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Androstenedione appears to threaten health

Androstenedione, a popular supplement taken to enhance athletic performance, did not enhance muscle-building or increase testosterone in the blood but appeared to produce adverse health effects in a small study of young men, according to an article in a recent issue of The Journal of the American Medical Association (JAMA).

Douglas S. King, Ph.D., of Iowa State University in Ames, and colleagues studied 30 healthy men ages 19-29 with normal testosterone levels in a randomized controlled trial.

Twenty of the men performed eight weeks of whole-body resistance training. During weeks one, two, four, five, seven and eight, 10 of the men were given 300 mg of androstenedione a day, and the others were given a placebo.

The researchers discovered that muscle strength did not differ between the placebo and androstenedione groups before training or after four and eight weeks of resistance training and supplementation. They also found that testosterone levels in the blood were not affected by the supplement intake.

The researchers did find a significant lowering of high density lipoprotein (HDL, or “good”) cholesterol in the blood in those receiving androstenedione. Also, certain estrogen levels in the blood increased in the men taking the supplement. In men, increased blood estrogen levels are associated with the development of gynecomastia (enlarged breasts), and increased risk of cardiovascular disease and pancreatic cancer.

In an accompanying editorial, Charles E. Yesalis III, MPH, Sc.D., of Pennsylvania State University in University Park, writes: “During the past year, the public was exposed to a barrage of drug scandals in sports. These involved Olympic champions in track and field, swimming and snowboarding, as well as elite cyclists, a three-time winner of the Boston Marathon, and a professional tennis player.

However, of all the drug-related stories in 1998, none received more media attention than home run record holder Mark McGwire's admission that he used androstenedione as a performance-enhancing substance.

“When questioned, supporters of McGwire borrowed several pages from today's political playbook and argued that what McGwire did was not illegal, was a personal matter, and, besides, the quest for the home run record was good for baseball,” Yesalis continues. “Nevertheless, while androstenedione is not outlawed in major league baseball, it is on the banned drug lists of the International Olympic Committee, the National Football League and the National Collegiate Athletic Association. Many expressed concern that the use of this agent by sports heroes, who may be considered role models, might encourage youngsters to use this steroid hormone. This apprehension is supported, in part, by the claim by Barry McCaffrey, director of the Office of National Drug Control Policy, that androstenedione use by youngsters has increased five-fold since McGwire's admission.

Yesalis writes that the authors of this new research have conducted a well-designed study that has provided valuable information, but that several scientific questions remain and indicate the need for further investigation.

“For example, of the young men enrolled, only two had ever engaged in resistance training, and that training had been more than one year earlier. Such inexperienced weight trainers generally make significant gains in the early phase of resistance training programs. These large strength gains could overshadow, statistically, any potential gains from androstenedione.”

He adds: “Future studies may need to focus on the effects of a higher dose of androstenedione administered during a period longer than eight weeks. While the study by King used a daily dose of 300 mg, recent advertisements for androstenedione recommend a daily dose of 500 to 1200 mg.”

Yesalis concludes: “In the case of androstenedione, the study by King contributes to the evidence suggesting that the government should carefully consider intervening and remove androstenedione and its derivatives from the market.”