Rugby player handed a 4-year sentence for doping

Lee Mapals

Lee Mapals

Hunslet Hawks winger Lee Mapals has been given a four-year ban after testing positive for the use of anabolic steroids, the Rugby Football League has announced.

The 31-year-old, who was in his second spell with the Kingstone Press League 1 club, tested positive for the anabolic steroid nandrolone and metabolites of the steroid oxymetholone following an out-of-competition test on June 16.

Mapals, who has also played for Keighley Cougars, Doncaster, York City Knights, Newcastle Thunder and Gloucestershire All Golds, during his career, has been banned by UK Anti-Doping (UKAD) from all sport until July 2020.

UKAD director of operations Pat Myhill said: “Testing positive for the presence of multiple prohibited substances is a serious breach of the anti-doping rules and the spirit of sport.

“When Lee Mapals made the decision to dope, he also chose to cheat his team-mates, his opposition, his fans and his sport.

“At the same time, his actions risked not just his career, but his reputation and health. “UKAD will always seek to impose the maximum possible sanction on any individual who decides to consciously cheat the system.

“I hope that this case acts as a deterrent to others who are considering the use of performance enhancing substances.”

Read more at:

Since 2005, number hospitalized for steroids has doubled

Rising numbers of people are being hospitalised in Ireland for taking anabolic steroids.

The country’s medicine watchdog, the Health Products Regulatory Authority (HPRA), has warned of the dangers of the prescription drugs. New figures from the HSE show the increasing health toll of the drugs. Anabolic steroids are male sexual hormones, and include testosterone, which builds muscle tissue.

In 2005, 185 people were hospitalised for taking anabolic steroids. Last year, this figure had almost doubled to 348 .

The HPRA warned young people against illegally pumping up on steroids.

Sports players and body builders claim the drugs help them to train harder and longer and to recover more quickly from gruelling gym sessions. They also build muscle mass.

However, the drugs have been cause ‘roid rage’, making some steroid users paranoid, irritable, aggressive and violent, and induce mood swings. The HPRA said a recent haul of prescription-only anabolic steroids was destined for the illegal performance- and image-enhancing markets.

“These include the body-building sector, where body-image enhancement through the abuse of these medicines is prevalent,” said the HPRA in a statement.

“The medicines concerned were unauthorised and imported for the purpose of sale on the illicit market.

“The abuse of anabolic steroid-containing medicines is prevalent in gymnasiums.”

The drugs are also being smuggled into Ireland’s prisons to be used by gym-going inmates.

Ben Buckley, from the Irish Prison Service, said some prisoners use the illegal drugs to pump up their muscles.

“Hundreds of tablets are being thrown over the walls in prisons,” said Mr Buckley. “The criminal elements have a big draw to the fitness thing. It’s those guys pulling in the steroids.

“Steroids are being used by guys who go to the gym. They don’t realise the danger of them. What is happening in prisons is reflective of what is happening in the streets.”

In young people, anabolic steroids can disrupt body development, stunting growth. It can also cause men to lose hair, develop acne, and suffer shrunken testicles.

Regular users can have trouble sleeping, becoming paranoid and experiencing dramatic mood swings.

Significant use of ‘steroids’ among Kuwaiti males: study

Dr Elham Al-Hamdan, President and Medical Director of FSRI

Dr Elham Al-Hamdan, President and Medical Director of FSRI

KUWAIT CITY, Sept 19: A recently published local study examining the use of Anabolic-Androgenic Steroid (AAS) amongst gym users in Kuwait found there to be significant use of AAS amongst Kuwaiti male gym-goers. The study, which was published in the International Journal of Men’s Health, was carried out by a research team at Fawzia Sultan Rehabilitation Institute (FSRI) and funded by Kuwait Foundation for the Advancement of Sciences (KFAS).

The study analyzed data collected and collated from 200 individuals of different gender, age, and nationality from across six gyms in Kuwait , amongst which 35% reported usage of AAS. The main findings listed age, smoking and nationality as the top predictors for AAS use; younger adults were significantly more likely to be AAS users, as are smokers and Kuwaiti males — both of whom are more than three time likely to be users of AAS than non-smokers and non-Kuwaitis, respectively.

