Evidence for the use of prescription vs non-prescription medications
21 April 2012, 03:59 PM
#31
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I would further assert that jef's information presented is below level 4.
Quote from second link in post #16:
Rather than berate the authorities and the quality of their intervention on nutrition and health of steroid users, he would first have to prove with good quality evidence as outlined above that his interventions worked.
I would further assert that because he is not using scientific method in the development of his intervention, then it has neither been proven to be beneficial nor shown that it will not cause further harm compared to another method. To intervene in this situation could be considered unethical despite best intentions, but the history of interventions that are not evidence based is littered with well meaning people causing harm.
Giving technical background and then making unsupported assertions without trials of number needed to treat and number needed to harm is IMHO dangerous.
Quote from second link in post #16:
Rather than berate the authorities and the quality of their intervention on nutrition and health of steroid users, he would first have to prove with good quality evidence as outlined above that his interventions worked.
I would further assert that because he is not using scientific method in the development of his intervention, then it has neither been proven to be beneficial nor shown that it will not cause further harm compared to another method. To intervene in this situation could be considered unethical despite best intentions, but the history of interventions that are not evidence based is littered with well meaning people causing harm.
Giving technical background and then making unsupported assertions without trials of number needed to treat and number needed to harm is IMHO dangerous.
my intervention in cases of a diet that consist of simples sugars/fats and almost zero protein, never mind vitamin/mineral profiles, and changin it to include fruit/veg, len proteins and come more complex carbs, is not been proven to be beneficial?
ive already provided example of authority advice, and seen countless gp's advice, just not to use them. and your own admission to the same- that has positive effects on health does it?
21 April 2012, 05:13 PM
#32
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Quackery does not have to mean lack of a certificate, but when there is a lack of a certificate combined with emphasis of personal experience over scientific process, and unproven action over no action, then it is quackery IMHO.
In particular, you criticising the advice to avoid androgrenic steroids would require substantial evidence to be credible.
That is an example of one of your claims that would require very robust evidence indeed when there is ample evidence of harm in the literature. You would have to demonstrate the precise circumstances you lay out are really different, and have a well designed double blinded trial of adequate statistical power to show the pre-determined postive effect compared to a control group with statistically similar baseline characteristics, and you would have to show over extended follow up that the existing harms do not apply. You would therefore be showing that your number needed to treat to gain a useful benefit is less than the number needed to produce harm. Further you would have to demonstrate that the benefit was sufficiently worthwhile compared to the severity of the harm so that you could favourably compare the number needed to treat with the number needed to harm.
In the meantime, from any reasoned perspective I believe you have an uphill argument to support your intervention which does not involve telling people to avoid androgenic steroids.
They might listen to you if you can relate to them, and I have no quibble about increasing fibre, vitamins, minerals, switching sugars and fats to proteins and complex carbohydrates.
The equivalent would be me not telling people to stop smoking and instead tell people to eat more foods containing antioxidants based on a nice idea that they may reduce their risk of lung cancer and heart disease. However, because someone has bothered to do the trials, we know that simple advice to give up smoking is beneficial. Granted, the risks of smoking compared with a well devised androgenic steroid regime may be higher, but the data isn't there to prove it.
In particular, you criticising the advice to avoid androgrenic steroids would require substantial evidence to be credible.
under THE RIGHT circumstances they can have positive effects that outweigh the negative.
In the meantime, from any reasoned perspective I believe you have an uphill argument to support your intervention which does not involve telling people to avoid androgenic steroids.
They might listen to you if you can relate to them, and I have no quibble about increasing fibre, vitamins, minerals, switching sugars and fats to proteins and complex carbohydrates.
The equivalent would be me not telling people to stop smoking and instead tell people to eat more foods containing antioxidants based on a nice idea that they may reduce their risk of lung cancer and heart disease. However, because someone has bothered to do the trials, we know that simple advice to give up smoking is beneficial. Granted, the risks of smoking compared with a well devised androgenic steroid regime may be higher, but the data isn't there to prove it.
21 April 2012, 05:21 PM
#33
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Without taking it off topic too much, I never had an ill view of Mother Theresa until I read Christopher Hitchens. I'm sure she was well intentioned, genuine, and may have subjected herself to poverty, and it all seemed like a jolly good idea. However, if you consider the evidence, you may conclude that her advice on condoms more than undid all the benefit she otherwise achieved.
