Q: What are the best anabolic steroid for women? Are Anavar and Primobolan the best bets to minimize masculinizing side effects?

A: It may seem surprising but IMO Anadrol (oxymetholone) is a good choice for women who wish to be conservative yet have very effective results.

I don’t specialize in cycles for women and don’t choose to involve myself with it — it almost only happens when the wife of someone I’m working with wants to use some anabolic steroids as well — but I haven’t seen 25 mg/day in divided doses go wrong yet.

Medically, you’d be astonished at the doses women and even girls have taken with very low virilization rates. So anyway, contrary to what intuition might suggest, Anadrol is not one of the riskier choices for women.

That aside, 15 mg/day of Anavar (oxandrolone) will be virilizing in quite a few cases. Probably about 5 mg/day of oxandrolone is comparable to 25 mg/day Anadrol (divided doses) for risk.

Primobolan up to 50 mg/week, divided injections, is a common and reasonable choice, but has some risk: not a particularly high rate though.

I first learned of [Anadrol for women] from Dan Duchaine. In the earlier parts of Denise Rutkowski’s career, he had her on 25 mg/day Anadrol. I don’t think I’m disclosing a secret here because he also published this. She obviously did very well with it and at that point she was not virilized at all. So from him mentioning this to me, I looked further into it.

The medical doses are pretty astonishing. The reason that 50 mg is the tablet size is because that’s the standard minimal medical dose, including for women and children! It used to be used extensively for improving red blood cell count.

I’m sure I could find it again, and I’ve posted it before, but there’s at least one paper in the literature reporting doses used for quite a large number of women and reporting low incidence of any side effects. And these doses were often more than 50 mg/day. Sometimes much more.

And further, personally I’ve never seen 25 mg/day go wrong.

I’m not saying it can’t: you see some women developing hoarse voices and facial hair naturally with time, so there must be some women that are right on the edge. But generally speaking, this is a conservative dose, yet quite effective.

The mg amount that women can tolerate of Anadrol is markedly higher than any other anabolic steroid. However, that said, it’s also true that effect per mg is less, but not enough so to make up the safety difference IMO. I would put 25 mg/day Anadrol (in divided doses) up against 50 mg/week Primo any time for effectiveness and it’s at least equally conservative.

Another thing about Anadrol that’s remarkable is that other anabolic steroids are very easily disruptive of the menstrual cycle. Even dosages such as 2.5 mg oxandrolone 2x/day commonly raise issues. Anadrol however medically has shown often only moderate effect on the menstrual cycle at 50 mg/day, and in my too-limited experience with it (as I generally don’t work with women on steroid cycles) 25 mg/day only lightened and shortened the cycles slightly. Remarkably less disruptive.

As a rough rule of thumb: take a dosage that would be quite moderate for a man, nearly the minimum likely to be recommended that could still give reasonable results for a novice, then divide by 10 to have something that’s moderate but effective for a woman.

For each individual steroid, my suggested mild-but-effective dosage range may differ from the above slightly, and of course the above also is only approximate because there will be diffferent opinions as to what would be moderate for a man. But if having nothing else to work with, if you see or are considering a dosage and want to do a quick “reality check,” the above can help. For example, say that someone is proposing EQ at 100 mg/week. Multiply by 10, and our comparison would be to 1000 mg/week of EQ for a man. That’s well above being a mild cycle. So we can see at a glance that this EQ dose is off, without having had to remember specific values for each steroid.

Also in general I’d forget stacking for women.

Returning to the stacks you asked about, and in general to anabolic steroids other than Anadrol for women:

I can’t say that it couldn’t possibly be that some stacking method might give better ratio of muscle gain to side effects, but as to whether we know what that is, that’s another question entirely. The best understood uses are single-drug, and single-drug works fine. Primo or Anadrol are my top two choices for bodybuilding and fitness; oxandrolone is also acceptable but must be lower dosed than those two; for quality of life enhancement, very very low dose testosterone works fine.

Is Anadrol an appropriate steroid for women?

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Originally published at: What are the Best Steroids for Women?

Q: Are SARMs (selective androgen receptor modulators) a good idea to add to your post cycle therapy (PCT)? And if so, why do you not see them being used during PCT by many people? And lastly, does anyone think SARMs are going to eventually replace anabolic steroids? Any info would be greatly appreciated.

A: I don’t think they are good to add to PCT.

I haven’t found any evidence that any SARM gives less suppression for given anabolic effect than is the case for anabolic steroids such as say Primobolan, Masteron, or oxandrolone.

I know I’m beating this point into the ground but it’s something that others just don’t say enough — actually I virtually never, anywhere, see people making this point except where the subject at hand is statistics: The phrases “no significant (x) was found” or even “There was no change in (x)” appearing in scientific papers are basically weasel language. The technical meaning is VERY different than what it could appear to mean.

The meaning is only that, because of random variation and the small number of subjects, no effect COULD have been detected that smaller than some given amount — which sometimes is quite large! — and the study found that they saw no effect of at least that size.

It does not at all mean that a very substantial, important effect may not have occurred!

For whatever reason, many scientists prefer to write in a manner that makes it appear that there most likely was no effect without telling directly how large or small their threshold of detection was. I guess it’s better sounding to omit “But we couldn’t have found any effect smaller than X anyway,” particularly where X is a large amount!

So you can have reports in scientific literature such as anabolic steroids, at the dose studied, providing NO muscle mass gains or performance enhancement.

Correct conclusion, what change there was, they couldn’t detect to statistical significance. Not the the benefit may not be significant, in the sense we may mean the word!

All that was to bring some sense to the fact that a study can, with this way of using words, make it appear that SARMs are non-inhibitory whether or not that is so.

I don’t at all think that that is the case. Taking a SARM during PCT is I think the equivalent of taking a pharmaceutical anabolic steroid during PCT.

In some instances a careful use can make sense, but in general, it sets back recovery.

And even in those instances, I’d just use the anabolic steroid.

(Editor’s note: For more discussion, see “SARMs S4 and PCT?“.

Ask Bill Roberts about anabolic steroids

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Researchers at Kingston University in London have discovered that drinking green tea or white tea can help steroid-using athletes beat a commonly used anti-doping test. Declan Naughton and colleagues reported that compounds known as catechins may allow athletes to use the anabolic steroid “testosterone” and avoid detection.

The testosterone:epitestosterone ratio (T:E ratio) test is frequently used to screen drug-tested athletes for the exogenous administration of testosterone. It determines the ratio of testosterone glucuronide to epitestosterone glucoronide in an athlete’s urine.

Exogenous administration of testosterone does not influence the levels of epitestosterone. Therefore, a testosterone-using athlete should have a higher ratio of testosterone metabolites in their urine when compared to epitestosterone.

The catechins found in green tea inhibit an enzyme called UGT2B17. This enzyme is responsible for attaching glucuronic acid to testosterone. By inhibiting UGT2B17, an athlete will excrete less testosterone glucoronide in their urine. This will help a testosterone-using athlete produce a normal ratio.

Most individuals have a ratio of 1:1 testosterone to epitestosterone. But ratios as high as 4:1 are not uncommon. The World Anti-Doping Agency (WADA) considers a ratio of 4:1 to be a putative indicator of doping subject to confirmation by another anti-doping procedure known as carbon isotope ratio (CIR) testing.

The T:E ratio test can not tell the difference between testosterone produced by the body and testosterone that has been introduced via injections, pills or creams.

CIR testing can detect exogenous testosterone of plant origin. However, if athletes are able to successfully pass the T:E ratio test, they are not subject to the more definitive CIR test.

Therefore, if athletes can avoid detection in the T:E ratio test, they can get away with the administration of exogenous testosterone.

While green tea may provide another method for athletes to beat the T:E ratio test, athletes have regularly beat the T:E ratio screen through other means.

Professor Charles Yesalis, a noted steroid expert and epidemiologist at Pennsylvania State University, has long been outspoken about the so-called “testosterone loophole“.

Even Don Catlin, the former director of UCLA’s Olympic Analytical Testing Lab and founder of the Anti-Doping Research Institute, has acknowledged that athletes can use testosterone without getting caught even though anti-doping testers know how they do it.