Dr Elham Al-Hamdan, President and Medical Director of FSRI, and one of the authors of the study commented: “The literature on AAS use in Kuwait is still fairly limited, and with our latest research we are hoping to build upon this and help shed light on the gravity and prevalence of this issue in Kuwait.

One of the pillars of the Fawzia Sultan Rehabilitation Institute is research and education, and in the past we have published a range of study’s focusing on health issues that impact the lives of people in our local community.

AAS has become a prevalent issue amongst the large gymgoing population in Kuwait, and hence has become a topic that needs to be studied and researched further.”

Due to the harmful effects that AAS use can have on the body, the study suggests that health policy and institutional reforms are needed in order to tackle the issue before it spreads. Although the complete elimination of AAS is not realistic, the study poses that reforms, public awareness and controlled distribution and administration of steroids are important steps to negate the harmful effects and draw attention to AAS use.

Dr Al-Hamdan further added: “We will be publishing a follow-up paper that explores the psychological and emotional impact AAS use can have on individuals, further strengthening the framework we have set out to provide education and insight into AAS use in Kuwait.”

Fawzia Sultan Rehabilitation Institute (FSRI) was founded in 2006 as a non-profit healthcare institution, becoming the only organization of its kind in Kuwait. Dr Elham Al-Hamdan, Co-founder & Medical Director, established FSRI with its mission to be a holistic medical institution providing high quality multi-disciplinary services, whilst also serving as a regional hub for health, research, education & advocacy.

FSRI houses a highly specialized and intensively trained team of physicians and clinicians, providing exceptional quality of healthcare services and compassionate care across a number of specialty areas including: pediatric rehabilitation (at its Children Evaluation & Rehabilitation Centre: CERC), family medicine, preventative medicine, psychology, physiotherapy & occupational therapy, speech therapy, neurology, elderly care, women’s health and research and education.

Abuse of Anabolic Steroids May Impair Insulin Resistance For Years After Discontinuation Interview with:
Jon Rasmussen, MD, PhD fellow
Department of Internal Medicine
Herlev Hospital, Denmark What is the background for this study?

Response: Abuse of anabolic androgenic steroids has become highly prevalent among young men involved in recreational strength training. A recent meta-analysis estimated that approximately 18% of young men involved recreational strength training abuse anabolic steroids.

Well-known adverse effects following abuse of anabolic steroids include hypogonadism (For those who have interest, we have recently published a paper concerning this issue, it can be read and downloaded at:

Yet, we have a poor understanding on the adverse effects these compounds might have on the metabolism and insulin sensitivity. What are the main findings?

Response: Our main findings were that both current and former abusers of anabolic steroids had decreased insulin sensitivity compared with control participants. Additionally, especially current abusers clearly had more visceral fat than control participants. Our results indicate these findings could be caused by anabolic steroids-suppression of the cardiac natriuretic peptides which have recently shown to be key components in metabolic processes. What should readers take away from your report?

Response: Abuse of anabolic androgenic steroids potentially has numerous adverse effects on the body which go beyond the side effects on the reproductive system and we poor understanding of these. Moreover, our findings suggest the adverse effect on the metabolism may persist years after discontinuation of anabolic steroids abuse. What recommendations do you have for future research as a result of this study?

Response: It would be very interesting to look more into the exact mechanism behind decreased insulin sensitivity among abusers of anabolic steroids at a more basic level on muscle and fat tissue. To see if it is the suppression of cardiac peptides which is the driving factor or if the mechanism is entirely different. Is there anything else you would like to add?

Response: The study is cross-sectional and therefore does not give a final answer on whether abusers of anabolic steroids are more prone to develop diabetes. Nevertheless, the former abusers had decreased insulin sensitivity years after discontinuation of their abuse, so it is possible that abuse of anabolic steroids may increase the risk of diabetes years even after discontinuation. Thank you for your contribution to the community.

Citation: EASD 2016  abstract:

History of anabolic androgenic misuse is associated with impaired insulin sensitivity and increased visceral abdominal fat among younger men

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

Are supplements safe?

Image result for dietary supplements

Emergency Department Visits for Adverse Events Related to Dietary Supplements

Dietary supplements are sometimes erroneously perceived as inherently healthy. And because of the way many supplements are advertised, it’s easy to overlook that improper administration can lead to adverse outcomes.

