (12,400) came from
non-abusers, 60% being males. Callers connected with gyms represented the largest
group (30%). Most calls about specific drugs concerned anabolic androgenic
steroids (AAS). Other drugs or products included ephedrine, clenbuterol and
creatine. The most commonly abused anabolic steroids were testosterone,
nandrolone-decanoate, methandienone and stanozolol. The ten most commonly
reported ADRs of AAS were aggressiveness (835), depression (829), acne (770),
gynecomastia (637), anxiousness (637), potency problems (413), testicular atrophy
(404), sleep disorders (328), fluid retention (318) and mood disturbances (302).
Female side effects included menstruation disturbances, hair growth in the face,
lower voice and enlarged clitoris. During the period 1996-200, totally 4339
persons reported about 10,800 side effects. This figure should be compared with
the very low number of ADRs (27) reported by prescribers to the Swedish ADR
committee during the same period. Abuse of doping agents appears to be a new
public health problem that needs detection, medical care and prevention.

Anabolic steroid abuse and cardiac sudden death: a pathologic study.

Arch Pathol Lab Med. 2001 Feb;125(2):253-5.

Anabolic steroid abuse and cardiac sudden death: a pathologic study.

Fineschi V, Baroldi G, Monciotti F, Paglicci Reattelli L, Turillazzi E.

CONTEXT: Androgenic anabolic steroids (AAS) used for improving physical
performance have been considered responsible for acute myocardial infarction and
sudden cardiac death.

OBJECTIVE: To establish the relationship between AAS and
cardiac death.

DESIGN: Case report.

PATIENTS: Two young, healthy, male
bodybuilders using AAS.

MAIN OUTCOME MEASURES: Pathologic cardiac findings
associated with AAS ingestion.

RESULTS: The autopsy revealed normal coronary
arteries. In one case, we documented a typical infarct with a histologic age of 2
weeks. A segmentation of myocardial cells at the intercalated disc level was
observed in the noninfarcted region. This segmentation was the only anomaly
detected in the second case. No other pathologic findings in the heart or other
organs were found. Urine in both subjects contained the metabolites of
nortestosterone and stanozolol.

COMMENT: A myocardial infarct without vascular
lesions is rare. To our knowledge, its association with AAS use, bodybuilding, or
both lacks any evidence of a cause-effect relationship. The histologic findings
in our 2 cases and in the few others reported in medical literature are
nonspecific and do not prove the cardiac toxicity of AAS. A better understanding
of AAS action on the neurogenic control of the cardiac function in relation to
regional myocardial contraction and vascular regulation is required.

Severe cholestasis with kidney failure from anabolic steroids in a body builder

Dtsch Med Wochenschr. 1999 Sep 10;124(36):1029-32.

[Severe cholestasis with kidney failure from anabolic steroids in a body builder]

[Article in German]

Habscheid W, Abele U, Dahm HH.

Medizinische Klinik, Paracelsus-Krankenhaus Ruit, Esslingen.

HISTORY AND ADMISSION FINDINGS: A 28-year-old body builder was admitted because
of jaundice. For 80 days, until 3 weeks before hospitalization, he had been
taking moderately high doses of anabolic steroids: metandienone (methandienone),
10-50 mg daily by mouth, and stanozolol, 50 mg intramuscularly every other day.
Physical examination was unremarkable except for yellow discoloration of the skin
and sclerae.

INVESTIGATIONS: Bilirubin concentration was raised to 4.5 mg/dl,
cholestasis enzymes were normal, while transaminase activities were raised. Liver
biopsy was compatible with cholestasis induced by anabolic steroids.

TREATMENT AND COURSE: Although the steroids had been discontinued, the patient's general
condition deteriorated over 7 weeks. Serum bilirubin rose up to a maximum of 77.9
mg/dl. In addition renal failure developed with a creatinine concentration of 4.2
mg/dl. The patient's state improved simultaneously with the administration of
ursodeoxycholic acid and the biochemical values gradually reached normal levels
after several weeks.

CONCLUSION: Anabolic steroids can cause severe cholestasis
and acute renal failure. In this case there was a notable temporal coincidence
between the administration of ursodeoxycholic acid and the marked clinical
improvement.

Atrial fibrillation and anabolic steroids.

J Emerg Med. 1999 Sep-Oct;17(5):851-7.

Atrial fibrillation and anabolic steroids.

Sullivan ML, Martinez CM, Gallagher EJ.