Me quoting Scottish guidelines has a resonance since Scotland had a huge influence in the enlightenment. I'm not Scottish, but pleased to live here. The basis of reasoning that we inherit from this movement is not a straight jacket but a framework to liberation and security that our actions are reasoned and beneficial, rather than well intentioned but potentially harmful. It is not being closed minded, but submitting our opinions to logic and scrutiny.
Me quoting Scottish guidelines has a resonance since Scotland had a huge influence in the enlightenment. I'm not Scottish, but pleased to live here. The basis of reasoning that we inherit from this movement is not a straight jacket but a framework to liberation and security that our actions are reasoned and beneficial, rather than well intentioned but potentially harmful. It is not being closed minded, but submitting our opinions to logic and scrutiny.
21 April 2012, 06:59 PM
#35
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but john what your asking is for me, 1 individual to have the funding and facilities to carry otu studies which would carry no public support and are unethical and taboo.
then youd expect me to present this info to a general council board with my non-medical background or full legislative understanding.
id then have to most likley go against, public perception, anti ped campaigns not to mention try to get a law over turned, which would very likley damage any politcal parties reputation.
let start at the begining, i think wed both agree the level of nutritional understanding in this country is woeful at best, obesity is ever increasing inc rising numbers in obese children.
with genetic predisposition being the number 1 deciding factor on health and longevity. (id go onto argue the importance of diet in both parents in having an influence on possible health problems in children)
follwed by lifestyle choices, including nutriton and excersise. altho extremeties in harmful lifestyle cud enhance gentic problems.
agreed?
the list of possible short term side effects from what i would class sensible doses and cyle legnths would you agree are recoverable from?
so the positives from use, ime and my whole point revolves around an increased interest and understanding of nutrition, excersise and lifestyle choices as a whole, is where the health benefits come from. instead of going ut getting bladdered at weekends using recreational drugs users stay at home eat well and rest if they want to make the most of whatever they choose to use.
and the health benefits dont stop there - youve then instilled nutritionalinformation into potential parents, who pass on information to kids - and possibly go somewhere to breaking the acceptance of alcohol mis-use. and usually get them involved in excersise to some degree or other.
at the moment we got parents with no nutritional understanding and then passing it on to kids. mothers feeding young kids irn bru in bottles..
atleast those taking an interest in gym, and training and diet are learmning, and even using sensible doses ae gaining more education by chsoing a lifestlye that involves sport and excersise.
and i repeat i do not advise the use of AAS to anyone, but for those that have already chosen ill do what i feel is relevant to help.
what you want me to provide john is a statistical analysis, and brekdown of figures between users and a placebo group
and have it repeated on a large enough sclae to be considered of use.
how on gods green earth would you expect this to be possible?
then youd expect me to present this info to a general council board with my non-medical background or full legislative understanding.
id then have to most likley go against, public perception, anti ped campaigns not to mention try to get a law over turned, which would very likley damage any politcal parties reputation.
let start at the begining, i think wed both agree the level of nutritional understanding in this country is woeful at best, obesity is ever increasing inc rising numbers in obese children.
with genetic predisposition being the number 1 deciding factor on health and longevity. (id go onto argue the importance of diet in both parents in having an influence on possible health problems in children)
follwed by lifestyle choices, including nutriton and excersise. altho extremeties in harmful lifestyle cud enhance gentic problems.
agreed?
the list of possible short term side effects from what i would class sensible doses and cyle legnths would you agree are recoverable from?
so the positives from use, ime and my whole point revolves around an increased interest and understanding of nutrition, excersise and lifestyle choices as a whole, is where the health benefits come from. instead of going ut getting bladdered at weekends using recreational drugs users stay at home eat well and rest if they want to make the most of whatever they choose to use.
and the health benefits dont stop there - youve then instilled nutritionalinformation into potential parents, who pass on information to kids - and possibly go somewhere to breaking the acceptance of alcohol mis-use. and usually get them involved in excersise to some degree or other.
at the moment we got parents with no nutritional understanding and then passing it on to kids. mothers feeding young kids irn bru in bottles..
atleast those taking an interest in gym, and training and diet are learmning, and even using sensible doses ae gaining more education by chsoing a lifestlye that involves sport and excersise.
and i repeat i do not advise the use of AAS to anyone, but for those that have already chosen ill do what i feel is relevant to help.
what you want me to provide john is a statistical analysis, and brekdown of figures between users and a placebo group
and have it repeated on a large enough sclae to be considered of use.
how on gods green earth would you expect this to be possible?
21 April 2012, 07:07 PM
#36
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In particular, you criticising the advice to avoid androgrenic steroids would require substantial evidence to be credible.
That is an example of one of your claims that would require very robust evidence indeed when there is ample evidence of harm in the literature. .
