Gene helps athletes beat drug test

Testosterone accounts for nearly 50 percent of positive drug tests in Olympic sports. Doping control labs detect supplemental testosterone by measuring the balance between testosterone and epitestosterone. Jenny Schulze and colleagues, from the Karolinska Institute in Sweden, found that most people with a common gene variant could take high doses of testosterone (500 milligrams of testosterone enanthate) and never test positive for the drug. They injected testosterone into people with three variant of the UGT2B17 gene and attempted to detect the drug for 15 days. One hundred percent of people without the gene variant tested positive throughout the 15-days period, while only about 50 percent with the variant were detected. The researchers concluded that genes play an important role in the metabolism and detection of drugs used in sports and are important considerations in drug testing. The world anti-doping agency (WADA) plans to test 4500 athletes at the upcoming Beijing Olympic Games, 1000 more tests than were conducted at the Athens games. It is not known whether they will screen for gene variants affecting the measurement of testosterone. (Journal Clinical Endocrinology and Metabolism, in press; published online March 11, 2008)

Most men treated with testosterone therapy are prescribed gels such as AndroGel or testim. Researchers from the University of Toronto found that men treated with AndroGel had testosterone levels on the low side of normal, but increased testosterone when treated with Testim. Likewise, men switching from testim to androgel experienced fewer side effects. Most bodybuilders who use testosterone inject testosterone esters such as testosterone enanthate, so they can get higher doses. Injectable testosterone also causes more serious side effects, such as increased hematocrit and hemoglobin (i.e. blood thickening), acne, swelling and gynecomastia (breast tissue development). Physicians can order testosterone creams in stronger concentrations than commercially available products from formulating pharmacies, which can increase testosterone levels above those produced by androgel and testim. (International Journal Impotence Research, 20: 213-217, 2008)

Gene discovery could lead to baldness cure

Male patterns hair loss affects more than half of men by age 50. The discovery of a gene linked to hair loss could result in the development of anti-baldness drugs. German researchers identified a gene that’s essential for the growth and maintenance of human hair. Defects in the gene are linked to hair loss. The discovery could lead to new drugs to treat baldness. Other factors promoting hair loss include disease, poor nutrition, stress and testosterone. Topical minoxidil promotes regrowth, but does little to stop hair loss. Other oral 5-alpha reductase inhibitors such as finasteride can stop hair loss but don’t promote regrowth. Hair-care products can make hair more manageable and look better, but they have no effect on hair loss. Male pattern baldness is not inevitable, so see your doctor if you are getting a little thin on top. (Nature Genetics, 40: 329-334, 2008)

Nortestosterone, sold as Deca-Durabolin, is extremely popular with bodybuilders. It is anabolic, but produces relatively mild side effects such as mild acne, water retention and gonadal suppression. It has little effect on blood pressure, liver function or gynecomastia (breast tissue formation). Germen researchers found that nortestosterone could be converted to estrogens in the liver, which could cause bleeding disorders and an increased in woman taking the drugs. The drug poses less risk in men. Many bodybuilders prefer Deca because it produces relatively few side effects. However, even a single does can be detected up to six months later, so athletes concerned with drug testing should not use it. (Climacteric, 10: 344-353, 2007)

The World Anti Doping Agency (WADA) and the International Olympic Committee have opted to allow athletes to take the erection-promoting drug Viagra (sildenafil). A Stanford University study showed that Viagra improved endurance performance at a simulated altitude of 12,000 feet but did not improve performance at sea level. Many athletes and coaches misinterpreted this study and began using Viagra as a performance-enhancing drug. The media caused such a stir about the “illicit use” of Viagra by athletes that it stimulated WADA to examine the drug’s effects on athletes more closely. Viagra works by increasing the effects of nitric oxide, which increases tissue blood flow. Lung blood flow is sometimes restricted at high altitude, which decreases performance. Viagra reduces blood flow resistance in the lungs, which increases exercise performance at altitude. Elevated lung blood pressure does not limit performance in most people at sea level, so the drug will not increase exercise capacity. The big stir about Viagra and athletes was created by the news media and is much ado about nothing. (Associated press, June 27, 2008)

Bud winter, the legendary track coach of Olympic athletes such as John Powell, Lee Evans, Tommy Smith and John Carlos, used to give his athletes “Bud Winter Super Pills” to improve performance. Winter claimed the pills helped his athletes run faster, even though they mage from sugar. They were nothing more than placebos that worked by the power of suggestion. Bodybuilders are suckers for placebos. They see amazing changes after using the latest supplement, drug, or training method and think they have discovered the key to the sport. They forget that training or dieting causes positive changes that might have nothing to do with the supplement. Thomas Trojian and Christopher Beedie concluded that placebo could trigger physical changes similar to those caused by medications. Researchers should take great care to separate the actions of drugs and supplements from the placebo effect when designing studies. Placebos show the importance of positive thinking for success in bodybuilding and sports. (Current Sports Medicine Reports, 7: 214-217, 2008)

 

