Steroids & Athletes

According  to  the  Medical  Dictionary  of  Medicinenet.com  steroids  are  defined  as  “A  general  class  of  chemical  substances  that  are  structurally  related  to  one  another  and  share  the  same  chemical  skeleton  (a  tetracyclic  cyclopenta[a]phenanthrene  skeleton).”[1]

Encyclopedia  Britannica  Online  defines  them  as  “Any  of  a  class  of  natural  or  synthetic  organic  chemical  compounds  characterized  by  a  molecular  structure  of  17  carbon  atoms  arranged  in  four  rings.  In  the  parent  structure  (named  gonane  and  referred  to  as  the  steroid  nucleus),  the  carbon  atoms  are  bonded  to  28  hydrogen  atoms.”[2]

Another  definition  is  provided  by  the  Science  and  Technology  Encyclopedia:  “Any  of  a  group  of  organic  compounds  belonging  to  the  general  class  of  biochemicals  called  lipids,  which  are  easily  soluble  in  organic  solvents  and  slightly  soluble  in  water.”[3]

Steroids  defined  above  are  organic  compounds  occurring  naturally  throughout  both  plant  and  animal  kingdoms.  They  are  fat  soluble  compounds  (lipid)  that  have  a  number  of  important  functional  roles.  Their  main  characteristic  is  the  carbon  skeleton  that  has  four  fused  rings.  The functional groups of steroids are attached to the four rings.  Numerous  distinct  steroids  have  been  identified  in  plants,  animals  and  fungi.  All  steroids  are  derived  from  sterols:  lanosterol  (animals  and  fungi)  or  the  sterol  cycloartenol  (plants).[i]

“Steroids  are  quite  diverse  and  include  the  sterols  (such  as  cholesterol)  of  vertebrates,  bile  acids  from  the  liver,  all  sex  hormones,  adrenal  cortical  hormones  (corticosteroids),  toad  poisons,  and  products  of  the  digitalis  plant  used  to  treat  heart  disease.  Hormonal steroids are synthesized from cholesterol in the body.  The  biosynthetic  mechanisms  are  similar  in  all  steroid-secreting  tissue  (adrenal  cortex,  testis,  ovary,  and  placenta).”[ii]

Hormonal  steroids  are  synthesized  from  cholesterol  in  the  body,  it  is  essential  to  investigate  what  hormones  are  before  introducing  the  topic  of  this  paper:  today’s  uses  of  steroids.

Hormones  are  chemical  messengers  that  go  from  one  cell  or  cellular  group  to  another.  Although  hormones  are  produced  almost  by  every  organ  system  and  tissue  type  in  any  animal  body,  the  well  known  animal  hormones  are  produced  by  the  endocrine  glands  of  vertebrate.  These  are  synthesized  and  secreted  by  the  ductless  glands  of  the  endocrine  systems  in  humans  and  animals.  The  hormone  messengers  are  transported  by  the  circulatory  system  to  the  target  tissues  where  receptors  interact  with  the  messengers  to  cause  the  desired  biological  effect.  The following quote describes the transportation of hormone molecules.

However,  not  all  hormones  are  transported;  some  produce  localized  (paracrine)  effect  such  as  the  hormones  in  the  gastrointestinal  tract.  The  function  of  hormones  is  to  regulate  the  response  of  the  body  to  the  external  and  internal  stimuli,  the  homeostasis,  as  well  as  controlling  tissue  development,  morphogenesis,  and  reproduction.[iii]

However, it is not limited to these functions only. 