21 April 2012, 07:40 PM
#37
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heres maybe an better example
TRT patient - dosage 250mg multi esterd testsoterone 1 controlled inj every 2 weeks. for life. cotrolled by physician.
AAS user using 500mg testosterone per week. 2 x ten week cycles per year
both equal in age, weight bodytypes.
neither present recognisable health problems, neither have a known gentetic predisposition to health issues that maybe effected.
the TRT user does no excersise, lives a sedatory lifestlye, with alcohol consumption on a weekly level (not excessive alcoholic) and has the average nutrition undertanding
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845931/
http://www.menshealthforum.org.uk/fi...cottishmen.pdf
even though studies suggest against it, well give the trt user benefit of the doubt with a 3000kcal intake with a macro breakdown of carbs 50%, protein 15 and fats 35%
the AAS user witha good nutritoonal understanding is likely to incorproate 3-3.5kcals 35-40% lean proteins, same of well sourced carbs and the rest in an explained ratio of mono-to polyunsaturated fats. excersises for 5 hours weekly
who would say would be in a better state of health?
now if your argument would be the aas user would be in even better health without that addition, depandant on other variables id agree - but would they still have the enthusiasm to learn, understand ect?
its a situation ive seen literally over 700 times
TRT patient - dosage 250mg multi esterd testsoterone 1 controlled inj every 2 weeks. for life. cotrolled by physician.
AAS user using 500mg testosterone per week. 2 x ten week cycles per year
both equal in age, weight bodytypes.
neither present recognisable health problems, neither have a known gentetic predisposition to health issues that maybe effected.
the TRT user does no excersise, lives a sedatory lifestlye, with alcohol consumption on a weekly level (not excessive alcoholic) and has the average nutrition undertanding
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845931/
http://www.menshealthforum.org.uk/fi...cottishmen.pdf
even though studies suggest against it, well give the trt user benefit of the doubt with a 3000kcal intake with a macro breakdown of carbs 50%, protein 15 and fats 35%
the AAS user witha good nutritoonal understanding is likely to incorproate 3-3.5kcals 35-40% lean proteins, same of well sourced carbs and the rest in an explained ratio of mono-to polyunsaturated fats. excersises for 5 hours weekly
who would say would be in a better state of health?
now if your argument would be the aas user would be in even better health without that addition, depandant on other variables id agree - but would they still have the enthusiasm to learn, understand ect?
its a situation ive seen literally over 700 times
21 April 2012, 07:54 PM
#38
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Luan Pra bang, I would like to see the quality evidence with long term safety data Luan Pra bang. In reviews of androgenic steroid use I have seen no references to this data, but I see references to harms.
The quote below doesn't come out well but I cannot attach the article for copyright reasons. Hall RC et al. Abuse of Supraphysiologic Doses of Anabolic Steroids, Southern Medical Journal 98:553 (2005)
This also addresses your fair points jef about research difficulties.
Agree on your points about nutrition, although don't agree that it is mostly due to poor understanding, most people know what they should do and health education is arguably too intrusive.
I cannot disagree more with your next statement about short term side effects from what you would class sensible doses and cycles lengths are recoverable from. This has not been demonstrated as we've discussed.
Quite agree about alcohol and recreational drugs.
Since the trial isn't easily possible and the data that is available supports harm, and we're not treating an illness, then the use of androgenic steroids outwith their licensed indications, prescribed by a physican should be discouraged (as the law does by controlling them). If you can't do the trial, the medical approach would not be to just go ahead and use it anyway. How can it be rational to argue otherwise?
The quote below doesn't come out well but I cannot attach the article for copyright reasons. Hall RC et al. Abuse of Supraphysiologic Doses of Anabolic Steroids, Southern Medical Journal 98:553 (2005)
Because their use is illegal, reports of side effects associated
with AAS abuse are difficult to define with any precision,
as the patient is often unaware of what or how much
AAS they are actually using.'^ Anabolic-androgenic steroid
abusers may take steroid preparations that were not meant for
human consumption (eg, veterinary medication). This makes
it difficult to determine if side effects are due to the hormone
or to the carrier medium. For ethical reasons, giving super
high doses of AAS to induce side effects cannot be studied in
laboratory settings. Data defming cumulative effects caused
by stacking remains speculative and is derived from case
reports and medical literature from lower level doses. "'•''
Side effects can be as benign as acne or fluid retention and
extend to more distressing effects such as gynecomastia, decreased
high-density lipoprotein (HDL), and sleep apnea.
