Every new Olympics seems to yield new drug cheating controversies. Taking performance-enhancing drugs, which can have serious side effects, gives athletes a major unfair advantage over other athletes who do not take drugs. Many athletes at the highest level of sports are taking drugs that can harm them, and this practice is extremely unlikely to diminish in the future.
The New York Times has a feature article on Shirley Babashoff, arguably America's greatest female swimmer ever (August 1, 2016). Forty years ago, she was the best female swimmer in the world and was favored to win seven gold medals at the 1976 Montreal Olympics, as Mark Spitz had done in the 1972 Munich Olympics. Instead, she came away from the games with only one gold medal in the relays and four Olympic silver medals. In the 1976 Olympics, the cheating East German women won 11 of 13 gold medals in swimming after having failed to win even one gold medal four years earlier.
Clean Shirley Babashoff was beaten in the 100- and 200-meter freestyles by 17-year-old East German Kornelia Ender, who won four gold medals, and in the 400 and 800 freestyles by 15-year-old East German Petra Thumer.
Babashoff correctly claimed that she was beaten by women with huge masculine muscles, facial hair and deep voices, but she was shunned as a sore loser by the news media and even by many swimming officials who should have supported her. Instead of making millions of dollars in endorsements that would have followed the gold medals that should have been hers, she had to raise her son as a single mother while working as a postal carrier.
She had spent her entire youth training as much as five hours a day in the pool while her classmates socialized and got advanced degrees to raise their future standard of living. She was deprived of her rightful fame and fortune by the cheating, lying East German government with its systematic program of drugs for all of its athletes. Many of the women who took the drugs became infertile and had increased risk for various cancers and heart problems.
Babashoff, now 59, says: "I worked so hard for what I didn’t get, I had a bad taste in my mouth for years . . . It’s weird, my story is still relevant. The thing is, it’s still going on. And it’s not going to go away." According to the New York Times, retesting athletes' urine from the 2008 Beijing Games and the 2012 London Games found nearly 100 positive doping samples, and many of these athletes still have the medals they stole from their more honest competitors.
How Anabolic Steroids Work
Anabolic steroids are synthetic male hormones that make you faster and stronger (NEJM, 1996(July 4);335(1):1-7) and give you greater endurance. They can be taken as a pill, as a shot into a muscle, or as a gel or cream rubbed on the skin. Steroids increase red blood cell counts. The limiting factor for how fast a person can go over distance is the time it takes to get oxygen into exercising muscles. Since 98 percent of the oxygen in your muscles is carried by your red blood cells and very little is diffused in the blood fluid, anything that increases the number of red blood cells allows the blood to carry more oxygen and gives the athlete greater endurance.
Athletes train by taking a hard workout that damages muscles on one day, feeling sore on the next day, then going easier until the soreness diminishes, and then going hard again. As soon as athletes start to take anabolic steroids, they notice that they recover much faster, so they can do intense training almost every day and thus become much stronger (Sports Med, 2004;34(8):513-54). Many men who are not athletes take steroids to make themselves look more attractive with larger muscles.
Women Gain Even More Strength from Steroids Than Men Do
Anabolic steroids act by attaching to special muscle androgen receptors that stimulate muscles to increase their uptake of protein and make muscles recover faster from exercise and grow larger. Since women have much lower levels of natural testosterone than men, women gain a much greater increase in muscle strength when they take anabolic steroids.
All of East Germany's 1976 Olympic team athletes had participated in the state-sponsored doping program, but the women showed the most dramatic improvements. The same thing happened with Chinese athletes in the 1990's.
In September 1993, Chinese female runner Wang Junxia broke four world records in three events in six days. She ran 3,000 meters in 8 minutes, 6.11 seconds, 16 seconds faster than the previous world record. Four other Chinese women broke the world record for the 3,000 meter run in that same race. She also broke the world record in the 10,000 meters and the 1,500 meter run, arousing suspicions because China had never excelled in track.
Before that week, no Chinese runner had ever held a world record in running. Their coach claimed that they were using herbal medicine made from worms. Since none of the Chinese men held world running records, Mary Slaney, the American record holder, wanted to know, "Why aren't their men eating those worms?" None of these Chinese women ever won races in which they were checked for anabolic steroids.
Dangers of Anabolic Steroids
Anabolic steroids can damage the liver (Clin J Sprt Med, 1999;9(1):34-39), heart muscle (Med Sci Sprts & Ex. February, 1992), enlarge the prostate (Brit J of Urol. Oct 1994;74(4):476-478) and cause infertility (Lancet, December 1990). Athletes who take anabolic steroids are at increased risk for heart damage, as well.
