Anabolic steroid

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Anabolic steroid
Anabolic steroids, technically known as anabolic-androgenic steroids (AAS), are drugs that are structuraly related
to the cyclic steroid ring system and have similar effects to testosterone in the body. They increase protein within
cells, especially in skeletal muscles. Anabolic steroids also have androgenic and virilizing properties, including the
development and maintenance of masculine characteristics such as the growth of the vocal cords, testicles (primary
sexual characteristics) and body hair (secondary sexual characteristics). The word anabolic comes from the Greek
anabole, "that which is thrown up, mound", and the word androgenic from the Greek andros, "of a
man" + - -genes, "born".
Anabolic steroids were first made in the 1930s, and are now used therapeutically in medicine to stimulate bone
growth and appetite, induce male puberty and treat chronic wasting conditions, such as cancer and AIDS. The
American College of Sports Medicine acknowledges that AAS, in the presence of adequate diet, can contribute to
increases in body weight, often as lean mass increases and that the gains in muscular strength achieved through
high-intensity exercise and proper diet can be additionally increased by the use of AAS in some individuals.
[1]
Health risks can be produced by long-term use or excessive doses of anabolic steroids. These effects include harmful
changes in cholesterol levels (increased low-density lipoprotein and decreased high-density lipoprotein), acne, high
blood pressure, liver damage (mainly with oral steroids), and dangerous changes in the structure of the left ventricle
of the heart. Conditions pertaining to hormonal imbalances such as gynecomastia and testicular atrophy may also be
caused by anabolic steroids.
Ergogenic uses for anabolic steroids in sports, racing, and bodybuilding as performance-enhancing drugs are
controversial because of their adverse effects and the potential to gain unfair advantage is considered cheating. Their
use is referred to as doping and banned by all major sporting bodies. For many years, AAS have been by far the most
detected doping substances in IOC-accredited laboratories.
[2]
In countries where AAS are controlled substances,
there is often a black market in which smuggled, clandestinely manufactured or even counterfeit drugs are sold to
users.
History
Isolation of gonadal AAS
Chemical structure of the natural anabolic
hormone testosterone,
17-hydroxy-4-androsten-3-one
The use of gonadal steroids pre-dates their identification and isolation.
Medical use of testicle extract began in the late 19th century while its
effects on strength were still being studied. The isolation of gonadal
steroids can be traced back to 1931, when Adolf Butenandt, a chemist
in Marburg, purified 15 milligrams of the male hormone androstenone
from tens of thousands of litres of urine. This steroid was subsequently
synthesized in 1934 by Leopold Ruzicka, a chemist in Zurich.
In the 1930s, it was already known that the testes contain a more
powerful androgen than androstenone, and three groups of scientists,
funded by competing pharmaceutical companies in the Netherlands,
Germany, and Switzerland, raced to isolate it. This hormone was first
identified by Karoly Gyula David, E. Dingemanse, J. Freud and Ernst Laqueur in a May 1935 paper "On Crystalline
Male Hormone from Testicles (Testosterone)." They named the hormone testosterone, from the stems of testicle and
sterol, and the suffix of ketone. The chemical synthesis of testosterone was achieved in August that year, when
Butenandt and G. Hanisch published a paper describing "A Method for Preparing Testosterone from Cholesterol."
Only a week later, the third group, Ruzicka and A. Wettstein, announced a patent application in a paper "On the
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Artificial Preparation of the Testicular Hormone Testosterone (Androsten-3-one-17-ol)." Ruzicka and Butenandt
were offered the 1939 Nobel Prize in Chemistry for their work, but the Nazi government forced Butenandt to decline
the honor, although he accepted the prize after the end of World War II.
Clinical trials on humans, involving either oral doses of methyltestosterone or injections of testosterone propionate,
began as early as 1937. Testosterone propionate is mentioned in a letter to the editor of Strength and Health
magazine in 1938; this is the earliest known reference to an anabolic steroid in a U.S. weightlifting or bodybuilding
magazine. There are often reported rumors that German soldiers were administered anabolic steroids during the
Second World War, the aim being to increase their aggression and stamina, but these are, as yet, unproven.
[3]
Adolf
Hitler himself, according to his physician, was injected with testosterone derivatives to treat various ailments. AAS
were used in experiments conducted by the Nazis on concentration camp inmates, and later by the allies attempting
to treat the malnourished victims that survived Nazi camps. President John F. Kennedy was administered steroids
both before and during his presidency.
[4]
Development of synthetic AAS
Chemical structure of the synthetic steroid
Methandrostenolone (Dianabol).
17-Methylation (upper-right corner) enhances
oral bioavailability.
The development of muscle-building properties of testosterone was
pursued in the 1940s, in the Soviet Union and in Eastern Bloc countries
such as East Germany, where steroid programs were used to enhance
the performance of Olympic and other amateur weight lifters. In
response to the success of Russian weightlifters, the U.S. Olympic
Team physician Dr. John Ziegler worked with synthetic chemists to
develop an anabolic steroid with reduced androgenic effects. Ziegler's
work resulted in the production of methandrostenolone, which Ciba
Pharmaceuticals marketed as Dianabol. The new steroid was approved
for use in the U.S. by the Food and Drug Administration (FDA) in
1958. It was most commonly administered to burn victims and the
elderly. The drug's off-label users were mostly bodybuilders and
weight lifters. Although Ziegler prescribed only small doses to athletes, he soon discovered that those having abused
Dianabol suffered from enlarged prostates and atrophied testes.
