Performance Enhancing Substances

1. Performance Enhancing Substances

3. Ergogenic Aid – any substance, process, or procedure which may enhance performance through improved speed, strength, response time, or endurance • Can be physical and chemical

4. The Desire to Win • A 1997 SI survey of elite US athletes asked whether they would take an illegal drug that guaranteed an Olympic gold medal - 195 of 198 athletes would take illegal drug if assured of not being caught - 50% would take illegal drug even if side effects were lethal in 5 years

5. Ancient Greeks ate mushrooms • Aztec athletes ate human heart • 1800’s – European cyclists took heroin and cocaine • 1904 Olympic marathon winner took strychnine and brandy during the race • 1920 Olympic 100 champ – drank sherry and raw egg • 1960 Olympics, 1967 Tour De France deaths from amphetamines

6. Tom Simpson – amphetamines and alcohol, a lethal diuretic combinationHe reportedly was quoted as saying “If ten pills will kill me, I will take nine”.

7. - “Ergogenic” – Greek word means “to make work” -1889 – Dr. Brown-Sequard injects himself with extract from dog and guinea pig testicles • 1905 – hormones discovered • 1935 – testosterone isolated • 1950’s – Russian weight lifters receiving injections • US physicians develop Dianabol to keep pace with the Russians – Dr. John Ziegler “the Godfather of Steroids” • 1959 – first case of HS athlete taking steroids

8. 1960’s IOC banned steroid use and testing begins • U.S. Cycling team publicly admitted blood doping • 2000 Olympics - 27 Chinese athletes removed from team - Bulgarian and Romanian weight lifting teams expelled - USATF – alleged more than 12 positive tests not reported during the previous 2 years

9. WADA World Anti-Doping Agency Established 11/10/99 Prohibited List – once a substance or method is prohibited, it becomes unequivocal, and there is no grey zone for the athlete or physician.

10. Steroids Encompass a wide variety of useful chemicals and hormones 1. Estrogens and progesterone in birth control pills 2. Cortisone and prednisone for muscle injury and asthma 3. Anabolic steroids for men with low hormone levels, delayed puberty, and body wasting diseases. Used to treat hypogonadism – condition in which the testes produce low testosterone levels.

11. Common Anabolic Androgenic Steroids

12. The “Designer” Steroid Effective anabolic steroids which can not be detected in routine doping tests They are designed to remain unknown to the testers The Clear – designed by Patrick Arnold for BALCO (Bay Area Lab Co-operative) Used by Marion Jones and Jason Giambi A U.S. sprint coach delivered a syringe of the Clear t the USADA

13. Androgenic = masculizing The primary androgen is TESTOSTERONE Anabolic = tissue building http://www.youtube.com/watch?v=mdJ7HZqD8p8

14. Routes of Administration • Orally - by mouth as a form of a pill • Injection - injected to the muscle by a needle- intramuscularly (Users of steroids who shares needles are at a risk for serious infections such as Hepatitis A or B and HIV, the AIDS virus) • Cream or gel - rub on to the muscle area to where you want to enhance.

15. Why Abuse Anabolic Steroids? • Improve athletic performance • To gain muscle mass and/or reduce body fat for desired physical appearance • Reduce recovery time between periods of strenuous activity • No proven effect on endurance or stamina http://www.youtube.com/watch?v=5mxjefR-vdI

16. Results of Unnatural Anabolic Steroid Use In Women: 1. increased muscularity 2. decreased body fat 3. deepening of voice 4. increased facial hair 5. male-pattern balding 6. enlargement of clitoris

17. In Men: 1. decreased production of naturally occurring testosterone 2. gynecomastia – breast development 3. testicular atrophy 4. sterility 5. prostate hypertrophy 6. accelerated puberty in kids

18. Side Effects in Both Sexes: 1. increase size/mass of muscle 2. acne, increased body hair or baldness 3. premature growth plate closure 4. liver and kidney problems 5. increased cholesterol and triglycerides 6. hypertension, atherosclerosis, blood clotting 7. possible liver cancer 8. tendon damage

21. . Anabolic Steroid abusers may take 10 – 100 times higher doses than the doses used for medical conditions Stacking – taking 2 or more different steroids

22. Who was Lyle Alzado? - $30,000/year on steroids and growth hormone • 1991 diagnosed with brain cancer - In his account to Sports Illustrated, Alzado said he began taking anabolic steroids in college in 1969 and never stopped. "It wasn't worth it," Alzado wrote. "If you're on steroids or human growth hormone, stop. I should have." After receiving a radical chemotherapy treatment and contracting pneumonia, Alzado died on May 14, 1992 at his home in Portland, Ore. The official cause of death was complications from brain cancer.

23. Human Growth Hormone (hGH) • A protein produced by the pituitary gland • Levels rise after exercise, trauma, sleep • Production peaks at puberty, declines at middle age • Increases muscle size but not proportional strength • Increases strength/size of connective tissue, tendons, and ligaments • Cannot detect in urine • Very expensive – 1 yr supply for hormone deficient patients = $13,000

24. Study of volunteers • 303 received GH injections • 137 received placebos • Daily injections for 20 days • Lean body mass increased on average by 4.6 pounds (those that received injections) • However, no measurable increase in strength or exercise capacity • Subjects getting GH – fluid retention and increased fatigue than placebo group

25. During childhood = gigantism – person is abnormally tall After puberty = acromegaly – disease characterized by widening of bones, arthritis, organ enlargement https://www.youtube.com/watch?v=Ebhf1qKVA9A Excessive hGH secretion:

