PED (Performance-Enhancing Drugs)
A Performance-enhancing agent (or performance-enhancing drug) is a substance used to improve any form of activity performance in humans. A well-known example involves doping in sport, where physical performance–enhancing drugs are used by athletes and bodybuilders. Use of cognitive performance enhancers by students is sometimes referred to as academic doping. They are also used by military personnel to enhance combat performance.
Use of performance-enhancing drugs spans the categories of legitimate use and substance abuse.
Performance-enhancing drugs: Know the risks
Are you hoping to gain a competitive edge by taking muscle-building supplements or other performance-enhancing drugs? Learn how these drugs work and how they can affect your health.
Most serious athletes will tell you that the competitive drive to win can be fierce. Besides the satisfaction of personal accomplishment, athletes often pursue dreams of winning a medal for their country or securing a spot on a professional team. In such an environment, the use of performance-enhancing drugs has become increasingly common.
But using performance-enhancing drugs — aka, doping — isn't without risks. Take the time to learn about the potential benefits, the health risks and the many unknowns regarding so-called performance-enhancing drugs such as anabolic steroids, androstenedione, human growth hormone, erythropoietin, diuretics, creatine and stimulants. You may decide that the benefits aren't worth the risks.
What are they?
Some athletes take a form of steroids — known as anabolic-androgen steroids or just anabolic steroids — to increase their muscle mass and strength. The main anabolic steroid hormone produced by your body is testosterone.
Testosterone has two main effects on your body:
- Anabolic effects promote muscle building.
- Androgenic effects are responsible for male traits, such as facial hair and a deeper voice.
Some athletes take straight testosterone to boost their performance. Frequently, the anabolic steroids that athletes use are synthetic modifications of testosterone.
These hormones have approved medical uses, though improving athletic performance is not one of them. They can be taken as pills, injections or topical treatments.
Why are these drugs so appealing to athletes? Besides making muscles bigger, anabolic steroids may help athletes recover from a hard workout more quickly by reducing the muscle damage that occurs during the session. This enables athletes to work out harder and more frequently without overtraining. In addition, some athletes may like the aggressive feelings they get when they take the drugs.
A particularly dangerous class of anabolic steroids are the so-called designer drugs — synthetic steroids that have been illicitly created to be undetectable by current drug tests. They are made specifically for athletes and have no approved medical use. Because of this, they haven't been tested or approved by the Food and Drug Administration (FDA) and represent a particular health threat to athletes.
Many athletes take anabolic steroids at doses that are much higher than those prescribed for medical reasons, and most of what is known about the drugs' effects on athletes comes from observing users.
It is impossible for researchers to design studies that would accurately test the effects of large doses of steroids on athletes, because giving participants such high doses would be unethical. This means that the effects of taking anabolic steroids at very high doses haven't been well-studied.
Anabolic steroids come with serious physical side effects as well. Men may develop:
- Prominent breasts
- Shrunken testicles
- Prostate gland enlargement
Women may develop:
- A deeper voice
- An enlarged clitoris
- Increased body hair
- Infrequent or absent periods
Both men and women might experience:
- Severe acne
- Increased risk of tendinitis and tendon rupture
- Liver abnormalities and tumors
- Increased low-density lipoprotein (LDL) cholesterol (the "bad" cholesterol)
- Decreased high-density lipoprotein (HDL) cholesterol (the "good" cholesterol)
- High blood pressure (hypertension)
- Heart and circulatory problems
- Aggressive behaviors, rage or violence
- Psychiatric disorders, such as depression
- Drug dependence
- Infections or diseases such as HIV or hepatitis if you're injecting the drugs
- Inhibited growth and development, and risk of future health problems in teenagers
Taking anabolic-androgenic steroids to enhance athletic performance, besides being prohibited by most sports organizations, is illegal. In the past 20 years, more effective law enforcement in the United States has pushed much of the illegal steroid industry into the black market.
This poses additional health risks because the drugs are either made in other countries and smuggled in or made in clandestine labs in the United States. Either way, they aren't subject to government safety standards and could be impure or mislabeled.
What is it?
Androstenedione (andro) is a hormone produced by the adrenal glands, ovaries and testes. It's a hormone that's normally converted to testosterone and estradiol in both men and women. Andro is available legally only in prescription form and is a controlled substance.