Hormone  effects  vary  widely,  but  can  include  stimulation  or  inhibition  of  growth,  induction  or  suppression  of  apoptosis  (programmed  cell  death),  activation  or  inhibition  of  the  immune  system,  regulating  metabolism  and  preparation  for  a  new  activity  (e.g.,  fighting,  fleeing,  mating)  or  phase  of  life  (e.g.,  puberty,  caring  for  offspring,  menopause).  In  many  cases,  one  hormone  may  regulate  the  production  and  release  of  other  hormones.  Many  of  the  responses  to  hormone  signals  can  be  described  as  serving  to  regulate  metabolic  activity  of  an  organ  or  tissue.  Hormones  also  control  the  reproductive  cycle  of  virtually  all  multi cellular  organisms.[4]

The  secretion  of  hormones  is  stimulated  or  inhibited  as  desired  by  the  following:

• Other hormones  (stimulating–  or  releasing-hormones)
• Plasma concentrations  of  ions  or  nutrients,  as  well  as  binding  globulins
• Neurons and  mental  activity
• Environmental changes, e.g., of light or temperature.

The  hormones  of  vertebrates  are  comprised  in  three  chemical  classes  namely  amine,  peptide  hormones  and  lipid  and  phospholipids.  Steroids belong to this last chemical class.  Steroid hormones derive from cholesterol and the eicosanoids.  While  testosterone  and  cortisol  are  examples  of  steroid  hormones  calcitriol  is  an  example  of  sterol  hormones. (Yesalis,2003)

Historically  anabolic  steroids  have  been  known  since  1930  when  they  were  discovered.  Since  then  they  have  been  used  for  numerous  medical  purposes  such  as  stimulation  of  bone  growth,  appetite,  puberty  and  muscle  growth.  Today  anabolic  steroids  are  widely  used  for  ‘chronic  wasting  conditions  including  cancer  and  AIDS.

“Anabolic  steroids  can  produce  numerous  physiological  effects  including  increased  protein  synthesis,  muscle  mass,  strength,  appetite  and  bone  growth.  Anabolic  steroids  have  also  been  associated  with  numerous  side  effects  when  administered  in  excessive  doses  and  these  include  elevated  cholesterol  (increase  in  LDL,  decreased  HDL  levels),  acne,  elevated  blood  pressure,  hepatotoxicity,  and  alterations  in  left  ventricle  morphology.”[iv]

The  discovery  of  synthetic  testosterone  in  1930  was  the  beginning  of  using  anabolic  steroids  for  many  purposes.  This  continued  up  to  1950s  with  success  being  sometimes  positive  and  other  times  negative.  Initially  it  was  used  for  treatment  of  chronic  wasting,  which  was  the  ailment  of  Nazi  concentration  camp  prisoners.  It  is  also  reported  that  German  scientists  synthesized  other  anabolic  steroids  during  World  War  II.  Experiments  were  ran  on  prisoners  and  sometimes  German  soldiers.  These  experiments  were  in  the  hope  of  making  their  troops  more  aggressive.

Today  there  is  intensive  controversy  surrounding  the  use  of  steroids  due  to  the  abuses  reported  and  their  purported  side  effects.  The  alarming  part  of  steroid  issues  is  the  fact  that  there  is  “substantial  amount  of  propaganda,  junk  science,  and  misconceptions  concerning  their  use.  Although  anabolic  steroids  are  controlled  in  USA,  Canada  and  Britain,  it  is  not  controlled  (by  law)  in  other  parts  of  the  world  and  the  needs  for  such  measures  seem  to  be  urgent. (Yesalis, 2003)

The negative effects of steroids on behavior are a subject of some controversy. Much has been written in recent years about an association between steroid taking and violent rages. Where the absolute risk may be open to debate, most experts do agree that some individuals will have psychological problems as a result of taking steroids. It stands to reason that those who are better adjusted psychologically will have fewer consequences than those who are farther our on the behavior continuum, but nobody really knows who is at risk.

The special hazards faced by women who take steroids make it hard to comprehend the fact that this type of drug use in increasing among females. Because steroids are male sex hormones, their effect in women is to make them more like men, including deeper voices, unwanted facial hair, breast shrinking, and enlarged clitoris. However many female athletes have discovered that even a small amount of testosterone can make a big difference in sports performance. That may let some female athletes remain competitive at an age when the performance of other similarly talented competitors has declined. Or some may be able to advance to the next level of competition, something they were unable to do on their own. As women’s sports becoming more competitive and cash driven, the temptation for females to augment their power can be a very powerful motivator.