Extreme side effects can lead to lethal complications such
as liver failure and the development of certain cancers'"'*^
(Table 2).
The alkylated AAS (class B and class C) are highly
hepatotoxic, causing hepatocellular and intrahepatic eholestasis,
which can lead to hepatic failure.^'*''"^ Other hepatic effects
seen with AAS abuse include peliosis hepatis (which
can also occur with replacement doses), hepatocellular adenoma,
and hepatocellular carcinoma.'*^ Other liver changes
include eholestasis, subcellular changes of hepatocytes, hepatocellular
hyperplasia, and general hepatic damage evident
by increased alkaline phosphatase, lactate dehydrogenase, aspartate
aminotransferase, alanine aminotransferase, and conjugated
bilirubin.^'^^''"^ Some growths, initially believed to be
hepatocellular carcinomas, were found to be benign hyperplastic
lesions, which regressed with the discontinuation of
AAS abuse."^'''*
Anabolic-androgenic steroids taken at supraphysiologic
doses also produce cardiovascular side effects. "•'*^'^° The alkylating
agents, such as stanozolol, lower the HDL by approximately
33%, particularly HDL2, which is reduced 23 to
80%.^^*'^' The effect of testosterone is much less dramatic,
with only an approximately 9% reduction in HDL.^' The
alkylating AAS have also been shown to increase hepatic
triglyceride lipase activity between 21 to 123% and lowdensity
lipoprotein by as much as 29%, whereas testosterone
has been shown to decrease low-density lipoprotein by
Several case reports document myocardial infarction and
stroke in 20- to 30-year-old weightlifters who used AAS."'"
This increased risk for myocardial infarction and stroke is
attributed to the increased platelet count and platelet aggregation
that occurs in people who abuse AAS.^''"^* Testosterone,
even at concentrations in which it does not effect thrombus
risk, can potentiate cocaine's effects on both the
endothelium and platelet function. Therefore, the often reported
concomitant use of testosterone and cocaine increases
the risk of thrombus, stroke, and myocardial infarction.^^
Steroids also cause hypertrophy of the myocardium, which
also increases the likelihood of arrhythmias, sudden death,
systolic and diastolic hypertension, and myocardial infarc-
Whereas muscle and bone strength are increased hy AAS,
an interesting and almost paradoxical effect of high-dose AAS
use is decreased tendon strength caused hy the dysplasia of
collagen fihrils."'^^"^' The net result is that people who abuse
steroids to gain strength are at an increased risk for development
of either short-term or long-term disabling tendon ruptures.
Several studies document the increased risk of rare
triceps, biceps, and bilateral quadriceps ruptures in AAS abusers.^°-
«2
When AAS levels are elevated, they undergo aromatization,
being converted by fat and other cells to estrogens in
peripheral tissue.^'^^ This rise in estrogen levels can produce
either a reversible or irreversible gynecomastia in males.^''''''"
In females, elevated AAS levels result in menstrual irregularities
and breast atrophy. There can also be permanent .virilizing
effects such as male-pattern baldness, deepened voice,
hirsutism, and clitoromegaly.^'^"'*^
Pope and Katz*'* noted that anabolic steroids produce
clear psychiatric effects, particularly in individuals using excessive
doses (more than 1,000 mg/wk) ofthese compounds
and stacking the drugs. The most prominent psychiatric features
were manic-like presentations defined by irritability,
aggressivity, euphoria, grandiose beliefs, hyperactivity, and
reckless or dangerous behavior.^^ Other presentations have
included the development of acute psychoses, exacerbation of
tics, and the development of acute confiisional states,'' Individuals
using high doses over prolonged periods may undergo
steroid withdrawal with the development of depressive symptoms,
anhedonia, fatigue, impaired concentration, and even
suicidality. It has been noted that these withdrawal effects
may contribute to a syndrome of dependence.^^
with AAS abuse are difficult to define with any precision,
as the patient is often unaware of what or how much
AAS they are actually using.'^ Anabolic-androgenic steroid
abusers may take steroid preparations that were not meant for
human consumption (eg, veterinary medication). This makes
it difficult to determine if side effects are due to the hormone
or to the carrier medium. For ethical reasons, giving super
high doses of AAS to induce side effects cannot be studied in
laboratory settings. Data defming cumulative effects caused
by stacking remains speculative and is derived from case
reports and medical literature from lower level doses. "'•''
Side effects can be as benign as acne or fluid retention and
extend to more distressing effects such as gynecomastia, decreased
high-density lipoprotein (HDL), and sleep apnea.
