Science on Tap
Pushing the Boundaries of
“Best”: Sports Performance
Enhancement using Steroids,
B12, and Erythropoietin
April 1, 2008
Steven G. Gilbert, PhD, DABT
www.asmalldoseof.org
www.toxipedia.org
A Small Dose of Toxicology
Performance enhancement – 04/01/08
A Small Dose of Toxicology
See: www.asmalldoseof.org -- smdose
A Small Dose of Toxicology
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Small Dose of Toxicology
A Small Dose of Toxicology
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Milestones of Toxicology
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www.toxipedia.org
A free toxicology encyclopedia and
resource center that anyone can edit.
Toxipedia provides comprehensive,
accurate, and scientifically based
information on the hazards and risks of
chemical and physical agents, with the goal
of advancing human and environmental
health. Toxipedia
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Healthy World Theater
Coupling art and science
to forge a more healthy
and peaceful world
Healthy World Theater reaches to the heart
to promote awareness and understanding
through the arts to create a more healthy
and peaceful world so that all creatures may
reach, maintain, and enjoy their potential.
www.healthyworldtheater.org
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LDDI Consensus Statement
Scientific Consensus Statement on
Environmental Agents Associated with
Neurodevelopmental Disorders
Developed by the Collaborative on
Health and the Environment’s
Learning and Developmental Disabilities
Initiative
November 7, 2007
http://www.iceh.org/LDDI.html
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LDDI Consensus Statement
Given established scientific knowledge,
protecting children from neurotoxic
exposures from the earliest stages of fetal
development is clearly an essential public
health measure. By reducing environmental
factors that may lead to learning and
developmental disorders, we will create a
healthier environment in which all children
can reach and maintain their full potential.
http://www.iceh.org/LDDI.html
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Human & Environmental Health
“Conditions that ensure that all
living things have the best
opportunity to reach and maintain
their full genetic potential.”
Steven G. Gilbert, 1999
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What Is Performance Enhancement?
Athletics
Muscles
Strength
Endurance
Stimulant
Memory / Learning
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Baseball = Steroids?
Mitchell Report on Major
League Baseball players
– did Roger Clemens use
performance enhancing
substances?
Dose it matter?
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The First Bioethicist
Aldo Leopold
"A thing is right when it tends to
preserve the integrity, stability, and
beauty of the biotic community. It is
wrong when it tends otherwise." Aldo Leopold, 1949, A Sand County
Almanac
---------- 1887 - 1948 ---------A Small Dose of Toxicology
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Ethical Issues?
 Even if anabolic steroid use was legal, is it
ethical to artificially gain a performance
advantage over others?
 Should there be limits on what people can
do to their own bodies and minds?
 What about using legal supplements to
achieve a similar advantage?
 Should high school athletes be subject to
random-drug testing?
A Small Dose of Toxicology
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Ethical Issues?
 Fairness?
 Protecting people?
 Discouraging drug use?
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Doping / Athletic Performance
Doping - “the use of a drug
or blood product to improve
athletic performance.”
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Is This Doping?
 Taking Tylenol to relieve muscle
aches and pain
 Using an asthma inhaler to prevent
the constriction of the airway and to
allow proper respiration
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Ancient Awareness
Ancient Greek Athletes - “The Greek
physician, Galen, is reputed to have
prescribed ‘the rear hooves of an
Abyssinian ass, ground up, boiled in oil,
and flavored with rose hips and rose
petals’ to improve performance.”
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Ancient Awareness
Ancient Olympic athletes
Ate sheep testicles to boost
testosterone
(the base anabolic steroid)
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Ancient Drugs
Strychnine, a stimulant
used until the 20th century
Hashish
Cola plants
Cactus-based stimulants
Fungi (Mushrooms)
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End of Ancient Sports
 The Christian era marked the end
of the overwhelming popularity of
public sporting events.
 In 393 A.D., Emperor Theodosius
promulgated a ban on all forms of
“pagan” sports, including the
Olympic Games.