[5]
AAS were placed on the list of banned substances
of the IOC in 1976, and a decade later the committee introduced 'out-of-competition' doping tests because many
athletes used AAS in their training period rather than during competition.
Three major ideas governed modifications of testosterone into a multitude of AAS: Alkylation at 17-alpha position
with methyl or ethyl group created orally active compounds because it slows the degradation of the drug by the liver;
esterification of testosterone and nortestosterone at the 17-beta position allows the substance to be administered
parenterally and increases the duration of effectiveness because agents soluble in oily liquids may be present in the
body for several months; and alterations of the ring structure were applied for both oral and parenteral agents to
seeking to obtain different anabolic to androgenic effect ratios.
[6]
List of anabolic steroids
Exogenous anabolic androgenic steroids
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1-Androstenediol Methasterone
1-Androstenedione Methyldienolone
Bolandiol Methyl-1-testosterone
Bolasterone Methylnortestosterone
Boldenone Methyltestosterone
Boldione Metribolone
Calusterone Mibolerone
Clostebol Nandrolone
Danazol 19-Norandrostenedione
Dehydrochlormethyltestosterone Norboletone
Desoxymethyltestosterone Norclostebol
Drostanolone Norethandrolone
Ethylestrenol Oxabolone
Fluoxymesterone Oxandrolone
Formebolone Oxymesterone
Furazabol Oxymetholone
Gestrinone Prostanozol
4-Hydroxytestosterone Quinbolone
Mestanolone Stanozolol
Mesterolone Stenbolone
Metenolone 1-Testosterone
Methandienone Tetrahydrogestrinone
Methandriol Trenbolone
Endogenous anabolic androgenic steroids
Androstenediol
Androstenedione
Dihydrotestosterone
Prasterone (dehydroepiandrosterone DHEA)
Testosterone
Metabolites and isomers
Metabolites and isomers of endogenous anabolic androgenic steroids, including, but not limited to:
5-Androstane-3,17-diol 4-Androstenediol
5-Androstane-3,17-diol 5-Androstenedione
5-Androstane-3,17-diol Epi-dihydrotestosterone
5-Androstane-3,17-diol Epitestosterone
Androst-4-ene-3,17-diol 3-Hydroxy-5-androstan-17-one
Androst-4-ene-3,17-diol 3-Hydroxy-5-androstan-17-one
Androst-4-ene-3,17-diol 7-Hydroxy-DHEA
Androst-4-ene-3,17-diol 7-Hydroxy-DHEA
Androst-5-ene-3,17-diol 7-Keto-DHEA
Androst-5-ene-3,17-diol 19-Norandrosterone
Androst-5-ene-3,17-diol 19-Noretiocholanolone
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Pharmacology
Routes of administrations
A vial of injectable testosterone
cypionate
There are four common forms in which anabolic steroids are administered: oral
pills, injectable steroids, creams/gels for topical application, and skin patches.
Oral administration is the most convenient. Testosterone administered by mouth
is rapidly absorbed, but it is largely converted to inactive metabolites, and only
about 1/6 is available in active form. In order to be sufficiently active when given
by mouth, testosterone derivatives are alkylated at the 17 position, e.g.
methyltestosterone and fluoxymesterone. This modification reduces the liver's
ability to break down these compounds before they reach the systemic
circulation.
Testosterone can be administered parenterally, but it has more irregular
prolonged absorption time and greater activity in propionate, enanthate,
undecanoate, or cypionate ester form. These derivatives are hydrolyzed to release
free testosterone at the site of injection; absorption rate (and thus injection
schedule) varies among different esters, but medical injections are normally done
anywhere between semi-weekly to once every 12 weeks. A more frequent schedule may be desirable in order to
maintain a more constant level of hormone in the system. Injectable steroids are typically administered into the
muscle, not into the vein, to avoid sudden changes in the amount of the drug in the bloodstream. In addition, because
estered testosterone is dissolved in oil, intravenous injection has the potential to cause a dangerous embolism (clot)
in the bloodstream.
Transdermal patches (adhesive patches placed on the skin) may also be used to deliver a steady dose through the skin
and into the bloodstream. Testosterone-containing creams and gels that are applied daily to the skin are also
available, but absorption is inefficient (roughly 10%, varying between individuals) and these treatments tend to be
more expensive. Individuals who are especially physically active and/or bathe often may not be good candidates,
since the medication can be washed off and may take up to six hours to be fully absorbed. There is also the risk that
an intimate partner or child may come in contact with the application site and inadvertently dose himself or herself;
children and women are highly sensitive to testosterone and can suffer unintended masculinization and health
effects, even from small doses. Injection is the most common method used by individuals administering anabolic
steroids for non-medical purposes.
The traditional routes of administration do not have differential effects on the efficacy of the drug. Studies indicate
that the anabolic properties of anabolic steroids are relatively similar despite the differences in pharmacokinetic
principles such as first-pass metabolism. However, the orally available forms of AAS may cause liver damage in
high doses.