The classification of a supplement is defined in the United States Dietary Supplement Health and Education Act of 1994 (DSHEA) as a vitamin, mineral, herb or botanical, amino acid, and any concentrate, metabolite, constituent, or extract of these substances. In the U.S., the Food and Drug Administration (FDA) is the governing body that oversees the regulation of dietary supplements. If a supplement has been reported to be causing serious adverse events or reactions, the FDA has the authority to pull it from the market. However, no safety testing or FDA approval is required before a company can market their supplement. The lack of oversight authority given to the FDA has even drawn the attention of late night talk shows hosts like John Oliver, who humorously covered the issue in this YouTube video.

Many adults are using one or more supplements to address illnesses or symptoms, and to maintain or improve health. Half of all U.S. adults have reported using at least one supplement in the past 30 days. Twelve percent of college students have reported taking five or more supplements a week. Now, more than ever, there are seemingly endless options to choose from. The number of supplement products currently available on the market is thought to be in excess of 55,000. Compare that to the mere 4,000 available in 1994, when DSHEA was passed.

Furthermore, confidence in the safety and efficacy of these supplements is very high despite the lack of rigorous oversight by the FDA. A survey conducted by the trade association, Council for Responsible Nutrition, found that “85% of American adults … are confident in the safety, quality and effectiveness of dietary supplements.” An independent survey has echoed these results, finding that 67.2% of respondents felt extremely or somewhat confident in supplement efficacy and 70.8% felt extremely or somewhat confident about their safety.

While the majority of Americans trust in their supplements, more than one-third have not told their physician about using them. There are numerous documented drug-supplement interactions ranging from the mild to the severe. The herb St. John’s Wort is thought to be able to reduce symptoms in people with mild to moderate depression. But this ‘natural’ supplement also has 200 documented major drug interactions, including some with common depression medication. However, no good data currently exists to document how common adverse events related to dietary supplements may be. The authors of the present study have used surveillance data to try and fill this knowledge gap.

Due to DSHEA, supplements remain largely unregulated by the FDA. But dietary supplements are becoming ever more popular, as about half of U.S. adults report using one or more in the past 30 days. Trust in the safety and efficacy of these supplements also remains high. The authors of this study aimed to investigate how many annual adverse events are caused by improper supplement usage.

Who and what was studied?

The researchers looked at 10 years of data (2004–2013) to estimate the adverse events associated with dietary supplements in the United States from 63 different hospitals. The selection of these hospitals was meant to be nationally representative and included locations that had 24-hour emergency departments. Trained patient record abstractors reviewed the reports from each hospital to identify cases where supplements had been implicated as the likely source of the adverse event. These abstractors have been trained to analyze and compile medical information contained in patient records.

Cases were scanned for emergency room visits where the treating clinician had explicitly ascribed dietary supplements as the root cause of the medical issue. This included herbal or complementary nutritional products such as botanicals, microbial additives, and amino acids, in addition to micronutrients like vitamins and minerals. Products that may typically be classified as food were excluded, like energy drinks and herbal tea beverages. Topical herbal items and homeopathic products were included in the analysis even though they do not fall under the regulatory definition of dietary supplements.

Adverse events were classified as anything causing adverse or allergic reactions, excess doses, unsupervised ingestion by children, or other events like choking. Due to the non-standard death registration practices among different hospitals, cases involving a mortality were not included, as were any cases involving intentional self-harm, drug abuse, therapeutic failures, nonadherence, and withdrawal.

Researchers examined patient records from 2004 to 2013 from 63 different hospitals. Cases where the treating clinician had identified a supplement as the cause of the medical emergency were extracted from the dataset. However, deaths associated with or caused by supplements were not included, as hospitals differ in their practice of registering mortalities.

What were the findings?

Some of the major findings are summarized in Figure 1. Over 3,600 cases were identified within the predetermined 10-year period. The researchers extrapolated from these data that the U.S. experienced an average of 23,000 supplement-related emergency department visits per year, with estimates ranging from 18,600 to 27,400. Of these 23,000 emergency room visits, it was calculated that about 2,150 (9.4%) of these result in hospitalization. About 88% of these ER visits were attributed to a single supplement, as opposed to interactions or mixtures of multiple supplements. The average age of patients treated for supplement-related adverse events was 32 years, and the majority of these cases were female.

