“A man who takes anabolic steroids, even if he works out and misses…

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https://www.vox.com/the-goods/22760163/steroids-hgh-hollywood-actors-peds-performance-enhancing-drugs
“A man who takes anabolic steroids, even if he works out and misses half of his workouts and smokes and drinks and so on, can still surpass even the most dedicated male who does not take steroids.”
That appeal, he said, can often seem to outweigh the health risks like the increased possibility of a stroke and potential cardiovascular problems.
The use of human growth hormone (HGH) for performance enhancement is even newer than that of steroids. HGH is a protein that naturally occurs in the body, but, just like testosterone, it decreases over time. This is one reason that the older you are, the harder it is to maintain muscle. Its conventional medical use, which began in the 1950s and was synthesized and FDA-approved in 1985, was primarily for children who have been diagnosed with a growth hormone deficiency and were smaller in stature. Doctors prescribe HGH to literally help these children grow. In adults, HGH has been prescribed to people with HIV to combat the loss of body mass. There are also studies of growth hormone therapy used to help treat cystic fibrosis, inflammatory bowel disease and Crohn’s, and osteoporosis.
Doctors are still studying the full effects of HGH, but they believe its performance-enhancing properties can lead to body fat reduction and muscle building and recovery.
“It helps you regulate or decrease the fat body mass,” said Olivier Rabin, the senior executive director of science and international partnerships at the World Anti-Doping Agency (WADA). WADA is best known for monitoring drug testing in the Olympics, among other competitive sporting events. Rabin’s expertise is in pharmacology and toxicology.
Rabin said that a popular method today is to combine the two; taking HGH with a steroid regimen allows someone to take lower doses of steroids — perhaps decreasing the side effects or dependency — while enhancing their effectiveness.
What worries Pope, Rabin, and their colleagues is how effective these drugs are and how little we know about their long-term effects. What’s already clear is how influential they can be.
Drug education in the US has historically used fear to drive the point home, but that can lead to skepticism when the fears are revealed to be exaggerated. PEDs can lead to grim consequences, but they usually don’t happen instantly. Not every nightmare scenario happens, and not all at the same time.
The illegality of some PEDs is part of the problem in determining side effects and how dangerous they may be. While there are studies of anabolic steroid use in patients, it does not extend to the wide array of PEDs, nor can you conduct a study simulating heavy use over time. Pumping volunteers full of steroids isn’t ethical and would put them in danger. People can be hesitant to disclose their use, as they’d be admitting to breaking the law. When doctors like Harrison Pope study steroids and PEDs, then, they rely on volunteers with past or current drug use coming forward, sometimes to varying degrees.
The use of anabolic steroids is still fairly new, Pope said. The bodybuilders who popularized them in the ’80s and ’90s were mostly in their 20s and 30s. That means the first batch of heavy steroid users are just now coming out of middle age, and Pope and his cohort have only been able to study long-term effects for the past decade or so, and only with this select group of people. HGH is even more difficult to study, as its use as a PED is even more recent.
Pope uses smoking to illustrate our relative lack of knowledge. In 2021, it’s impossible to consider smoking without thinking about its connection to lung cancer. This was not always the case, however. Even though lung cancer had surged alongside the popularity of cigarettes at the turn of the 20th century enough to become an epidemic, it would take decades until scientists in the 1950s and ’60s found a concrete connection and made the public aware of it.
PEDs have barely begun that arc, and what doctors and scientists are seeing now, he fears, is akin to pulmonary doctors finding the first few cases of lung cancer in heavy smokers, having “no idea of what was about to hit us.”
“We may see a substantial increase in cases of cardiac complications over the next decade or two, as this group moves into older ages,” Pope said.
Steroids make muscles in your body stronger and bigger, but something funny can happen to your heart, arguably your most important muscle. With heavy steroid use, your heart may become weaker, more inefficient at pumping blood. Inefficient hearts can lead to heart failure. Steroids can also harden arteries and increase the risk of heart attacks and stroke."

https://www.vox.com/the-goods/22760163/steroids-hgh-hollywood-actors-peds-performance-enhancing-drugs