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Mechanism of action
The human androgen receptor bound to
testosterone The protein is shown as a ribbon
diagram in red, green, and blue, with the steroid
shown in white.
The pharmacodynamics of anabolic steroids are unlike peptide
hormones. Water-soluble peptide hormones cannot penetrate the fatty
cell membrane and only indirectly affect the nucleus of target cells
through their interaction with the cells surface receptors. However, as
fat-soluble hormones, anabolic steroids are membrane-permeable and
influence the nucleus of cells by direct action. The pharmacodynamic
action of anabolic steroids begin when the exogenous hormone
penetrates the membrane of the target cell and binds to an androgen
receptor located in the cytoplasm of that cell. From there, the
compound hormone-receptor diffuses into the nucleus, where it either
alters the expression of genes or activates processes that send signals to
other parts of the cell. Different types of anabolic steroids bind to the
androgen receptor with different affinities, depending on their chemical
structure. Some anabolic steroids such as methandrostenolone bind weakly to this receptor in vitro, but still exhibit
androgenic effects in vivo. The reason for this discrepancy is not known.
The effect of anabolic steroids on muscle mass is caused in at least two ways: first, they increase the production of
proteins; second, they reduce recovery time by blocking the effects of stress hormone cortisol on muscle tissue, so
that catabolism of muscle is greatly reduced. It has been hypothesized that this reduction in muscle breakdown may
occur through anabolic steroids inhibiting the action of other steroid hormones called glucocorticoids that promote
the breakdown of muscles. Anabolic steroids also affect the number of cells that develop into fat-storage cells, by
favouring cellular differentiation into muscle cells instead. Anabolic steroids can also decrease fat by increasing
basal metabolic rate (BMR), since an increase in muscle mass increases BMR.
Anabolic and androgenic effects
Relative androgenic:anabolic
activity in animals
Preparation Ratio
Testosterone 1:1
Methyltestosterone 1:1
Fluoxymesterone 1:2
Oxymetholone 1:3
Oxandrolone 1:31:13
Nandrolone decanoate 1:2.51:4
As the name suggests, anabolic-androgenic steroids have two different, but overlapping, types of effects: anabolic,
meaning that they promote anabolism (cell growth), and androgenic (or virilising), meaning that they affect the
development and maintenance of masculine characteristics.
Some examples of the anabolic effects of these hormones are increased protein synthesis from amino acids,
increased appetite, increased bone remodeling and growth, and stimulation of bone marrow, which increases the
production of red blood cells. Through a number of mechanisms anabolic steroids stimulate the formation of muscle
cells and hence cause an increase in the size of skeletal muscles, leading to increased strength.
The androgenic effects of AAS are numerous. Depending on the length of use, the side effects of the steroid can be
irreversible. Processes affected include pubertal growth, sebaceous gland oil production, and sexuality (especially in
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fetal development). Some examples of virilizing effects are growth of the clitoris in females and the penis in male
children (the adult penis size does not change due to steroids
[medical citation needed]
), increased vocal cord size,
increased libido, suppression of natural sex hormones, and impaired production of sperm. Women become more
masculine, their voices deepen, they grow facial hair, and their breasts size decreases. Men however become more
feminine. Development of breasts, reduced testicle size, and reduced sperm count are all indirect effects of AAS.
The androgenic:anabolic ratio of an AAS is an important factor when determining the clinical application of these
compounds. Compounds with a high ratio of androgenic to an anabolic effects are the drug of choice in
androgen-replacement therapy (e.g., treating hypogonadism in males), whereas compounds with a reduced
androgenic:anabolic ratio are preferred for anemia and osteoporosis, and to reverse protein loss following trauma,
surgery, or prolonged immobilization. Determination of androgenic:anabolic ratio is typically performed in animal
studies, which has led to the marketing of some compounds claimed to have anabolic activity with weak androgenic
effects. This disassociation is less marked in humans, where all anabolic steroids have significant androgenic
effects.
[]
A commonly used protocol for determining the androgenic:anabolic ratio, dating back to the 1950s, uses the relative
weights of ventral prostate (VP) and levator ani muscle (LA) of male rats. The VP weight is an indicator of the
androgenic effect, while the LA weight is an indicator of the anabolic effect. Two or more batches of rats are
castrated and given no treatment and respectively some AAS of interest. The LA/VP ratio for an AAS is calculated as
the ratio of LA/VP weight gains produced by the treatment with that compound using castrated but untreated rats as
baseline: (LA
c,t
LA
c
)/(VP
c,t
VP
c
). The LA/VP weight gain ratio from rat experiments is not unitary for testosterone
(typically 0.30.4), but it is normalized for presentation purposes, and used as basis of comparison for other AAS,
which have their androgenic:anabolic ratios scaled accordingly (as shown in the table above).
[7]
In the early 2000s,
this procedure was standardized and generalized throughout OECD in what is now known as the Hershberger assay.
Body composition and strength improvements
A review spanning more than three decades of experimental studies in men found that body weight may increase by
25kg as a result of short-term (<10 weeks) AAS use, which may be attributed mainly to an increase of lean mass.