Who uses steroids? From where does information about users come, and how do we know that information is true? A currently popular myth holds that steroids were a fad drug. Drug testing cleaned the problem up, so the story goes, and now the only users are marginal athletes trying to hang on, or kids who are experimenting. This scenario is indeed a myth. There has been almost no decrease in the amount of steroids and other illegal performance enhancing drugs that are being used by athletes looking for strength and power.

The continuing interest in physical development makes it unlikely that steroids will fade away. Contemporary culture has elevated muscles to an art form, as evidence by motion picture ads and magazine covers. And entire genre of popular action films features film heroes with sculpted physiques and bulging muscles that they use to great effect. Arnold Schwarzenegger, the popular prototype of the action hero, readily admits using steroids to achieve the look during his body building days, explaining that “everyone did it” back then. Today, the United States has more than 1 million current or former users of anabolic steroids. More than 300,000 of them used steroids within the past year. Almost none of them were under medical supervision despite the known potential for negative short-term effects on physical and mental well-being. (Charles E. Yesalis, 1998)

Anabolic steroids do have uses as medical therapy, and they are prescribed for specific conditions. For example, they might be given to a weakened patient before or after surgery. Some hormonal problems can be corrected with steroids. They also have been tested successfully as a male contraceptive, and they are used routinely to fight the wasting associated with HIV and AIDS. There also seems to be a strong emerging trend toward using steroids as hormone replacement therapy in older men in much the same manner that estrogen is used for postmenopausal women.

How are steroid users counted? Until the late 1980s, very little data were available on who the users were. Most information was based on anecdotes, testimonials, and rumors. The true dimensions of the steroid problem in United States were not known. The picture has changed since then, and important information has been gathered through several national surveys conducted by researchers at academic institutions and government agencies. A 1988 study by William Buckley and Charles Yesalis was the first nationwide survey of anabolic steroid use amount teenage boys. It showed that approximately 7 % of high school seniors have used this type.

In 1985 Michigan state study by Anderson and McKeag showed that the heaviest steroid use (defined as having occurred within the past year) was among NCAA football players which are 9%. This figure does not seem unreasonable because many college players believe they are good enough to make the pros and view the economic promise of the NFL as a justification for their steroid use. 4 % of the make participant in track and field reported steroid use. Overall, 5 % of division 1 athlete, both make and female.  4 % of division II athletes and 2 % of Division III athletes had used steroids within the 12 months prior to the study.

Anderson and McKeag repeated their study during the 1988-89 academic year and found steroid use has increased slightly over the intervening four years. Although steroid use remained at 5 % for Division I athletes, the use among Division II athletes rose to 5 %, and Division III use went to 4 %. Again the highest incidence of reported steroid use was among football players i.e. 10 %. Steroid use remained at 4 % for men’s track and field events, but declined in baseball by 2% and in tennis 2 %.

In 1993, the Michigan State study was repeated once more. This time, a significant decline in steroid use was observed among make athletes, although football players continued to have the highest level of self reported use 5%. Female athletes however showed considerable increase in steroid use relative to the earlier two studies.

The most commonly cited reason for steroid use is improved athletic performance.

Anabolic steroids can be taken either by mouth, by injection, or, more recently by skin creams or patches. If an individual simple swallowed a dose of testosterone, however, it would be quickly inactivated by the process of metabolism and cleared from the body through the liver. Steroids that are taken orally have had their chemical structures altered to slow their removal from the body by the liver but more toxic to the liver. Steroids taken by intramuscular injection or skin application also have been chemically altered to slow their release into circulation.

As was stated earlier, anabolic steroids were adopted initially by athletes in power sports such as weight lifting and football to increase strength and muscularity. From the beginning, these athletes consistently reported that the drugs also reduced their recovery time between workouts. That meant that they were able to work out more frequently, for longer periods of time, and with greater intensity. These observations by athletes very likely played an important role in the diffusion of anabolic steroids among sprinters in a variety of sports and thereafter to endurance athletes.

