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      Anabolic androgenic steroid abuse in young males

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          Abstract

          This review summarizes 10 years experience with male abusers of anabolic androgenic steroids (AAS). The typical user of AAS is male, aged between 20 and 40 and lifting weights. Illegal AAS are cheap and easily obtained via internet or local suppliers. AAS are mostly used in cycles with a duration between 6 and 18 weeks. Most AAS cycles contain multiple agents, used simultaneously in a dose vastly exceeding a substitution dose. A variety of other performance and image-enhancing drugs are commonly used, including human growth hormone, thyroid hormone, tamoxifen, clomiphene citrate and human chorionic gonadotrophin. Short-term clinical and biochemical side effects are well established. Long-term side effects are uncertain, but may include heart failure, mood-and anxiety disorders, hypogonadism and subfertility. We share our views on the management of common health problems associated with AAS abuse.

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          2,4-dinitrophenol (DNP): a weight loss agent with significant acute toxicity and risk of death.

          Johann Grundlingh, Paul I. Dargan, Marwa El-Zanfaly … (2011)
          2,4-Dinitrophenol (DNP) is reported to cause rapid loss of weight, but unfortunately is associated with an unacceptably high rate of significant adverse effects. DNP is sold mostly over the internet under a number of different names as a weight loss/slimming aid. It causes uncoupling of oxidative phosphorylation; the classic symptom complex associated with toxicity of phenol-based products such as DNP is a combination of hyperthermia, tachycardia, diaphoresis and tachypnoea, eventually leading to death. Fatalities related to exposure to DNP have been reported since the turn of the twentieth century. To date, there have been 62 published deaths in the medical literature attributed to DNP. In this review, we will describe the pattern and pathophysiology of DNP toxicity and summarise the previous fatalities associated with exposure to DNP.
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            Anabolic steroid-induced hypogonadism: diagnosis and treatment.

            Cyrus Rahnema, Larry Lipshultz, Lindsey E Crosnoe … (2014)
            To develop an understanding of hypogonadal men with a history of anabolic-androgenic steroid (AAS) use and to outline recommendations for management.
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              Dihydrotestosterone: Biochemistry, Physiology, and Clinical Implications of Elevated Blood Levels

              Ronald S. Swerdloff, Robert E Dudley, Stephanie T Page … (2017)
              Abstract Benefits associated with lowered serum DHT levels after 5α-reductase inhibitor (5AR-I) therapy in men have contributed to a misconception that circulating DHT levels are an important stimulus for androgenic action in target tissues (e.g., prostate). Yet evidence from clinical studies indicates that intracellular concentrations of androgens (particularly in androgen-sensitive tissues) are essentially independent of circulating levels. To assess the clinical significance of modest elevations in serum DHT and the DHT/testosterone (T) ratio observed in response to common T replacement therapy, a comprehensive review of the published literature was performed to identify relevant data. Although the primary focus of this review is about DHT in men, we also provide a brief overview of DHT in women. The available published data are limited by the lack of large, well-controlled studies of long duration that are sufficiently powered to expose subtle safety signals. Nonetheless, the preponderance of available clinical data indicates that modest elevations in circulating levels of DHT in response to androgen therapy should not be of concern in clinical practice. Elevated DHT has not been associated with increased risk of prostate disease (e.g., cancer or benign hyperplasia) nor does it appear to have any systemic effects on cardiovascular disease safety parameters (including increased risk of polycythemia) beyond those commonly observed with available T preparations. Well-controlled, long-term studies of transdermal DHT preparations have failed to identify safety signals unique to markedly elevated circulating DHT concentrations or signals materially different from T.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Endocr Connect
                Journal ID (iso-abbrev): Endocr Connect
                Journal ID (hwp): EC
                Title: Endocrine Connections
                Publisher: Bioscientifica Ltd (Bristol )
                ISSN (Electronic): 2049-3614
                Publication date Collection: April 2020
                Publication date (Electronic): 30 March 2020
                Volume: 9
                Issue: 4
                Pages: R102-R111
                Affiliations
                [1 ]Department of Internal Medicine , Spaarne Gasthuis, Haarlem, the Netherlands
                Author notes
                Correspondence should be addressed to W de Ronde: w.de.ronde@ 123456spaarnegasthuis.nl
                Article
                Publisher ID: EC-19-0557
                DOI: 10.1530/EC-19-0557
                PMC ID: 7219134
                PubMed ID: 32229704
                SO-VID: 7ec80902-d6f6-4b93-8c94-3d12d2359356
                Copyright © © 2020 The authors
                License:

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                Date received : 17 March 2020
                Date accepted : 30 March 2020
                Categories
                Subject: Review

                Keywords: anabolic androgenic steroids,side effects,hypogonadism,infertility,gynaecomastia
                Data availability:
                Keywords: anabolic androgenic steroids, side effects, hypogonadism, infertility, gynaecomastia

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