26. Increase size/mass of facial bones, especially jaw bones Space between teeth Increase size of hands and feet Signs of hGH use:

27. Blood Doping • Athletes are reinfused with their own Red Blood Cells (RBC’s) or someone else’s to temporarily increase the quantity of RBC’s in the body and therefore the oxygen carrying capacity of the blood. • Erythropoietin – stimulates production of new RBC’s, naturally produced in kidneys

28. Ergogenic Effect = increased oxygen carrying capacity of blood due to increased RBC’s • Side Effects: - thickness of blood - increase risk of stroke, heart attack, blood clots

29. Hematocrit – measurement of the percentage of packed RBC’s in a whole blood sample

31. USADA – October 10, 2012:‘The evidence shows beyond any doubt that the US Postal Service Pro Cycling Team ran the most sophisticated, professionalised and successful doping program that sport has ever seen.” • https://www.youtube.com/watch?v=G7KZxIR1t-o

32. Herbal Supplements Contain plant or plant parts Have not been scientifically scrutinized Why? Do not have to get approval from the Food and Drug Administration (FDA) Examples of claims: Echinacea to prevent colds. Ginkgo to improve memory. Flaxseed to lower cholesterol

33. Are they safe? • Categorized as Dietary Supplements • Do not need FDA approval • Must follow good manufacturing practices • FDA is responsible for monitoring safety once on the market • The FDA requires that the following information be included on the labels of all herbal supplements: • The name of the herbal supplement • The name and address of manufacturer or distributor • A complete list of ingredients — either in the Supplement Facts panel or listed beneath it • Serving size, amount and active ingredient • THESE RULES DO NOT GAURANTEE THAT HERBAL SUPPLEMENTS ARE SAFE

34. According to the market report the top 10 best selling herbs in 2011 were, in rank order: Cranberry Saw palmetto Soy Garlic Gingko Echinacea Milk thistle Black cohosh St. John's Wort Ginseng

35. Stimulants • Amphetamines: Adderall Ritalin Ephedrine • Caffeine Jason Grimsely revealed to federal investigators that amphetamines were readily available in clubhouses. “greenies” - “as an antidote for everything from hangovers to garden-variety fatigue.”

36. During the Pittsburgh drug trials in the mid-1980s, outfielder John Milner testified that Willie Mays introduced him to a liquid amphetamine known as "red juice." More than a decade later, Tony Gwynn spoke of rampant amphetamine use in the game, and David Wells referred to greenies in his book, "Perfect I'm Not: Boomer on Beer, Brawls, Backaches, and Baseball."

37. Amphetamines have become as much a part of the clubhouse scene as card games and hot feet. In a Kansas City Star story, former Royals outfielder Brian McRae recalled how there were always two pots of coffee brewing in the clubhouse -- one conventional and the other laced with stimulants. "I had to make sure I got the unleaded," McRae said.

38. Why Amphetamines? • Stimulative Effects: • Wakefullness • Alertness • Decreased sense of fatigue • Decreased appetite • Acute side effects include: Increased heart rate, Increased blood pressure, Reduced appetite and weight loss, Insomnia, Headaches, Convulsions, Hallucinations and paranoia. Death may also occur due to ruptured blood vessels in the brain, heart attacks, heart rhythm abnormalities and heatstroke Can be detected for 2-4 days in urine

39. Who can use Amphetamines? Fighter pilots “Go pills” – Dexidrine The military says use is voluntary and pilots may refuse them

40. Caffeine - increases time to fatigue - likely beneficial to endurance - no real strength/power benefit Doses: 2-5 mg/kg effective 250-500 mg Cola: 40mg, Coffee: 100mg, Tea: 20-100mg, Red Bull: 115mg

41. Ephedra (Ma Huang) • Increases alertness and euphoria • Often stacked with other stimulants such as caffeine • Decreased sense of fatigue

42. Side Effects: - dehydration - loss of thermal autoregulation - tachycardia – rapid heartbeat - heat exhaustion and heat stroke FDA banned sale of ephedra containing supplements on 4/12/04 Currently banned by the IOC, WADA, NFL, NBA

44. Linked to recent deaths: - Steve Bechler – Balt. Orioles pitcher heat stroke temp 108 degrees Using ephedra and did not eat for 2 days - Cory Stringer – Minnesota Vikings was using Ripped Fuel – contains ephedra - Implicated in a “friendly fire” incident in Afganistan. As of October 2007, on list of banned substances for the military

45. Creatine • First used in 1992 by British sprinters • Ergogenic Effect: increase resting levels of creatine phosphate so as to regenerate more ATP and delay fatigue • Synthesized by liver and pancreas • Dietary sources – meats and fish • 95% stored in skeletal muscle • Other than a small weight gain (muscle, water?), seems to be few short term side effects other than dehydration and cramping • Questions remain regarding long term effect on muscles (heart) and kidneys (Anecdotal)

46. Steroid Precursors (Prohormones) Androstendione (“Andro”) a potent anabolic-androgenic steroid produced by the adrenal glands and gonads Converted by the body into testosterone or estrone DHEA a weak androgen produced by the adrenal cortex converted to androstendione and then testosterone

47. Adverse Effects • Potential male gynecomastia • Decrease in natural testosterone production over time

48. Gregg Valentino • http://www.youtube.com/watch?v=oYlNfvwFN_I

50. http://www.youtube.com/watch?v=58K_JzRQpRU • http://www.youtube.com/watch?v=UPwhAMD1He8 • http://www.youtube.com/watch?v=SPcvuPHhIfw