Injecting testosterone causes large spikes in blood testosterone levels, particularly in doses higher than 200 milligrams. The spikes increase the risk of side effects such as acne, gynecomastia and thickening of the blood (i.e. increased hematocrit). Testosterone creams are an alternative to injections but must be applied twice a day to maintain elevated blood testosterone levels. Japanese researchers found that twice-daily applications of testosterone cream maintained near-normal levels of testosterone in middle-aged men (about 300ng per 100 ml of blood). While these testosterone levels are acceptable for aging males with low testosterone output, they aren’t high enough to cause significant muscle hypertrophy in serious bodybuilders. The product contained 100 mg of testosterone per 10g of cream. Compounding pharmacies in the United States can make more concentrated products. (Journal Sexual Medicine, 5: 1727-1736, 2008)

Drugs that inhibit angiotensin-converting enzyme (ACE), such as captopril, lisinopril or fosinopril, reduce blood pressure by lowering the activity of the rennin-angiotensin system that causes blood vessel constriction. They are used primarily to treat high blood pressure and congestive heart failure. They might also increase energy expenditure, reduce body fat and improve blood sugar regulation. Australian researchers compared genetically altered mice that could not produce ACE with normal mice. Genetically altered mice showed greater total energy expenditure, increased resting metabolism and increased activity of genes that control the release and breakdown of fat. Reducing ACE activity decreased body fat accumulation, particularly in the abdominal fat depots. ACE inhibitors might promote weight loss by increasing energy expenditure and the metabolism of fatty acids in the liver. No study has shown that these drugs promote weight loss in humans, but ACE increases fat storage and fat cell production, so ACE inhibitors might help people lose weight. (Proceedings New York Academy of Sciences, 105: 6531-6536, 2008)

The scientific literature is full of case studies describing diseases in athletes who had taken anabolic steroids. It is often difficult to separate independent medical problems from those related to the side effects of the drugs. Italian researchers studied the long-term side effects of anabolic steroids in 20 bodybuilders over a two-year period. The drugs were self administered and were often taken with other drugs and supplements. The most significant long-term side effects included reduced fertility and decreased HDL cholesterol (the good cholesterol). Sperm counts dropped by 24 percent and HDL decreased by 23 percent. long-term use had no effects on the prostate or heart. The study showed that the long-term use of anabolic steroids has relatively minor side effects. The media and certain segments of the medical community have overstated the dangers of these drugs. (International Journal Sports Medicine, 29: 679-687, 2008)

Growth hormone (GH) is a popular drug for athletes in Olympic and professional sports because it can’t be detected using current drug-testing methods. That could be changing. Australian researchers developed a technique that can detect growth hormone use for up to six weeks. The test uses short-term (IGF proteins) and long-term (collagen metabolism) markers of GH use. They administered growth hormone (2mg per day for eight weeks) to 63 men and 33 women and measured blood markers of GH during and six weeks after the subjects took the drug. Half the men also received testosterone and the other half received a placebo (fake testosterone). IGF proteins increased markedly when the subjects were taking GH, but decreased rapidly during the six-week washout period. Collagen markers increased more slowly, but remained elevated for up to six weeks after GH administration. Testosterone did not interfere with GH detection. Elite athletes are subject to random drug tests. The results of this study show that it is possible to detect GH within six weeks of using the drug. It might be some time before this test is approved and instituted by various sports organizations, but its coming. (Journal Clinical Endocrinology and Metabolism, 93: 2213-2222, 2008)

Growth hormone (GH) is extremely popular with older adults trying to slow down the aging process, and with young adults, bodybuilders and power athletes who want to build muscle and loss fat. GH is expensive and mainstream medicine has discouraged people from using it. We are beginning to see long-term studies of GH use in nonathletic adult populations. Japanese researchers from the Kobe University Graduate School of Medical found that GH improved body composition in middle-aged adults with few side effects. Low doses of (0.3mg per day; dose varied according to IGF-1 levels) increased lean mass (mainly muscle) by about 5 percent in men and women and decreased fat by 2.4 percent in women and 8.9 percent in men. A study published in 2007 by Swedish researchers found that middle-aged men and women given daily injections of GH for 10 years (0.47 to 0.98mg per day) increased muscle mass, maintained body fat and improved blood markers of general health (cholesterol, HDL and hemoglobin A1c). Both studies conclude that GH therapy caused positive changes in body composition with minimal side effects. (Growth hormone & IGF research, 18: 307-317, 2008; Journal Clinical Endocrinology Metabolism, 92: 1442-1445, 2007)

The brain is the final frontier in our understanding of sports medicine and exercise physiology. Until recently, it has been difficult to study because the blood brain barrier prevented us from examining brain function with normal blood samples. The advent of tracer isotopes and sophisticated scanning devices allows us to study the inner workings of the brain. Central nervous system fatigue (brain fatigue) is a common cause of decreased performance. The inability of neurotransmitters (brain chemicals such as dopamine and norepinephrine) to combine with their receptor sites interferes with exercise capacity. Normally, these transmitters are destroyed after they bind with the receptor site. Drugs called reuptake inhibitors prevent the destruction of the neurotransmitters and keep them in the brain longer. Several studies have shown that inhibiting dopamine and epinephrine reuptake improved performance. A study from Belgium showed that specifically inhibiting norepinephrine reuptake decreased performance in hot and normal environments. The study showed the beneficial effects of enhanced dopamine levels in the brain for improving exercise capacity. (Journal of Applied Physiology, 105: 206-212, 2008)