Performance Enhancing Drugs – Not Just For The Elite

Anabolic steroids

Anabolic steroids

Performance-enhancing drug-use continues to make headlines thanks to Lance Armstrong, the Australian sporting community and now maybe even Oscar Pistorius.   And while such professional sportsmen’s furtive actions should be exposed, there is another group of users that often go unnoticed – the everyday person trying to get fit.  Whether it’s young kids wishing to boost their self-image or a gym-goer wanting to build body mass, drugs are proving to be prevalent outside of the sporting world.

A recent report in British Medical Journal (BMJ) reiterated this by saying, “The use of anabolic steroids is no longer limited to elite athletes.”   The research stems from a gym survey showing 15% of 792 homosexual men had used steroids, along with the UK Department of Health’s numbers indicating young people that had tried steroids rose from .2% to .6% in 2006.  Possibly more frightening, estimated figures from the most recent British Crime Survey (BCS) reveal 50,000 people in the UK use steroids for strength training; some health officials believe this could be over 100,000 due to unreported usage.

Dan Novelli, personal trainer at Soho Gyms in London, said over 60% of his clients use performance enhancing drugs (PEDs).  “PEDs which include anabolic steroids are rife.  They are used in most competitive sports right down to the ordinary person. There are more gyms, therefore more users.”

He is referring to the 2012 State of the UK Fitness Industry Report that says the number of gym memberships has reached an all-time high of 7.6 million.  And while it is difficult to discern the direct link between gyms and PED users (The Fitness Industry Association did not have these numbers available), it can be looked at as more probable due to accessibility.

So the question arises: Does the public not want to know about these alarming figures, or rather they aren’t being told?

This is difficult to answer; an answer not one particular individual or organisation seems able to address.  The grey area begins with the Misuse of Drugs Act’s classification of anabolic steroids and the Human Growth Hormone (HGH) as Class C drugs, which means they can be bought and taken for personal use, but they cannot be sold (this already being generous in comparison to countries like the US where both selling and consuming are illegal).  If caught for supplying, prison sentences can be up to fourteen years plus a fine.   This sounds steep, but according to DrugScope, few arrests are made on this basis, as it’s difficult to prove supplying over personal use.

Further measures are being pushed forward by the Advisory Council on the Misuse of Drugs (ACMD).  In 2011, the Department of Health granted ACMD’s proposals to remove the term ‘medicinal product’ used in reference to anabolic steroids and HGH in efforts not to make steroids sound like an over-the-counter healing agent.  The Department of Health also passed the prohibition of the importing of power-enhancing drugs via online purchasing.  Professor Les Iversen, Chairman of ACMD, believes steroids bought online can be contaminated, and that a law disabling people from buying these, can only help in deterring such purchases.

But in a contradictory shift, the Department of Health also agreed with ACMD to continue allowing possession of personal steroids since life-threatening overdoses are uncommon (or at the very least not reported).  The Department of Health also agreed that the potential harmful side effects needed to be brought to the public eye, but felt this was already being done by literature in NHS clinics and the campaign FRANK that provides support for users.  Lastly, it emphasised the importance of the local community (referring to gyms, schools and community centres) to make the resources more available, including the published book ‘A Summary of the Health Harms of Drugs’ and nearby treatment centres.

This may sound good in theory, but most gyms don’t want to admit PED use is commonplace and General Practitioners (GPs) insist their patients would not openly admit to taking PEDs – this making it tricky for both parties to push such types of literature.  Dr. Kaz Strycharczyk, a GP at Highgate Private Hospital, explains that patients don’t admit to taking steroids for fear their employers or health insurance companies would find out.  He adds, “Most GPs no little about recreational steroid use.  There are so many unknowns, and conventional medicine doesn’t educate doctors about this. It’s a problem, particularly in university towns where steroid use can be more routine.”

Dr. Naomi Craft, a GP at Cavendish Health Centre in London, agrees by saying, “I very rarely get patients admitting to steroid use so I wouldn’t enforce these supportive materials.  If patients do confess, I would recommend treatment immediately.  But specialised treatment centres are not easy to find.”

