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Clinical Use of Anabolics and Hormones
Clinical Use of Anabolics and Hormones
TRT to Supraphysiological Levels for Body Building
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<blockquote data-quote="tareload" data-source="post: 215609"><p>I gave you quite a few pieces to read.</p><p></p><p>Let me know when you've had enough.</p><p></p><p>[URL unfurl="true"]https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x[/URL]</p><p></p><p>From the article:</p><h2>Adverse effects of anabolic steroids</h2><p> </p><p>The most common reported side-effects were increased libido (61%), changes in mood (48%), reduced testicular volume (46%), and acne (43%). Gynaecomastia and abnormal liver function tests was also a common finding. Despite these effects, only 19% reported that they would not use anabolic steroids in the future [<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b23" target="_blank">23</a>]. Women athletes tolerate the side-effects of anabolic steroids such as facial hair, aggressiveness, deepening of the voice, and clitoral enlargement [<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b24" target="_blank">24</a>].</p><p></p><p> </p><h3>Cardiovascular adverse effects</h3><p> </p><p>Adverse cardiovascular effects induced by anabolic steroids include hypertension, left ventricular hypertrophy, impaired diastolic filling, polycythaemia, and thrombosis. Although the incidence of anabolic steroid induced adverse cardiovascular effects is unknown, anaesthetists and surgeons should be aware of the increased peri-operative risks in anabolic steroid abusers who are undergoing elective surgery.</p><p></p><p> </p><p>There are several case reports of sudden death associated with exercise among anabolic steroid abusers [<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b25" target="_blank">25</a>-<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b30" target="_blank">30</a>]. Weight training and exercise induce ventricular hypertrophy. Some studies suggested that myocardial hypertrophy was more extensive in athletes who used anabolic steroids in addition to exercise [<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b31" target="_blank">31</a>, <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b32" target="_blank">32</a>]. However, a case series study reported that the echocardiographic measurements of left ventricular hypertrophy (LVH) in weight lifters who used anabolic steroids were not different from those did not use them [<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b33" target="_blank">33</a>]. Ventricular hypertrophy causes impaired isovolumetric relaxation, diastolic dysfunction and fractional shortening [<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b30" target="_blank">30</a>].</p><p></p><p> </p><p>Focal areas of myocardial fibrosis are commonly found at autopsy among anabolic steroid users [<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b26" target="_blank">26</a>, <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b27" target="_blank">27</a>, <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b30" target="_blank">30</a>, <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b34" target="_blank">34</a>]. It is suggested that focal myocardial fibrosis is caused by rapid myocardial fibre growth outstripping its blood supply, resulting in piecemeal necrosis and subsequent fibrosis [<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b27" target="_blank">27</a>]. A direct cellular toxic mechanism mediated by disturbances of ion fluxes, and loss of membrane integrity (leading to cell death and fibrosis) has been suggested [<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b14" target="_blank">14</a>, <a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b35" target="_blank">35</a>]. These changes are irreversible. The fibrotic areas can potentially act as a focus for a malignant arrhythmia, or if extensive, cause cardiomyopathy.</p><p></p><p> </p><p>Animal studies have shown that anabolic agents enhance the pressor response to catecholamines, mediated by inhibition of extraneuronal uptake of neuroamines, and increased vascular response to norepinephrine [<a href="https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b36" target="_blank">36</a>]. These changes may contribute to malignant arrhythmias and cause sudden death during periods of exertion.</p><p></p><p></p><p>Excellent article. Note that blood work on its own may not give the full picture.</p><p></p><p>[ATTACH=full]19219[/ATTACH]</p></blockquote><p></p>
[QUOTE="tareload, post: 215609"] I gave you quite a few pieces to read. Let me know when you've had enough. [URL unfurl="true"]https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x[/URL] From the article: [HEADING=1]Adverse effects of anabolic steroids[/HEADING] The most common reported side-effects were increased libido (61%), changes in mood (48%), reduced testicular volume (46%), and acne (43%). Gynaecomastia and abnormal liver function tests was also a common finding. Despite these effects, only 19% reported that they would not use anabolic steroids in the future [[URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b23']23[/URL]]. Women athletes tolerate the side-effects of anabolic steroids such as facial hair, aggressiveness, deepening of the voice, and clitoral enlargement [[URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b24']24[/URL]]. [HEADING=2]Cardiovascular adverse effects[/HEADING] Adverse cardiovascular effects induced by anabolic steroids include hypertension, left ventricular hypertrophy, impaired diastolic filling, polycythaemia, and thrombosis. Although the incidence of anabolic steroid induced adverse cardiovascular effects is unknown, anaesthetists and surgeons should be aware of the increased peri-operative risks in anabolic steroid abusers who are undergoing elective surgery. There are several case reports of sudden death associated with exercise among anabolic steroid abusers [[URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b25']25[/URL]-[URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b30']30[/URL]]. Weight training and exercise induce ventricular hypertrophy. Some studies suggested that myocardial hypertrophy was more extensive in athletes who used anabolic steroids in addition to exercise [[URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b31']31[/URL], [URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b32']32[/URL]]. However, a case series study reported that the echocardiographic measurements of left ventricular hypertrophy (LVH) in weight lifters who used anabolic steroids were not different from those did not use them [[URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b33']33[/URL]]. Ventricular hypertrophy causes impaired isovolumetric relaxation, diastolic dysfunction and fractional shortening [[URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b30']30[/URL]]. Focal areas of myocardial fibrosis are commonly found at autopsy among anabolic steroid users [[URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b26']26[/URL], [URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b27']27[/URL], [URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b30']30[/URL], [URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b34']34[/URL]]. It is suggested that focal myocardial fibrosis is caused by rapid myocardial fibre growth outstripping its blood supply, resulting in piecemeal necrosis and subsequent fibrosis [[URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b27']27[/URL]]. A direct cellular toxic mechanism mediated by disturbances of ion fluxes, and loss of membrane integrity (leading to cell death and fibrosis) has been suggested [[URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b14']14[/URL], [URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b35']35[/URL]]. These changes are irreversible. The fibrotic areas can potentially act as a focus for a malignant arrhythmia, or if extensive, cause cardiomyopathy. Animal studies have shown that anabolic agents enhance the pressor response to catecholamines, mediated by inhibition of extraneuronal uptake of neuroamines, and increased vascular response to norepinephrine [[URL='https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2044.2005.04218.x#b36']36[/URL]]. These changes may contribute to malignant arrhythmias and cause sudden death during periods of exertion. Excellent article. Note that blood work on its own may not give the full picture. [ATTACH type="full"]19219[/ATTACH] [/QUOTE]
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Clinical Use of Anabolics and Hormones
Clinical Use of Anabolics and Hormones
TRT to Supraphysiological Levels for Body Building
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