Androgen abuse in the community.
ABSTRACT To provide information of the current prevalence of illicit use of androgens by individuals of the community.
Prevalence of abuse of androgens in individuals of the general population has reached alarming dimensions. Use of androgens is no longer limited to competitive sports, but has spread to leisure and fitness sports, bodybuilding, and nonathletes motivated to increase muscular mass and physical attractiveness. Alarming studies from Germany demonstrated that members of the healthcare systems provide illegal androgens to 48.1% of abusers visiting fitness centers. The new trend to combine androgens with growth hormone, insulin, and insulinotropic milk protein-fortified drinks may potentiate health risks of androgen abuse.
The use of androgens has changed from being a problem restricted to sports to one of public health concern. The potential health hazards of androgen abuse are underestimated in the medical community, which unfortunately contributes to illegal distribution of androgens. Both the adverse effects of current androgen abuse especially in young men as well as the chronic toxicity from past long-term abuse of now middle-aged men has to be considered as a growing public health problem. In the future, an increasing prevalence of androgen misuse in combination with other growth-promoting hormones and insulinotropic milk protein products has to be expected, which may have further promoting effects on the prevalence of chronic western diseases.
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ABSTRACT: Besides its well appreciated role in diabetes, obesity, and metabolic syndrome, insulin resistance (IR) is associated with smoking, use of hormonal contraceptives, androgens, glucocorticoids, beta-adrenergic blockers, thiazide diuretics, intake of food with high glycaemic index, and reduced physical activity. IR increases serum hormone levels of insulin and insulin-like growth factor-1 (IGF-1), which are most important mediators of cell proliferation, differentiation and inhibitors of apoptosis. Milk and dairy are introduced as new risk factors inducing IR, the physiologic growth-promoting principle of mammalian milk. This hypothesis explains IR as the underlying pathophysiologic mechanism of all major risk factors of chronic Western diseases. Evidence will be provided which supports that Western life style permanently boosters IR from intrauterine life to senescence. It becomes detrimental when the human intrinsic insulin/IGF-1-axis is continuously superimposed by external IR-potentiating effectors. This hypothesis can be proved by monitoring and proper adjustment of all aggravating effectors of IR. An all-encompassing consideration of IR-inducing risk factors from the beginning of life to adulthood appears to be of crucial importance for the prevention and treatment of chronic Western diseases.Medical Hypotheses 07/2009; 73(5):670-81. DOI:10.1016/j.mehy.2009.04.047 · 1.15 Impact Factor
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ABSTRACT: It is the purpose of this viewpoint article to delineate the regulatory network of growth hormone (GH), insulin, and insulin-like growth factor-1 (IGF-1) signalling during puberty, associated hormonal changes in adrenal and gonadal androgen metabolism, and the impact of dietary factors and smoking involved in the pathogenesis of acne. The key regulator IGF-1 rises during puberty by the action of increased GH secretion and correlates well with the clinical course of acne. In acne patients, associations between serum levels of IGF-1, dehydroepiandrosterone sulphate, dihydrotestosterone, acne lesion counts and facial sebum secretion rate have been reported. IGF-1 stimulates 5alpha-reductase, adrenal and gonadal androgen synthesis, androgen receptor signal transduction, sebocyte proliferation and lipogenesis. Milk consumption results in a significant increase in insulin and IGF-1 serum levels comparable with high glycaemic food. Insulin induces hepatic IGF-1 secretion, and both hormones amplify the stimulatory effect of GH on sebocytes and augment mitogenic downstream signalling pathways of insulin receptors, IGF-1 receptor and fibroblast growth factor receptor-2b. Acne is proposed to be an IGF-1-mediated disease, modified by diets and smoking increasing insulin/IGF1-signalling. Metformin treatment, and diets low in milk protein content and glycaemic index reduce increased IGF-1 signalling. Persistent acne in adulthood with high IGF-1 levels may be considered as an indicator for increased risk of cancer, which may require appropriate dietary intervention as well as treatment with insulin-sensitizing agents.Experimental Dermatology 09/2009; 18(10):833-41. DOI:10.1111/j.1600-0625.2009.00924.x · 4.12 Impact Factor
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ABSTRACT: The use of anabolic-androgenic steroids (AAS) by young athletes has been a primary concern of sports governing bodies because of the implications for unfair advantage in performance and the potential for adverse side effects. Research over several decades indicated a lifetime prevalence of AAS use for adolescent males of 4-6% and for females of 1.5-3%, indicating a problem involving millions of athletes and a potential epidemic of AAS-related pathologies. However, recent studies have questioned the presumption that participation in organised sport is the primary risk factor for AAS use in adolescents as well as the extant estimates of the magnitude of the problem. Increasing evidence indicates that AAS use is associated with non-athletes and is linked to a broader syndrome of problem behaviours rather than efforts to achieve sporting success, and that sports participation may be protective against AAS use. Moreover, employing lifetime prevalence to gauge AAS use limits accurate evaluation of the personal and public health risk as the majority of respondents are not habitual users. Previous studies may have also inflated prevalence values through ambiguously worded survey questions and other design flaws, and few data are available on actual dosages. Prevention efforts need to be focused beyond organised sport and target the general adolescent population rather than athletes and should be founded on interventions with demonstrated efficacy for delinquent, antisocial and self-destructive behaviours rather than the ethical imperative of fair play.British Journal of Sports Medicine 11/2009; 44(1):26-31. DOI:10.1136/bjsm.2009.068924 · 5.03 Impact Factor