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Chapter Objectives

After reading this chapter, the student will be able to:

  1. Describe a brief history of steroid and sports supplement use.

  2. Describe additional resources to locate information on steroid or sports supplements.

  3. Understand the pathophysiology of steroid use on the body.

  4. Recognize the signs, symptoms, adverse effects, and complications of steroid abuse.

  5. Understand the pathophysiology of human growth hormone, dehydroepiandrosterone (DHEA) and beta-hydroxy-beta-methylbutyrate, and creatine.

  6. Recognize the signs, symptoms, and adverse effects of the use of human growth hormone, dehydroepiandrosterone and beta-hydroxy-beta-methylbutyrate, and creatine.

  7. Explain information with which to counsel athletes using miscellaneous sports supplements.

  8. Understand the mechanisms of action of miscellaneous sports supplements.

  9. Recognize the signs and symptoms, adverse effects, and/or possible complications of miscellaneous sports supplements.

Chapter Outline

  • Steroids

    • History

    • Methods of Use

    • Physiological Effects of Steroids

    • Adverse Effects of Steroids

    • What to Tell the Athlete

  • Scenario From the Field

  • Human Growth Hormone

    • History

    • Mechanism of Action

    • Effects on the Body

    • Adverse Effects of HGH

  • Dehydroepiandrosterone and Beta-hydroxy-beta-methylbutyrate

    • Dehydroepiandrosterone

    • Beta-hydroxy-beta-methylbutyrate

  • Creatine

    • History

    • Mechanism of Action

    • Who Uses It

    • Adverse Effects of Creatine

  • Miscellaneous Agents

    • Androstenedione

  • Scenario From the Field

    • What to Tell the Athlete

  • Discussion Topics

  • Chapter Review

As athletic trainers, we work with many athletes who are enticed to use muscle-building agents to become more competitive in their sport. Being more competitive can mean better scholarship opportunities to better schools where the athlete might have a chance to make it to professional sports and possibly make millions of dollars. Typically, in sports such as football and baseball, athletes are more willing to use muscle-building agents to become bigger, stronger, and faster. However, athletes competing in other sports, such as tennis, volleyball, or track and field, are becoming more willing to use drugs for ergogenic purposes. An ergogenic aid is something an athlete might take to increase work output or, more specifically, increase the potential for work output during the athlete’s sport or activity.

The disqualification of many Olympic and non-Olympic athletes for the use of steroids has been headline news since the 1960s, when medical personnel from the Soviet-Bloc countries were promoting steroid use to all types of athletes. The use of muscle-building agents by both male and female athletes, from baseball players to table-tennis players, continues to grow as the rewards of fame generated by sports performance continue to soar.

Muscle-building agents are abused not only by college and professional athletes; high-school athletes have also been using anabolic steroids for years. In 1988, Buckley et al3 published what was then an eye-opening article indicating that approximately 6.6% of high-school seniors nationwide had used anabolic steroids starting at an average age of 16. In the years following, other authors have confirmed that high-school athletes continue to use anabolic steroids. The National Collegiate Athletic Association (NCAA) also reports the use of anabolic-androgenic steroids (AAS) in collegiate athletes from surveys they periodically administer to college athletes. ...

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