The truth is that anabolic steroids work. That is to say those anabolic steroids, especially when used in conjunction with intense strength training, increase muscle mass and strength well beyond what can be achieved with training alone. Experts have suggested the following mechanisms to explain the performance enhancing effect of anabolic steroids.

• An increase in protein synthesis.
• Prevention of muscle tissue destruction caused by heavy work or exercise.
• The effects on the central nervous system and the neuro-muscular junctions.
• Increased aggressiveness
• The placebo effect.

In the normal way of things, two things can happen when athletes such as wrestlers, runners, or swimmers stress their bodies through training at high levels of intensity over prolonged periods. First, their natural production of testosterone can drop precipitously, often to levels as low as those of a castrated man. Second, the body responds by releasing another type of steroid called glucocortocoids, when are not anabolic (tissue building) but catabolic meaning that they break down muscle tissue. A popular theory holds that a visible sign of over training in muscle wasting.

Although the evidence is incomplete, scientists have speculated that anabolic steroids inhibit or block the catabolic effects of these glucocortocoids. If this theory is correct a runner could endure more miles of road work per week and consequently lower her times or a weight lifter could work out more often and do more sets and reps and achieve greater muscle and strength gains. Some experts have gone so far as to theorize that this ant catabolic mechanism may be the most important factor in untangling the performance effects of anabolic steroids. Beyond helping negate the muscle breakdown effects of glucocorticoids, anabolic steroids help replenish testosterone levels depleted by intense training. (Charles E. Yesalis, 1998)

The anabolic effect of steroids comes through increasing protein synthesis through their attachment to receptors in target tissues, which includes skeletal and heart muscle, skin, testes, prostate and various areas of the brain.

Athletes want the following things from steroids.

• Alteration of body composition (increased muscle mass and reduced fat).
• Increased strength
• Increased endurance
• Faster recovery from exercise. (So the athlete can perform longer, more frequent, or higher-intensity workouts).
• Enhanced athletic performance

The quick answer to the question about whether steroids “work” is yes, but that is just a short answer to a very complex question. Even though most of the athletic community accepts that steroids do enhance exercise capacity and performance, the extent to which these effects occur and the factors influencing such effects still is not clearly understood.

The two potential sources of information about steroid effects on performance and appearance are the scientific literature and the testimonials of users. The scientific literature includes studies of humans and animals that were performed according to generally accepted methods of scientific investigation. The problem is that results of these studies are inconsistent.

On the other hand, the testimonials from steroid users are highly consistent but all anecdotal reports are somewhat questionable. Generally researchers do not like to consider testimonials as data even though they may provide interesting scientific leads. Nevertheless ever though such reports do not replace a base of accurate information gained from well-designed scientific studies, the large amount of information obtained from the personal experiences of steroid users should not and cannot be ignored. Steroid users give themselves amount and combinations of drugs and no ethical scientific investigator could ever do, especially not to women and adolescents.

Anabolic steroid users believe that using the drugs in conjunction with training, will increase their lean boy mass and decrease their fat mass, whereas some researchers have reported no significant increase, others say there are increases. The reasons for these inconsistencies are in the study design and include factors such as how long the study lasted; the use of inexperienced subjects versus using trained athletes, steroid dosage and so on. The consensus of experts is that steroids and a diet that is adequate for building muscle can contribute to increase in muscle mass beyond what could be achieved from training along.

It  is  confusing  to  know  that  a  doctor  specialized  in  hormones  warns  young  people  from  taking  steroids  to  enhance  athletic  performance  while  he  “he  takes  a  derivative  of  testosterone  himself  as  part  of  a  regimen  that  he  believes  restores  vitality  in  aging  men  and  women.”[5]

His  explanation  is  that  when  the  hormone  production  is  maintained  in  a  healthy  body  giving  more  hormone  is  only  overloading  the  body  with  that  specific  hormone,  which  leads  to  serious  health  and  ethical  issues.  On  the  contrary  “replacing  hormones  that  are  no  longer  produced  naturally  can  lead  to  a  healthier  life.”[6]

According to Dr.  Mintz:

