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Case Study Athletics and Anabolic Steroids

Ron Diggs is a 15-year-old white cross-country runner who comes to your office requesting help in gaining muscle strength and endurance. He is a good athlete who would like to get a college scholarship and thinks that if he can increase his muscle strength, he will get better and win a scholarship. He knows of some other athletes who are using anabolic steroids and requests your help. What would you do?

Answer: The use and abuse of anabolic steroids by athletes and body builders of either sex to increase strength and muscle mass is widespread. Surveys indicate that in the United States 6% of high school athletes, 20% of college athletes, and more than 50% of professional athletes in certain sports use or abuse anabolic steroids at some time. Use of these compounds does result in increased muscle mass, strength, and endurance. However, much of this benefit is now thought to be due as much to en hanced training effort as it is to the protein anabolic effects of the androgens. Individuals who take these compounds typically use 100 to 200 times the normal dose and will cycle or stack multiple anabolic compounds together in an effort to enhance the biological effect.

Common endocrine side effects of these compounds include virilization in women, suppression of endogenous gonadotropins, hypogonadism (amenorrhea in women, impotency in men), and severe psychological disturbances (depression, mania, steroid rage). Other physiological side effects are hepatotoxicity, suppression of high-density lipopro-tein cholesterol, increased cardiovascular risk, insulin resistance, and decreased thyroid hormone production. It would be malpractice and unlawful to consider such treatment for this person. However, it is important to educate him about the risk-benefit ratio and reason for not using them.

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