Extreme side effects can lead to lethal complications such
as liver failure and the development of certain cancers'"'*^
(Table 2).
The alkylated AAS (class B and class C) are highly
hepatotoxic, causing hepatocellular and intrahepatic eholestasis,
which can lead to hepatic failure.^'*''"^ Other hepatic effects
seen with AAS abuse include peliosis hepatis (which
can also occur with replacement doses), hepatocellular adenoma,
and hepatocellular carcinoma.'*^ Other liver changes
include eholestasis, subcellular changes of hepatocytes, hepatocellular
hyperplasia, and general hepatic damage evident
by increased alkaline phosphatase, lactate dehydrogenase, aspartate
aminotransferase, alanine aminotransferase, and conjugated
bilirubin.^'^^''"^ Some growths, initially believed to be
hepatocellular carcinomas, were found to be benign hyperplastic
lesions, which regressed with the discontinuation of
AAS abuse."^'''*
Anabolic-androgenic steroids taken at supraphysiologic
doses also produce cardiovascular side effects. "•'*^'^° The alkylating
agents, such as stanozolol, lower the HDL by approximately
33%, particularly HDL2, which is reduced 23 to
80%.^^*'^' The effect of testosterone is much less dramatic,
with only an approximately 9% reduction in HDL.^' The
alkylating AAS have also been shown to increase hepatic
triglyceride lipase activity between 21 to 123% and lowdensity
lipoprotein by as much as 29%, whereas testosterone
has been shown to decrease low-density lipoprotein by
Several case reports document myocardial infarction and
stroke in 20- to 30-year-old weightlifters who used AAS."'"
This increased risk for myocardial infarction and stroke is
attributed to the increased platelet count and platelet aggregation
that occurs in people who abuse AAS.^''"^* Testosterone,
even at concentrations in which it does not effect thrombus
risk, can potentiate cocaine's effects on both the
endothelium and platelet function. Therefore, the often reported
concomitant use of testosterone and cocaine increases
the risk of thrombus, stroke, and myocardial infarction.^^
Steroids also cause hypertrophy of the myocardium, which
also increases the likelihood of arrhythmias, sudden death,
systolic and diastolic hypertension, and myocardial infarc-
Whereas muscle and bone strength are increased hy AAS,
an interesting and almost paradoxical effect of high-dose AAS
use is decreased tendon strength caused hy the dysplasia of
collagen fihrils."'^^"^' The net result is that people who abuse
steroids to gain strength are at an increased risk for development
of either short-term or long-term disabling tendon ruptures.
Several studies document the increased risk of rare
triceps, biceps, and bilateral quadriceps ruptures in AAS abusers.^°-
«2
When AAS levels are elevated, they undergo aromatization,
being converted by fat and other cells to estrogens in
peripheral tissue.^'^^ This rise in estrogen levels can produce
either a reversible or irreversible gynecomastia in males.^''''''"
In females, elevated AAS levels result in menstrual irregularities
and breast atrophy. There can also be permanent .virilizing
effects such as male-pattern baldness, deepened voice,
hirsutism, and clitoromegaly.^'^"'*^
Pope and Katz*'* noted that anabolic steroids produce
clear psychiatric effects, particularly in individuals using excessive
doses (more than 1,000 mg/wk) ofthese compounds
and stacking the drugs. The most prominent psychiatric features
were manic-like presentations defined by irritability,
aggressivity, euphoria, grandiose beliefs, hyperactivity, and
reckless or dangerous behavior.^^ Other presentations have
included the development of acute psychoses, exacerbation of
tics, and the development of acute confiisional states,'' Individuals
using high doses over prolonged periods may undergo
steroid withdrawal with the development of depressive symptoms,
anhedonia, fatigue, impaired concentration, and even
suicidality. It has been noted that these withdrawal effects
may contribute to a syndrome of dependence.^^
Agree on your points about nutrition, although don't agree that it is mostly due to poor understanding, most people know what they should do and health education is arguably too intrusive.
I cannot disagree more with your next statement about short term side effects from what you would class sensible doses and cycles lengths are recoverable from. This has not been demonstrated as we've discussed.
Quite agree about alcohol and recreational drugs.
Since the trial isn't easily possible and the data that is available supports harm, and we're not treating an illness, then the use of androgenic steroids outwith their licensed indications, prescribed by a physican should be discouraged (as the law does by controlling them). If you can't do the trial, the medical approach would not be to just go ahead and use it anyway. How can it be rational to argue otherwise?