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Modern Sports
 19th century, sporting events
returned with the onset of the
Industrial Revolution
 Recreation and entertainment
 And Business
 And Doping
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Endurance Sports - Cycling
 European cyclists
 Used caffeine, ether-coated
sugar cubes, cocaine-laced wine
 1886 a Dutch cyclist died from an
overdose of cocaine and heroin
 1896 a Welsh cyclist died after
taking strychnine
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Olympics
 1896 - Summer Olympics were
held and doping was prevalent
 1904 – 3rd Olympic Games in
St. Louis - Thomas Hicks took
brandy laced with strychnine –
almost died, but kept the gold
metal
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Olympics - 1936
 1930s, Nazi doctors created anabolic
steroids – testosterone that could be
administered through a syringe – goal
of increasing aggression in troops
 Germany 89 medals - won the overall
medal count
 United States came in second with 56
medals
 Massive doping
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Post WWII - Olympics
 Cold war – new weapons
 Nuclear Arms Race
 Competition at Olympic sports
 Anabolic Steroid Race
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Banning Doping
 1928 – first bans but no tests
 1950s - the International Cycling
Union (UCI) introduced drug
testing programs
 1960 - Olympic Games, Danish
cyclist, Knut Jensen, died from
amphetamines
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Increased Awareness
 1967 - Tom Simpson, a British
cyclist, died in the Tour de France.
He collapse during a climb and
three tubes of amphetamines
were found in the back pocket of
his racing jersey.
 Event widely publicized (see
youtube videos)
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Wide Spread Use
 Cycling
 Football
 Baseball
 Basketball
 Hokey
 Running
 Olympic sports
 Wrestling
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Toxicology Definition
Toxicology - the study of poisons or
the adverse effects of chemical and
physical agents on living
organisms.
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Key Words
Dose / Response
Risk =
Hazard X Exposure
Individual Sensitivity
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What Is This Drug?
O
CH3
N
O
CH3
N
7
1
3
N
N
CH3
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Wired – X344
Warning:
If you can’ t handle massive Caffeine,
then stay away from this one! We jacked
up the caffeine to 344 mg per 16 oz. Can!
Ever wonder why some so called energy
drinks don’t list their caffeine content?
How about their Taurine? Guarana? B
Vitamins? What’s up with the “energy
blends”? Here’s what’s in your X-344
Extreme Energy Supplement.
Ingredients per 16 oz. can include:
344 mg
Caffeine
250 mg
Guarana Seed Extract
3000 mg Taurine
100 mg
Inositol
60 mg
White Tea Extract
500%
RDI Vitamin B12
200%
RDI Vitamin B6
160%
RDI Vitamin B3
100%
RDI Vitamin B5
http://www.wiredenergydrink.com/x344.htm
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Wired – XXX
Extreme Energy Supplement
Arouse your senses with this stimulating
herbal combination. Wired Triple X is
specially formulated with the benefits of
Horny Goat Weed, L-Arginine, Maca, and
Tribulus terrestris to help enhance your
sexual prowess. Get Wired, Stay Wired!
Ingredients per 16 oz. can include:
3000% RDI Vitamin B12
500% RDI Vitamin B6
200% RDI Vitamin B3
100% RDI Vitamin B5
1000 mg Taurine
1000 mg L-Arginine
150 mg Caffeine
100 mg Inositol
100 mgEpimedium (Horny Goat Weed)
10 mg Maca
4 mg Tribulus terrestris
http://www.wiredenergydrink.com/xxx.htm
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My Neighborhood
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My Neighborhood
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My Neighborhood
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Blood Doping
 Blood doping originally meant literally
doping with blood, i.e. the transfusion of
RBCs.
 Extract blood, harvest RBCs re-inject
 Increases oxygen to muscles
 Used by endurance athletics, cycling,
marathon runners
 Hazard – blood clotting, stoke, death
 See also EPO
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What is This?
Erythropoietin
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Erythropoietin (EPO)
 Stimulates the production of red
cells in bone marrow and a
treatment for anemia in humans.
(kidney disease, cancer,
(chemotherapy & radiation)
 Amgen made a fortune
 Endurance sports (cycling) –
Increases number of RBC
 Clotting - death
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What is This?
Testosterone
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Testosterone
 Used for 1000s of years
 1930’s modern chemistry
 Natural Anabolic Steroids
 Synthesis and now 100s
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Testosterone’s Desired Effects
 increase protein synthesis within
cells, which results in the buildup of
cellular tissue (anabolism), especially
in muscles
 muscle mass and physical strength
 stimulates bone growth and appetite,
 induce male puberty
 treat chronic wasting conditions such
as cancer and AIDS
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Testosterone’s Hazards







growth of the vocal cords
body hair
harmful changes in cholesterol levels
acne
high blood pressure
liver damage
changes in the structure of the left
ventricle of the heart
 testicular atrophy
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What is This?