“I could figure out how to take a fair amount of testosterone and you’d never catch me, and if I can say that, a lot of others can too,” admitted Catlin.

Athletes simply add epitestosterone to their drug protocol in order to maintain the 4:1 ratio. However, they must keep the absolute levels of urinary testosterone gluconoride and epitestosterone gluconoride below the 200ng/mL limit allowed by WADA.

“The cream” used by BALCO a decade ago was simply a variation of the testosterone and epitestosterone cocktail that had been historically used by athletes for decades to fool drug testers.

BALCO athletes used a unique transdermal delivery system to administer a customized testosterone and epitestosterone formula. One gram of “the Cream” contained 5 milligrams epitestosterone for every 100 milligrams of testosterone in a 1:20 ratio according to Victor Conte. This allowed BALCO athletes to use testosterone without getting caught.

Even after the $60+ million government investigation into BALCO, the $20 million Mitchell report on steroid use by MLB players and the sensationalistic Congressional hearings on steroid in baseball and other professional sports, the “testosterone loophole” has not been closed. The “cream” is just as effective as ever for a professional baseball player.

As if the T:E ratio test didn’t suck enough as an effective anti-doping tool, four years ago researchers at the Karolinska University Hospital in Stockholm discovered that some athletes can inject impressive amounts of testosterone and not fail the T:E ratio if they lacked the gene that produces the UGT2B17 enzyme.

Approximately 40% of these “genetically gifted” athletes could take a whopping injection of 500mg of testosterone enanthate without raising flags from current WADA doping controls.

And this genetic anomaly is relatively common and is more common in certain ethnic groups. Thus, an athlete’s ethnicity may give them a doping advantage.

• 78.0% – Mulatto (Brazilian)
• 66.7% – Eastern Asian (Korean)
• 57.3% – Cape Colored (Cape Town, South Africa)
• 37.6% – Mexican Mestizo
• 30.4% – Asian Pacific (Southeast Asian/Southern Chinese, Asian Indian, Japanese)
• 29.1% – Black (African Americans, African Blacks, South/Central American Blacks)
• 9.3% – White Caucasian (Swedish)
• 3.5% – White Caucasian (primarily European)

Four years ago, I asked “Could there be a rogue chemist who discovered a pharmaceutical drug that can block the UGT2B17 enzyme?” I guess a rogue chemist wasn’t required. Little did I know that green tea or white tea could effectively block UGT2B17. While the UGT2B17-blocking effect of green tea is news to the scientific community, somehow I suspect this “secret” has been common knowledge in some elite athletic circles.

The use of testosterone remains one of the most popular methods used by steroid-using athletes to avoid detection. The “testosterone loophole” will continue to be exploited as long as the T:E ratio test is used as the primary screen for testosterone use.

Green tea helps athletes get away with using testosterone

Source:

Jenkinson, C. et al. (2012). Dietary green and white teas suppress UDP-glucuronosyltransferase UGT2B17 mediated testosterone glucuronidation. Steroids. http://dx.doi.org/10.1016/j.steroids.2012.02.023

The anabolic steroid testosterone can be used by athletes to enhance athletic performance and muscle growth. UDP-glucuronosyltransferase (UGT2B17) is the key enzyme involved in the glucuronidation of testosterone to testosterone glucuronide, which also serves as a marker for the testosterone/epitestosterone (T/E) ratio detect testosterone abuse in sport. Inhibitors of testosterone glucuronidation could have an impact on circulating testosterone levels, thus aiding performance, as well as potentially affecting the urinary T/E ratio and therefore masking testosterone abuse. Previous reports have revealed that non-steroidal, anti-inflammatory drugs, diclofenac and ibuprofen, inhibit the UGT2B17 enzyme. The aim of this study is to analyse dietary tea samples for inhibition of testosterone glucuronidation and, where inhibition is present, to identify the active compounds. Analysis of testosterone glucuronidation was conducted by performing UGT2B17 assays with detection of un-glucuronidated testosterone using high performance liquid chromatography. The results from this study showed that testosterone glucuronidation was inhibited by the green and white tea extracts, along with specific catechin compounds, notably: epicatechin, epigallocatechin gallate (EGCG) and catechin gallate. The IC50 inhibition value for EGCG was determined, using a Dixon plot, to be 64 μM, equalling the most active NSAID inhibitor diclofenac. Thus, common foodstuffs and their constituents, for the first time, have been identified as inhibitors of a key enzyme involved in testosterone glucuronidation. Whilst these common compounds are not substrates of the UGT2B17 enzyme, we showed that they inhibit testosterone glucuronidation which may have implications on current doping control in sport.

Conte, Victor. (VictorConte). “”The cream” contained 5 mgs per gram of epitestosterone, so the T/E ratio was 20 to 1 RT @millardbaker: @VictorConte how much epi-t.” 27 Feb 12, 9:09 a.m. Tweet.

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Originally published at: Green Tea Helps Steroid-Using Athletes Beat Anti-Doping Test

Q: I was talking with a friend of mine at the gym today who is a very experienced bodybuilder and trainer. He basically informed that the more “juice” you do over time, the more steroids you will require in the future. Do you have to “continually” up the dosage amount to keep or gain more muscle?

A: I don’t myself agree with a principle of needed dose being related to past usage, though things can work out where it can appear that way.

Rather, for any given hormonal status and a given individual, there is only so much that the body can attain with let’s-say near-optimal training and nutrition. Another slightly different way of looking at it is, only so much the body can attain in a given time frame such as say 6 months of further dedicated training.

If where you are now is far from that point, then your gains to to near that point can be fast. The farther away you are, the faster your gains can be, or alternately the less-extreme the hormonal envirornment will need to be for you to still have fast gains.

Another way of putting it: If you’re stagnant at X pounds in lean condition despite great training and nutrition and your use has been say 1 gram per week of steroids and no peptides, then if you want fast further gains you are going to have to step it up. Not really because of past use, but because X pounds is where your body reaches a homeostasis point with that amount of drugs and good training.

But if X pounds is where you would wind up at that usage level, or did wind up in the past but have since backslid, however you are now thirty lb less than that in lean condition, then you could make fast gains even with say 750 mg/week. Regardless that you might have used any higher amount in the past.

Does this have anything to do with your article written in 1998 about androgen receptor upregulation?

Not so much, it’s more a matter of there being no “record,” so to speak, kept in the body of what drugs have been used before and how much, and more importantly that rate of growth does wind up being very much related to how far away one is from what would be the experienced “set-point” for the drugs being used.

By set-point, I mean a muscular size where the body tends to settle into a homeostasis and neither lose muscle nor readily gain more.

When well under that point, gains are fast… when very near it, gains will not be fast or at least not for any extended period of time. (There could be a brief burst.)

For most this is very important when having already made a lot of gains past a very solid naturally-build base — or a huge amount of gains if having gone straight to steroids or nearly so — and having used only modest doses such as say 500 mg/week. In that case, absolutely having reached or nearly reached an apparent limit for that amount of drugs will mean that using more steroids can give very considerably more drugs.

Less so, but still true, at say 750 mg/wee; still less so but still true at say 1000 mg/week. If really having put in the time and quality work and nutrition at 1000 mg/week and having plateau’d, doubling up can make a further difference though not so great a difference.

Where the article is relevant is that it used to be believed in bodybuilding that receptors were damaged or permanently downregulated by high dose use, and that is not the case.

So let’s say a steroid novice goes and does a 2000 mg/week cycle and doesn’t build himself to anything like what he could with time achieve with even 750 mg/week.

Some would be concerned, and the article explains why not, that his 2000 mg/week usage ruined him and now he couldn’t respond to anything less than that. Not so: he can still achieve on say 750 mg/week just as much as he ever could on that dosage.

Ask Bill Roberts about anabolic steroids

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Steroids are bad. Very bad. And what better way to demonize steroids than to link them to evil, Nazi doctors?! Schutz-Staffel soldiers were allegedly injected with steroids to increase their aggressiveness before battle in Adolf Hitler’s Nazi Germany. The specter of steroids has been reported as one of the factors underlying the violence and atrocities in Nazi-occupied territories and the systematic state-sponsored murder of millions of Jews during the Holocaust. Anything associated with Nazi Germany has been considered sinister and malicious. Steroids are no exception.