Animal studies also found that fat mass was reduced, but most studies in humans failed to elucidate significant fat
mass decrements. The effects on lean body mass have been shown to be dose-dependent. Both muscle hypertrophy
and the formation of new muscle fibers have been observed. The hydration of lean mass remains unaffected by AAS
use, although small increments of blood volume cannot be ruled out.
[8]
The upper region of the body (thorax, neck, shoulders, and upper arm) seems to be more susceptible for AAS than
other body regions because of predominance of androgen receptors in the upper body. The largest difference in
muscle fiber size between AAS users and non-users was observed in type I muscle fibers of the vastus lateralis and
the trapezius muscle as a result of long-term AAS self-administration. After drug withdrawal, the effects fade away
slowly, but may persist for more than 612 weeks after cessation of AAS use.
The same review observed strength improvements in the range of 520% of baseline strength, depending largely on
the drugs and dose used as well as the administration period. Overall, the exercise where the most significant
improvements were observed is the bench press.
[9]
For almost two decades, it was assumed that AAS exerted
significant effects only in experienced strength athletes, particularly based on the studies of Hervey and coworkers.
In 1996, a randomized controlled trial published in the New England Journal of Medicine demonstrated, however,
that even in novice athletes a 10-week strength training program accompanied by testosterone enanthate at
600mg/week may improve strength more than training alone does. The same study found that dose to be sufficient
to significantly improve lean muscle mass relative to placebo even in subjects that did not exercise at all. A 2001
study by the same first author, showed that the anabolic effects of testosterone enanthate were highly dose
dependent.
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Adverse effects
Anabolic steroids can cause many adverse effects. Depending on the length of drug abuse, there is a chance that the
immune system can be damaged. Most of these side-effects are dose-dependent, the most common being elevated
blood pressure, especially in those with pre-existing hypertension, and harmful changes in cholesterol levels: Some
steroids cause an increase in LDL "bad" cholesterol and a decrease in HDL "good" cholesterol. Anabolic steroids
have been shown to alter fasting blood sugar and glucose tolerance tests. Anabolic steroids such as testosterone also
increase the risk of cardiovascular disease or coronary artery disease. Acne is fairly common among anabolic steroid
users, mostly due to stimulation of the sebaceous glands by increased testosterone levels.
[10]
Conversion of
testosterone to dihydrotestosterone (DHT) can accelerate the rate of premature baldness for males genetically
predisposed, but testosterone itself can produce baldness in females.
High doses of oral anabolic steroid compounds can cause liver damage, as the steroids are metabolized
(17-alkylated) in the digestive system to increase their bioavailability and stability.
There are also sex-specific side-effects of anabolic steroids. Development of breast tissue in males, a condition
called gynecomastia (which is usually caused by high levels of circulating estradiol), may arise because of increased
conversion of testosterone to estradiol by the enzyme aromatase. Reduced sexual function and temporary infertility
can also occur in males. Another male-specific side-effect that can occur is testicular atrophy, caused by the
suppression of natural testosterone levels, which inhibits production of sperm (most of the mass of the testes is
developing sperm). This side-effect is temporary: The size of the testicles usually returns to normal within a few
weeks of discontinuing anabolic steroid use as normal production of sperm resumes. Female-specific side-effects
include increases in body hair, permanent deepening of the voice, enlarged clitoris, and temporary decreases in
menstrual cycles. When taken during pregnancy, anabolic steroids can affect fetal development by causing the
development of male features in the female fetus and female features in the male fetus.
A number of severe side-effects can occur if adolescents use anabolic steroids.
For example, the steroids may prematurely stop the lengthening of bones (premature epiphyseal fusion through
increased levels of estrogen metabolites), resulting in stunted growth. Other effects include, but are not limited to,
accelerated bone maturation, increased frequency and duration of erections, and premature sexual development.
Anabolic steroid use in adolescence is also correlated with poorer attitudes related to health.
Other side-effects can include alterations in the structure of the heart, such as enlargement and thickening of the left
ventricle, which impairs its contraction and relaxation. Possible effects of these alterations in the heart are
hypertension, cardiac arrhythmias, congestive heart failure, heart attacks, and sudden cardiac death. These changes
are also seen in non-drug-using athletes, but steroid use may accelerate this process. However, both the connection
between changes in the structure of the left ventricle and decreased cardiac function, as well as the connection to
steroid use have been disputed.
Psychiatric effects
A 2005 review in CNS Drugs determined that "significant psychiatric symptoms including aggression and violence,
mania, and less frequently psychosis and suicide have been associated with steroid abuse. Long-term steroid abusers
may develop symptoms of dependence and withdrawal on discontinuation of AAS". High concentrations of AAS,
comparable to those likely sustained by many recreational AAS users, produce apoptotic effects on neurons, raising
the specter of possibly irreversible neuropsychiatric toxicity. Recreational AAS use appears to be associated with a
range of potentially prolonged psychiatric effects, including dependence syndromes, mood disorders, and
progression to other forms of substance abuse, but the prevalence and severity of these various effects remains
poorly understood. There is no evidence that steroid dependence develops from therapeutic use of anabolic steroids
to treat medical disorders, but instances of AAS dependence have been reported among weightlifters and
bodybuilders who chronically administered supraphysiologic doses. Mood disturbances (e.g. depression,
[hypo-]mania, psychotic features) are likely to be dose- and drug-dependent, but AAS dependence or withdrawal
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effects seem to occur only in a small number of AAS users.
