Context: Many clinicians, trainers, and athletes do not have a true understanding of the effects of commonly used performance-enhancing drugs (PEDs) on performance and health.
Objective: To provide an evidence-based review of 7 commonly used pharmacological interventions for performance enhancement in athletes.
Data Sources: PubMed and Scopus databases were searched on April 8, 2022.
Study Selection: Systematic reviews (SRs) and meta-analyses (MAs) assessing the performance-enhancing effects of the following interventions were included: androgenic anabolic steroids (AAS), growth hormone (GH), selective androgen receptor modulators (SARMs), creatine, angiotensin-converting enzyme (ACE)-inhibitors, recombinant human erythropoietin (rHuEPO), and cannabis.
Study Design: Umbrella review of SRs and MAs.
Level Of Evidence: Level 4.
Data Extraction: Primary outcomes collected were (1) body mass, (2) muscle strength, (3) performance, and (4) recovery. Adverse effects were also noted.
Results: A total of 27 papers evaluating 5 pharmacological interventions met inclusion criteria. No studies evaluating SARMs or ACE-inhibitors were included. AAS lead to a 5% to 52% increase in strength and a 0.62 standard mean difference in lean body mass with subsequent lipid derangements. GH alters body composition, without providing a strength or performance benefit, but potential risks include soft tissue edema, fatigue, arthralgias, and carpel tunnel syndrome. Creatine use during resistance training can safely increase total and lean body mass, strength, and performance in high-intensity, short-duration, repetitive tasks. Limited evidence supports rHuEPO benefit on performance despite increases in both VOmax and maximal power output, and severe cardiovascular risks are documented. Cannabis provides no performance benefit and may even impair athletic performance.
Conclusion: In young healthy persons and athletes, creatine can safely provide a performance-enhancing benefit when taken in controlled doses. AAS, GH, and rHuEPO are associated with severe adverse events and do not support a performance benefit, despite showing the ability to change bodily composition, strength, and/or physiologic measures. Cannabis may have an ergolytic, instead of ergogenic, effect.
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http://dx.doi.org/10.1177/19417381231197389 | DOI Listing |
Ann Emerg Med
January 2025
Division of Medical Toxicology, University of Pittsburgh School of Medicine, Pittsburgh, PA.
Study Objective: The osmol gap can help detect and manage those with toxic alcohol exposure, and it is altered by all alcohols including ethanol. The optimal correction for ethanol that would allow accurate detection of an alternative alcohol is unclear.
Methods: We conducted a prospective cohort study to assess baseline variations in osmol gap, and then to assess the validity of 2 commonly used coefficients (correction factors) for ethanol.
Dis Esophagus
January 2025
Department of Digestive and Oncological Surgery, Claude Huriez Hospital, Chu Lille, Lille, France.
Background: Malnutrition is common with esophagogastric cancers and is associated with negative outcomes. We aimed to evaluate if immunonutrition during neoadjuvant treatment improves patient's health-related quality of life (HRQOL) and reduces postoperative morbidity and toxicities during neoadjuvant treatment.
Methods: A multicenter double-blind randomized controlled trial (RCT) was undertaken.
Lipids Health Dis
January 2025
Department of Urology, Qilu Hospital of Shandong University, 107 Wenhuaxi Road Jinan, Shandong, 250012, People's Republic of China.
Background: An association exists between obesity and reduced testosterone levels in males. The propose of this research is to reveal the correlation between 15 indices linked to obesity and lipid levels with the concentration of serum testosterone, and incidence of testosterone deficiency (TD) among adult American men.
Methods: The study utilized information gathered from the National Health and Nutrition Examination Survey (NHANES) carried out from 2011 to 2016.
J Med Case Rep
January 2025
Department of Surgery, Center for Endocrinology, Diabetes and Metabolism, Children's Hospital Los Angeles and Keck School of Medicine of USC, Los Angeles, CA, USA.
Background: Classic congenital adrenal hyperplasia, primarily due to 21-hydroxylase deficiency, leads to impaired cortisol and aldosterone production and excess adrenal androgens. Lifelong glucocorticoid therapy is required, often necessitating supraphysiological doses in youth to manage androgen excess and growth acceleration. These patients experience higher obesity rates, hypertension, and glucose metabolism issues, complicating long-term health management.
View Article and Find Full Text PDFBMC Endocr Disord
January 2025
Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
Background: Menopause is a significant phase in women's health, in which the incidence of obstructive sleep apnea (OSA) is significantly increased. Body fat distribution changes with age and hormone levels in postmenopausal women, but the extent to which changes in body fat distribution affect the occurrence of OSA is unclear.
Methods: This research performed a cross-sectional analysis utilizing data from the 2015-2016 National Health and Nutrition Examination Survey (NHANES).
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