The association has conveniently demonized the entire class of hormones. The problem with the Nazi-steroid connection is that it, like much anti-steroid propaganda, is not true. Empirical evidence supporting an association between steroid use and Nazi soldiers simply does not exist.

German scientists, who happened to be working in Nazi Germany, were undeniably active in early steroid research during the 1930s and 1940s as were researchers in other countries. But the German contributions to steroid development did not extend to the theater of war. German steroid research, while significant, may not have been as extensive as the contributions of another group of researchers.

The myth of Nazi steroids has had the unfortunate effect of overshadowing the significant role played by Jewish chemists and entrepreneurs in the history and development of anabolic steroids. Jewish researchers arguably made a greater number contributions in the field than their Nazi-funded German counterparts.

It appears that the role of Nazis has been considerably overstated. Indeed, the Nazis did have a major impact on steroid development. It’s just not the direct impact we’ve been told to believe.

Nazi Germany indirectly influenced the early boom in steroid research by precipitating the mass exodus of Jewish researchers from Europe during the rise of the Third Reich.

Testosterone, Dianabol, Deca Durabolin, Anadrol, Masteron, Sustanon, Superdrol – do they sound Jewish?

• The first person to isolate and name the primary male androgen as “testosterone” in 1935 was of Jewish ancestry.
• A Jewish chemist from Ciba collaborated on the research team that shared the Nobel Prize in Chemistry for first synthesizing testosterone in 1939.
• The co-founder of the company that introduced Deca Durabolin and Sustanon 250 witnessed his two daughters being deported to a Nazi concentration camp as he himself went into hiding.
• The co-founders of the company that introduced Anadrol were Jewish emigrants who moved to Mexico.
• It was yet another Jewish refugee who was involved in the synthesis of Anadrol, Masteron and Superdrol.

Maybe it’s time we stop blaming the Nazi for anabolic steroids and start thanking the Jews?

Rather than demonize steroids, we should celebrate these remarkable compounds. The people involved in the creation of various anabolic steroids deserve credit and recognition and should be proud of the discoveries.

Organon (Oss, Netherlands), Ciba (Basel, Switzerland) Syntex (Mexico) and Schering (Berlin, Germany) were the four pharmaceutical companies that controlled the early development of steroids. Only Schering was linked to research funded by the Nazi-controlled government of Germany. The other three companies were either founded by Jewish entrepreneurs and/or dominated by Jewish organic chemists.

Ernst Laqueur co-founded Organon in 1923. Laqueur’s mother, Anna Levy, was a Jew from Poland. Laqueur, a non-practicing Jew who baptized his children in the Protestant church, was still forced into hiding from the German Occupation forces in Holland during the Holocaust because of his Jewish ancestry. Laqueur escaped deportation but his two adult daughters were not so fortunate and spent several months in the Bergen-Belsen concentration camp before being liberated by Soviet troops when World War II came to an end.

Laqueur and his colleagues at Organon were the first to isolate and identify the primary male androgen from hundreds of pounds of bull testicles. Being the first to discover gave them the naming rights. They decided to call the hormone “testosterone” in the classic paper entitled “On Crystalline Male Hormone from Testes (Testosterone): More Active Than Androsterone Preparations from Urine or Cholesterol” in 1935. In the decades that followed, Organon introduced many drugs that became household names in the bodybuilding and athletic communities. These included Deca Durabolin, Durabolin, Sustanon 250 and Pregnyl (hCG).

The early method of extracting testosterone from bull testicles was quite expensive. Schering and Ciba independently discovered  new, less expensive methods of synthesizing testosterone in August 1935. The 1939 Nobel Prize in Chemistry was awarded to German Adolf Butenandt (Schering) and Croatian Leopold Ružička (Ciba) for this reasearch.

Butenandt was forced to decline the award by the Nazi government leaving Ružička  as the sole recipient of the award. While Ružička was Catholic, his collaborator on the testosterone research at Ciba, Alfred Wettstein, was Jewish.

The Catholic Ružička was also an outspoken opponent of the Nazi regime. He was a founding member of the Swiss-Yugoslav Relief Society that helped provide refuge in Switzerland from German Occupation forces in Europe during World War II. He had established a reputation for shielding and mentoring Jewish scientists at the Swiss Federal Institute of Technology (Eidgenossische Technische Hochschule, or ETH) in Zürich.

In addition to their work on testosterone synthesis, Ružička and his international research team were the first to synthesize methyltestosterone and androstenedione.

Ružička came under increasing pressure for his protection of his Jewish colleagues at the Zurich-based ETH during World War II. Six chemists at ETH decided to leave in order to protect their mentor.

George Rosenkranz was one of six Ružička’s proteges at ETH that left Switzerland. He was interviewed for a position as Director of Scientific Research at Syntex in Mexico City on the same day that the Enola Gay dropped the atomic bomb on Hiroshima.

Syntex was co-founded by German Jewish refugee Federico Lehmann and Hungarian Jewish refugee Emeric Somlo only a year earlier in March 1944.

Rosenkranz was directly involved in the creation of the steroids Anadrol (oxymetholone), Masteron (drostanolone acetate) and Superdrol (methyldrostanolone or methasteron).

(As a side note, Rosenkranz was responsible for hiring Austrian Jewish refugee Carl Djerassi to work at Syntex. Djerassi’s work was instrumental in the creation of an entirely different type of steroid hormone – the birth control pill.)

So, there you have it. Testosterone, Dianabol, Deca Durabolin, Anadrol and Masteron, some of the most popular steroids in sports history, today and yesterday, all had Jewish origins.

Stay tuned for my next articles where I completely deconstruct the myth of Nazi steroids.

Jewish chemists created Dianabol, Anadrol and many other steroids

References

Anadrol

Anabolic steroid. Prepn: Ringold et al., J. Am. Chem. Soc. 81, 427 (1959); Ringold, Rosenkranz, DE 1070632 (1959 to Syntex).

Dianabol

Vischer E, Meystre C, Wettstein A. Herstellung weiterer 1-Dehydrosteroide auf mikrobiologischem Wege. Helv Chim Acta 1955;38:1502-6.

Meystre C, Frey H, Voser W, Wettstein A. Gewinnung von 1,4-Bisdehydro-3-oxo-steroiden. HeIv Chim Acta 1956;39:734-42.

Masteron

Synthetic estrogen antagonist. Prepn: H. J. Ringold et al., J. Am. Chem. Soc. 81, 427 (1959); H. J. Ringold, G. Rosenkranz, US 3118915 (1964 to Syntex).

Superdrol

H. J. Ringold and G. Rosenkranz. “Steroids. LXXXIII. Synthesis of 2-Methyl and 2,2-Dimethyl Hormone Analogs.” Journal of Organic Chemistry. 21. (1956): 1333.

Testosterone

Leopold Ružička and Alfred Wettstein. On the Artificial Preparation of the Testicular Hormone Testosterone (Androsten-3-one-17-ol). August 31, 1935.

“Ružička, Leopold.” Complete Dictionary of Scientific Biography. 2008. Retrieved March 06, 2012 from Encyclopedia.com: [url]http://www.encyclopedia.com/doc/1G2-2830905308.html[/url]

Founders of Organon

Ernst Laqueur. (n.d.). In Wikipedia. Retrieved February 22, 2012, from [url=http://de.wikipedia.org/wiki/Ernst_Laqueur]Ernst Laqueur – Wikipedia[/url]
Szpilfogel, S.A.;*Zeelen, F.J. Steroid research at Organon in the golden 1950s and the following years. Steroids, Volume 61 (8) Elsevier – Aug 1, 1996

Renata Laqueur:*Bergen-Belsen Diary, 1944-1945 ISBN 3771623081

Founders of Syntex

Djerassi, Carl. This Man’s Pill: Reflections on the 50th Birthday of the Pill, Oxford University Press, USA, 2004.*ISBN 0-19-860695-8*(autobiography)

George S. Cohen. Mexico’s Pill Pioneer. Perspectives in Health Magazine: The Magazine of the Pan American Health Organization. Volume 7, Number 1, 2002 Retrieved from http://www.paho.org/english/dpi/Number13_article4_7.htm

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Originally published at: Stop Blaming the Nazis for Steroids and Start Thanking the Jews

There is so much confusing and contradictory information out there about healthy eating.  I will try to summarize what I have learned as a bodybuilder who wants to stay healthy as I age.  The choices of foods that we can now can have a significant effect not only on our body shape and quality of life, but also  mortality and on how well we age.