In a sense, the steroid user is in a world isolated from health professionals, self managed both in dosage and in treatment.  Gym buddies and online forums become the ‘GP’ so to speak.  Fred Hibbs, Personal Trainer and Gym-owner in Surrey (1), further adds, “Getting steroids and PEDs is simple.  There are dealers in almost every gym or you can buy on-line.  Despite the new law, it’s easy to import [if the web-site is based in a country where selling steroids is legal such as China or Egypt].  Steroid cycles are then self-taught from hundreds of web-sites as well as the local guys at the gym.  The problem is many of the drugs bought on-line are risky since you don’t know what’s in them.  The other problem is guys recommending doses higher than you should take.  You see this happening with guys starting out, particularly the younger kids.”

The sites he is referring to include and where subjects range from ‘Steroids for Advanced Users’ to ‘Celebrity Steroids’.   There is no governing body monitoring these, just the forum writers themselves varying from professional body builders to ‘newbies’ wanting to bulk up fast.  Some forum entries suggest trying a cycle, then asking your GP to monitor your health.  Based on doctors’ already limited schedule (and budget), this seems a tall order, especially when not all GPs are fully aware what to look out for.

However, in an article published in the Journal of Endocrinology titled ‘Drug in Sport – the Role of the Physician ‘, the author points out that ‘primary care doctors need to keep an open mind.  It is ideal that patients don’t use performance-enhancing drugs, but if they cannot be swayed, we (the physician) can help in harm reduction, ie. shorter cycles, lower doses and proper injection methods.’

Doctors are slowly beginning to take this approach.  Dr. Strycharczyk adds, “In the case of body builders, they were clear that steroid use was necessary.  They gave the impression of being very knowledgeable.  As a GP, I could only advise there would be risks ranging from uncertain provenance of the drugs, unclean needle use to impaired fertility.”

Personal trainers are also taking a more open-minded view.  Andrew Winnery, a Personal Trainer at Bannatynes Health Club in the City, has himself tried PEDs and knows the negative side effects well.  But if a client is determined to take them, “I would give them guidance on the best way to use them.”

Paul Hunt, a Personal Trainer in North London and Anti-steroid Advocate to kids in Haringey Council, agrees but reminds both physicians and personal trainers that the psychology behind users must not be overlooked.  “The marketing behind elite athletes and sports paraphernalia urges people to look svelte.  It’s the same kind of marketing centrered around steroids online: get bigger and feel better.  This creates a false message both about exercise and a healthy body.  This is where we need to focus, particularly for the younger generation as steroid effects can’t be reversed on premature bodies.”

In the lead-up to London 2012, UK Anti-Doping joined forces with Dame Kelly Holmes’ charity GSK to create the Science in Sport Outreach programme, informing kids 11-14 of the values and morals required in sport.  The Youth Sport Trust charity also has a programme educating Gifted and Young athletes on leading a balanced lifestyle.  There are several other like-minded organisations, but very few focusing on young kids that take PEDs for image enhancement or bullying prevention.

As it stands today, PEDs are still an illicit subject.  True statistics are difficult to find as people don’t report their usage – this pertaining to fatal side effects such as heart and liver failure to crime figures relating to aggressive behavior, or ‘roid rage’.  Occupational Health Therapist Dr. John Sterland adds, “Users are for the most part fit people with good bodies which can handle changes or abuse before they show long-term effects.”   This then makes it difficult to veer those determined in using, as short-term effects are ambiguous, varying from person to person.  John Stephens, a Nutritionist and Weight-Lifter, ascertains that “short cycles make you feel stronger, and therefore good about yourself.  So the cycle begins, and next thing you know, you’re taking longer cycles with higher doses.”

It’s a slippery slope, and one that doesn’t get the publicity it deserves.  Paul Hunt reminds people, “Ultimately, your health is in your own hands.  Exercise is about being healthy.  The body is not a machine, it is meant to gradually see results.”