21 April 2012, 07:58 PM
#39
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heres a article regarding ben johnstones situation.
the ensuing scandal outrgaed americans and as such steroids were the scapegoat and public opinion influnced the laws surrounding such drugs,
http://www.winstrol.net/ben-johnson-and-winstrol.php
theres further reports and a detailted history of AAS here - along with this interesting quote
It should be noted, as it has always been a bit of an interesting quam, with the passage of the Steroid Control Act four various Federal entities were called to back and support the bill; the FDA, the AMA, the DEA and the NIDA; all four opposed the ban and denied their support. Unfortunately there isn’t a lot of detail we can give you on this; the federal government blatantly ignored the advice they asked for and reasoning for the lack of support has rarely been spoken of since. However, during the floor hearings for the bill, all four agencies emphatically stated there was no medical or legal reason to call for classifying anabolic steroids as schedule III narcotics.
For the majority of the 1990’s after the original Steroid Control Act, steroid news would begin to take a back seat; according to the “experts” anabolic steroids had been beaten and put in its rightful dead to rot place; they could not have been more wrong. Ironically, it would also be in the 1990’s when anabolic steroids began to see heavy use by the medical community to improve survival rates of AIDS and Cancer patients, when it was discovered that loss of lean body mass was associated with increased mortality rates respective to these diseases (14). With this discovery some, including the four governing bodies mentioned during the Steroid Control Act have asked one serious perplexing question; if anabolic steroids are bad for you and will kill you if you’re healthy, how is it they are good for you and will save your life if you are sick? Raise your hand if you have a good answer for that one.
Read more: http://www.steroid.com/History-of-St...#ixzz1shdMlqoK
john, all internet heresay? half truths
harmful information?
ill go on to google 100 more involved studies if you wish, and granted you could google me the same back.
the ensuing scandal outrgaed americans and as such steroids were the scapegoat and public opinion influnced the laws surrounding such drugs,
http://www.winstrol.net/ben-johnson-and-winstrol.php
theres further reports and a detailted history of AAS here - along with this interesting quote
It should be noted, as it has always been a bit of an interesting quam, with the passage of the Steroid Control Act four various Federal entities were called to back and support the bill; the FDA, the AMA, the DEA and the NIDA; all four opposed the ban and denied their support. Unfortunately there isn’t a lot of detail we can give you on this; the federal government blatantly ignored the advice they asked for and reasoning for the lack of support has rarely been spoken of since. However, during the floor hearings for the bill, all four agencies emphatically stated there was no medical or legal reason to call for classifying anabolic steroids as schedule III narcotics.
For the majority of the 1990’s after the original Steroid Control Act, steroid news would begin to take a back seat; according to the “experts” anabolic steroids had been beaten and put in its rightful dead to rot place; they could not have been more wrong. Ironically, it would also be in the 1990’s when anabolic steroids began to see heavy use by the medical community to improve survival rates of AIDS and Cancer patients, when it was discovered that loss of lean body mass was associated with increased mortality rates respective to these diseases (14). With this discovery some, including the four governing bodies mentioned during the Steroid Control Act have asked one serious perplexing question; if anabolic steroids are bad for you and will kill you if you’re healthy, how is it they are good for you and will save your life if you are sick? Raise your hand if you have a good answer for that one.
Read more: http://www.steroid.com/History-of-St...#ixzz1shdMlqoK
john, all internet heresay? half truths
harmful information?
ill go on to google 100 more involved studies if you wish, and granted you could google me the same back.
21 April 2012, 08:16 PM
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TRT patient - dosage 250mg multi esterd testsoterone 1 controlled inj every 2 weeks. for life. cotrolled by physician.
21 April 2012, 08:16 PM
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john it can be argued and i will continue to do so,
you can advise people not to drnk, smoke, eat well excersises, not take drugs, inc AAS.
regardless people still will do so - and therefore its an issue that shouldnt be brushed under the carpet but addressed as best as possibly can
i know you as a professional cannot advocate or condane what the law considers mis-use.
your artical has aso so so many maybes, can possibly'S and could cause statements - its about as for from conclusive as anything promoting AAS use i could post - it has continual referances to cocaine?
now ill go and google the possible side effects of NSAID's like ibuprofen, or even alcohol - we both know know there only thre for legal reasons and its almost infinaltey unlikley that any users would suffer them all, and commonly suffer none atall..
ill continue to thakyou for your input john - i dont want this to evolve into a tit for tat session
your posting links to articles which have littel bearing on what im talking about, im posting links to artiles you may consider positivley biased
but in truth its coming down to what ive always stated from the start
steroid use is common and ever growing, along with that is half truths and lies - the medical community cant or wont support handing out information to the use of a classified drug - there in ies the problem.