Baseball star Ken Caminiti, the Most Valuable Player in the National League in 1996, died of an apparent heart attack in 2004. He was one of the first professional baseball players to admit using steroids. In 1988, 38-year old Florence Griffith-Joyner suffocated after suffering a seizure. The three-time gold medalist track star was rumored to have taken male hormones, although this has never been proven.
She is considered to be the fastest woman of all time, still holding the world records she set in 1988 for the 100 and 200 meter dashes. From the 100 to the 1500 meters (except the 400 meter hurdles), no women’s track and field world record has been broken since 1993, when testing for male hormones became more sophisticated. After FloJo’s death, Lorna Boothe, a former training partner, stated that FloJo used a cocktail of steroids and testosterone to change her from an average athlete to the best of all time. She said that she came forward after FloJo’s death to discourage other athletes from taking steroids and suffering the potential side effects.
How Steroids Damage the Heart
Taking male hormones stimulates sympathetic nerves leading to the heart to delay heart muscle recovery from exercise. Your heart rate is supposed to slow down as soon as you stop exercising. Those who take male hormones take longer for their heart rates to slow down after exercise and also have reduced flow of blood to their heart muscles (Int J Sports Med, Oct 2013;34(10):931-5). Taking male hormones also causes the left ventricle, the main pumping chamber of the heart, to enlarge disproportionately, compared to the rest of the heart. This increases chances for irregular heartbeats and sudden death (Heart, May 2004;90(5):473–475).
Steroids also lower blood levels of the good HDL cholesterol and increase levels of the bad LDL cholesterol. Adding HGH (human growth hormone) to steroids increases heart enlargement even more, without enlarging the nerves that control the heart's contractions, to increase risk of heart failure and death from irregular heartbeats. Steroids also cause the bone marrow to increase production of red blood cells and platelets, which can cause the red blood cells to clump together to form clots that cause heart attacks and strokes.
All anabolic steroids act similarly to the male hormone, testosterone. Researchers reviewed the medical records of 55,593 men who were given testosterone for low testosterone levels or sexual dysfunction and compared them to men who received Viagra or Cialis but no testosterone. After three months, the risk for heart attacks was double in the testosterone group for all of the men older than 65, and in the men younger than 65 who had a history of heart disease (Public Library of Science, January 29, 2014).
This study prompted the U.S. Food and Drug Administration to start an investigation of the risk for heart attacks after taking testosterone. Another study of 8,709 men with low testosterone levels showed an increased risk of strokes, heart attacks, and deaths after starting testosterone (JAMA, November 6, 2013). A study to see if testosterone gel helped frail older men to build muscle and strength had to be stopped early because of a marked increase in heart attacks and one death (NEJM, November 4, 2010).
Anabolic Steroids can Kill You Long After You Stop Taking Them
Anabolic steroids and human growth hormone, either taken together or alone, can enlarge your heart muscle without also enlarging the heart nerves that control your heartbeat. That means that people who take anabolic steroids are at increased risk for sudden death from irregular heartbeats while they take them and this increased risk for sudden death can continue for 30 or more years after they stop taking them.
List of Side Effects of Steroids
In both men and women: high blood pressure, increased risk for heart attacks and strokes, raised LDL (bad) cholesterol, lowered HDL (good) cholesterol, increased risk for liver disease and liver cancer, oily skin, acne, male-pattern baldness, irritability, rage, violence, manic behavior, delusions, insomnia
In men: reduced sperm count, shrunken testicles, infertility, enlarged breasts
In women: increased body hair, rough skin, decreased breast size, enlarged clitoris, deepened voice, increased risk for breast cancer (Sports Med. 2004;34(8):513-54).
Why Athletes Can Still Cheat
At this time it is not possible to catch all of the anabolic steroids that athletes use to make themselves better athletes. As new derivatives are concocted, it takes time to devise tests that will identify them.
Each type of anabolic steroid has a certain chemical structure, and existing tests find only the known structures. If the chemical structure of a steroid is altered by changing just one double bond or one atom, the existing tests cannot detect it. These minor changes of structure do not change the benefit to the athlete, but make that new molecule undetectable by present methods. To detect a banned substance, scientists have to know what molecule they are looking for. Thus,
- Steroid manufacturers will forever be able to change molecules and make them undetectable by the current testing methods
- Some athletes will use any method to win at all costs
- Athletes who take the new performance enhancers will always have an advantage over clean athletes who refuse to take them.
Gabe Mirkin, M.D.
, is a sports medicine doctor and fitness guru. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin has run more than 40 marathons and is now a serious tandem bike rider with his wife, Diana. His website is http://drmirkin.com/
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