(1) Name has been changed for protective purposes


What are Anabolic Steroids and Performance Enhancing Drugs?

These are often grouped under the same category, either as ‘Steroids’ or PEDS.  Some also refer to these as Performance Image Enhanced Drugs (PIEDs).

To break down further:

Anabolic steroids (2):

Anabolic steroids are manufactured drugs that mimic the effects of the male hormone testosterone. They have limited medical uses and are not to be confused with corticosteroids, a different type of steroid drug commonly prescribed for a variety of (medical) conditions.  They are known to increase muscle mass and decrease fat, and are usually injected into the muscle, but can sometimes be taken as tablets or as a cream or gel applied to the skin.

This involves injecting the drugs for a period of time, then stopping for a rest period before starting again. This is known as ‘cycling’.  More than one type of anabolic steroid may be used at a time. Users believe that this increases the effectiveness. This is known as ‘stacking’. The term ‘pyramiding’ refers to a combination of both stacking and cycling.

What are the side effects? 

Heart attack, stroke, liver or kidney tumours, high blood pressure, blood clots, fluid retention, high cholesterol. aggressive behavior, mood swings, hallucinations, addiction, depression, insomnia, fatigue, decreased sex drive, muscle and joint pain

Men specific:

Baldness, breast development, severe acne, increased risk of prostrate cancer, reduced sperm count, infertility, shrinking of testicles

Female specific:

Growth of facial hair, loss of breasts, swelling of clitoris, deepened voice, increased sex drive, problems with period, hair loss, acne

What are performance enhancing drugs (PEDs)? (3)

In addition to anabolic steroids, these can include Human Growth Hormone (HGH), Androstenedione, Erythropoietin, Diuretics, Creatine, Stimulants Such as Caffeine and Amphetamines. 

What are the side effects?

Human Growth Hormone (HGH): A hormone that improves muscle mass and performance. Administered by injection. But it can also cause joint pain, muscle weakness, fluid retention, impaired glucose regulation, high cholesterol, diabetes, high blood pressure

Androstenedione (‘Testosterone’): A hormone produced by the adrenal glands, ovaries and testes.  It is normally converted to testosterone in both men and women.  Users take it to train harder and recover more quickly.  But it can also cause acne, diminished sperm production, shrinking of testicles, enlargement of breasts and masculinisation in women 

Erythropoietin (‘EPO’): A type of hormone used for endurance.  Increases red blood cells and hemoglobin, resulting in more oxygen to muscles.  But they can cause stroke, heart attack and pulmonary edema

Diuretics:  Drugs that alter your body’s natural balance of fluids and electrolytes.  Can help one lose weight or pass urine quickly acting as a ‘masking’ agent.  But they can also cause muscle cramps, dehydration, fainting, dizziness, potassium deficiency, low blood pressure and loss of balance 

Creatine: Technically a supplement.  A naturally occurring compound in your body that helps muscles release energy.  Used for quick bursts of activity.  But they can also cause stomach and muscle cramps, nausea, diarrhea and weight gain

Stimulants Such as Caffeine and Amphetamines:  Can improve endurance, reduce fatigue and increase alertness.  But they can also create anxiety, insomnia, dehydration and heat stroke

Treatment Centres Available

Drugs in Sport Clinic and Users’ Support (DISCUS), Surrey Harm Reduction Outreach Service, Wirral Harm Reduction Service, FRANK

Alternatives to steroids:

First and foremost, a healthy, balanced diet originating from fresh, natural ingredients.  In addition to a focus on proteins, a decent amount of healthy fats and decent carbs (eggs and olive oil).  Possible additional supplements in low doses, and only if body is lacking in such nutrients, include Zinc, Magnesium, Vitamin B6, Whey Protein and Flaxseed Oils. 


(2)  Information taken from

(3)  Information taken from

(4) Centres listed in ACMD’s  Anabolic Steroid Index and The Department of Health

(5) Taken from a group of registered Personal Trainers in the UK