its left to people like me, who you think are mis-guided, mis-educated and possiby ill informed, topass on information. you ccn then take any moral highground saying my advice is poor or harmful - i can say atleast im trying.
can recount persoanl experiences as much as you may dismiss them as evidence, they are infact the best evidence you could ever attain, since your individual genetics dicate your reaction to food, training, peds. not on a grand scale granted.
you can advise people not to drnk, smoke, eat well excersises, not take drugs, inc AAS.
regardless people still will do so - and therefore its an issue that shouldnt be brushed under the carpet but addressed as best as possibly can
i know you as a professional cannot advocate or condane what the law considers mis-use.
your artical has aso so so many maybes, can possibly'S and could cause statements - its about as for from conclusive as anything promoting AAS use i could post - it has continual referances to cocaine?
now ill go and google the possible side effects of NSAID's like ibuprofen, or even alcohol - we both know know there only thre for legal reasons and its almost infinaltey unlikley that any users would suffer them all, and commonly suffer none atall..
ill continue to thakyou for your input john - i dont want this to evolve into a tit for tat session
your posting links to articles which have littel bearing on what im talking about, im posting links to artiles you may consider positivley biased
but in truth its coming down to what ive always stated from the start
steroid use is common and ever growing, along with that is half truths and lies - the medical community cant or wont support handing out information to the use of a classified drug - there in ies the problem.
its left to people like me, who you think are mis-guided, mis-educated and possiby ill informed, topass on information. you ccn then take any moral highground saying my advice is poor or harmful - i can say atleast im trying.
can recount persoanl experiences as much as you may dismiss them as evidence, they are infact the best evidence you could ever attain, since your individual genetics dicate your reaction to food, training, peds. not on a grand scale granted.
21 April 2012, 08:25 PM
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id suggest a blood sample has shown low free testosterone levels, the patient suffers lethargy has erectile dysfunction and a fairly low libido.
your a qualified physcian , dont like blood tests and may look elsewhere
but thats not really the point - the situation im asking is around the health of 2 users outlined
its about overall health
your a qualified physcian , dont like blood tests and may look elsewhere
but thats not really the point - the situation im asking is around the health of 2 users outlined
its about overall health
21 April 2012, 08:44 PM
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I love blood tests and routinely perform them for lethargy or erectile dysfunction. I don't like unfocussed tests that are a feature of bad medicine.
How is the safety data from replacing testosterone to physiological levels in any way comparable to supraphysiological levels? Does that mean I should make all my euthyroid patients hyperthyroid because they might feel better, lose weight and because I use thyroxine to treat hypothyroidism? No, I'd give them the side effects of hyperthyroidism. Each indication for a drug should be evidence based and because a drug has a benefit for one indication doesn't mean you can just use it for others. That is called malpractice. It seems obvious as I deal daily with so many values in my patients that have a correct range, if they are under and I get them to normal it certainly does not mean that if I put them over they will be even better, nearly always they will be harmed if the deviation is significant enough, depending on the parameter. Even physiological levels of testosterone confer significant disadvantages for male health compared to female health hence the premature death and cardiovascular disease in men.
The side effects of NSAIDs are not just there for "legal" reasons! Tell that to the patients that get a perforated gastric ulcer, heart failure and renal failure from them. I'm really careful with NSAIDs especially in those at risk.
I suspect if you don't like the wording in the review I quoted from it is related to your inexperience in reading medical literature rather than it being a bad review, but you cannot see the full text due to copyright.
Your ongoing preference for anecdotes over scientific method really leaves us with nil common ground here.
but thats not really the point - the situation im asking is around the health of 2 users outlined
its about overall health
its about overall health
The side effects of NSAIDs are not just there for "legal" reasons! Tell that to the patients that get a perforated gastric ulcer, heart failure and renal failure from them. I'm really careful with NSAIDs especially in those at risk.
I suspect if you don't like the wording in the review I quoted from it is related to your inexperience in reading medical literature rather than it being a bad review, but you cannot see the full text due to copyright.
Your ongoing preference for anecdotes over scientific method really leaves us with nil common ground here.
Last edited by john banks; 21 April 2012 at 08:46 PM.