Department of Emergency Medicine, Jacobi Medical Center, Bronx, New York, USA.

A young male bodybuilder, consuming large doses of anabolic steroids (AS),
presented to the Emergency Department (ED) with symptomatic rapid atrial
fibrillation (AF). Echocardiogram revealed significant septal hypokinesis, and
posterior and septal wall thickness at the upper limit of normal for highly
trained athletes. The atrial fibrillation had not recurred at 10 weeks after
discontinuation of AS use. Consumption of these agents in athletes has been
associated with hypertension, ischemic heart disease, hypertrophic
cardiomyopathy, and sudden death.

The effect of anabolic androgenic steroids on muscle strength, body weight and lean body mass in body-building men

Ugeskr Laeger. 1989 Mar 6;151(10):610-3.

[The effect of anabolic androgenic steroids on muscle strength, body weight and
lean body mass in body-building men]

[Article in Danish]

Søe M, Jensen KL, Gluud C.

A review of the effects of anabolic-androgenic steroids (AAS) on muscle strength,
body weight and lean body mass in body-building men is presented. In about half
of the placebo-controlled studies, a significant effect on the above mentioned
response variables is found. In all cases where an effect was achieved, the drug
used was methandrostenolone or stanozolol. Whether this is connected with a
special quality of these AAS or whether the negative results achieved with the
other AAS are caused by type 2 error is not yet known. The use of AAS as
ergogenic drugs must be deprecated because of their marginal effects, the risks
of side effects and the unsporting, unethical aspects.

Effect of testosterone and anabolic steroids on the size of sebaceous glands in power athletes.

Am J Dermatopathol. 1987 Dec;9(6):515-9.

Effect of testosterone and anabolic steroids on the size of sebaceous glands in
power athletes.

Király CL, Collan Y, Alén M.

Department of Dermatology, South-Saimaa Central-Hospital, Lappeenranta, Finland.

The effect of testosterone and anabolic steroids on the size of sebaceous glands
was studied by means of interactive morphometry in skin biopsies of power
athletes. The subjects used self-administered high doses of testosterone and
anabolic steroids during a 4-week strength training period. After 4 weeks' use of
hormones, the area of sectioned sebaceous glands enlarged significantly by a
factor of 89.2% (p less than 0.005). The number of cells in the so-called
differentiating cell pool (DCP) and in the undifferentiated cell pool (UCP) also
increased significantly (p less than 0.025, p less than 0.05, respectively). The
size of the area occupied by UCP cells increased significantly (p less than
0.05). The study suggests that high doses of testosterone and anabolic steroids
lead to an enlargement of sebaceous glands in male power athletes.

Serum lipids in power athletes self-administering testosterone and anabolic steroids.

Alén M, Rahkila P, Marniemi J.

Serum lipids in power athletes self-administering testosterone and anabolic steroids.

Int J Sports Med. 1985 Jun;6(3):139-44.

ABSTRACT: The purpose of the present investigation was to study the effects of testosterone and anabolic steroids on serum lipids in power athletes. Altogether 11 national top-level adult athletes completed the study. Five of them volunteered for the study group and the rest for controls. The follow-up consisted of 9 months of a strength training period. During the first 6 months, the subjects in the study group self-administered androgenic steroids on an average of 57 +/- 24.9 mg/day. The most interesting observation was the extremely low high-density lipoprotein (HDL) and HDL2 cholesterol concentrations of the androgen users. After 8 weeks of training, the study group had significantly (P less than 0.05) lower HDL cholesterol concentrations than the control group (0.53 +/- 0.11 and 1.14 +/- 0.19 mmol/l, respectively). This difference remained significant from 8 to 32 weeks of training. No systematic changes were observed in the control group. The HDL2 cholesterol concentration decreased by about 80% (P less than 0.01) and HDL3 cholesterol by about 55% (P less than 0.01) from the onset values in the study group. A substantial decrease in HDL cholesterol to total cholesterol and in HDL2 cholesterol to HDL3 cholesterol ratios were also noticed under the influence of exogenous androgens. The results of this study suggest that the sustained use of testosterone and anabolic steroids have a marked unfavorable effect on the pattern of HDL cholesterol in the serum of male power athletes.

Physical health and fitness of an elite bodybuilder during 1 year of self-administration of testosterone and anabolic steroids: a case study.

Alén M, Häkkinen K.

