Baseline characteristics of the HAARLEM study: 100 male amateur athletes using anabolic androgenic steroids

Abstract

Background The use of anabolic androgenic steroids (AAS) is common among visitors of fitness centers. Knowledge about health risks of AAS use is limited due to lack of clinical studies. Methods One hundred men, at least 18 years old, intending to start a cycle of AAS were recruited. Baseline demographical data and reasons for AAS use were recorded. Subjects provided samples of AAS for analysis with UPLC‐QTOF‐MS/MS. Results One hundred and eleven men were seen for a baseline visit. Nineteen percent had competed in bodybuilding competitions. Recent illicit drug use was reported by 56%. Seventy‐seven percent of participants had used AAS in the past, and 97% of them had experienced side effects. After exclusion, 100 men comprised the cohort for follow‐up. The AAS cycle performed had a median duration of 13 weeks (range 2‐52), and the average dose of AAS equivalents was 901 mg per week (range 250‐3.382). Subjects used other performance and image–enhancing drugs (PIEDs) such as growth hormone (21%). In total, 272 AAS samples were analyzed and 47% contained the AAS indicated on the label. The principal reason for AAS use was gain of muscle mass (44%). Forty‐eight percent self‐reported to being addicted to AAS. Conclusion The HAARLEM study cohort shows that strength athletes use AAS in a wide variety of cycles and often also use illicit drugs and other potentially harmful PIEDs. The quality of the AAS used is strikingly low. Follow‐up of the cohort will provide novel data regarding health risks of AAS use.

Anabolic androgenic steroid abuse in young males

“…A cycle of anabolic steroids is not expensive. In our HAARLEM cohort, the mean cost per week was €30, adding up to €400 per cycle (3). This means that cost is rarely a barrier to start using AAS.…”

“…Almost all users report positive effects when using AAS -more muscle mass, more strength, less fat mass, more energy and enhanced concentration. Although almost all users also report negative effects, these are mostly expected, mild and transient and do not outweigh the beneficial effects (3).…”

“…Only about one half of analyzed AAS samples contained the AAS type as indicated on the label and more often than not the samples contained AAS types not indicated on the label. In a minority of products, no active ingredient was found (3). We suspected that roughly 40% originated from Eastern Europe and Asia, whereas 60% appeared to be produced locally in illegal, so called underground laboratories.…”

“…Although anabolic steroids are by far the most abused drugs, a variety of other performance and image-enhancing drugs are commonly used (2,3). These can be categorized as muscle builders, fat burners, pre-workout agents and agents to prevent or treat side effects.…”

“…The population seen in our outpatient clinic is selected on the basis of health problems and may not be representative for all steroid users in the Netherlands. Therefore, we started an observational cohort study in 100 AAS abusers without health problems, the HAARLEM study (acronym for Health risks of Anabolic Androgenic steRoid use by maLE aMateur athletes), of which the design and baseline characteristics have been published recently (3). The results of 12 months follow-up are expected soon.…”