Manufacturers and bodybuilding magazines tout its ability to allow athletes to train harder and recover more quickly. However, its use as a performance-enhancing drug is illegal in the United States.
Scientific studies that refute these claims show that supplemental androstenedione doesn't increase testosterone and that your muscles don't get stronger with andro use.
Side effects of andro in men include:
- Diminished sperm production
- Shrinking of the testicles
- Enlargement of the breasts
In women, side effects include:
- Masculinization, such as deepening of the voice and male-pattern baldness
In both men and women, andro can decrease HDL cholesterol (the "good" cholesterol), which puts you at greater risk of heart attack and stroke.
Human growth hormone
What is it?
Human growth hormone, also known as gonadotropin, is a hormone that has an anabolic effect. Athletes take it to improve muscle mass and performance. However, it hasn't been shown conclusively to improve either strength or endurance. It is available only by prescription and is administered by injection.
Adverse effects related to human growth hormone range in severity and may include:
- Joint pain
- Muscle weakness
- Fluid retention
- Vision problems
- Carpal tunnel syndrome
- Impaired glucose regulation
- Enlarged heart (cardiomegaly)
- High cholesterol (hyperlipidemia)
- High blood pressure (hypertension)
What is it?
Erythropoietin is a type of hormone used to treat anemia in people with severe kidney disease. It increases production of red blood cells and hemoglobin, resulting in improved movement of oxygen to the muscles. Epoetin, a synthetic form of erythropoietin, is commonly used by endurance athletes.
Erythropoietin use among competitive cyclists was common in the 1990s and allegedly contributed to at least 18 deaths. Inappropriate use of erythropoietin may increase the risk of thrombotic events, such as stroke, heart attack and pulmonary embolism.
What are they?
Diuretics are drugs that change your body's natural balance of fluids and salts (electrolytes) and can lead to dehydration. This loss of water can decrease an athlete's weight, helping him or her to compete in a lighter weight class, which many athletes prefer. Diuretics may also help athletes pass drug tests by diluting their urine and are sometimes referred to as a "masking" agent.
Diuretics taken at any dose, even medically recommended doses, predispose athletes to adverse effects such as:
- Muscle cramps
- Potassium deficiency
- Drop in blood pressure
- Loss of coordination and balance
What is it?
Many athletes take nutritional supplements instead of or in addition to performance-enhancing drugs. Supplements are available over-the-counter as powders or pills. The most popular supplement among athletes is probably creatine monohydrate.
Creatine is a naturally occurring compound produced by your body that helps your muscles release energy. Scientific research indicates that creatine may have some athletic benefit by producing small gains in short-term bursts of power.
Creatine appears to help muscles make more adenosine triphosphate (ATP), which stores and transports energy in cells, and is used for quick bursts of activity, such as weightlifting or sprinting. There's no evidence, however, that creatine enhances performance in aerobic or endurance sports.
Your liver produces about 0.07 ounces (2 grams) of creatine each day. You also get creatine from the meat in your diet.
Creatine is stored in your muscles, and levels are relatively easily maintained. Because your kidneys remove excess creatine, the value of supplements to someone who already has adequate muscle creatine content is questionable.
Supplements are considered food and not drugs by the FDA. This means supplement manufacturers are not required to conform to the same standards as drug manufacturers do. In some cases, supplements have been found to be contaminated with other substances, which may inadvertently lead to a positive test for performance-enhancing drugs.
Possible side effects of creatine that can decrease athletic performance include:
- Stomach cramps
- Muscle cramps
- Weight gain
Weight gain is sought after by athletes who want to increase their size. But with prolonged creatine use, weight gain is more likely the result of water retention than an increase in muscle mass. Water is drawn into your muscle tissue, away from other parts of your body. This puts you at risk of dehydration.
High-dose creatine use may potentially damage your:
It appears safe for adults to use creatine at the doses recommended by manufacturers. But there are no studies investigating the long-term benefits and risks of creatine supplementation.
What are they?
Some athletes use stimulants to stimulate the central nervous system and increase heart rate and blood pressure.