[11]
Large-scale long-term studies of psychiatric effects on AAS users are not currently available. In 2003, the first
naturalistic long-term study on ten users, seven of which having completed the study, found a high incidence of
mood disorders and substance abuse, but few clinically relevant changes in physiological parameters or laboratory
measures were noted throughout the study, and these changes were not clearly related to periods of reported AAS
use. A 13-month study, which was published in 2006 and which involved 320 body builders and athletes suggests
that the wide range of psychiatric side-effects induced by the use of AAS is correlated to the severity of abuse.
Aggression and hypomania
From the mid-1980s onward, the media reported "roid rage" as a side-effect of AAS.
[12]
A 2005 review determined that some, but not all, randomized controlled studies have found that anabolic steroid use
correlates with hypomania and increased aggressiveness, but pointed out that attempts to determine whether AAS
use triggers violent behavior have failed, primarily because of high rates of non-participation. A 2008 study on a
nationally representative sample of young adult males in the United States found an association between lifetime and
past-year self-reported anabolic-androgenic steroid use and involvement in violent acts. Compared with individuals
that did not use steroids, young adult males that used anabolic-androgenic steroids reported greater involvement in
violent behaviors even after controlling for the effects of key demographic variables, previous violent behavior, and
polydrug use. A 1996 review examining the blind studies available at that time also found that these had
demonstrated a link between aggression and steroid use, but pointed out that with estimates of over one million past
or current steroid users in the United States at that time, an extremely small percentage of those using steroids appear
to have experienced mental disturbance severe enough to result in clinical treatments or medical case reports.
A 1996 randomized controlled trial, which involved 43 men, did not find an increase in the occurrence of angry
behavior during 10 weeks of administration of testosterone enanthate at 600mg/week, but this study screened out
subjects that had previously abused steroids or had any psychiatric antecedents. A trial conducted in 2000 using
testosterone cypionate at 600mg/week found that treatment significantly increased manic scores on the YMRS, and
aggressive responses on several scales. The drug response was highly variable. However: 84% of subjects exhibited
minimal psychiatric effects, 12% became mildly hypomanic, and 4% (2 subjects) became markedly hypomanic. The
mechanism of these variable reactions could not be explained by demographic, psychological, laboratory, or
physiological measures.
A 2006 study of two pairs of identical twins, in which one twin used anabolic steroids and the other did not, found
that in both cases the steroid-using twin exhibited high levels of aggressiveness, hostility, anxiety, and paranoid
ideation not found in the "control" twin. A small-scale study of 10 AAS users found that cluster B personality
disorders were confounding factors for aggression.
Depression and suicide
The relationship between AAS use and depression is inconclusive. There have been anecdotal reports of depression
and suicide in teenage steroid users, but little systematic evidence. A 1992 review found that anabolic-androgenic
steroids may both relieve and cause depression, and that cessation or diminished use of anabolic-androgenic steroids
may also result in depression, but called for additional studies due to disparate data.
Addiction potential
In an animal study, male rats developed a conditioned place preference to testosterone injections into the nucleus
accumbens, an effect blocked by dopamine antagonists, which suggests that androgen reinforcement is mediated by
the brain. Moreover, testosterone appears to act through the mesolimbic dopamine system, a common substrate for
drugs of abuse. Nonetheless, androgen reinforcement is not comparable to that of cocaine, nicotine, or heroin.
Instead, testosterone resembles other mild reinforcers, such as caffeine, or benzodiazepines. The potential for
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androgen addiction remains to be determined.
Medical and ergogenic uses
Medical uses
Various anabolic steroids and related compounds
Since the discovery and synthesis of testosterone in the 1930s, anabolic
steroids have been used by physicians for many purposes, with varying
degrees of success, for the treatment of:
Bone marrow stimulation: For decades, anabolic steroids were the
mainstay of therapy for hypoplastic anemias due to leukemia or
kidney failure, especially aplastic anemia. Anabolic steroids have
largely been replaced in this setting by synthetic protein hormones
(such as epoetin alfa) that selectively stimulate growth of blood cell
precursors.
Growth stimulation: Anabolic steroids can be used by pediatric endocrinologists to treat children with growth
failure. However, the availability of synthetic growth hormone, which has fewer side effects, makes this a
secondary treatment.
Stimulation of appetite and preservation and increase of muscle mass: Anabolic steroids have been given to
people with chronic wasting conditions such as cancer and AIDS.
Induction of male puberty: Androgens are given to many boys distressed about extreme delay of puberty.
Testosterone is now nearly the only androgen used for this purpose and has been shown to increase height,
weight, and fat-free mass in boys with delayed puberty.
Male contraception, in the form of testosterone enanthate; potential for use in the near-future as a safe, reliable,
and reversible male contraceptive.
Stimulation of lean body mass and prevention of bone loss in elderly men, as some studies indicate. However, a
2006 placebo-controlled trial of low-dose testosterone supplementation in elderly men with low levels of
testosterone found no benefit on body composition, physical performance, insulin sensitivity, or quality of life.
Hormone replacement for men with low levels of testosterone; also effective in improving libido for elderly
males.