Strychnine
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Strychnine
Stimulant at low dose
Widely used as medicine
Pesticide at higher doses
Muscle convulsions
Effects glycine receptor
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What is This?
Vitamin B12
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Vitamin B12
 Vitamin B-12, factor in normal
functioning of the brain and
nervous system and for the
formation of blood
 Stress relief
 Purported to increase energy and
is largely anecdotal
 Can have deficient – little tox
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What is This?
Growth hormone
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Growth hormone
 191-amino acid, single chain
polypeptide hormone
 somatotrophin the recombinant DNA "rhGH“
 Body builders inject growth hormone
to decrease body fat and increase
muscle mass.
 Fat burning is increased and glucose
burning is decreased.
 Result is muscle bulk and strength.
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Growth Hormone Hazards
 high levels of blood fats
 glucose intolerance
 gigantism in pre-adolescents
 diabetes
 enlarged heart
 high blood pressure
 heart disease
 nerve disease
 lung disease
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What is This?
Gamma-hydroxybutyrate (GHB)
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Gamma-hydroxybutyrate (GHB)
 More of a social drug – related to
growth hormones
 Naturally occurring
 Intoxicant or as a date rape drug
 Athletes and bodybuilders use GHB,
to elevate human growth hormone
 Hazards - unconsciousness,
convulsions, vomiting, suppression
of the gag reflex, respiratory
depression and death
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What is This?
Insulin
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Insulin
 Hormone which causes liver and
muscle cells to take in glucose and
store it in the form of glycogen
 way of 'energizing' the body increase muscle mass
 widespread amongst the body
building community
 hypoglycemic coma and death
 type 2 diabetes
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What is This?
Viagra
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Viagra
 Performance issue?
 Pfizer - Billion $$ plus drug
 Treat male erectile dysfunction
(impotence)
 Pulmonary arterial hypertension
(PAH)
 causes release of nitric oxide (NO)
 Hazards - hypotension, myocardial
infarction, ventricular arrhythmias,
stroke,
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Memory Enhancement
 Hydergine
 Vincamine, Nimodipine and
Vinpocetine (from periwinkle)
 Ginko biloba
 L-Deprenyl
 Rasagiline
 ……….
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Ethical Issues?
 Even if anabolic steroid use was legal, is it
ethical to artificially gain a performance
advantage over others?
 Should there be limits on what people can
do to their own bodies and minds?
 What about using legal supplements to
achieve a similar advantage?
 Should high school athletes be subject to
random-drug testing?
A Small Dose of Toxicology
Performance enhancement – 04/01/08
Ethical Issues?
 Should society respect a person’s choices about
his or her own body, even if the behavior is risky?
 Are enhancements harmful or beneficial to
individuals who use them?
 Are enhancements harmful or beneficial to society
when individuals use them?
 Is it fair for an individual to use an enhancement?
 Does fairness require that everyone in society
have equal access to enhancements?
 Does using enhancements in performance violate
the integrity of the performance?
 Is the achievement of an individual who uses an
enhancement less authentic?
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Principles of Toxicology
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Additional Information
•
Taking performance-enhancing drugs: Are you risking
your health?
http://www.mayoclinic.com/health/performanceenhancing-drugs/HQ01105
•
National Institute on Drug Abuse: NIDA, NIH, DHHS
Steroid-related resources geared towards the general
public
US Anti-Doping Agency: dedicated to eliminating the
practice of doping in sport, and to preserving the well
being of sport and ensuring the health of athletes
through research initiatives and educational programs
What's wrong with enhancement? The President's
Council on Bioethics
•
•
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Authorship Information
This presentation is supplement to
“A Small Dose of Toxicology”
For Additional Information Contact
Steven G. Gilbert, PhD, DABT
E-mail: smdose@asmalldoseof.org
Web: www.asmalldoseof.org
www.toxipedia.org
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NW Public Health
Public Health and
the Precautionary
Principle
By Steven G. Gilbert
See: http://healthlinks.washington.edu/nwcphp/nph/
nwph
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Precautionary Principle
“When an activity raises threats of harm to
human health or the environment,
precautionary measures should be take even if
some cause and effect relationships are not
fully established scientifically.”
Wingspread Conference, 1998.
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Central components
• Setting goals (Health indicators)
• Taking preventive action in the face of
uncertainty
• Shifting the burden of responsibility to the
proponents of an activity (Who benefits?)
• Exploring a wide range of alternatives to
possibly harmful actions (Is it necessary?)
• Increasing public participation in decision
making (transparency of information &
environmental justice)
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