Figure 2 shows age and supplement category related results. About a quarter of ER visits involved people between the ages of 20 to 34, but people older than 65 years old were more likely to have a visit that resulted in hospitalization. Of patients above 65 admitted to the ER, 16% had to be hospitalized. Surprisingly, one-fifth of supplement-related ER visits were due to accidental ingestion by children. When the data covering unsupervised ingestion of dietary supplements by children was not included, the researchers found that the majority of ER visits (65.9%) were due to herbal or complementary nutritional products. The top five products in this category included the following: weight loss (25.5%), energy (10.0%), sexual enhancement (3.4%), cardiovascular health (3.1%), and sleep, sedation, or anxiolysis (i.e. anti-anxiety) (2.9%). Multivitamins or unspecified vitamin products were the biggest contributors to ER visits under the micronutrient product category.

ER visits also varied according to gender and age. Weight loss and micronutrient supplements disproportionately landed females in the ER, while sexual enhancement and bodybuilding products largely affected males. Among patients younger than four years old and adults over 65, micronutrients were the number one cause of emergency department visits. This is in contrast to the other age groups, where herbal and complementary nutritional products were the biggest contributor. In people ages five to 34, weight loss products or energy products were implicated in more than 50% of ER visits. Weight loss products mostly affected patients from 20 to 34 years of age, while the micronutrients iron, calcium, and potassium mostly affected those older than 65.

About 23,000 people go to the ER for supplement-related visits every year. The biggest contributors to this are herbal or complementary nutritional products like weight loss and energy supplements, which largely affect people between the ages of five to 34. Females are more likely than males to end up in the ER due to adverse supplement reactions. Those over the age of 65 are most at risk for an ER visit due to micronutrient supplements such as iron, calcium, and potassium.

What does the study really tell us?

While 23,000 annual supplement-related emergency visits may sound high, this is less than 5% of pharmaceutical product-related ER visits. However, these ER admittance rates do not line up with the marketing that has promoted dietary supplements as fundamentally healthy. That is, the general public overwhelmingly perceives these products to be safe and effective, but the present data does not support this notion (ERD readers excluded. We think you are all ahead of the curve on this one).

However, it should also be noted that overall incidences of supplement-related ER visits have remained constant over time. No significant changes were detected between 2004 and 2013 when accounting for population increases. The only increase that occurred was ER visits associated with micronutrient supplements, which jumped 42.5%, from 3,212 to 4,578 cases in this same time frame.

Unlike their highly regulated pharmaceutical counterparts, there are no legal requirements for dietary supplements to identify any potential adverse effects or major drug interactions on their packaging. The lack of adequate warning labels may be a contributing factor to why histories of dietary supplement usage are rarely obtained by clinicians. This can be due to a combination of clinicians not asking proper patient screening questions and to a lack of disclosure by the patient.

Given that there is a tendency to underreport supplement usage, the researchers have noted that their calculations of emergency department visits attributed to supplement-related adverse events are probably an underestimation. A further limitation was the relatively small sample of hospitals used. But this method of data collection is likely to yield more accurate results over voluntary reporting despite the fact that voluntary reporting would have likely allowed for a larger sample population.

While 23,000 annual supplement-related emergency visits may not be a large contributor to ER visits in the larger scheme of things, it does provide a counter-narrative to the marketing that often portrays supplements as always health promoting. Supplements are not required to come with labels warning of adverse events or potential drug interactions, which can be a contributing factor to supplement-related ER visits.

The big picture

The supplement industry is the wild west of nutrition. By and large, DSHEA has hampered the ability of the FDA to adequately regulate supplements. If you have ever taken a supplement that makes a health claim, you may have encountered this statement on the label: “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.” While all ingredients must be declared on the label, there is little oversight to ensure that these ingredients are present in the supplement, at the doses that are advertised on the packaging. Under DSHEA, there is no requirement for companies to provide any data to the FDA showing that their supplement is safe and effective, unless they are introducing a new or novel ingredient. It falls on the FDA to show that a supplement is unsafe before any action can be taken.