The components of whole food.
Foods are made up of many different components—some are “micro” or smaller quantity nutrients, like vitamins, and some are “macro” or larger quantity nutrients. The three macro groups that compose the majority of our diets are carbohydrates, proteins, and fats. These three units are the basic materials that fuel our activities and metabolism and maintain body composition. Selecting the best sources and amounts of these three macronutrients may help to minimize metabolic disorders (such as high cholesterol and blood sugar) and prevent loss of lean body mass and accumulation of body fat.⁾

The best carbohydrates.
Carbohydrates provide our body’s main source of quick energy. After carbohydrates are digested and after some processing by the liver, they are released into the bloodstream as a sugar called glucose to be delivered to the cells.

Throughout the majority of the last million years of our evolution, the human diet consisted of animal carcasses, some seeds, nuts, and fibrous vegetable and fruit carbohydrate sources that are generally nutrient-rich with lots of water, but are not calorie-dense like processed foods of today. The majority of these carbohydrate sources are vegetables, leaves, roots, and fruits (all rich in fiber). Because vegetable fiber tends to slow down digestion, a majority of the carbohydrates in these foods are absorbed relatively slowly, inducing less blood sugar (glucose) and insulin spikes than processed sweets that contain no fiber. Some people call these “slow carbs.”

It was only after the advent of agriculture that human beings were introduced to higher intakes of grains as carbohydrate sources. Higher intakes of grains deliver lots of calories. Additionally, some grains deliver their sugar energy relatively quickly, especially if the grain is milled (which removes the fiber that slows down sugar absorption), as are the grains in breads and pasta. Unless you are very active and exercise enough to metabolize nutrients more rapidly, this quick glucose release into the bloodstream can create a dysfunctional hormonal environment that can ultimately promote obesity, cardiovascular disease, and diabetes. This hormonal shift also has a profound effect on lean body mass and fat metabolism, and possibly immune function. The key hormone involved in this problem is called insulin, produced by an organ called the pancreas.

Insulin and insulin resistance.
The hormone insulin is produced by the pancreas to control blood sugar and store it in muscles for later use as glycogen. Insulin’s main job in the body is to promote the delivery of sugar energy as glucose to cells. When a small amount of glucose is delivered into the bloodstream, a small amount of insulin is produced by the pancreas to accompany it. When there is a large amount of glucose, the pancreas works to produce a large amount of insulin to facilitate its delivery so that cells can take in as much glucose as possible. Extra glucose that cannot be taken in by the cells circulates in the bloodstream and can be toxic to brain cells, so under normal circumstances, most of it is soon converted into triglycerides (fat) in the liver to be stored for later use. But we have to be careful with high blood levels of triglycerides, since they are what feed fat cells.

The correct amount of carbohydrate sources will provide enough sugar to give a healthy amount of glucose to the cells, but not too much at once. Thus, levels of glucose and insulin in the bloodstream are not unusually elevated for any long period of time. The pancreas works, but it is not overworked trying to keep up with an unusual demand for insulin.  However, in the U.S., much of the diet consists not only of large amounts of high-calorie carbohydrate sources, but also of carbohydrates from sweets and sodas, which are very concentrated sources of sugar. The net effect that intake of these calorie-dense carbohydrate foods creates is a bloodstream that is occasionally flooded with large amounts of glucose, a pancreas that is overworked, and large amounts of insulin and triglycerides circulating in the bloodstream. Note that excess insulin causes increased production of cholesterol.

Over time, these occasional glucose, triglyceride, and insulin floods can cause a decrease in the sensitivity of the cells’ response to insulin, which reduces the cells’ ability to take in glucose. Insensitivity to insulin is called insulin resistance, and it is a serious consideration in metabolic problems. Some HIV medications can worsen insulin resistance, so we need to be aware of nutritional considerations that can help. Ways to decrease insulin resistance are to exercise, follow a proper diet, and taking medications that improve insulin response. For instance, several studies have found that people consuming an overall high-quality diet, rich in fiber and adequate in energy and protein, were less likely to gain fat. This is why it is best to select the majority of your carbohydrate intake from fiber-rich, slow-releasing carbohydrate sources that do not contain an excessive amount of calories. And these good carbs should be accompanied by good sources of protein and fats.

Combining carbohydrates with protein, fiber, and fat.
Protein, fiber, or fat will slow the absorption into the blood of glucose from carbohydrates, which helps to reduce the rise in blood sugar and insulin spikes. So, mixing carbohydrates with protein, fiber, and good fats is one way to reduce their problematic effect on blood sugar and insulin. Ensure that every meal and snack you consume has a mix of these three macronutrients. But what are the best fats, protein, and high-fiber carbohydrates sources out there?

Fats and oils.
There are a number of different kinds of fats. There is motor oil, there is butter, and there are essential fatty acids. The most important oil to keep a Honda running right is not the kind with essential fatty acids (EFAs), but if you want to help your body stay healthy and your immune system operating at its best, you had better consider getting these EFAs on a daily basis. They are called “essential” because your body cannot manufacture them, and must obtain them from an outside source, like food or supplements. These oils are necessary for every critical function in your metabolism, including building lean body mass and fighting infections.

The main point is that since we need EFAs and other fats for health, we should be getting them in our diets from fresh, high-quality sources. A proper diet reduces the amount of starchy carbohydrates while maintaining a certain amount of healthy fats so that there is a different macronutrient balance than the old high-carbohydrate, high-protein, low-fat diets contained. This means striving to get fatty acids from several sources, the least of which are the saturated fats in butter or animal fat. Understand that saturated fats are not the demons we have been led to believe. When we realize that we evolved getting a certain amount of saturated fat from foods in the wild, it is only logical that they would have a place in a healthy diet. One recent study showed that dietary saturated fat and mono-unsaturated fat were associated with healthy testosterone production in humans, while EFAs had no effect. So it appears that we need a little saturated fat for optimal hormonal health. However, most people get far too much saturated fat, which promotes insulin resistance and metabolic problems, and not enough EFAs, which are needed for healthy cells and immune function.

The other important kind of fat that we should consciously include in our daily diet is mono-unsaturated fat, which we get from foods like olive oil. Recent data have shown that mono-unsaturated fats decrease the risk of certain cancers, and have an anti-inflammatory effect.

Fatty acid recommendations.

EFAs include the omega-3 and omega-6 fatty acids. Most people get an imbalance of these two by consuming too small an amount of omega-3 fats, which have anti-inflammatory properties, and relatively too large an amount of omega-6 fats, which tend to promote inflammation when out of balance. To get more omega-3s, eat more fish, including salmon, tuna, sardines, anchovies, mackerel, rainbow trout, and herring. Omega-6s are contained in common vegetable oils, like sunflower, safflower, and corn oils. Try to reduce your intake of these.

Oils and cooking.
Olive oil is one of the best oils to cook with. For sauteing that exposes oil to high temperatures, you can also cook with high-oleic sunflower oil, avocado, canola, macadamia, or any oil that is high in mono-unsaturated fatty acids.

Avoid cooking with oils made from corn and sesame. These oils contain more omega-6 fats, and less mono-unsaturated fats, so they have a higher potential for spoiling and turning to trans-fats, which are bad for the immune system. Try to avoid any intake of these oils when they are not absolutely fresh.

Also, choose oils that are minimally processed. Most of the clear oils in supermarkets are stripped of some of their natural components to make them more suitable for sitting on store shelves for long periods of time without spoiling. Do not use these stripped oils. When you do cook, do not overheat the oil so that it smokes, which causes the formation of carcinogens and destroys the beneficial fatty acids.

Avoid margarine, hydrogenated fats, or processed oils.
Do your best to avoid processed fats or oils, as they have negative effects on cellular health, overall metabolism, and your immune system. Look out for the words hydrogenated and partially-hydrogenated. These kinds of manipulated fats probably do increase the risk of cancer and heart disease. They also weaken healthy cellular immune metabolism. Lastly, they are also likely to promote high lipid levels and insulin resistance.