- Improve endurance
- Reduce fatigue
- Suppress appetite
- Increase alertness and aggressiveness
Common stimulants include caffeine and amphetamines. Cold remedies often contain the stimulants ephedrine or pseudoephedrine hydrochloride.
Energy drinks, which are popular among many athletes, often contain high doses of caffeine and other stimulants. The street drugs cocaine and methamphetamine also are stimulants.
Although stimulants can boost physical performance and promote aggressiveness on the field, they have side effects that can impair athletic performance.
- Nervousness and irritability, which make it hard to concentrate on the game
- Insomnia, which can prevent an athlete from getting needed sleep
- Addiction or tolerance, meaning that athletes need greater amounts to achieve the desired effect, so they'll take doses that are much higher than the intended medical dose
Other side effects include:
- Heart palpitations
- Heart rhythm abnormalities
- Weight loss
- Mild high blood pressure (hypertension)
- Heart attack and other circulatory problems
The bottom line
Do performance-enhancing drugs boost performance? Some athletes may appear to achieve physical gains from such drugs, but at what cost?
The long-term effects of performance-enhancing drugs haven't been rigorously studied. And short-term benefits are tempered by many risks. Not to mention that doping is prohibited by most sports organizations. No matter how you look at it, using performance-enhancing drugs is risky business.
Performance Enhancing Drugs - PEDs
What is Performance Enhancing Drugs - PEDs?
Drugs/substances taken by athletes that help improve their performance. Often illegal or, at least, banned by the governing body of the sport the athelete particpates in, these substances are taken for the specific reason to improve performance. Performance Enhancing Drugs - PEDs can be a reference to many different types of substances including anabolic steriods, human growth harmones, and certain stimulants.
Sporting Charts explains Performance Enhancing Drugs - PEDs
PEDs have become a bane to statheads' existence because it's become impossible to quantify the effect its had on sports and the statistics accumlated. For example, the "PED era" in baseball is generally accepted to be from the late 1980s through (appx) 2010. This has put a general black cloud over such hallowed numbers like most home runs in a season (Barry Bonds - 73 in 2001), most career home runs (Barry Bonds - 762), and most Cy Young awards (Roger Clemens - 7). It even has affected those who never have been accuesed of PED use, but played in the PED era. In 2013, no player was elected into the baseball Hall of Fame, despite eligbile candidates like Barry Bonds, Mark McGwire, Craig Biggio, Roger Clemens.
With all the information, attention, and debate over performance-enhancing drugs (or PEDs), many people want to further understand how performance-enhancing drugs affect one’s body. It’s an important area of concern for athletes and at the foundation of why USADA and other anti-doping organizations exist. Simply put, PEDs have the ability or potential to drastically alter the human body and biological functions, including the ability to considerably improve athletic performance in certain instances. These drugs, however, can be extremely dangerous and, in certain situations, deadly. The negative effects these drugs can have on one’s body make USADA’s mission paramount as to why no athlete should ever have to consider PED use to succeed in sport.
This section provides answers to common questions about the health and safety risks associated with substances and methods on the WADA Prohibited List (List). It also provides information concerning the legitimate medical use of substances. When these compounds are misused, it constitutes a breach of ethics both by the user and supplier.
Anabolic Agents (Including Testosterone)
The primary medical use of these compounds is to treat delayed puberty, some types of impotence, and wasting of the body caused by HIV infection or other muscle-wasting diseases. What are some potential side effects of anabolic steroid abuse? Some physiological and psychological side effects of anabolic steroid abuse have potential to impact any user, while other side effects are gender specific. The following list is not comprehensive.
- Male pattern baldness
- Liver Damage*
- Premature closure of the growth centers of long bones (in adolescents) which may result in stunted growth*
- Stunted growth and disruption of puberty in children
- Increased aggressiveness and sexual appetite, sometimes resulting in abnormal sexual and criminal behavior, often referred to as “Roid Rage”
- Withdrawal from anabolic steroid use can be associated with depression, and in some cases, suicide.
Gender Specific – Males
- Breast tissue development*
- Shrinking of the testicles*
- Reduction in sperm production
*Effects may be permanent and can vary by individual.
