100 bodybuilders were surveyed

A survey done on 100 bodybuilders attending four gyms were asked using an anonymous self administered questionnaire.

Results-Anabolic steroid doses ranged from 250 to 3200 mg per week and users combined different drugs to achieve these doses. Injectable and oral preparations were used in cycles lasting four to 12 weeks. Eighty six per cent of users admitted to the regular use of drugs other than steroids for various reasons, including additional anabolic effects, the minimization of steroid related side effects, and
withdrawal symptoms.

Top steroids used
1. Nandrolone decanoate (Deca-Durabolin) Testosterone cypionate
2. Stanozolol (Winstrol) Testosterone propionate (Virormone)
3. Methandrostenolone (Dianabol) Testosterone blend (Sustanon 250)
4. Methenolone (Primobolan) Testosterone heptylate (Theramex)
5. Trenbolone (Parabolan) Testosterone enanthate (Testaviron)
6. Oxandrolone (Anavar) Testosterone undecanoate (Andriol)
7. Oxymetholone (Anapolon)
8. Drostanolone (Masteron)
9. Boldenone (Equipoise)

drugs other than anabolic steroids used by athletes

Clenbutarol 70 %
Ephedrine 57%
Human chorionic gonadotrophin 49%
Tamoxifen 45%
Growth hormone 12%
Diuretics 22%
Nalbuphine (Nubain) 6%
Insulin 2%
Thyroid hormone 2%
Aminoglutethimide (Orimeten) 3%
Esiclene 5%
None 14%

side effects associated with steroid use

Acne 54%
Gynaecomastia 34%
Striae 34%
Testicular atrophy 40%
None 12%

Age distribution of steroid users

16-19 10%
20-24 27%
25-29 36%
30-34 14%
35-39 10%
40+ 3%
Total 100%

Duration of steroid use

Year
< 1 21%
1-2 13%
2-3 26%
3-4 15%
4-5 10%
> 5 15%
Total 100%

The lowest recorded weekly dose was 250 mg and the highest was 3200 mg. The duration of steroid administration (steroid cycle) was reported as follows: 4-6 weeks (28%), 8-10 weeks (39%),12 weeks (33%). Forty eight per cent of the sample stated that their annual steroid use was less than six months, while the other 52% used steroids for more than six months each year. Three athletes admitted continuous steroid use for 52 weeks of the year.

The most popular agents were intramuscular nandrolone decanoate (84%), testosterone esters (75%), and oral methandrostenolone (68%). Eighty five per cent used both parenteral and oral preparations, 1 1% used solely injectable preparations, and 4% used tablets only. Most self administered intramuscular injections were sited in the gluteal region, but the thigh and deltoid were also used.

Scientific studies have attributed gains in muscle size and strength to anabolic steroids, provided they are used in conjunction with an appropriate training program and a high protein diet. Even in the absence of such clinical data, 50 years of steroid use by athletes would imply a positive benefit. The anabolic action of these drugs is mediated in two ways. An anticatabolic effect is achieved by minimising the catabolic action of corticosteroids released during stress (athletic activity). The second action is the maintenance of positive nitrogen balance by improving utilization of ingested protein. Anabolic steroids also have motivating effects, inducing a state of euphoria and diminished fatigue, thereby enhancing training capabilities.

Illicit drug use by the athletes in this study was not confined to anabolic steroids, and 86% admitted using other drugs for different reasons. Non-steroid agents with anabolic properties include clenbutarol, growth hormone, and insulin. Clenbutarol is a 3, receptor agonist used by 70% of this group for its ability to stimulate protein deposition in skeletal muscle (so called "repartitioning agent"), and also for its thermogenic properties, which increase energy expenditure, thereby reducing body fat.Growth hormone is taken by a smaller number of steroid users (12%), probably because of its high black market price. Insulin, for example 1-2 units with meals, was also being used by two competitors for a supposed anabolic effect. It appears that the athletes in this sample used steroids as their primary anabolic agent, with clenbutarol, growth hormone, or insulin being used as secondary anabolic drugs. Ephedrine is a 12 receptor agonist used medically as a bronchodilator and vasoconstrictor sympathomimetic during anaesthesia. Fifty seven per cent of the athletes in this sample used ephedrine as a stimulant to aid athletic performance, and also as a thermogenic fat reducing agent.

Anticatabolic agents are also used to provide anabolic-like effects. Aminoglutethimide (Orimeten), used by 3% of the sample, is a steroid antagonist which preferentially blocks corticosteroid pathways, shifting the testosterone to cortisol ratio in favour of anabolism. The parenteral analgesic nalbuphine (Nubain) was used by 6% to relieve musculoskeletal pain and for a proposed "stress reducing" anticatabolic action. Additional drugs are used before bodybuilding competitions to enhance skeletal muscle visibility. L-thyroxine (for example, 200 ,ug daily) may be used in the four to six weeks leading up to a contest to reduce the amount of subcutaneous body fat.