The scoop on steroids and performance-enhancing drugs

Athletes are often under a lot of pressure to perform, and the desire to win at all costs can be very strong. These pressures make some athletes turn to performance-enhancing drugs.

What are performance-enhancing drugs and how do they work?

A performance-enhancing drug is a substance used to boost athletic abilities. Because of their health risks and the fact that they offer an unfair advantage, they are widely banned by athletic organizations.

Common performance-enhancing drugs include:

• anabolic steroids ("steroids"): Testosterone, the main anabolic steroid, is a hormone that is used to build up muscles.
• androstenedione ("andro"): Although this hormone is touted as a way to help athletes recover faster after training, evidence suggests it may not really work.
• creatine: This compound, available in foods and as a supplement, helps the body release energy in the muscles, giving a quick boost of power for sports such as weight-lifting or cycling sprints.
• stimulants: These drugs (such as caffeine, amphetamines, and cocaine) are used to reduce fatigue, increase metabolism and alertness, suppress the appetite, and increase aggressiveness. Stimulants are not just street drugs - they're also found in cold remedies.
• diuretics ("water pills"): These drugs make the body lose water and salts through the urine. Athletes may use them for quick weight loss so they can compete in a lighter class, or to dilute urine before a drug test.
• erythropoietin ("epo"): This medication increases the number of oxygen-carrying red blood cells, which helps increase stamina. This is also called "blood doping." (Athletes also use blood transfusions for blood doping.)

What are the health risks?

By using performance-enhancing drugs, athletes are risking a lot more than their careers. These drugs can cause serious side effects.

Misusing anabolic steroids and androstenedione can cause the following effects:

• for women: a deeper voice, baldness, more body hair, an enlarged clitoris, and an increased appetite
• for men: baldness, a higher voice, fertility problems, shrunken testicles, and breast enlargement
• for children: stunted growth
• in general: acne, liver problems, high cholesterol, aggression, rage, violence, depression, drug dependence

Creatine can damage the liver, kidneys, or heart if used at high doses. It can also cause stomach cramps, muscle cramps, nausea and vomiting, fluid retention, or diarrhea. Plus, some of the inactive ingredients in creatine supplements can cause a serious allergic reaction.

Stimulants can cause nervousness and irritability. Misusing stimulants can lead to addiction, sleep problems, high blood pressure, heart problems (e.g., heart attack, heart rhythm abnormalities), seizures, and hallucinations.

Misusing diuretics can cause dehydration, muscle cramps, and irregular heart rhythms.

Misusing erythropoietin can lead to heart disease, strokes, and blood clots in the lungs or brain.

So, athletes beware: think twice before using performance-enhancing drugs. You could be putting your health at risk.

Trish Rawn, PharmD