MD’s Legal Muscle

By Rick Collins, Esq.

Combat ‘Gear’ for Our Troops?

Q: Do you think the military will ever allow combat soldiers to use steroids?

A: Non-medical anabolic steroid use has long been banned for the military, and service members have even been discharged for using steroids. So, for the Department of Defense to fund a study to explore whether testosterone (T) might assist battlefield soldiers to perform better and recover faster would be a bold departure. And yet, that research is taking place.

The United States Army Medical Research Acquisition Activity sent out a Request for Information (RFI) seeking to determine the availability of a Contract Research Organization (CRO) who can perform “Androgen Therapy for Biomedical Performance Enhancement to Optimizing Performance for Soldiers.” Dr. Doug Kalman, Vice President of Scientific Affairs for Nutrasource, a CRO, said, “Combat troops are exposed to the kinds of extreme stressors that lower T levels. A soldier who is stranded in a hostile environment with limited food or held as a prisoner of war (subject to torture) will likely be hypocaloric, dehydrated and sleep deprived. The Army is exploring what role T administration might play in tactical and cognitive performance and overall recovery.”

Indeed, allowing soldiers facing the intense pressures of warfare to be in better shape and recover faster seems to make sense. War is hell. Why not give our brave service members every advantage? This isn’t about an Olympic gold medal or a plastic trophy; this is about survival. Life and death.

Since the Army’s RFI referred to the study as “Optimizing Performance for Soldiers II,” I checked out the original “Optimizing Performance for Soldiers.” I found out that in 2017, the study protocol for a “randomized, placebo-controlled trial for Optimizing Performance for Soldiers (OPS)” was published, seeking to study the “physiological and psychological effects of testosterone during severe energy deficit and recovery.”¹ Recognizing that prolonged energy deficits can cause plummeting T levels, with consequential loss of lean body mass and impaired mood, decreased attentiveness and reduced decision-making capabilities, the study authors sought to determine whether maintaining normalized or high T levels would improve the performance (and hence, potential survival) of our soldiers under extreme conditions. The study design: recruiting 50 physically active men with normal T levels to undergo a three-phase trial. After baseline measurements, Phase 1 would be 14 days of a healthy diet with adequate calories. In Phase 2, the participants would be randomly divided into two groups under strict controls for 28 days. Both would face high energy demands (intense exercise) and receive severely inadequate calories (less than half of what they needed), but one group would receive supplemental T (four shots of 200 mg testosterone enanthate each, roughly once a week) and the other would get a placebo. In Phase 3, the participants would resume habitual diet and physical activity patterns, with the researchers assessing how long it would take for the participants to recover baseline total body mass and skeletal muscle mass.

The results of the original study were published in 2019, and can be found here: https://www.thelancet.com/journals/ebiom/article/PIIS2352-3964(19)30501-8/fulltext. “This proof-of-concept, single centre, randomised, double-blind, placebo controlled trial is the first, to our knowledge, assessing the efficacy of supplemental testosterone on body composition, muscle function, and clinical health biomarkers in healthy, non-obese, young men exposed to 28 d of severe exercise- and diet-induced energy deficit representative of strenuous military training and combat operations,” note the authors. Obviously, the results of the original study were generally positive or the Department of Defense wouldn’t be seeking to fund a follow-up study. Indeed, the T group retained more skeletal muscle mass than the placebo group. I’m told that the follow-up study will be of a longer duration – perhaps 16 weeks – and may use a T implant rather than injections to better understand how T might best be used to improve “soldier lethality” – an Army mission term for the psychological and physiological qualities that make a soldier best equipped for combat.

Without a doubt, the severe caloric deficit in combat situations is hard to overcome, even with T administration. Still, we owe it to our brave combat troops to continue to explore how to maximize their survival potential by keeping them as strong as possible under the most extreme conditions.

Rick Collins, Esq., CSCS [https://rickcollins.com/] is the lawyer that members of the bodybuilding community and dietary supplement industry turn to when they need legal help or representation. [© Rick Collins, 2019, updated 2020. All rights reserved. For informational purposes only, not to be construed as legal or medical advice.]

Reference:

1. Contemporary Clinical Trials 58 (2017) 47-57.

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