Gender Identity Disorder, by producing secondary male characteristics, such as a deeper voice, increased bone
and muscle mass, facial hair, increased levels of red blood cells, and clitoral enlargement in female-to-male
patients.
Ergogenic use and abuse
Numerous vials of injectable anabolic steroids
Between 1 million and 3 million people (1% of the population) are
thought to have misused AAS in the United States. Studies in the
United States have shown that anabolic steroid users tend to be mostly
middle-class heterosexual men with a median age of about 25 who are
noncompetitive bodybuilders and non-athletes and use the drugs for
cosmetic purposes. "Among 12- to 17-year-old boys, use of steroids
and similar drugs jumped 25 percent from 1999 to 2000, with 20
percent saying they use them for looks rather than sports, a study by
insurer Blue Cross Blue Shield found."(Eisenhauer)<ref Another study
found that non-medical use of AAS among college students was at or
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less than 1%. According to a recent survey, 78.4% of steroid users were noncompetitive bodybuilders and
non-athletes, while about 13% reported unsafe injection practices such as reusing needles, sharing needles, and
sharing multidose vials, though a 2007 study found that sharing of needles was extremely uncommon among
individuals using anabolic steroids for non-medical purposes, less than 1%. Another 2007 study found that 74% of
non-medical anabolic steroid users had secondary college degrees and more had completed college and fewer had
failed to complete high school than is expected from the general populace. The same study found that individuals
using anabolic steroids for non-medical purposes had a higher employment rate and a higher household income than
the general population. Anabolic steroid users tend to research the drugs they are taking more than other
controlled-substance users; however, the major sources consulted by steroid users include friends, non-medical
handbooks, internet-based forums, blogs, and fitness magazines, which can provide questionable or inaccurate
information.
Anabolic steroid users tend to be disillusioned by the portrayal of anabolic steroids as deadly in the media and in
politics. According to one study, AAS users also distrust their physicians and in the sample 56% had not disclosed
their AAS use to their physicians. Another 2007 study had similar findings, showing that, while 66% of individuals
using anabolic steroids for non-medical purposes were willing to seek medical supervision for their steroid use, 58%
lacked trust in their physicians, 92% felt that the medical community's knowledge of non-medical anabolic steroid
use was lacking, and 99% felt that the public has an exaggerated view of the side-effects of anabolic steroid use. A
recent study has also shown that long term AAS users were more likely to have symptoms of muscle dysmorphia and
also showed stronger endorsement of more conventional male roles.
Anabolic steroids have been used by men and women in many different kinds of professional sports to attain a
competitive edge or to assist in recovery from injury. These sports include bodybuilding, weightlifting, shot put and
other track and field, cycling, baseball, wrestling, mixed martial arts, boxing, football, and cricket. Such use is
prohibited by the rules of the governing bodies of most sports. Anabolic steroid use occurs among adolescents,
especially by those participating in competitive sports. It has been suggested that the prevalence of use among
high-school students in the U.S. may be as high as 2.7%. Male students used anabolic steroids more frequently than
female students and, on average, those that participated in sports used steroids more often than those that did not.
Legal and sport restrictions
Legal status
Various compounds with anabolic and
androgenic effects, their relation with anabolic
steroids
The legal status of anabolic steroids varies from country to country:
some have stricter controls on their use or prescription than others
though in many countries they are not illegal. In the U.S., anabolic
steroids are currently listed as Schedule III controlled substances under
the Controlled Substances Act, which makes simply possessing of such
substances without a prescription, first offense, a federal crime
punishable by up to one year in prison. Unlawful distribution or
possession with intent to distribute anabolic steroids punishable as a
first offense is punished by up to ten years in prison. In Canada,
anabolic steroids and their derivatives are part of the Controlled drugs
and substances act and are Schedule IV substances, meaning that it is illegal to obtain or sell them without a
prescription; however, possession is not punishable, a consequence reserved for schedule I, II, or III substances.
Those guilty of buying or selling anabolic steroids in Canada can be imprisoned for up to 18 months. Import and
export also carry similar penalties. In Canada, researchers have concluded that steroid use among student athletes is
extremely widespread. A study conducted in 1993 by the Canadian Centre for Drug-Free Sport found that nearly
83,000 Canadians between the ages of 11 and 18 use steroids. Anabolic steroids are also illegal without prescription
Anabolic steroid
11
in Australia, Argentina, Brazil and Portugal, and are listed as ClassC Controlled Drugs in the United Kingdom.
Anabolic steroids are readily available without a prescription in some countries such as Mexico and Thailand.
United States
Steroid pills intercepted by the US Drug Enforcement
Administration during the "Operation raw deal" bust in
September 2007.
The history of the U.S. legislation on anabolic steroids goes back
to the late 1980s, when the U.S. Congress considered placing
anabolic steroids under the Controlled Substances Act following
the controversy over Ben Johnson's victory at the 1988 Summer
Olympics in Seoul. During deliberations, the American Medical
Association (AMA), Drug Enforcement Administration (DEA),
Food and Drug Administration (FDA) as well as the National
Institute on Drug Abuse (NIDA) all opposed listing anabolic
steroids as controlled substances
[citation needed]
, citing the fact that
use of these hormones does not lead to the physical or
psychological dependence required for such scheduling under the
Controlled Substance Act. Nevertheless, anabolic steroids were
added to Schedule III of the Controlled Substances Act in the
Anabolic Steroid Control Act of 1990.