Protein, food for the immune system.
Dairy protein fractions, such as caseine (contained in milk curd) and whey, are at the top of the list of proteins that optimally feed lean body mass growth. In dairy products, the amino acid balances, insulin-raising potential, and overall growth factor content add up to one thing: milk proteins were created to make mammals grow bigger. While there is a lot of hoopla related to which dairy protein fractions are best, there is more misinformation than reality in this area. Those with lactose intolerance should be careful in their selection of milk-based products. Aged cheeses and yogurt may be more tolerable for those who cannot digest lactose.

Egg protein.
Next on the list are egg proteins. The important thing to remember is that whole egg is probably somewhat better than egg white for lean body mass growth and overall health effect, because the yolk is a rich nutrient source, and its protein content complements the protein in the egg white. Together they are a better source of protein.

Meat protein.
While real food like meat often seems to take a back seat to protein powders because of a mindset created by slick advertising, professional athletes know the value of real food related to lean body mass growth. If you do not make real food and meat fundamentals in your diet, you will not grow lean body mass tissue as well. Fish, chicken, turkey, and beef are vitally important foods, not only because of their protein content, but because they contain numerous other nutritional components that are important for a healthy metabolism. The message is: eat real food, then supplement food with protein powder drinks if you need them.

Lean red meat is a superior source for lean body mass growth and blood-building nutrients. These include creatine, carnitine, phenylalanine, conjugated linoleic acid (CLA), and heme- (blood) iron, the most absorbable form of iron. And meat, in general, is less likely to cause allergic reactions than eggs or dairy proteins, like casein and whey. The only caution about red meat is that the high amount of saturated fat most commercial red meat contains could promote metabolic problems. So be moderate about including it in your diet and choose leaner meats if you do.

Important details on meat: cooking kills bacteria in meats. Stewed meat is better for digestion (chicken soup, beef stew). Roasting is okay. Try not to fry or barbecue with charcoal. Charred foods are associated with increased risk of gastrointestinal system cancers. Any cooking of meat or vegetable protein that causes the formation of a hard outer skin renders the protein that becomes the skin to be much less digestible because it cross-links the protein.

Vegetarian diets
It is very difficult to gain lean muscle weight on a vegetarian diet. In fact, it is almost impossible for most people, especially when they are fighting infections that burn lean body.

If you do choose a vegetarian diet, your best protein sources are beans, seeds and nuts. Digestion of nuts and seeds will be improved by soaking them overnight to reduce the enzymes they contain that inhibit digestion of proteins. If you can eat them without digestive problems, many nuts and seeds are ideal foods because they contain protein, healthy fat, and complex carbohydrates in a very good balance for overall health. They also make a great snack between meals. However, the amino acid balances in these proteins do not appear to be optimum for lean body mass growth for humans.

Calcium and vitamin D—two important micronutrients
We know that calcium and vitamin D help to strengthen bone. Many of us chose to take calcium plus vitamin D supplements, but there are also foods that are rich in these nutrients. Calcium-rich foods include milk, cheese, spinach, fortified orange juice (be careful with the sugar, though!), fish, eggs, and beans. Vitamin D-rich foods include milk, most fish, and eggs. However, most of us do not consume the 1000 mg and 2000 IU needed per day for calcium and vitamin D, respectively, and need to take over-the-counter supplements.

Miscellaneous nutrition tips

• For your food, shop mostly in the outer part of the grocery store where the fresh produce, meats, and milk products/eggs are. Avoid overly processed canned or packaged foods, except for frozen vegetables. Read the labels and avoid products with many preservatives and additives. Trans-fats and hydrogenated oils, high fructose corn syrup, and high sugar should be on your radar when reading labels.
• Try to eat several smaller balanced (protein + good carbs + good fats) meals or snacks instead of two to three large ones. Smaller meals/snacks are more easily digestible, keep blood sugar and insulin more constant through the day, and keep you from binge eating late at night.
• Eat more almonds, walnuts, pecans and pistachios (good cholesterol-lowering fats). Twice a day, snack on such nuts to get your good fats and fiber. If you wish, mix them with some dried fruit. Research has shown that people who eat nuts tend to have lower LDL cholesterol.
• Avoid junk and fast food. The best way to do this is to have enough food at home and to bring lunch to work. Cook a lot of food on weekends and freeze meals in small containers you can heat up later.
• Do not sabotage yourself by bringing sweets and junk into your home. Watch your cravings at night, when most people find it the most difficult to avoid overdrinking alcohol or eating ice cream, cookies, and comfort foods.
• Eat a large breakfast, a moderate lunch, and a small dinner. Skipping breakfast makes you more prone to overcompensate by eating more calories late in the day. Your body has spent several hours without food and is starved for nutrients in the morning. Do not feed it sugar and white flour products at this important time. Eggs, oatmeal (the type that has no added sugar, and you can add whey protein powder to it!), Greek-style yogurt with nuts and fiber supplements, low-fat cottage cheese with fruit, almond butter on multigrain (high-fiber) bread, and fruit are all good choices for breakfast.
• For lunch have some soup and a glass of water first and wait 10 minutes to trick your body into feeling full faster. Grilled chicken with vegetables, tuna salad over greens and nuts, a Greek salad with sliced steak, and any Mediterranean food choices are good.
• For dinner, fill yourself with stir-fried (use olive oil!) vegetables and lean meats. Two hours before bed, you can have half an almond butter sandwich or yogurt with fruit. You will not be hungry and desperate with this diet!
• Eat fruits and vegetables of all colors. Each has a different antioxidant profile. The produce section of the market is basically a fresh vitamin department and a medicine chest. Some foods like garlic, onions, and ginger have genuine therapeutic effects. Eating the widest variety of fresh produce on a daily basis assures you of getting all the ingredients that nature provides that can help keep your body strong enough to handle bacteria and viruses so that you stay healthy.
• Avoid sodas, sweet drinks, and fruit juices (fruit sounds healthy, but juice contains too much sugar and no fiber to slow down its absorption into the blood).  Consuming sugar daily can affect your metabolism, create insulin resistance, make you fat, and have all kinds of negative health consequences. The suggested pecking order of carbohydrate food sources that support your health without increasing insulin resistance follows. Best are vegetables in their many forms. Next are beans and peas. These deliver more calories than vegetables, but the carbohydrates release much more slowly than grains. Next are whole grains, which are calorie-dense but contain carbohydrates that, in general, release somewhat slowly. At the bottom, and the most likely to promote body fat problems, are carbohydrates from milled grains, like wheat and corn. Whole grains are marginally better than processed grains, but when they are milled into flour the difference is not that great. The very worst carbohydrate sources are sweets, like candies, which can deliver as many as 2,000 calories per pound. Try to eat from the first group of slow-release carbohydrate sources most of the time, and if you are relatively healthy, you can have small amounts of milled wheat products or sweets once in awhile.
• Drink lots of water. Six to eight glasses a day is a good goal. If you get thirsty, you are already dehydrated!
• Eat a high-protein, complex carbohydrate-rich meal after workouts. Examples: chicken salad with nuts, cottage cheese or yogurt and nuts/fruit, celery sticks and hummus (chickpea butter), etc.
• Manage your intake of caffeine (it reduces appetite but can increase anxiety). Do not have any caffeine after 4 p.m., since it can impair your sleep.
• Minimize hidden sugars like high fructose corn syrup. Read the labels of food you buy. Diet sodas tend to make your brain crave sweets in general, so they are not good substitutes for sugary drinks. Water, water, water!
• If you do not consume at least 20 grams of fiber a day, add to your intake supplements like Citrucell or Benefiber, purchased in any grocery store. Fiber improves insulin sensitivity, makes you feel full longer, keeps your gut healthy (friendly gut bacteria that produce vitamins love fiber), keeps you regular and reduces diarrhea, and can lower the chances of getting colon cancer.
• Eating healthy is eating smart, and it does not mean that you should starve yourself. Hopefully, this information has shed some light on healthy food sources and how they can affect health and the bodySo, take charge of your health and take care of your body. It is the only one you have.