“We  are  totally  against  the  use  of  steroids  to  boost  athletic  performance.  A 25-year-old athlete has no need for them.  The price is too high.  But  we  really  need  to  understand  the  difference  between  abuse,  for  which  I  have  no  tolerance,  and  the  appropriate  use  of  sex  hormones  to  maintain  health.  It  gives  you  the  power  to  have  a  healthy  life  in  your  later  years.  There’s  a  tremendous  benefit  if  you  go  about  it  the  right  way.  It’s very exciting medicine.”⁶

Anabolic  steroids  in  sports  refers  to  the  “synthetically  produced  variants  of  the  naturally  occurring  male  hormone  testosterone.”  While  the  class  of  drugs  is  steroids,  androgenic  refers  to  the  products  that  promote  masculine  characteristics,  and  anabolic  refers  to  the  tissue  building  drugs.  The  slang  terms  for  anabolic  steroids  in  the  streets  include:  arnolds,  gym  candy,  pumpers,  roids,  stackers,  weight  trainers,  and  juice.  [7]

Legitimately  prescribed  anabolic  steroids  for  medical  purposes  are  administered  in  a  number  of  way  including:  intramuscular/subcutaneous  injection,  oral  pills,  pellet  implantation  under  the  skin  and  locally  applied  to  the  skin  in  forms  of  gel  or  patches.  Of  course  the  administrative  routes  can  be  used  by  abusers,  but  the  most  common  ones  are  injections  and  oral  administration.  The  abusers  doses  range  from  1  to  upwards  of  100  times  normal  therapeutic  does.  It  may  also  involve  taking  two  steroids  concurrently,  a  practice  that  is  called  ‘stacking’.  The  duration  of  use  is  also  conventionalized  as  they  alternate  periods  of  high  dose  that  extends  from  6  to  16  weeks  with  low  dose  or  no  drug  periods.  This is referred to as ‘cycling’.  In  another  mode  called  ‘pyramiding’  slowly  escalate  the  use  of  the  drugs  either  by  increasing  the  number  of  drugs  they  use  at  one  time  and/or  the  dose  of  one  or  more  drugs.  But why do they do so.?

The  following  table  includes  examples  of  anabolic  drugs  abused;  these  the  ones  administered  orally  or  as  injections.

Figure 5

While  the  dangers  of  abusing  steroids  are  very  serious,  young  people  in  sports  or  at  school  are  motivated  by  their  belief  that  steroids  help  them  to  have  a  competitive  advantage  in  sports  and  generally  improve  their  physical  performance.

The  dangers  of  abusing  steroids  are  many  and  are  very  serious.  While  the  short  term  side  effects  are  established,  the  long  term  ones  have  not  been  studied  yet.  Many of the side effects are irreversible, particularly in women.  The  following  tables  illustrate  the  undesirable  physical  changes  of  anabolic  steroids.

Figure 6

[8]

On  the  other  hand  sports  authorities  also  have  their  own  regulations.  “The  International  Olympic  Committee  (IOC),  National  Collegiate  Athletic  Association  (NCAA),  and  many  professional  sports  leagues  (e.g.  Major  League  Baseball,  National  Basketball  Association,  National  Football  League  (NFL),  and  National  Hockey  League)  have  banned  the  use  of  steroids  by  athletes,  both  because  of  their  potential  dangerous  side  effects  and  because  they  give  the  user  an  unfair  advantage.”[9]

“The  International  Olympic  Committee  (IOC),  National  Collegiate  Athletic  Association  (NCAA),  and  many  professional  sports  leagues  (e.g.  Major  League  Baseball,  National  Basketball  Association,  National  Football  League  (NFL),  and  National  Hockey  League)  have  banned  the  use  of  steroids  by  athletes,  both  because  of  their  potential  dangerous  side  effects  and  because  they  give  the  user  an  unfair  advantage.  The  IOC,  NCAA,  and  NFL  have  also  banned  the  use  of  steroid  precursors  (e.g.  Androstenedione)  by athletes for the same reason steroids were banned.  The  IOC  and  professional  sports  leagues  use  urine  testing  to  detect  steroid  use  both  in  and  out  of  competition.”[10]