In light of this lack of regulatory oversight, if you are currently taking or thinking about adding a supplement to your diet, be sure to notify your doctor. Supplements can interact with prescription medication or could exacerbate certain medical conditions. Warfarin (Coumadin) is a good example. It is a blood-thinning medication that can be prescribed to people at risk of forming blood clots. To ensure that the medication works properly, these patients are usually placed on a low vitamin K diet, as vitamin K plays an essential role in forming blood clots. If these patients do not disclose that they are taking a multivitamin with vitamin K, multivitamins being one of the most commonly used supplements, they could be putting themselves at risk for developing unwanted clots.

Currently, the supplement industry is partially policed by itself. Companies that market and sell supplement products do not have to show the FDA data of safety or efficacy in the same fashion that pharmaceutical companies do. The FDA can step in when a supplement has been shown to cause harm and pull it from the market. It is important to discuss all supplements you may be taking with your doctor to avoid unpleasant or dangerous interactions. Be sure to tell them even if they do not ask during your screening.

Frequently asked questions

Is there any way to ensure that I’m purchasing a quality supplement?

There are companies out there that do supply third-party certifications to supplement manufacturers. These companies will verify that the supplements listed on the ingredient list are present in the concentrations claimed. There are four major companies that provide these certifications, which are shown in Figure 3: NSF International, Informed Choice, Consumer Lab, andU.S. Pharmacopeia. With the exception of Consumer Lab, all of these third-party certifiers print their seal on the products they have screened.

The testing process often involves looking at the purity, strength, and bioavailability of the product.Good manufacturing practices, which help to provide systems that track proper design, monitoring, and control of the manufacturing process and facilities, are also frequently taken into account. Many employ continuous random testing in order for a given supplement to remain certified. It is very important to note that these companies do not test for efficacy. That is to say, these certifications do not ensure that any health claims made about the supplement are truthful.

What should I know?

While 23,000 dietary-supplement related ER visits may not seem like a lot when compared to something like the 610,000 deaths caused by heart disease every year in the U.S., it is something that can be easily prevented with education and awareness. Although supplement-related deaths were not included in the ER-visit projection, which could lead to an underestimation, it is also possible that emergency department physicians may have incorrectly ascribed certain signs and symptoms to supplements, which could consequently lead to overestimation. Essentially, the 23,000 annual ER visits should be viewed as a very rough estimation.

If you are currently taking or planning to introduce a supplement to your diet, be sure that you are consuming the recommended dose for that product and consult your doctor beforehand. Supplements are not automatically healthful, no matter what the marketing says. Treat dietary supplements the way you would treat medication, with caution and respect for their ability to both help and harm your health.


Bodybuilders illegally sell steroids to fund own use and maintain social status

Image result for steroids bodybuilding

Many bodybuilders illegally sell steroids to help fund their own use of performance and image enhancing drugs and maintain their social status in the weightlifting community, a new academic study has found.

Researchers at Birmingham City University analysed more than 60 criminal cases and interviewed dozens of people involved in the purchase and sale of performance enhancers in the Netherlands and Belgium, to identify the different types of people drawn to selling the drugs.

The report found that sellers often broke the law to help fund their own use of steroids and that most viewed the substances no differently to high street supplements such as protein powders, energy bars or sports drinks.

While many government agencies and sport officials have suggested that substances are sold largely by organized crime groups for financial gain, the findings showed that the majority of performance and image enhancing drugs within bodybuilding subcultures were distributed by individuals for social reasons or to support their own training.

Those who sold products such a steroids, human growth hormone or illegal tanning lotions most commonly did so to put extra money towards the sport, to help out friends, or to ensure safe and quality substances were being taken.

Their social status within the bodybuilding community was found to normalise the sale of drugs, with many overlooking legal implications of the act, while some saw sale as an entrepreneurial opportunity.

One seller said: “It depends who it is, not with friends. But sometimes I do ask extra. Bodybuilding is such an expensive sport, especially when you do cycles, so it is nice to have something extra once in a while. Most of my money goes to the sport.”