The same act also introduced more stringent controls with higher criminal penalties for offenses involving the illegal
distribution of anabolic steroids and human growth hormone. By the early 1990s, after anabolic steroids were
scheduled in the U.S., several pharmaceutical companies stopped manufacturing or marketing the products in the
U.S., including Ciba, Searle, Syntex, and others. In the Controlled Substances Act, anabolic steroids are defined to
be any drug or hormonal substance chemically and pharmacologically related to testosterone (other than estrogens,
progestins, and corticosteroids) that promote muscle growth. The act was amended by the Anabolic Steroid Control
Act of 2004, which added prohormones to the list of controlled substances, with effect from January 20, 2005.
United Kingdom
In the United Kingdom, anabolic steroids are classified as class C drugs for their illegal abuse potential, which puts
them in the same class as benzodiazepines. Anabolic steroids are in Schedule 4, which is divided in 2 parts; Part 1
contains most of the benzodiazepines and Part 2 contains the anabolic and androgenic steroids.
Part 1 drugs are subject to full import and export controls with possession being an offence without an appropriate
prescription. There is no restriction on the possession when it is part of a medicinal product. Part 2 drugs require a
Home Office licence for importation and export unless the substance is in the form of a medicinal product and is for
self-administration by a person.
Anabolic steroid
12
Status in sports
Legal status of anabolic steroids and other
compounds with anabolic effects in Western
countries
Anabolic steroids are banned by all major sports bodies including
Association of Tennis Professionals, Major League Baseball,
Fdration Internationale de Football Association
[13]
the Olympics, the
National Basketball Association, the National Hockey League, and the
National Football League. The World Anti-Doping Agency (WADA)
maintains the list of performance-enhancing substances used by many
major sports bodies and includes all anabolic agents, which includes all
anabolic steroids and precursors as well as all hormones and related
substances. Spain has passed an anti-doping law creating a national
anti-doping agency. Italy passed a law in 2000 where penalties range
up to three years in prison if an athlete has tested positive for banned
substances. In 2006, Russian President Vladimir Putin signed into law
ratification of the International Convention Against Doping in Sport
which would encourage cooperation with WADA. Many other countries have similar legislation prohibiting anabolic
steroids in sports including Denmark, France, the Netherlands and Sweden.
Detection of use
The most commonly employed human physiological specimen for detecting anabolic steroid usage is urine, although
both blood and hair have been investigated for this purpose. The anabolic steroids, whether of endogenous or
exogenous origin, are subject to extensive hepatic biotransformation by a variety of enzymatic pathways. The
primary urinary metabolites may be detectable for up to 30 days after the last use, depending on the specific agent,
dose and route of administration. A number of the drugs have common metabolic pathways, and their excretion
profiles may overlap those of the endogenous steroids, making interpretation of testing results a very significant
challenge to the analytical chemist. Methods for detection of the substances or their excretion products in urine
specimens usually involve gas chromatographymass spectrometry or liquid chromatography-mass
spectrometry.
[14][15]
Illegal trade
Several large buckets containing tens of
thousands of anabolic steroid vials confiscated by
the DEA during "Operation Raw Deal" in 2007.
Anabolic steroids are frequently produced in pharmaceutical
laboratories, but, in nations where stricter laws are present, they are
also produced in small home-made underground laboratories, usually
from raw substances imported from abroad. In these countries, the
majority of steroids are obtained illegally through black market trade.
These steroids are usually manufactured in other countries, and
therefore must be smuggled across international borders. As with most
significant smuggling operations, organized crime is involved.
In the late 2000s, the worldwide trade in illicit AAS increased
significantly, and authorities announced record captures on three continents. In 2006, Finnish authorities announced
a record seizure of 11.8 million AAS tablets. A year later, the DEA seized 11.4 million units of AAS in the largest
U.S seizure ever. In the first three months of 2008, Australian customs reported a record 300 seizures of AAS
shipments.
In the U.S., Canada, and Europe, illegal steroids are sometimes purchased just as any other illegal drug, through
dealers who are able to obtain the drugs from a number of sources. Illegal anabolic steroids are sometimes sold at
gyms and competitions, and through the mail, but may also be obtained through pharmacists, veterinarians, and
Anabolic steroid
13
physicians. In addition, a significant number of counterfeit products are sold as anabolic steroids, in particular via
mail order from websites posing as overseas pharmacies. In the U.S., black-market importation continues from
Mexico, Thailand, and other countries where steroids are more easily available, as they are legal.
