Designer steroids – over‐the‐counter supplements and their androgenic component: review of an increasing problem

Abstract

SUMMARYColloquially referred to by various misleading monikers ('pro-hormones', 'natural steroids', 'testosterone boosters', etc.) designer anabolic steroids have been popular now for over a decade as a way to achieve classic anabolic steroid-like results from products sold in the legal marketplace. Recent evidence suggests that anabolic steroid use may be the most common cause of hypogonadism in men of reproductive age. Despite recent regulatory efforts that have banned specific compounds, many anabolic-androgenic steroids (AAS) remain available in over-the-counter dietary supplements that are legally sold in the United States. Severe side effects including hepatotoxicity, cholestasis, renal failure, hypogonadism, gynecomastia, and infertility have been reported secondary to the use of these products. While some of these side effects may be reversible, more aggressive use may result in more permanent end-organ damage as has been previously described for the case of aggressive AAS users (Rahnema et al., Fertil Steril, 2014). Designer AAS remain easily available for purchase in over-the-counter bodybuilding supplements and these products appear to be increasingly popular, despite the known health risks associated with their use. We conducted a systematic search to identify the designer steroids that are most commonly sold in dietary supplements as of April 2014 and review what is known regarding their potency and toxicity. We propose that the impact of AAS use on the reproductive and hormonal health of men is underestimated in the literature owing to previous studies' failure to account for designer steroid use. Lastly, we make clinical recommendations to help physicians steer patients away from potentially harmful supplements, and summarize key regulatory obstacles that have allowed potent androgens to remain unregulated in the legal marketplace.

Protective effect of silymarin on the testes of rats treated with anabolic androgenic steroid: A biochemical, histological, histochemical and immunohistochemichal study

“…However, these compounds could be abused by athletes to increase their muscle mass by increasing protein synthesis [4]. On the other hand, AAS abuse can lead to some harmful side effects such as liver failure and decrease high density lipoprotein levels, acne vulgaris, gynaecomastia, cholestasis, and renal failure [5,6]. AAS also might cause side effects in the reproductive systems, both in human and experimental animals, disturbing the regular endogenous doi: 10.7243/2055-091X-4-10 production of testosterone and gonadotrophins [7].…”

Adverse effects of sports supplements in men

“…5,6,13 When these synthetic drugs have been developed to evade regulatory control, they are referred to as 'designer steroids'. 6 In many cases these synthetic steroids have never been evaluated by regulatory bodies for purity, clinical efficacy or toxicity, so there are additional risks. 6 Designer steroids are often heavily marketed as prohormones, natural steroids and testosterone boosters on websites that promote supplement use for muscle bulk and strength.…”

“…6 Designer steroids are often heavily marketed as prohormones, natural steroids and testosterone boosters on websites that promote supplement use for muscle bulk and strength. 6 The use of sports supplements containing steroids is a growing public health concern with evidence of increasing use among young gym attendees and men over 40 years old.…”

“…[2][3][4] They may contain steroids that are not listed on the product label. 5,6 Australian research has found anabolic drugs or stimulants in 13 out of 67 supplements. 2 It was recognised over a decade ago that some 20% of nutritional supplements sold in Europe and the USA contained anabolic steroids.…”

MECHANISMS IN ENDOCRINOLOGY: Medical consequences of doping with anabolic androgenic steroids: effects on reproductive functions

“…When counted in November 2011, there were 328 000 internet pages accessible under the search term 'steroids for sale' (9)! Furthermore, AASs may be added to food supplements -often undeclared on the label (10,11,12) or found in phytopharmaka and animal organ extracts. For example, musk pods used in Chinese traditional medicine contain 16 different, undeclared AASs, as discovered in doping controls (13).…”