The research paper titled, Social suppliers: Exploring the cultural contours of the performance and image enhancing drug (PIED) market among bodybuilders in the Netherlands and Belgium, identified three main types of dealer:

  • Market oriented dealers – Less embedded in bodybuilding culture but aware of entrepreneurial opportunities
  • Social-commercialist dealers – Heavily embedded in bodybuilding culture but aware of money making opportunities through sale
  • Minimal commercialist dealers – Heavily embedded in bodybuilding culture but normally sell to help friends, build contacts or ensure high quality products are used

The report, published in the International Journal of Drug Policy, is one of very few studies to look at the criminal element of performance and image enhancing drugs.

Another seller said: “At gyms you always knew one or multiple people who sell. Most people use themselves and if approached in the right way, they are always prepared to do it [sell]. Maybe they have never sold before in their lives, but if you ask them, they basically automatically drift into it…. You just sell something to a buddy and you just ask 50 Euros extra. In that way you also financed part of your own consumption.”

The report suggests that in order to cut crime, reduce harm and improve treatment, greater attention needs to be paid to the social and cultural factors which lead to sales of performance and image enhancing drugs.

Dr Katinka Van de Ven, Lecturer in Criminology at Birmingham City University, said: “While preventing performance and image enhancing drugs use is important, we need to realise that in certain subcultures the use of steroids and other substances in not likely to stop soon – and may even increase in the coming years.

“For these people that currently cannot stop or wish to continue, it is important to reduce harms as much as possible, and have proper harm reduction measures in place, like we do for recreational drug users.

“For example, some of these suppliers in bodybuilding subcultures, often referred to as ‘steroid mentors’, have a high status in these communities. Instead of driving them away, by targeting them with law enforcement measures, this may offer a potential opportunity to deliver accurate information via an established and credible communication network, and may help in providing accessible and acceptable health-related information.”

The report was co-written by Kyle Mulrooney, DCGC fellow at the University of Kent.

He added: “It is much too simple to point to organised crime and criminal groups and to respond with zero-tolerance and criminal justice measures.

“The fact is we know very little about the illegal market for performance and image enhancing drugs. Our point here is to indicate that there are different rationales and motivations for selling these substances and as such policy should likewise reflect this plurality of drivers.

“To do so however, we must first learn to separate ‘performance and image enhancing drugs as a public health matter’ from ”performance and image enhancing drugs as anti-doping matter.”

The research was funded by the School of Social Policy, Sociology & Social Research of the University of Kent and the Educational Audio-visual and Culture Executive Agency of the European Union.

Para-Olympic cyclist Michael Gallagher admits taking EPO

Gallagher returned a positive A-sample result for the blood booster EPO (Erythropoietin) in an out of competition test at a July training camp in Italy.

“Although the B sample is yet to be tested, It will not change the situation. I have done the wrong thing. People deserve an explanation and I want to give it,” he said in a Facebook post.

“Huge apologies to all the people I have raced during this period, everyone is entitled to an honest performance and I know how cheated people would feel.

“Sorry to the Paracycling team who are about to go into the biggest event with this blow and an unfair link to my stupid actions.

“The support staff, coaches and athletes were all so supportive of me and it breaks my heart to have let them down. I will be following their results and wishing them all the best I can. The apology also extends to the whole Paralympic team.”

Gallagher, who won gold medals in London 2012 Olympic Games and earlier in Beijing, said a range of personal issues led him to the drug in the lead up to Rio.

“Although there are never any excuses for something like this, you do self-analyse and look for reasons. No one in my life saw this coming and if you asked me over a year ago I would never have seen it coming either.

“Worsening mental health issues (depression) and other personal issues in life led to an inability to train and hurt myself like I used to. With the expectations of living up to past performances in a Paralympic year and the need to do so to pay my bills, the pressure mounted.

“Rather than seek help l self-medicated to motivate, crossed the dark line, took short cuts and cheated. I had many ways of justifying this use for Para-sport which in hindsight were merely just dark, paranoid and selfish justifications to talk myself into it.

“I think complete honesty is my first road to recovery. I cheated at sport and put an end to a chapter in my life which has given me so much by my own wrongdoing. I will need to accept and live with that.

“But all this doesn’t sadden me as much as the feeling of letting the important people in my life down.”

Patriots Defensive End tests positive for banned substance, suspended four games

(AP Photo/Winslow Townson)

FOXBOROUGH, Mass. (WPRI) — Star quarterback Tom Brady will not be the only Patriots’ player who will miss the first four games of the season.