References
[1] [1] Michael Powers, "Performance-Enhancing Drugs" in Joel Houglum, in Gary L. Harrelson, Deidre Leaver-Dunn, "Principles of Pharmacology
for Athletic Trainers", SLACK Incorporated, 2005, ISBN 1-55642-594-5, p. 330
[2] [2] Hartgens and Kuipers (2004), p. 515
[3] [3] Pat Lenehan, "Anabolic Steroids: And Other Performance-enhancing Drugs", CRC Press, 2003, ISBN 0-415-28030-3, page 6
[4] [4] Online NewsHour with Senior Correspondent Ray Suarez and physician Jeffrey Kelman, "Pres. Kennedy's Health Secrets", The NewsHour
with Jim Lehrer transcript, November 18, 2002
[5] Justin Peters The Man Behind the Juice (http:/ / www.slate. com/ id/ 2113752/ ), Slate Friday, Feb. 18, 2005, Accessed 29 April 2008
[6] [6] Hartgens and Kuipers (2004), p. 516
[7] L.G. Hershberger, E.G. Shipley, R.K. Meyer, Myotropic activity of 19-nortestosterone and other steroids determined by modified levator ani
muscle method, Proc. Soc. Exp. Biol. Med. 83 (1953), 175180
[8] [8] Hartgens and Kuipers (2004), p. 519-527
[9] [9] Hartgens and Kuipers (2004), p. 528
[10] [10] Hartgens and Kuipers (2004), p. 543
[11] Hartgens and Kuipers (2004), p. 514515
[12] [12] Pat Lenehan, "Anabolic Steroids: And Other Performance-enhancing Drugs", CRC Press, 2003, ISBN 0-415-28030-3, page 23
[13] http:/ / es. fifa.com/ mm/ document/ afdeveloping/ medical/ 50/ 29/ 56/ fifadocregulations_09. 01. 09_e. pdf
[14] Blackledge RD. Bad science: the instrumental data in the Floyd Landis case. Clin Chim. Acta. 406: 813, 2009.
[15] R. Baselt, Disposition of Toxic Drugs and Chemicals in Man, 8th edition, Biomedical Publications, Foster City, CA, 2008, pp. 95, 393, 403,
649, 695, 952, 962, 1078, 1156, 1170, 1442, 1501, 1581.
Tygart, Travis T. "Steroids, the Media, and Youth." Prevention Researcher Integrated Research Services, Inc., Vol.
16 Supplement. December 2009: 79. SIRS Researcher. Web. 25 Oct 2010.
Eisenhauer, Lisa. "Do I Look OK?." St. Louis Post-Dispatch (St. Louis, MO). Nov. 7 2005: HF1+. SIRS Researcher.
Web. 25 Oct 2010.
Further reading
D. Kochakian, Charles (2000). Anabolic Steroids in Sport and Exercise. Human Kinetics. ISBN0-88011-786-9.
Daniels, R. C. (February 1, 2003). The Anabolic Steroid Handbook. Richard C Daniels. p.80.
ISBN0-9548227-0-6.
Gallaway, Steve (January 15, 1997). The Steroid Bible. Belle Intl; 3rd Sprl edition. p.125. ISBN1-890342-00-9.
Llewellyn, William (January 28, 2007). ANABOLICS 2007 : Anabolic Steroid Reference Manual (6th Ed.). Body
of Science. p.988. ISBN978-0-9679304-6-6.
Roberts, Anthony; Brian Clapp (January 2006). Anabolic Steroids: Ultimate Research Guide. Anabolic Books,
LLC. p.394. ISBN1-59975-100-3.
Yesalis, Charles E. (July 2000). Anabolic Steroids in Sport and Exercise. Human Kinetics Publishers; 2nd edition.
p.493. ISBN0-88011-786-9.
Sigmarsson, Victor (January 15, 2007). Inside Secrets: The Bodybuilders Guide To Buying Steroids On The
Internet!. SA LABS LLC ; 2nd edition. p.7. ISBN978-1-4507-5402-6.
Tygart, Travis T. "Steroids, the Media, and Youth." Prevention Researcher Integrated Research Services, Inc., Vol.
16 Supplement. December 2009: 79. SIRS Researcher. Web. 25 Oct 2010.
Anabolic steroid
14
External links
Dmoz Directory of websites on anabolic steroids (http:/ / www. dmoz. org/ Sports/ Strength_Sports/
Bodybuilding/ Supplements/ Anabolic_Steroids)
Article Sources and Contributors
15
Article Sources and Contributors
Anabolic steroid Source: https://en.wikipedia.org/w/index.php?oldid=577352978 Contributors: -Freebird-, 123home123, 1allstarjosh, 21655, 21millerd,
2602:306:BC35:5CD0:80BB:DECA:B7EB:56CD, 2602:306:C5CD:DA10:21B:63FF:FE09:86DD, 28421u2232nfenfcenc, 5964331a, 8ty3hree, A.M.962, A.amitkumar, ABF, ACEOREVIVED,
AF1987, AKK, AVand, Abarry, Abdull, Abeg92, Abrech, Adam mayers, Addshore, Adrian J. Hunter, Ahoerstemeier, Aitias, Alansohn, AlecX3, Alexandermsn, Alexf, AlexiusHoratius, Alialiac,
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Anthonyhcole, Arbitrarily0, Arbor to SJ, Arcadian, Arda Xi, Arnowt, Arria Belli, Artichoker, Ashmoo, Aspensti, AuburnPiIot, AuburnPilot, Autodidactyl, Avraham, Avriette, Avs5221, Axl,
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spartan082, Darkfight, Darkwind, Darth Pincho, Davemck, David Kries, Davidcannon, Dcurtissheron, DeadEyeArrow, Deli nk, Delldot, Demonman5, DennisDaniels, DerHexer, Derek.cashman,
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