Physical health and fitness of an elite bodybuilder during 1 year of self-administration of testosterone and anabolic steroids: a case study.

Int J Sports Med. 1985 Feb;6(1):24-9.

ABSTRACT: An adult male bodybuilder of international level, who had decided to complement his training by self-administering the androgenic hormones (actually 53 mg/day), volunteered as a subject for investigation of his physical health and fitness over a training period of 1 year including only a 4-week abstinence from drugs in the middle of the year. The subject was able to gain greatly in fat-free weight (from 83 to 90 kg), in mean fiber area of the VL muscle (enlargement of 11.4% after a half year's training), and in maximal strength (from 5145 to 5948 N). The high level of serum testosterone and low level of serum SHBG observed tend to strengthen suggestions of the anabolic effects of androgenic steroids during training. The subject's health status was affected. A high serum E2 level during the use of androgens, atrophic testicles, and low LH, FSH, and T levels after drug withdrawal indicate that sustained testosterone/anabolic steroid administration affects the function of the pituitary and leads to long-lasting impairment of testicular endocrine function, and consequently to azoospermia and cynegomastia. The observed decrease in serum HDL-cholesterol (from 1.59 to 0.44 mmol/l) and in HDL2-cholesterol (from 0.42 to 0.01 mmol/l) may indicate a higher risk for atherogenesis.

Changes in neuromuscular performance and muscle fiber characteristics of elite power athletes self-administering androgenic and anabolic steroids.

Alén M, Häkkinen K, Komi PV.

Changes in neuromuscular performance and muscle fiber characteristics of elite power athletes self-administering androgenic and anabolic steroids.

Acta Physiol Scand. 1984 Dec;122(4):535-44.

ABSTRACT: The influence of androgenic-anabolic steroid-induced changes in measures of body composition, muscle fiber characteristics and various aspects of the neuromuscular performance of the leg extensor muscles was investigated in five experimental and six control power athletes during the 24-week programmed strength training followed by the additional six week training without hormone drugs. The mean values of the dosages of self-administration during the 24-week period were 31.0 +/- 14.3 mg/day for anabolic steroids (methandienone, stanozolol, nandrolone) and 178.4 +/- 82.7 mg/week for testosterone. During the 24-week hormone period the experimental group gained in fat-free weight (p less than 0.01) and in the mean muscle fiber areas (p less than 0.01) of the vastus lateralis muscle while the corresponding gains in the control group were minor (NS). The increases of maximal isometric force in the experimental and control groups were 14.7% (p less than 0.01) and 6.1% (NS), respectively, and the values obtained in average load-vertical jumping height curves were improved significantly (p less than 0.05) only in the experimental group. Increases of 18.2% (p less than 0.001) and 12.9% (p less than 0.01) took place in the squat lift in the experimental and control groups, respectively. Both groups demonstrated similar (p less than 0.05) improvements in isometric fast force production. During the additional six week programmed training without hormone drugs significant (p less than 0.05) increases were observed in the experimental group in addition to maximal isometric force and the squat-lift but also in isometric fast force production, while the corresponding changes in the control group were minor (NS). It is suggested that strength training in combination with administration of androgenic-anabolic steroids causes improvements in selected neuromuscular parameters. These changes may be greater than those of caused by the strength training alone.

Relative binding affinity of anabolic-androgenic steroids: comparison of the binding to the androgen receptors in skeletal muscle and in prostate, as well as to sex hormone-binding globulin.

Saartok T, Dahlberg E, Gustafsson JA.

Relative binding affinity of anabolic-androgenic steroids: comparison of the binding to the androgen receptors in skeletal muscle and in prostate, as well as to sex hormone-binding globulin.

Endocrinology. 1984 Jun;114(6):2100-6.