Defensive end Rob Ninkovich has tested positive for a banned substance, forcing him to serve a four-game suspension to open the 2016 regular season.

According to ESPN, Ninkovich said Friday that he is devastated and shocked, and would never knowingly take an illegal substance.

Ninkovich, 32, has yet to miss a game with the New England Patriots heading into his 8th season with the team.

The pass-rusher has been in integral part of their defense, recording 47 career sacks in the regular season and playoffs.

Chris Long, a veteran and newly signed defense end, will take over in Ninkovich’s place.

Long, 31, will look to get back to form in years past where he was top 10 in sacks recorded in 2011 and 2012, with 13 sacks and 11.5 sacks respectively.

NHL adds meldonium to banned substances list


The NHL has added meldonium to its list of banned substances.

Deputy commissioner Bill Daly confirmed the addition in an email to The Associated Press on Wednesday. It was first reported by the Russian news agency TASS.

The change goes into effect for the upcoming season. The NHL and NHL Players’ Association had to agree to add meldonium to its list of prohibited substances.

Daly says that decision was made for the same reason the World Anti-Doping Agencybanned meldonium on Jan. 1.

Image result for Maria Sharapova

Maria Sharapova

Russia switched out its roster for the International Ice Hockey Federation Under-18 tournament in the spring over fears that players could test positive for meldonium. Russia used its U17 team in the tournament instead

The drug, which is typically used for heart conditions, is not approved for use in the United States. It increases blood flow, which improves exercise capacity by carrying more oxygen to the muscles. There is significant debate among doping experts over whether meldonium, also known as mildronate, actually enhances performance.

Bigorexia: Body dysmorphia driving increased usage of anabolic steroids

Image result for bigorexia

In the past decade or so, doctors have started to see men who are so hung up on beefing up their bodies that it becomes an obsession.

Some of them even end up with liver or kidney damage after overdosing on anabolic steroids in their frenzy to become Mr Muscle Man. The men, many in their late teens and up to their 30s, work out at the gym compulsively, some twice a day. They take protein supplements to build up their muscles.

Some even turn to the black market to buy anabolic steroids, getting them from peddlers making illegal sales online or offline, to build muscle mass.

Anabolic steroids can be prescribed only by a medical professional. They are used medically, for example, to help patients with muscular degenerative diseases such as muscular dystrophy, to regain much-needed muscle tissue.

The abuse of anabolic steroids can cause liver, kidney or heart damage, said Dr Alakananda Gudi, an associate consultant at the Psychiatry Department at the Singapore General Hospital (SGH). It could also cause other problems such as depression and psychosis, where one loses touch with reality.

 The growing popularity of working out in the gym to achieve a chiselled body – coupled with the trend of men posting pictures of their hot bods on social media – has fuelled this bulking up trend, observers said. And some do go overboard until it becomes an obsession.

Mr Kevin Chiak, president of the Fitness Movement League, said: “Men flaunt their bodies on social media. And girls notice the muscular guys when they walk past them.”

Dr Gudi said that she has noticed more male patients becoming obsessed with bulking up in the past few years. Last year, the SGH eating disorders programme saw 10 men with various eating disorders and some had this obsession. They usually would not seek help unless they run into a medical emergency, such as liver or kidney damage, she said.

Dr Lee Ee Lian, a psychiatrist at the Better Life Clinic who specialises in treating eating disorders, said this is an obsessive-compulsive disorder called muscle dysmorphia.

She said: “They are convinced they are too scrawny, their muscles are too tiny and their emotional distress (about their body) impairs their lives.”

On top of muscle dysmorphia, some men may also have an eating disorder, such as bulimia nervosa, where they binge eat and later purge the food eaten. Dr Lee sees one or two male patients with muscle dysmorphia a year.

Dr Ken Ung, a psychiatrist at the Adam Road Medical Centre, had a patient who became paranoid and believed people were out to harm him.

The man in his 20s had been so obsessed with bodybuilding that he had bought steroids from the black market to build up his muscle mass.

The pills caused his paranoia and his condition only improved after he stopped taking them, Dr Ung said.

Theresa Tan