The  extent  of  the  problem  of  abuse  of  steroids,  which  is  indeed  widespread  and  diverse,  has  been  studied  in  the  United  States.  According  to  the  ‘Substance  Abuse  and  Mental  Health  Services  Administration’s  National  Household  Survey’  “1,084,000  Americans,  or  0.5  percent  of  the  adult  population,  said  that  they  had  used  anabolic  steroids.  In  the  18  to  34  age  group,  about  1  percent  had  ever  used  steroids.”  While  these  figures  are  those  of  the  general  public,  the  survey  among  school-age  children  is  also  alarming.

Figure9

Percent of Students Reporting Steroid Use 1991 – 2002

Percent of Students Reporting Steroid Use in 2002

The  classical  technique  for  detecting  use  of  anabolic  steroid  is  ‘gas  chromatographic  mass  spectrometry  (GC/MS)’.  It  is  the  most  reliable  and  valid  technique  for  detecting  anabolic  steroid  in  urine.  Recent  technological  advances  have  facilitated  a  more  sensitive  high  resolution  mass  spectrometry  (HRMS)  which  made  it  possible  to  detect  the  substance  at  much  lower  concentrations.  Although  the  technique  is  not  yet  fully  accepted  by  sports  authorities.

Even though athletes have been using steroids for nearly half a century, we did not have reliable data on, who the users were until the late 1980s. Since that time, several studies have established a figure of approximately 1 million past or current steroid users in the United States. Because of these studies, we now know that more than half a million adolescents and preteens have experimented with steroids.

     Because we know that younger kinds are trying steroids, any intervention to stop steroid use must begin early. When the youngest users are taking drugs because of concerns with body shape and size, they are more vulnerable in every way. Many individuals long for increased strength and power. They cannot expect, of course, to get the type of gains that are seen in conditioned athletes.

The observation of a link between the male sex organs and physical strength is age-old. However, it was not until the 1930s that scientists successfully synthesized testosterone. All anabolic steroids trace their origin to the primary male sex hormone, testosterone, but there are many different chemical formulations, and the list is long and still growing, to date, no one has been able to complete divorce the masculinizing element of steroids from the tissue-building element.

A common source of information about most drugs is physicians except in the case of anabolic steroids. Although physicians did prescribe steroids for athletes in the early days, they have not been a major source of supply for some time both because of their knowledge about negative health effects and because steroids are now state and federally regulated drugs.

Many athletes stopped using physicians as a source of steroid information in the 1960s and ‘70s when a disagreement about whether steroids were effective flared up after the first steroids studies showed contradictory results. Some studies reported strength and muscle gains; other did not. The lack of agreement led many physicians to believe steroids were not effective, and this position caused them to lose credibility with the sports community. Many athletes, by that time, had experienced gains in strength and muscle for themselves by using steroids.

Unlike some European countries, the United States has never had a government-sponsored steroid research program. However, East Germany under communism was noted for its highly developed drug-aided sports programs that were developed with the cooperation of government officials, physicians, researchers, coaches, and physical trainers.

Many researchers have been keenly interested in the association of steroids and other drugs with dietary supplements and special diets. Most steroids users are on special diets, usually ones containing high level of protein. In addition steroid users frequently take dietary supplements such as vitamins, amino acids, minerals, garlic, protein powders and creatine. Some use “steroid replacers”, (substances taken during the user’s off-steroids portion of the cycle) including chromium picolinate, glandular extracts, vanadyl sulfate, boron, DHEA and smilax. Anabolic steroids users commonly take other performance enhancing drugs such as human growth hormone, human chrionic gonadotropic (HCG), clenbuterol and moodaltering drugs including alcohol, marijuana, cocaine and tobacco. As on the perceived needs of the athlete. Male endurance athletes use steroids primarily for their alleged effect of lowering recuperation time between workouts, and they use dosages at or slightly below what the body normally produces, about 7 mg a day of testosterone. Although sprinters desire similar results, the strength and power requirements of their activity results in dosages that are approximately 1.5 to 2 times normal levels.