Healthy Eating Shopping List

1. Produce

• Spinach and other green leafy vegetables
• Broccoli and cabbage
• Green beans
• Avocados
• Raspberries and all berries. You can buy frozen ones and add to whey protein shakes
• Whole fruits (remember no juices).
• Sweet potatoes, carrots
• Hummus
• Beans and other legumes (you can buy canned or frozen ones)

2. Nuts, Grains, Oil

• Mix of almonds and other nuts
• Peanut, almond, and cashew butters without hydrogenated oil   (the   healthy   nut   butters   show   oil   and   butter separated since the lack of hydrogenated oils prevents emulsification)
• Pumpkin and sunflower seeds
• Wild rice (the darker the rice, the better)
• Whole grain breads and pasta
• High fiber crackers
• Oatmeal (not the little packets; those are loaded with sugars)
• Olive oil

3. Dairy

• Low fat milk, cheese
• Yogurt (Greek style, no sugar added)
• Eggs (free range or Omega 3 enriched if possible)

4. Meat

• Lean meats
• Salmon, sardines and tuna
• Occasional glass of red wine per day (optional)

5. Supplements

• Whey protein (I like the Isopure brand since it does not give me gut problems and it is very light)
• Vitamin D
• A multivitamin (Super Nutrition’s Super Blend)
• Fish Oils

NELSON VERGEL, a chemical engineer from Venezuela,  created the Program for Wellness Restoration (PoWeR) and founded the Body Positive Wellness Center in Houston. Nelson has lectured extensively around the country and overseas, and with his research partner, Michael Mooney, co-authored the book Built to Survive. In 2011, he wrote and published Testosterone: A Man’s Guide—Practical Tips for Boosting Physical, Mental and Sexual Vitality (available on amazon.com)

Bodybuilding Nutrition

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Originally published at: Smart Bodybuilding Nutrition

One of the most enduring myths in the history of anabolic steroids is the belief that Dr. John Ziegler created Dianabol. The truth is that Ziegler had nothing to do with the invention of Dianabol. The real inventors were organic chemists working in a laboratory half way around the world.

Dianabol (methandrostenolone or metandienone) (l7beta-hydroxy-17alpha-methylandrosta-1,4-dien-3-one) was first synthesized by organic chemists working for CIBA Pharmaceuticals in Switzerland. The European researchers who created Dianabol probably never heard of John Ziegler, either before or after its development, and most certainly did not collaborate with John Ziegler.

So who really created Dianabol?

The following illustrious and prolific steroid hormone chemists at CIBA Pharmaceuticals (Switzerland) all share credit for its invention: Albert Wettstein, Alfred Hunger, Charles Meystre, Ludwig Ehmann, Ernst Vischer, Hans Peter Frey and Walter Voser. They were all part of the team that first outlined the synthesis of methandrostenolone in the Swiss-founded scientific journal Helvetica Chimica Acta.

• Vischer E, Meystre C, Wettstein A. Herstellung weiterer 1-Dehydrosteroide auf mikrobiologischem Wege. Helv Chim Acta 1955;38:1502-6.
• Meystre C, Frey H, Voser W, Wettstein A. Gewinnung von 1,4-Bisdehydro-3-oxo-steroiden. HeIv Chim Acta 1956;39:734-42.

The inventors of record in the United States patent for methandrostenolone (US 2900398) are listed as Wettstein, Hunger, Meystre, and Ludwig Ehmann of CIBA. The patent application only references the aforementioned 1956 Helvetica Chimica Acta study.

The CIBA researchers were no lightweights. Wettstein collaborated with the Leopold Ružička’s research team that won the 1939 Nobel Prize in Chemistry for their remarkable work on the synthesis of testosterone. The discovery of Dianabol was just another feather in his cap.

Why then has Dr. John Ziegler been erroneously credited with inventing Dianabol?

The romanticized account of how a small-town country doctor created a synthetic anabolic steroid to level the playing field between American Olympic lifters and their testosterone-using Russian counterparts certainly made for a feel-good story of die-hard nationalism during the height of the Cold War. The misinformation became part of steroid mythology with each re-telling of the story in the bodybuilding press and even mainstream journalism.

The fact that John Ziegler did not really invent Dianabol does not diminish his significance in the history of steroid use in the United States. Ziegler helped facilitate the adoption of steroids in general, and Dianabol in particular, by American athletes.

Ziegler was the first person to introduce Dianabol to competitive athletes shortly after its commercial introduction by CIBA in 1958. He had access to the CIBA laboratory in Summit (New Jersey) during the 1950s and was already supplying weightlifters with testosterone propionate for “research purposes”. However, there was no active steroid research at the CIBA facility in New Jersey; all steroid hormone synthesis was reserved for the corporate headquarters in Switzerland.

When Dianabol became available, CIBA (New Jersey) reportedly asked Ziegler to administer the newly developed Dianabol to Olympic weightlifters training at York Barbell in late 1959. He subsequently systematically prescribed 10 milligrams of Dianabol per day to weightlifters John Grimek, Bill March, Tony Garcy and Louis Riecke. They were the very first athletes to use Dianabol.

Although the steroids testosterone propionate, methyltestosterone and Nilevar were already being used by some West Coast bodybuilders, it wasn’t until CIBA introduced Dianabol in 1958, and Ziegler started prescribing it, that steroid use quickly went mainstream in bodybuilding and weightlifting before gradually spreading to all competitive sports.

Dianabol emerged as the steroid of choice among American bodybuilders and athletes. It currently remains one of the most popular steroids used by contemporary bodybuilders. For the millions of athletes that have used Dianabol, John Ziegler will continue to hold a special place in their hearts.

Dr. John Ziegler was not the inventor of Dianabol

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Originally published at: The Creation of Dianabol and the Myth of Dr. John Ziegler

While working out recently in a local Gold’s Gym in Latham, New York, a man named Chad Brothers, 32, described as a “gentle giant” by his family, reportedly went berserk, toppling weight machines, throwing dumbbells, and assaulting a patron. After being Tasered numerous times by law enforcement officers and even allegedly taking a Taser from an officer and using it on himself, he suffered a heart attack an hour later and died. Brothers was a large man at 6’1″ and 235 to 240 pounds, he was working out in a gym, and toxicology reports apparently found anabolic steroids in his blood.

The local District Attorney’s office announced that Brothers’ spontaneous and unprovoked rampage was a case of excited or agitated delirium (AD). AD is usually characterized by extremely high body temperature, loss of contact with reality, out of control aggressive and agitated behavior, superhuman strength and an unwillingness to back down from confrontation in the face of overwhelming numbers (e.g., Grant, Southall, Mealey, Scott, & Fowler, 2009; Vilke, Payne-James, & Karch 2012). Not surprisingly, those suffering from the syndrome are often ultimately subdued via physical or electrical measures at the hands of law enforcement agents (Grant et al., 2009). The cause of death among those who exhibit AD is usually cardiac-related and it has been plausibly suggested that the syndrome emerges from extreme catecholamine (e.g., adrenergic) activity (e.g., Otahbachi, Cevik, Bagdure, & Nugent, 2010). Consistent with this “over-arousal” of the sympathetic nervous system, AD is often related to the abuse of stimulants. In fact, a finding of sympathomimetics (drugs that stimulate the sympathetic nervous system) in the blood has traditionally been one criterion used for diagnosing AD after fatal rampages like Brothers’ (Vilke et al., 2012). Drugs that have been linked to occurrence of this syndrome include cocaine (most often), methamphetamine, lysergic acid diethylamide, and phencyclidine (PCP) (e.g., Sztajnkrycer & Baez, 2005; Takeuchia, Ahern, & Henderson, 2011). In fact, PCP’s undesirable effects of “…agitation, violent behavior, paranoid delusions, disorientation, delirium, and hallucinations… (p. 658; deRoux, Sgarlato, & Marker, 2011)” led to its abandonment as an anesthetic.

The Albany Times-Union covered the Chad Brothers rampage with the headline: “Officials: Man had steroids in system” (http://www.timesunion.com/local/article/Officials-Man-had-steroids-in-system-2390621.php). The DA’s spokeswoman was quoted that AD is “a condition that can result from steroid use.”

