Supra‐physiological doses of anabolic androgenic steroids impact erythropoietin and blood parameters

Abstract

Hematological parameters and erythropoiesis are known to be influenced by anabolic androgenic steroid (AAS) use. However, little is known in relation to supra‐physiological doses of AAS. Therefore, the aim of this study was to evaluate the effect of supra‐physiological doses of AAS on serum and urinary erythropoietin (EPO), and blood parameters, from self‐reported AAS users. Serum EPO levels were higher in testosterone positive AAS users (11.83 mIU/mL ± 4.19) than nonpositive (6.60 mIU/mL ± 2.70, p = 0.03), while no differences in urinary EPO levels were noted. There were positive correlations between serum EPO and testosterone levels (rs = 0.46, p = 0.01) and reticulocyte percentage (rs = 0.43, p = 0.02). Individuals with AAS‐induced hypogonadism (ASIH; luteinizing hormone levels <1.4 IU/L) had approximately 75% higher serum EPO (p < 0.05) and 140% higher high fluorescence reticulocyte fractions (p < 0.001), as well as other affected hematological parameters, compared with non‐ASIH individuals. The results extend the knowledge of how endocrine and hematological biomarkers are affected by AAS doping.

Annual banned‐substance review 16th edition—Analytical approaches in human sports drug testing 2022/2023

“…Here, Derwand et al provided first insights using a rat model, where up to 50 mg of testosterone per kg bodyweight was administered daily for up to 3 weeks, suggesting a ceiling of the dose–response of various organs at daily testosterone dosages of 10 mg/kg 53 . Also blood parameters such as serum erythropoietin (EPO) concentrations and percentage of reticulocytes were corroborated to be affected under supraphysiological AAS use, 54 and health risks observed in humans appear to outreach physical effects, with personality disorders and clinical psychiatric syndromes in males and females having recently been attributed to AAS misuse, too 120–123 …”

“…Here, Derwand et al provided first insights using a rat model, where up to 50 mg of testosterone per kg bodyweight was administered daily for up to 3 weeks, suggesting a ceiling of the dose-response of various organs at daily testosterone dosages of 10 mg/kg. 53 Also blood parameters such as serum erythropoietin (EPO) concentrations and percentage of reticulocytes were corroborated to be affected under supraphysiological AAS use, 54 and health risks observed in humans appear to outreach physical effects, with personality disorders and clinical psychiatric syndromes in males and females having recently been attributed to AAS misuse, too. [120][121][122][123] In the light of the 2021 anti-doping testing figures, where anabolic agents (and in particular AAS) represented 40% of reported AAFs, the extensive efforts that resulted in various publications within the past 12 months (aiming at faster and orthogonal strategies as well as more comprehensive and extended analytical retrospectivity for AAS in sports drug testing) appear warranted.…”

A review of the analytical techniques for the detection of anabolic–androgenic steroids within biological matrices

“…Testosterone concentrations (3.2 and 2.3 μg/L) detected in serum using LC–MS, were found to indicate doping in two females, which had not surpassed the typical urine testosterone ( T ) to epitestosterone ( E ) ratio ( T / E ratio) threshold required for further investigation due to potential urine sample tampering and a genetic deletion (Handelsman & Bermon, 2019) (discussed further in Section 7). However, serum concentrations of drostanolone and metenolone were lower than their metabolite concentrations in the corresponding urine (Makvandi et al, 2023). Furthermore, the analysis of blood matrices (plasma and/or serum) can detect intact AAS esters, strongly indicating exogenous AAS administration (de la Torre et al, 2021; Tretzel et al, 2014) (discussed further in Section 8).…”

“…The length of the ester chain significantly impacts the rate of elimination with blood samples providing a similar pattern to DBSs, testosterone propionate (<5 days), phenylpropionate and isocaproate (<11 days), decanoate (<18 days) and undecanoate (>60 days) when analyzed via LC–MS/MS (Forsdahl et al, 2015). An LC–MS/MS method developed for the detection of testosterone esters as well as 8 AASs was highly applicable to both urine and serum for the detection of exogenous AASs (Makvandi et al, 2023). Sixteen estered AASs observed no significant matrix effects and recovery efficiencies of ≥33% from serum when analyzed via UHPLC–MS/MS, with longer chained esters demonstrating reduced recoverability when extracted via ISOLUTE® SLE+ with DCM.…”

“…Thirteen AASs were stable for at least 6 months at −20°C in serum and a methanolic stock solution was stable for at least 2.5 months at −20°C. Processed solutions were stable for 24 hours at 8°C in the autosampler (Makvandi et al, 2023). Testosterone esters were found to be highly stable (>18 months) in DBSs when stored in a freezer (−20°C) (Solheim et al, 2022).…”