Dr. Testosterone
By George Touliatos, MD

THE SIGNIFICANCE OF MEDICAL PREVENTION IN BODYBUILDING

Bodybuilding is impressive, but is also a double-edged sword, when it is not consistent with the requirements of knowledge, know-how and prevention. You should not blame the drugs in case you use them carelessly, or if you carelessly stack different compounds.

The contradictory and paradoxical issue with the use of chemical enhancement is that while you improve your external appearance, at the same moment, you risk your health. Conversely, when you cease using drugs, your physique starts to flaw, but your health starts getting better and laboratory tests improve.

Each doctor is obliged to tell to his patients how to preserve their well-being. The fact that bodybuilders decide not to follow it is due to their vanity, weaknesses and personal choices.

The sport of bodybuilding involves a risk, a craze, a vanity – all of which pose dangers in the long term, so exaggeration and the thought that “the more is better” is not panacea and does not necessarily guarantee success. Side effects of a particular substance are dependent on various parameters, such as age, time of abuse, dosage, combination of performance-enhancing drugs (PEDs), lifestyle, proper nutrition and supplementation, medical prevention rules and family history.

Time of abuse and dosage play a major role. This practically translates into either big doses for a small amount of period (shocking therapy), or small doses for prolonged duration. So, small doses of testosterone as TRT (hormone replacement) will offer a better libido, muscularity, skin elasticity, improved bone mineral density, improved self-esteem and sexual drive, diminished omental fat – midsection fat reduction, ultimately resulting in a confidence boost as a way of life. But over time, there might be changes in the atherosclerotic profile – fraction (HDL/LDL), inflammation of the prostate gland (BPH) because of the reduction to DHT, androgenic alopecia (MPB), hair growth on the back and shoulders, thickening of heart’s left ventricle. That’s the reason regular medical monitoring by measuring the values of PSA/FREE PSA, biochemical serum tests and echocardiography are required. The same applies to the anti-aging somatropin (HGH) as well. Even with small doses of 4 IU daily in five years time, it is possible to cause excrescences in the abdominal region due to visceral enlargement (small and large intestine, liver, spleen) irrespective of the use of insulin. The only difference is that while some things are potentially reversible, others are not, such as the cardiomegaly, acromegaly and the possibility of tumor genesis (colon cancer).

You don’t have to make brief abuses to get ill. Even minimal doses for prolonged periods may result in similar medical issues. Overall lifestyle and the prevention rules play a major role. Lifestyle includes a healthy diet, low in sugar-refined carbohydrates, saturated-trans fats and salt, with a variety of fruits and vegetables, fiber-rich whole grains and low-fat dairy products. For overall cardiovascular health, regular (five times per week) cardiovascular physical activity is recommended. Also cessation of smoking, moderate use of alcohol and avoidance of narcotics are mandatory preventive approaches.Before the onset, during and after the end of a cycle of AAS/PEDs, the user has the obligation to undergo specific blood tests to evaluate his general medical condition. This is crucial firstly to determine the user’s current health and risks before any cycle is initiated, then to assess the direct impact of the AAS/PEDs use and finally to evaluate the distortion or restoration of original state of good health. We all have a specified genetic predisposition (DNA), which largely determines our genetic limits and our standards. Anabolic-androgenic steroids (AAS) do not kill instantly, or at least not in a few hours. On the contrary, 30mg of benzodiazepam can lead to a coma, due to respiratory center suppression. Also 5 grams of salicylic acid (aspirin) will lead to lead to gastric mucosa bleeding and ulcer. Impressively, a high dosage of potassium can be lethal, as a result of ventricular fibrillation.

The most dangerous drugs in bodybuilding are:

1) insulin,

2) diuretics and

3) CNS stimulants

These medications can lead respectively to lethal:

1) hypoglycemic coma,

2) hypovolemic shock and severe heart arrhythmia,

3) aneurysm rupture, leading to hemorrhagic stroke and acute myocardial infarction – in other words, heart attack.

Chemical enhancement with PEDs receives negative propaganda. It’s impressive that the majority of those who use PEDs are not professional athletes, but mainly recreational or amateur athletes.

AAS/PEDs are not the first choice drugs on pharmacy shelves. They are specialized drugs, manufactured and prescribed for the treatment of certain diseases (hypogonadism, anemia, osteoporosis, muscle weakness, angioedema, AIDS cachexia, breast cancer) and used under medical prescription.

The legal status of AAS varies from country to country; some have stricter controls on their use or prescription than others, though in many countries they are not illegal. In the United States, AAS are currently listed as Class C controlled substances, same as barbiturates and opioids. As a former athlete who competed at the bodybuilding nationals, I realized that the persecution against chemical enhancement resulted in the withdrawal of specific steroids worldwide by legitimate pharmaceutical companies. Unfortunately, they were replaced by underground and illegal products (counterfeits). Contamination is easier, since these chemicals do not comply with or adhere to ISO standards for human use. Heavy metals and poor-quality solvents (oils) are most likely to be presented. Of course, underdosed solutions are also a highly possible case scenario.

George Touliatos, MD is an author, lecturer, champion competitive bodybuilder and expert in medical prevention regarding PED use in sports. Dr. Touliatos specializes in medical biopathology and is the medical associate of Orthobiotiki.gr and Medihall.gr, Age Management and Preventive Clinics in Athens, Greece. Heis the author of four Greek books on bodybuilding, has extensively developed articles for www.anabolic.org and is the medical associate for the book Anabolics, 11th Edition (2017). Dr. Touliatos has been a columnist for the Greek editions of MuscleMag and Muscular Development magazines, and has participated in several seminars across Greece and Cyprus, making numerous TV and radio appearances, doing interviews in print and online. His personal website is https://gtoul.com/

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