ABSTRACT: It is unclear whether anabolic steroids act on skeletal muscle via the androgen receptor (AR) in this tissue, or whether there is a separate anabolic receptor. When several anabolic steroids were tested as competitors for the binding of [3H]methyltrienolone (MT; 17 beta-hydroxy-17 alpha-methyl-4,9,11-estratrien-3-one) to the AR in rat and rabbit skeletal muscle and rat prostate, respectively, MT itself was the most efficient competitor. 1 alpha-Methyl-5 alpha-dihydrotestosterone (1 alpha-methyl-DHT; mesterolone) bound most avidly to sex hormone-binding globulin (SHBG) [relative binding affinity (RBA) about 4 times that of DHT]. Some anabolic-androgenic steroids bound strongly to the AR in skeletal muscle and prostate [ RBAs relative to that of MT: MT greater than 19-nortestosterone ( NorT ; nandrolone) greater than methenolone (17 beta-hydroxy-1-methyl-5 alpha-androst-1-en-3-one) greater than testosterone (T) greater than 1 alpha-methyl-DHT]. In other cases, AR binding was weak (RBA values less than 0.05): stanozolol (17 alpha-methyl-5 alpha- androstano [3,2-c]pyrazol-17 beta-ol), methanedienone (17 beta-hydroxy-17 alpha-methyl-1,4-androstadien-3-one), and fluoxymesterolone (9 alpha-fluoro-11 beta-hydroxy-17 alpha-methyl-T). Other compounds had RBAs too low to be determined (e.g. oxymetholone (17 beta-hydroxy-2-hydroxymethylene-17 alpha-methyl-5 alpha-androstan-3-one) and ethylestrenol (17 alpha-ethyl-4- estren -17 beta-ol). The competition pattern was similar in muscle and prostate, except for a higher RBA of DHT in the prostate. The low RBA of DHT in muscle was probably due to the previously reported rapid reduction of its 3-keto function to metabolites, which did not bind to the AR [5 alpha-androstane-3 alpha, 17 beta-diol and its 3 beta-isomer (3 alpha- and 3 beta-adiol, respectively)]. Some anabolic-androgenic steroids (only a few synthetic) bound to SHBG (1 alpha-methyl-DHT much greater than DHT greater than T greater than 3 beta-adiol greater than 3 alpha-adiol = 17 alpha-methyl-T greater than methenolone greater than methanedienone greater than stanozolol). The ratio of the RBA in rat muscle to that in the prostate (an estimate of the myotrophic potency of the compounds) was close to unity, varying only between about 0.4 and 1.7 in most cases.(ABSTRACT TRUNCATED AT 400 WORDS)

Hepatic angiosarcoma associated with androgenic-anabolic steroids.

Falk H, Thomas LB, Popper H, Ishak KG.

Hepatic angiosarcoma associated with androgenic-anabolic steroids.

Lancet. 1979 Nov 24;2(8152):1120-3.

ABSTRACT: A retrospective epidemiological study of deaths from hepatic angiosarcoma (HAS) in the U.S. showed that during 1964--74 there were 168 such cases, of which 37 (22%) were associated with previously known causes (vinyl chloride, 'Thorotrast', and inorganic arsenic) and 4 (3.1%) of the remaining 131 cases with the use of androgenic-anabolic steroids. It is suggested that the long-term use of androgenic-anabolic steroids is the fourth cause of HAS, the majority of cases still being of unknown aetiology. Moreover, the presented cases serve as a link in a spectrum of hepatic disorders recently recognised to be caused by environmental agents such as vinyl chloride, arsenic, and thorotrast, and by contraceptive and anabolic steroids. Similar precursor stages, usually not recognised by clinical laboratory tests and consisting of areas of hyperplasia of hepatocytes and sinusoidal cells and sinusoidal dilatation, lead potentially to hepatic adenoma, carcinoma, peliosis, and angiosarcoma.

Effect of anabolic steroids on plasma antithrombin III. alpha2 macroglobulin and alpha1 antitrypsin levels.

Walker ID, Davidson JF, Young P, Conkie JA.

Effect of anabolic steroids on plasma antithrombin III. alpha2 macroglobulin and alpha1 antitrypsin levels.

Thromb Diath Haemorrh. 1975 Sep 30;34(1):106-14.

ABSTRACT: The effect of seven different anabolic steroids (Ethyloestrenol, Methenolone acetate, Norethandrolone, Methylandrostenediol, Oxymetholone, Methandienone, and Stanozolol) on three alpha-globulin antiprotease inhibitors of thrombin and plasmin was studied in men with ischaemic heart disease. In distinct contrast to the oral contraceptives, five of the six 17-alpha-alkylated anabolic steroids studied produced increased plasma Antithrombin III levels and five produced decreased levels of plasma alpha2-macroglobulin. The effect on plasma alpha1-antitrypsin levels was less clear-cut but three of the steroids examined produced significantly elevated levels. The increased plasma fibrinolytic activity which the 17-alpha-alkylated anabolic steroids induce is therefore unlikely to be secondary to disseminated intravascular coagulation.