By Dr. Peter Nieman, For the Calgary Herald
Q: My 17-year-old son told me that a close friend of his, on their football team, admitted that he is using steroids, supplements and stimulants to enhance his endurance. I am concerned that this friend's decision will influence my son.
A: The use of performance-enhancing drugs (PED) by teenagers has increased over the past decade, and is more common among male athletes - particularly football players, wrestlers, weight trainers, baseball players and gymnasts. A recent study revealed that 3.3 per cent of high school athletes admitted they use anabolic steroids.
Adolescent athletes who use PED are often motivated by pressure from peers, by a deep desire to win at all costs in order to enjoy more fame and influence, to get sport scholarships, and - in rare circumstances - by pressure from coaches or parents.
Adolescents with a history of depression, those with a negative body image and teens who have a tendency to compare their own bodies to those who are known users of steroids are at an increased risk of using PED.
Studies have shown that media also has an impact on teens, especially when it comes to body image. Adolescents who regularly read fitness and body building magazines are twice as likely to use substances to enhance their performance, build muscle or lose weight.
The use of PED is not new. In fact, during the original Olympic Games, cash awards given to the winners contributed to a win-at-all-cost attitude. The word "doping" originates from the use of a type of opium juice called "doop," used by some original Olympic athletes to perform better. And Roman gladiators were known to use strychnine to avoid injury and increase endurance.
What are PEDs?
There are four main groups of PED: anabolic agents, nutritional supplements, stimulants and a general group that includes diuretics, erythropoietin and human growth hormone.
The anabolic agents are steroids, testosterone and steroid precursors. Steroids can be injected, taken orally or absorbed via the skin. These products preserve and increase muscle mass and delay muscle breakdown. As a result, muscles get up to 20 per cent stronger; when combined with strength training, this provides athletes with an extra edge. It also has an effect on aggression, helping an athlete to train and push themselves harder.
The main side-effects of anabolic steroids and steroid precursors are damage to the heart, liver and bone growth. However, there is a long list of other adverse effects, including lower height, tendon strains and rupture, altered libido, testicular shrinking, reduced sperm production, formation of breast tissue in boys, hairy skin in girls, loss of menstruation, deep voices due to thickened vocal cords, acne, male pattern baldness, increased blood pressure, high cholesterol and depression.
Three common nutritional supplements are creatine, amino acids and beta-hydroxy beta-methylbutyric acid. Creatine has become very popular, especially among adolescents who lift weights or play football. It is a non-essential amino acid that is made in the liver, pancreas and kidney, and can be found naturally in meat, milk and fish. By taking additional supplements, athletes can increase their sport performance in short, high intensity exercises such as weightlifting, gymnastics and wrestling. The benefits of taking creatine in performances of longer duration remain less obvious.
The side-effects of creatine are weight gain, nausea, water retention, muscle cramping and kidney damage.
Stimulants such as ephedrine, guarana and caffeine are used by adolescents to improve alertness and aerobic performance; they reduce the perception of fatigue and increase the time to exhaustion. These products are widely available and difficult to detect.
In the past, ephedrine was available in cough and cold remedies over the counter, but Ephedra was banned in 2004: side-effects include high blood pressure, weight loss, insomnia, anxiety, tremors, headaches and irregular heart rates, and it was associated with several athlete deaths.
Guarana is a plant extract and is found in some energy drinks. Guarana seeds contain extra amounts of caffeine, which improves muscle function. However, it is not useful for sprints and short bursts of activity; it may be effective for prolonged sports such as tennis, running or hockey.