While  the  medical  advances  in  uses  of  steroids  will  definitely  be  a  breakthrough  for  many  of  the  ailments  of  human  beings,  the  use  of  steroids  by  athletes  and  young  school-age  children  is  a  problem  that  should  receive  more  attention  from  authorities  and  families.  A  report  from  “The  Partnership  for  Drug  Free  America”  offers  some  advice:

“Educate yourself and your kids about the dangers of steroids.  Remind  your  child  that  taking  steroids  is  a  form  of  cheating  —  not  only  themselves,  but  their  team,  their  sport  and  their  bodies.  Teach  your  young  athlete  how  to  refuse  offers  to  try  the  drugs.  You  should  encourage  healthy  habits  such  as  proper  nutrition,  supervised  strength  training,  and  pre-season  conditioning  to  help  build  their  bodies  without  the  use  of  drugs.  If  your  teen  is  working  out  at  a  gym,  be  aware  of  who  he  or  she  is  hanging  out  with  —  there  may  be  seemingly  harmless  people  pushing  steroids.  For  girls  who  are  using  steroids  to  get  thinner,  it’s  essential  to  make  your  daughter  feel  good  about  herself  and  develop  a  positive  body  image.  Encourage  healthy  eating  and  exercise  and  remind  her  of  the  negative  physical  characteristics  that  steroid  use  can  cause,  which  include  masculine  traits.  Be  aware  of  your  child’s  goals  —  as  well  as  his  or  her  insecurities,  pressures  and  stress.  While  it’s  important  to  push  your  child  to  excel,  know  that  there’s  a  fine  line  between  support  and  unrealistic  expectations.  Encourage  your  child  to  have  interests  beyond  athletics  so  that  if  they  lose  a  big  game,  match  or  tournament,  she  or  he  will  have  other  activities  and  friends  to  turn  to.  Parents  should  harness  the  excitement  of  sports  and  competition  while  encouraging  their  teens  to  eat  right,  live  right  and  play  by  the  rules.”[11]

Work Cited

Charles E. Yesalis, Virginia S. Cowart, Human Kinetics, (1998).The steroids game

Adalf, E.M., & Smart, R.G. (1992). Characteristics of steroid users in an adolescent school population. Journal of Alcohol and Drug Education, 38(1), 43-49.

American College of Sports Medicine. (1984). Position stand on the use of anabolic-androgenic steroids in sports. Sports Medicine Bulletin, 19, 13-18.

Anderson, W., Albrecht, M., & McKeag, D. (1993). Second replication of a national study of substance use and abuse habits of college student-athletes. Final report. Overland Park, KS: National Collegiate Athletic Association.

Bahrke, M., Yesalis, C., & Wright, J. (1996). Psychological and behavioral effects of endogenous testosterone and anabolic-androgenic steroids: an update. Sports Medicine, 22(6), 367-390.

Brower, K. (2002). Anabolic steroid use and dependence. Current Psychiatry Reports 4, 377-387.

Buckley, W.E., Yesalis, C.E., Friedl, K.E., Anderson, W.A., Streit, A.L., & Wright, J.E. (1988). Estimated prevalence of anabolic-androgenic steroid use among male high school seniors. Journal of the American Medical Association, 260(23), 3441-3445.

Karila, T. et al. (2003). Anabolic-androgenic steroids produce dose-dependent increase in left ventricular mass in power athletes, and this effect is potentiated by concomitant use of growth hormone. International Journal of Sports Medicine 24: 237-343.

Kersey, R. (1993). Anabolic-androgenic steroid use by private health club/gym athletes. Journal of Strength and Conditioning, 7, 118-126.

Wu, F. & von Eckardstein, A. (2003). Androgens and coronary artery disease. Endocrine Reviews 24 (2): 183-217.

Yates, W.R., Perry, P.J., MacIndoe, J., Holman, T., & Ellingrod, V.L. (1999). Psychosexual effects of three doses of testosterone cycling in normal men. Biological Psychiatry, 45, 254-260.

