Androgenic Steroids Use and Abuse

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PeterBond

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The terms erythrocytosis and polycythemia still being used interchangeably in the literature (even in this paper that dropped today). Thumbs down.

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Hi there, I'm the lead author of the paper. Both terms may be used interchangeably as described by standard works, such as Harrison's Principles of Internal Medicine. Some authors choose to make a distinction between them – in the field of hematology in particular – but we choose not to as it's irrelevant to our field. We, therefore, mentioned both terms, followed by the definition we're using for the remainder of the paper.
 
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tareload

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Hi there, I'm the lead author of the paper. Both terms may be used interchangeably as described by standard works, such as Harrison's Principles of Internal Medicine. Some authors choose to make a distinction between them – in the field of hematology in particular – but we choose not to as it's irrelevant to our field. We, therefore, mentioned both terms, followed by the definition we're using for the remainder of the paper.
Peter Bond in the digital flesh. Pleasure to make your acquaintance and thanks for taking the time to respond. I was planning on joining Meso just to thank you for your efforts in the field.

See attached for more info (and links therein). In particular the concepts of elevated Hct and viscosity with respect to cardiac workload does not get enough attention. Clotting isn't the only or primary concern in my opinion. Plasma viscosity and interplay with Hct gets almost no love.




Always take the time to help people learn to use the right terminology. I understand the terms are used interchangeably in the literature (erroneously). Unfortunate given there is another term that makes the layperson even more confused -- polycythemia vera (PCV). That issue gives cover to the hand wavers that then say..."see, PCV not the same as erythrocytosis. Elevated Hct is harmless." Hence, the poor average chap doesn't know up from down given all the confusing terminology.

However you can use your platform to make a difference. Beginning of wisdom is to call things by their correct name.

Best regards.
 
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T

tareload

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@PeterBond

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Erythrocytosis is defined as an increase in red blood cell (RBC) mass, usually absolute, and is also associated with an increased hematocrit (HCT) and hemoglobin concentration. Although some use the term polycythemia interchangeably with erythrocytosis, the two are not synonymous. Polycythemia in precise terms refers to an increased number of any hematopoietic cell in blood, be it RBCs, platelets or leukocytes. An increase in RBC number (whether relative to changes in body water or an absolute increase in RBC mass) is more precisely called erythrocythemia, but this term is not in general use and we are currently using the term erythrocytosis instead of polycythemia for an increase in RBCs (relative or absolute). Complicating matters is the term polycythemia vera, which specifically refers to a type of chronic myeloid leukemia that only affects the erythroid lineage or, in other words, a chronic erythroid leukemia.[/ICODE]

Actually quite the opposite....very relevant to our field since erythrocytosis secondary to AAS use is a common and important side effect.

Thanks again. As you may read I am a stickler (only here now as I left TNation). Appreciate your gracious response.

I enjoyed your paper. I should have stated that above. Merry Christmas.
 
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BigTex

Well-Known Member
Hi there, I'm the lead author of the paper. Both terms may be used interchangeably as described by standard works, such as Harrison's Principles of Internal Medicine. Some authors choose to make a distinction between them – in the field of hematology in particular – but we choose not to as it's irrelevant to our field. We, therefore, mentioned both terms, followed by the definition we're using for the remainder of the paper.
@PeterBond I agree with @readalot and welcome you to the board. Your expertise in the field is very helpful to all of us. I read the whole paper and think you did a good job covering the use of anabolic steroids. I am not too fond of their term "abuse" since most of use used steroids as a function of our sport. I do think that many who are not competing have a goal as well, even if it is aesthetic. My biggest problem with anabolic steroids is they should have never been criminalized and instead left in the hands of doctors. If anyone abused anything it was government. Anyway, off my soap box and thanks again for your participation.
 

PeterBond

New Member
I'm aware of the distinction made by some authors, especially in the field of hematology. Each to their own, personally I don't see the use of making the distinction in this context. Importantly, increased red cell mass measurements are rarely, if ever, performed in studies administering AAS - or even in an outpatient setting. We're always relying on hemoglobin or hematocrit levels as surrogates (which is perfectly fine). Therefore, strictly speaking, it's a suspected or unconfirmed erythrocytosis. Depending on which hematologist you run into, polycythemia might be defined as either an increase in the number of any of the blood cells or an increase in the number of all blood cells. The latter would always imply polycythemia vera (a definition adhered to by Williams Hematology; with the sidenote that they mention that there's no consensus on terms and that erythrocytosis and polycythemia are used interchangeably). The first, an increase in the number of any of the blood cells, would include the erythrocytosis as induced by AAS, as it's a secondary absolute increase. In any case, in practice, hematocrit or hemoglobin levels are measured, and both will be increased with either polycythemia or erythrocytosis. We therefore choose to use them interchangeably and, to prevent confusion, we explicitely define them in the paper; an increase in hematocrit or hemoglobin levels.

@PeterBond I agree with @readalot and welcome you to the board. Your expertise in the field is very helpful to all of us. I read the whole paper and think you did a good job covering the use of anabolic steroids. I am not too fond of their term "abuse" since most of use used steroids as a function of our sport. I do think that many who are not competing have a goal as well, even if it is aesthetic. My biggest problem with anabolic steroids is they should have never been criminalized and instead left in the hands of doctors. If anyone abused anything it was government. Anyway, off my soap box and thanks again for your participation.
Thank you!

I'm not too fond of using the term continuously either, I find it rather useless, although it would be the correct term to employ from a medical point of view. It's pretty much the reason why we included this sentence in the introduction:
For brevity, in the remainder of this review we employ the term ‘AAS use’ to refer to the nonmedical high-dose abuse of AAS.
In the rest of the paper we only mention the word 'abuse' once, because it was functional to make a clear distinction with TRT.
 
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BigTex

Well-Known Member
I completely understand, unfortunately many of us say we are on TRT have yet to figure out the difference between TRT and "abuse." We learn here that blasting and cruising is NOT TRT. Keep up the good work, we need more research on anabolic steroids. Hopefully some of the tyrannical laws can be ended and more doctors can get involved in testing people who use them and keeping them healthy.
 
T

tareload

Guest
Importantly, increased red cell mass measurements are rarely, if ever, performed in studies administering AAS - or even in an outpatient setting.
Good point. Thanks for bringing this up.

The latter would always imply polycythemia vera (a definition adhered to by Williams Hematology; with the sidenote that they mention that there's no consensus on terms and that erythrocytosis and polycythemia are used interchangeably).

9th ED, p 871:

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I appreciate your scholarship. There is consensus that erythrocytosis is the more accurate term (even in the reference you cited).

Happy New Year.

BTW, chap 34 of this book is excellent.
 
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