Is this an open and shut case of steroid-induced aggression – the infamous “’roid rage”? Did steroids cause Brothers’ AD? Although some experts have suggested that if “’roid rage” exists at all, it occurs rarely and only in a small fraction of predisposed steroid users (p. 60; Yesalis & Cowart), we will probably never know for sure what role, if any, the man’s apparent use of steroids may have played in this tragic incident. Human behavior is generally too complex to pin-point a single cause, although simple explanations are much more attractive. As we have seen before in such cases (e.g., Chris Benoit, David Jacobs), selectively blaming steroids for a tragedy, rather than presenting a fuller account of other possible causative factors, is a convenient way to sensationalize the news.

There’s no direct causal evidence or documentation linking steroids to AD. But that doesn’t stop the media from quickly accepting knee-jerk conclusions. The Times-Union relied on the District Attorney (DA) as a source, apparently doing no independent fact-checking. It should be noted that this DA is the same controversial Albany politician who catapulted himself into national headlines by his anti-steroid investigations of doctors and pharmacies located in Florida. Up for reelection next year, he currently faces a Democratic primary challenger who has criticized his grandstanding anti-steroid crusade against businesses located far beyond his state’s boundaries and with minimal ties to New York.

Had the paper conducted even minimal due diligence, it would have learned a critical fact: that PCP – more popularly known as Angel Dust – was also found in Brothers’ blood. It would also have learned that a man with Brothers’ Body Mass Index (31) would be at increased risk for fatal AD (Park, Korn, & Henderson, 2001). If the Times-Union had learned these things, the public could have learned them as well. Although at this point we do not know how much PCP was in Brothers’ blood (nor do we know what steroid concentrations or types were found), the simple fact is that science links PCP to AD (e.g., Takeuchi et al., 2011). Additionally, a similar fatal case of AD occurred in Michigan only one month previously. Bradford Gibson, 35, also died after being Tased by police; autopsy reports showed he had PCP in his system (http://blogs.phoenixnewtimes.com/valleyfever/2011/12/taser_off_the_hook_for_two_dea.php). The relationship between the use of such “Electronic Control Devices” and AD remains a subject of investigation (e.g., Jauchem, 2011).

One would like to think there was no intent or collusion by the Times-Union and the DA to cherry-pick which facts to report, even though Times-Union reporters have had a virtual partnership with the DA’s press office in disseminating information about the anti-steroid investigations to the public. One would also like to think that the core of such investigations, whether by DAs or reporters, is the desire to know the truth, to understand what actually happened and why. But it’s hard to not be skeptical when the goal appears to be manipulation rather than knowledge. Once again, the media falls short on its obligations to report the important facts or help the public understand, choosing instead to blindly rely on sources that appear far from objective. The media’s role seems to have morphed from presenting and evaluating information to merely passing along what others say as fact. The public was misled into thinking that the only possible cause of the rampage was steroids. And if not for other news sources, the public would have never been the wiser.

In the midst of such abrogation of duty, is it any wonder that today’s public runs from one panic to another? This unfortunate situation emerges when “…a condition, episode, person or group of persons emerges to become defined as a threat to societal values and interest; its nature is presented in a stylized and stereotypical fashion by the mass media; the moral barricades are manned by editors, bishops, politicians, and other right-thinking people (p. 9; Cohen, 1972)”. With steroid headlines like this one, and steroid reporting in general, do mainstream media sources serve as bulwark against such panic … or its facilitator?

Photo credit: YNN [http://www.ynn.com/]

References

Cohen, S. (1972). Folk devils and moral panics: The creation of the mods and rockers. London: MacGibbon & Kee Ltd.

deRoux, S.J., Sgarlato, A, & Marker, E. (2011). Phencyclidine: A 5-Year retrospective review from the New York City Medical Examiner’s Office. Journal of Forensic Sciences, 56, 656-659.

Grant, J.R., Southall, P.E., Mealey, J., Scott, S.R., & Fowler, D.R. (2009). Excited delirium deaths in custody: Past and present. The American Journal of Forensic Medicine and Pathology, 30, 1-5.

Jauchem, J.R. (2011). Pathophysiologic changes due to TASER devices versus excited delirium: Potential relevance to deaths-in-custody? Journal of Forensic and Leal Medicine, 18, 145-153.

Otahbachi, M., Cevik, C., Bagdure, S., & Nugent, K. (2010). Excited delirium, restraints, and unexpected death: A review of the pathogenesis. American Journal of Forensic Medicine and Pathology, 31, 107-112.

Park, K.S., Korn, C.S., & Henderson, S.O. (2001). Agitated delirium and sudden death: Two case reports. Prehospital Emergency Care, 5, 214-216.

Sztajnkrycer, M.D., & Baez, A.A. (2005). Cocaine, excited delirium and sudden unexpected death. Emergency Medical Services, 34, 77-81.

Takeuchi, A., Ahern, T.L., & Henderson, S.O. (2011). Excited delirium. Western Journal of Emergency Medicine, 12, 77-83.

Vilke, G.M., Payne-James, J., & Karch, S.B. (2012). Excited delirium syndrome (EDS): Redefining an old diagnosis. Journal of Forensic and Legal Medicine, 19, 7-11.

Yesalis, C.E., & Cowart, V.S. (1998). The Steroids Game. Champaign: Human Kinetics.

© Darkes and Collins, 2011

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Originally published at: “Of Course, It’s the Steroids!” (Here We Go Again…)

Q: Nelson, I am a HIV long term survivor, undetectable, all numbers great. Testosterone used to be high normal, is now right in the middle. Sex drive and sensation continues to go down hill..am in my mid 40′s(male) but it really seems to early for that to happen. Am in very good shape, very good health, but every year it gets less and less. Doc does think adding testosterone would increase my sex drive, but says it would in anyone… But its not time for me to do that she says.. Still being relatively young, and in great health, what are other options to increase my natural testosterone? I have heard of Tribulus terrestris a supplement may help..any other ideas? I am not on any new meds or anything i that i was not on years ago so its not that…

Response from Mr. Vergel: I wish having a sex drive was as simple as increasing testosterone blood levels.

Yes, testosterone replacement increases desire for sex and thoughts of sex in men who have low testosterone. But many factor can interfere with a healthy desire for sex:

1. Stress
2. Too busy of a schedule
3. Lack of attraction to the person you usually have sex with
4. Performance anxiety
5. Medications (blood pressure and antidepressant medications and others)
6. Fatigue
7. Sleep apnea
8. Diabetes
9. Having low free testosterone even in the presence of normal total testosterone blood levels
10. aving high estradiol blood levels (testosterone can convert into estradiol, a female hormone, in men)
11. Having thyroid dysfunction
12. Loss of sense of exploration to bring new experiences into our sex lives to prevent boredom

Some people take supplements hoping that they increase testosterone and/or sex drive.

Testosterone prohormones such as androstenedione, androstenediol, and dehydroepiandrosterone (DHEA) have been heavily marketed as testosterone-enhancing and muscle-building nutritional supplements for the past decade. Concerns over the safety of prohormone supplement use prompted the United States Food and Drug Administration to call for a ban on androstenedione sales, and Congress passed the Anabolic Steroid Control Act of 2004, which classifies androstenedione and 17 other steroids as controlled substances. As of January 2005, these substances cannot be sold without prescription. Contrary to marketing claims, research to date indicates that the use of prohormone nutritional supplements (DHEA, androstenedione, androstenediol, and other steroid hormone supplements) does not produce either anabolic or ergogenic effects in men.

Tribulus terrestris L. (Zygophyllaceae) have been used as an aphrodisiac both in the Indian and Chinese traditional systems of medicine. Administration of Tribulus terrestris extract (TT) increased sexual behavior and intracavernous pressure both in normal and castrated rats and these effects were probably due to the androgen increasing property of TT

In a study done in Bulgaria, twenty-one healthy young 2036 years old men were randomly separated into three groupstwo experimental (each n = 7) and a control (placebo) one (n = 7). The experimental groups were named TT1 and TT2 and the subjects were assigned to consume 20 and 10 mg/kg body weight per day of Tribulus terrestris extract, respectively, separated into three daily intakes for 4 weeks. No changes in testosterone, androstenedione and luteinizing hormone blood levels were observed with either dose.