Yesalis, C., & Bahrke, M. (2003). History of Doping in Sport. International Sports Studies, 24(1):42-76.

Davidson,  Julian  M.  “steroid.”  Grolier  Multimedia  Encyclopedia.  2007.  Grolier  Online.  28  Jan.  2007  http://gme.grolier.com/cgi-bin/article?assetid=0276770-0

Steroid  From  Wikipedia,  the  free  encyclopedia  Available  at:  http://en.wikipedia.org/wiki/Steroid  accessed  on  28  January  2007

Hormones  From  Wikipedia,  the  free  encyclopedia  Available  at:  http://en.wikipedia.org/wiki/hormone    accessed  on  28  January  2007

Williams,  John  The  Demonization  of  Anabolic  Steroids  I:  What  Makes  These  Hormones  So  Evil?  Available  at:  http://www.mesomorphosis.com/articles/williams/demonization-of-anabolic-steriods-01.htm  Accessed  on  28  January  2007

Anabolic  Steroid  from  Wikipedia  the  free  encyclopaedia  available  at:  http://en.wikipedia.org/wiki/Anabolic_steroid  accessed  on  28  January  2007

[1]  Medical  Dictionary  of  Medicinenet.com  available  at:  http://www.medterms.com/script/main/art.asp?articlekey=5556  accessed  on  28  January  2007

[2]  Encyclopaedia  Britannica  Online  available  at:  http://www.britannica.com/eb/article-9069640/steroid  Accessed  on  28  January  2007

[3]  Science  and  Technology  Encyclopaedia  available  at:  http://www.answers.com/library/Science%20and%20Technology%20Encyclopedia-cid-2026808543  accessed  on  28  January  2007

[4]  Hormones  From  Wikipedia,  the  free  encyclopedia  Available  at:  http://en.wikipedia.org/wiki/hormone    accessed  on  28  January  2007

[5]  Strizak,  Alan  Marc.  “sports  medicine.”  Grolier  Multimedia  Encyclopedia.  2007.  Grolier  Online.  28  Jan.  2007  http://gme.grolier.com/cgi-bin/article?assetid=0274390-0

[6]  Dvorchak,  Robert  (October  2005)  –  Good  uses  for  steroids  overshadowed  by  bad  –  Pittsburgh  Post-Gazette  –  Available  at:  http://www.post-gazette.com/pg/05278/582577.stm    accessed  on  28  January  2007

[7]  Anabolic  Steroids  –  Hidden  Dangers  –  Presented  as  a  public  service  by:  Drug  Enforcement  Administration  Office  of  Diversion  Control  Washington,  D.C.  20537  –  available  at:  http://www.deadiversion.usdoj.gov/pubs/brochures/steroids/hidden/index.html  Accessed  on  28  January  2007

[8]  Dr.  James  Tolliver  (Pharmacologist)  (March  2004)  –  Steroid  Abuse  in  Today’s  Society  –  A  Guide  for  Understanding  Steroids  and  Related  Substances  available  at:  http://www.deadiversion.usdoj.gov/pubs/brochures/steroids/professionals/index.html  accessed  on  28  January  2007

[9]  Dr.  James  Tolliver  (Pharmacologist)  (March  2004)  –  Steroid  Abuse  in  Today’s  Society  –  A  Guide  for  Understanding  Steroids  and  Related  Substances  available  at:  http://www.deadiversion.usdoj.gov/pubs/brochures/steroids/professionals/index.html  accessed  on  28  January  2007

[10]  Dr.  James  Tolliver  (Pharmacologist)  (March  2004)  –  Steroid  Abuse  in  Today’s  Society  –  A  Guide  for  Understanding  Steroids  and  Related  Substances  available  at:  http://www.deadiversion.usdoj.gov/pubs/brochures/steroids/professionals/index.html  accessed  on  28  January  2007

[11]  Sports  are  Great  for  a  Kid’s  Body  Steroids  Aren’t  from  The  Partnership  for  a  Drug-free  America,  California  Chapter  available  at:  www.drugfree.org/parent  accessed  on  29  January  2007