Heavy Testosterone Use among Bodybuilders: An Uncommon Cohort of Illicit Substance Users

OBJECTIVE:

To identify and characterize patterns of use among a contemporary cohort of current anabolic-androgenic steroid (AAS) users.

PATIENTS AND METHODS:

An anonymous, self-administered, 49-item questionnaire was posted on message boards of Internet websites popular among AAS users and administered via SurveyMonkey from February 1, 2015, to June 1, 2015. Thirty-seven questions were analyzed for this study.

RESULTS:

A total of 231 male respondents met the inclusion criteria. 

• Most were white, were older than 25 years, were employed with above average income, and had received a formal education beyond high school. 
• 93% began using AAS after the age of 18 years, and 
• 81% reported using 400 mg or more of testosterone per week. 

Factors associated with longer duration of use (>5 years) included 

• higher incomes (≥$75,000, P=.003), 
• increased testosterone dosages (>600 mg per week, P=.007), 
• older age (≥35 years, P<.001), 
• being married (P<.001), 
• and being self-employed (P<.001). 

The Internet was the most common source of testosterone (53%). 

• 93% used at least one additional performance-enhancing drug. 
• 77% had routine laboratory tests performed, and 
• 38% reported laboratory abnormalities at some point. 

Nearly all experienced subjective adverse effects while using and not using testosterone. 

• 53% reported use of other illegal substances, 
• most commonly (90%) beginning before AAS initiation. 
• 10% had a criminal conviction, 
• 91% of which preceded AAS use. 
• 50% were felonies.

CONCLUSION:

The population of AAS users is disparate from that of other drugs of abuse. Laboratory test abnormalities and adverse effects are common and should be taken into account when counseling patients who may be using AASs.

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By:  Westerman ME1, Charchenko CM1, Ziegelmann MJ1, Bailey GC1, Nippoldt TB2, Trost L3.

• 1Department of Urology, Mayo Clinic, Rochester, MN.
• 2Division of Endocrinology, Metabolism and Nutrition, Department of Medicine, Mayo Clinic, Rochester, MN.
• 3Department of Urology, Mayo Clinic, Rochester, MN. Electronic address: Trost.Landon@mayo.edu (http://www.mayoclinic.org/biographies/trost-landon-w-m-d/bio-20055549)
• Mayo Clin Proc. 2016 Jan 5. pii: S0025-6196(15)00890-3. doi: 10.1016/j.mayocp.2015.10.027. 

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