Nelson Vergel Author Testosterone: A Man’s Guide

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Human chorionic gonadotropin (HCG) (not to be confused with human growth hormone, or HGH) is a glycoprotein hormone that mimics LH (luteinizing hormone), produced in pregnancy by the developing embryo soon after conception, and later by part of the placenta. Its role is to prevent the disintegration of the corpus luteum of the ovary and to maintain the progesterone production critical for pregnancy in women. It supports the normal development of an egg in a woman’s ovary, and stimulates the release of the egg during ovulation. HCG is used to cause ovulation and to treat infertility in women.

You’re probably asking yourself why you should care about this. But in men, HCG is also used in young boys when their testicles have not dropped down into the scrotum normally.  Additionally, HCG is used to increase testicular size after long-term testosterone or anabolic steroid use.

As mentioned at the beginning of the book, testosterone replacement therapy triggers the hypothalamus to shut down its production of GnRH (gonadotropin releasing hormone). Without GnRH, the pituitary gland stops releasing LH. Without LH the testes (testicles or gonads) shut down their production of testosterone. For males HCG closely resembles LH. If the testicles have shrunken after long-term testosterone use, they will likely begin to enlarge and start their testosterone production shortly after HCG therapy is instituted. HCG jump-starts your testes to produce testosterone and to increase their size.

HCG can be extracted from pregnant women’s urine or through genetic modification. The product is available by prescription under the brand names Pregnyl, Follutein, Profasi, and Novarel. Novire is another brand but it is a product of recombinant DNA. Compounding pharmacies can also make HCG by prescription in different vial sizes. Brand names of HCG in regular pharmacies cost over $100 per 10,000 IUs.  The same amount of IUs cost around $50 in compounding pharmacies. Many insurance policies do not pay for HCG since they consider its use for testicular atrophy while on TRT an off label use. So, most men using it pay for it themselves and get it from compounding pharmacies that sell it a lot cheaper.

HCG is dispensed as a powder contained in vials of 3,500 IUs, 5, 000 IUs or 10, 000 IUs. You can call compounding pharmacies and have them make vials for you with different IU amounts, though. These are usually accompanied by another vial of 1 mL (or cc) of bacteriostatic water to reconstitute the powder into a liquid solution. Bacteriostatic water (water with a preservative that is provided with the prescription) is mixed in with the powder to reconstitute, or dissolve, it before injection. This type of water can preserve the solution for up to 6 weeks when refrigerated. Some patients do not use the 1 mL water vials that come with the commercially (non compounded) available product and instead get their doctors to prescribe 30 cc bottles of bacteriostatic water so that they can dilute the HCG down to a more workable concentration that is more practical for men using lower doses of HCG weekly.

HCG is given as an injection under the skin or intramuscularly (there is still debate on which method is best). The number of IUs per injection will depend on how much bacteriostatic water you add to the dry powder vial. If you add 1 mL to a 5,000 IU powder vial, then you will have 5,000 IUs per mL, so 0.1 mL would be 500 IUs. If you add 2 mL to the 5,000 IU dry powder vial, then you will have 2,500 IUs/mL; 0.1 ml (or cc) in an insulin syringe will equal 250 IUs. If you need to inject 500 IUs, then you inject 0.2 ccs of this mixture. Table 3 provides dilution volumes at different HCG powder/water proportions.

Ultra-fine needle insulin syringes are used to inject HCG under the skin, making this very easy to take even for the needle-phobic. Typical sizes are:

• 1 ml, 12.7 mm long, 30 gauge and
• 0.5 ml, 8 mm, 31 gauge syringes.

Syringes require a separate prescription. Some compounding pharmacies will automatically include them with the shipment, but do not forget to ask them. Never use the syringe that you used for injecting the bacteriostatic water into the powder for injecting yourself; the needle will be dull (I usually use a regular 23 gauge, 1 inch, 3 ml syringe to load up the water). Remember that you also need alcohol pads to clean the injection area and the tip of the vial. Typical injection sites are the abdominal area close to the navel or in the pubic fat pad. Pinch a little of fat on your abdominals and inject into that pinched area, then massage with an alcohol pad. Discard syringes into the sharps container that can be provided by your pharmacy.

As I mentioned before, compounded HCG is a lot cheaper than the commercially available pharmaceutical products. Sometimes it is difficult to find commercially available HCG in regular pharmacies.

A review of the literature reveals a wide range of doses of HCG used and that there is very little agreement among physicians. For male infertility, doses range from 1250 IU three times weekly to 3000 IU twice weekly (these studies did not include men on testosterone replacement).

How long does the boost in testosterone last after an injection of HCG? A study looked into that and also tried to determine if high doses would be more effective at sustaining that boost. The profiles of plasma testosterone and HCG in normal adult men were studied after the administration of 6000 IU HCG under two different protocols. In the first protocol, seven subjects received a single intramuscular injection. Plasma testosterone increased sharply (1.6 ± 0.1-fold) within 4 hours. Then testosterone decreased slightly and remained at a plateau level for at least 24 hours. A delayed peak of testosterone (2.4 ± 0.3-fold) was seen between 72–96 hours. Thereafter, testosterone declined and reached the initial levels at 144 hours. In the second protocol, six subjects received two intravenous (IV) injections of HCG (5-8 times the dose given by injection to the first group) at 24-hour intervals. The initial increment of plasma testosterone after the first injection was similar to that seen in the first protocol despite the fact that plasma HCG levels were 5–8 times higher in this case. At 24 hours, testosterone levels were again lower than those observed at 2–4 hours and a second IV injection of HCG did not induce a significant increase. The delayed peak of plasma testosterone (2.2 ± 0.2-fold of control) was seen about 24 hour later than that in the first protocol. So, this study shows that more is not better when dosing HCG. In fact, high doses may desensitize Leydig cells in the testicles.  It also showed that testosterone blood levels peak not once but twice after HCG injections.  I wish they had studied a lower dose than 6000 IU since very few physicians prescribe this high dose.

HCG may not only boost testosterone but also increase the number of Leydig cells in the testicles. It is well known that Leydig cell clusters in adult testes enlarge considerably under treatment with HCG. However, it has been uncertain in the past whether this expansion involves an increase in the number of Leydig cells or merely an enlargement of the individual cells. A study was performed in which adult male Sprague-Dawley rats were injected subcutaneously daily with 100 IU HCG for up to 5 weeks. The volume of Leydig cell clusters increased by a factor of 4.7 during the 5 weeks of HCG treatment. The number of Leydig cells (initially averaging 18.6 x 106/cm3 testis) increased to 3 times the control value by 5 weeks of treatment (P<0.001), while the average volume of individual Leydig cells (initially  ~2200 µm3) enlarged only 1.6 times. They concluded that chronic treatment with HCG increases the number of Leydig cells in the testes of adult rats. We do not know if these results can be extrapolated to men.

Currently there are no HCG guidelines for men who need to be on testosterone replacement therapy and want to maintain normal testicular size. A study that used 200 mg per week of testosterone enanthate injections with HCG at doses of 125, 250, or 500 IU every other day in healthy younger men showed that the 250 IU dose every other day preserved normal testicular function (no testicular size measurements were taken, however). Whether this dose is effective in older men is yet to be proven. Also, there are no long-term studies using HCG for more than 2 years.

Due to its effect on testosterone, HCG use can also increase estradiol and DHT, although I have not seen data that shows if this increase is proportional to the dose used.

So, the best dose of HCG to sustain normal testicular function while keeping estradiol and DHT conversion to a minimum has not been established (I will explain why these two metabolites are important in TRT management).

Some doctors are recommending using 200–500 IUs twice a week for men who are concerned about testicular size or who want to preserve fertility while on testosterone replacement. Higher doses, such as 1,000–5,000 IUs twice a week, have been used but I believe that these higher doses could cause more estrogen and DHT-related side effects, and possibly desensitize the testicles for HCG in the long term. Some doctors check estradiol levels a month after this protocol is started to determine whether the use of the estrogen receptor modulators tamoxifen (brand name: Nolvadex) or anaztrozole (brand name: Arimidex), is needed to counteract any increases in estradiol levels. High estradiol can cause breast enlargement and water retention in men but it is important at the right blood levels to maintain bone and brain health (refer to the Gynecomastia section for more on this subject).

Human Chorionic Gonadotropin (HCG)

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Originally published at: What You Need to Know about Human Chorionic Gonadotropin (HCG)