Gender Specific – Females
- Deepening of the voice*
- Cessation of breast development
- Growth of hair on the face, stomach and upper back*
- Enlarged clitoris*
- Abnormal menstrual cycles
Peptide Hormones, Growth Factors, and Related Substances
The primary medical use of these compounds vary, but include treatment of cancer or aiding those born prematurely. The presence of an abnormal concentration of a hormone, its metabolites, relevant ratios or markers in your sample is deemed to contain a prohibited substance unless you can demonstrate the concentration was due to a physiological or pathological condition. Examples include human growth hormone (hGH), erythropoietin (EPO), insulin, human chorionic gonadotrophin (HCG), and adrenocorticotrophin (ACTH). Despite the presence of some growth factors, platelet-derived preparations were removed from the List as current studies on PRP do not demonstrate any potential for performance enhancement beyond a potential therapeutic effect.
- hypertension (EPO/hGH)
- blood cancers/leukemia (EPO/hGH)
- Anemia (EPO)
- strokes (EPO)
- heart attacks
- Pulmonary embolism (EPO)
- feminization (HCG)
- thyroid problems (hGH)
Note that individual growth factors are still prohibited when given separately as purified substances as described in S.2.5.
Human Growth Hormone (hGH)
- Severe headaches
- Loss of vision
- Acromegaly (Protruding or enlarged jaw, brow, skull, hands and feet)
- High blood pressure and heart failure
- Diabetes and tumors
- Crippling arthritis
The primary medical use of these compounds is to treat conditions such as asthma and other respiratory ailments. Some studies have shown beta-2 agonists have performance-enhancing effects when consistently high levels are present in the blood.
- Muscle cramps
The primary medical use of these compounds is to treat conditions such as hypertension, kidney disease and congestive heart failure. Taken without medical supervision, diuretics can result in potassium depletion and possibly even death.
The primary medical use of these compounds is to treat conditions such as Attention Deficit Disorders (ADD/ADHD), asthma, narcolepsy, and obesity.
- Weight loss
- Dependence and addiction
- Increased heart rate and blood pressure
- Increased risk of stroke, heart attack, and cardiac arrhythmia
In small doses narcotics have medical uses that include relieving severe pain and inducing sleep. However, narcotic overdose is a medical emergency and can lead to respiratory depression and even death.
While a sensation of euphoria and psychological stimulation are effects common to the use of narcotics, the misuse of narcotics can pose ethical questions about the handling of the substance as well as great health risks. Those include:
- A false sense of invincibility
- Nausea and vomiting
- Increased pain threshold and failure to recognize injury
- Decreased heart rate
- Physical and psychological dependence; leading to addiction
Marijuana is classified by Congress as a Schedule 1 drug under the Controlled Substances Act (CSA). This means that it has a high potential for abuse, no accepted medical use in the United States, and lacks accepted safety data for use under medical supervision. Side effects of cannabinoid use include:
- Increased heart rate
- Impaired short-term memory
- Slowed coordination and reaction of reflexes
- Diminished ability to concentrate
- Distorted sense of time and space
- Respiratory diseases
- Mood instability
- Impaired thinking and reading comprehension
The primary medical use of these compounds is to treat allergies, asthma, inflammatory conditions, and skin disorders among other ailments
- Loss of muscle mass
- Weakening of injured areas in muscle, bone, tendon, or ligament
- Decrease in or cessation of growth in young people
The primary medical use of beta-blockers is to control hypertension, cardiac arrhythmias, angina pectoris (severe chest pain), migraine, and nervous or anxiety-related conditions.
- Lowered blood pressure
- Slow heart rate
- Sleep disorders
- Spasm of the airways
Blood doping is the practice of misusing certain techniques and substances to increase the red blood cell mass in the body. Since the red blood cells carry oxygen to the muscles, this allows the body to transport more oxygen to working muscles and therefore can increase their aerobic capacity and endurance. There are three widely known substances or methods used for blood doping, namely, erythropoietin (EPO), synthetic oxygen carriers and blood transfusions*. The primary use of blood transfusions and synthetic oxygen carriers are for patients who have suffered massive blood loss, either during a major surgical procedure or caused by major trauma. Erythropoietin is used in the treatment of anemia related to kidney disease. However, misuse of these substances and techniques could lead to:
- Increased stress on the heart
- Blood clotting
* With transfusions, there is an increased risk of infectious disease such as AIDS or hepatitis.