However, note that both AAS and NMDA cause cell damage/death by increasing calcium entry into the brain cell. It is inherently clear that the effect of the two agents combined would be additive, with both attacking the cell via different receptors. The influx and buildup of calcium would occur at a more rapid rate and result in greater damage/death, as the study found. These findings are a bit chilling, as they suggest that common food additives (MSG, aspartame) may cause brain damage that AAS users are especially sensitive to, particularly if they use a nonaromatizing AAS or Arimidex or other aromatase inhibitors. Nortestosterone (Deca), stanzolol (Winstrol) and gestrinone were all associated with greater damage in concentrations that would easily be reached in an anabolic cycle, particularly gestrinone. Testosterone was relatively safe in normal concentrations (assuming no aromatase inhibitor is used) and concentrations used in most recreational cycles (400mg-600mg testosterone enanthate/week). Testosterone enanthate cycles using more than 1,250mg/week may begin to enter the range, wherein the risk for NMDA-induced damage increases. A study published in the Archives of General Psychiatry in 2001 found that subjects administered methyltestosterone at a dose of 240mg/day for four days had CSF concentrations of the steroid approaching 1 µm, though there was a great deal of variability among subjects. In that study, methyltestosterone was found to be present in greater concentration in the CSF than in the blood, which may not be typical of all steroids. Granted, methyltestosterone is not used as an anabolic steroid by athletes or bodybuilders, but the chemistry of the drug is similar to other steroids, particularly oral steroids. Also, 240mg/day is an excessively high dose, as the closely related and more familiar AAS methandienone (Dianabol) is commonly used in the 20mg-25mg/day range.

    MSG and aspartame are considered safe by the FDA and they are nowhere near as potent as NMDA at inducing brain cell damage. Further, the concentration of NMDA used in the study was quite high. However, for those wishing to use testosterone or other AAS, it appears to be prudent to avoid those two food additives during a cycle. MSG may be listed as monosodium glutamate, glutamate, umami or by trade names. It is very high in Soy sauce and Parmesan cheese. Aspartame is commonly used in numerous food and beverages.

    The BALCO scandal created a number of ethical dilemmas, but a graver concern for any users exposed to the gestrinone-like steroid THG is the possibility of brain injury, given the finding that gestrinone increased the vulnerability of brain cells to NMDA damage. Fortunately, in the absence of NMDA, gestrinone did not appear to cause direct harm. Further, the number of athletes to whom THG was made available appears to have been somewhat limited. A responsible move by the government would be to fund a study to examine athletes known to have used THG and determine if any cognitive impairment or structural lesions are present. Further studies looking at the brains of AAS users who undergo autopsy would also be beneficial to see if the possibility for brain cell damage is relevant to non-medical use in humans.