21 April 2012, 09:20 PM
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pardon my dismission of NSAIDS-the possible side effects are very real but these aare still available OTC.
any im asking - are the serious side effects associated common? if so why are they available OTC?
evidence of the situation youve descrdibed above where youve put patients over levels and the subsequet harm its caused please? evidnece in your terms please.
and it s a very populr tchnique used by people trying to push a negative enviroment. youve inclcuded sections of a publication with reference to vetinery drugs, presumabley trenbolone or equpoise - and made clear the intended use of these drugs,
the article makes continual referance to
cocaine - which is a pleasant change from the association to herion use due to perceived method of administration.
but its highlighted feamle aas use which i origiaonally highlighted a long time agao as a real proeblem with real irreversable effects - in extreme cases may i add - but still and increased risk.
both these inclusions are included to sensationalise the reading-aand are not part of the discusssion thats meant to be taking aplce..
your article mentiones 17aa hepatoxic steroids -which i highlighted along time ago as to the poor advice that was given out - but it gives no coNtext -and why would it, its an article to prove the point that aas are harmful. caffine is hepatoxic but yet inclcuded in many peoples daily routine - No mention of alchohol hepatoxicity, or even with other POM .
when you prescribe POM WITH hepatoxic possible effects is that acCompanied by nutritonal advice to combat it? never ever ever in my years of exposure has it. why not?
My yet unanswered question is of the scenarios ive provided who would you consider to be at greater risk of ill health.
and then a link to your medical standard levels of info proving recovery from my suggested protocol are incocrrect/unrecoverable from- and by which means youve measured the results
i await your points
any im asking - are the serious side effects associated common? if so why are they available OTC?
evidence of the situation youve descrdibed above where youve put patients over levels and the subsequet harm its caused please? evidnece in your terms please.
and it s a very populr tchnique used by people trying to push a negative enviroment. youve inclcuded sections of a publication with reference to vetinery drugs, presumabley trenbolone or equpoise - and made clear the intended use of these drugs,
the article makes continual referance to
cocaine - which is a pleasant change from the association to herion use due to perceived method of administration.
but its highlighted feamle aas use which i origiaonally highlighted a long time agao as a real proeblem with real irreversable effects - in extreme cases may i add - but still and increased risk.
both these inclusions are included to sensationalise the reading-aand are not part of the discusssion thats meant to be taking aplce..
your article mentiones 17aa hepatoxic steroids -which i highlighted along time ago as to the poor advice that was given out - but it gives no coNtext -and why would it, its an article to prove the point that aas are harmful. caffine is hepatoxic but yet inclcuded in many peoples daily routine - No mention of alchohol hepatoxicity, or even with other POM .
when you prescribe POM WITH hepatoxic possible effects is that acCompanied by nutritonal advice to combat it? never ever ever in my years of exposure has it. why not?
My yet unanswered question is of the scenarios ive provided who would you consider to be at greater risk of ill health.
and then a link to your medical standard levels of info proving recovery from my suggested protocol are incocrrect/unrecoverable from- and by which means youve measured the results
i await your points
21 April 2012, 09:34 PM
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jef, looking at http://www.steroid.com/steroids_side_effects.php from the site you already linked, it is quite amazing the hoops the author tries to jump through to minimise the perceived side effects of steroids.
I'll run through a few thoughts, numbered the same as his here:
1-3: gross misuse of statistics. The p values are showing that there is a statistically significant difference between ex-abusers and abusers showing on average some recovery. However, the number of subjects needed to show a difference (15 to 17 in each group) is not sufficient to show side effects which could occur less commonly than about 1 in 16, and for a serious side effect that isn't enough safety information. It also shows a misinterpretation of the average reverting to the normal range but doesn't point out the outliers in the same tables that show persistent abnormalities even in this small sample (look at the range data). If you look at the hormone data in 1 for example, 5 out of the 6 have at least one subject outwith the normal range. This is not remotely reassuring data. For the liver enzymes, 7 out of 9 of them have at least one subject outwith the normal range. For the lipid profies, for the trigylcerides and HDL which were the statistically significant differences, both showed at least one subject outwith the normal range. In such a small sample I draw the conclusion that this is a tendency towards harm.
4. What is the safety of anti-oestrogens used outwith their license?
6. 5% (1.4 to 10.4% for CI 95%) for hypomania or mania is actually seriously worrying. Hypomania or mania are not just psychological effects, they are psychiatric disorders. There is quite a difference.
8. Worringly glossed over. Prove safety rather than assume it.
10. Same, no long term follow up. Suggesting finasteride glosses over the risk, and the safety of finasteride in this situation is unproven.
13. Spurious link with AIDS. It is like the author considers the immune system to be a simple one way switch!
14. I love the advice to use diuretics carefully because of cramp. What about renal failure and hypokalaemia (both of which can be fatal) from diuretic use?
The article is using selective and misguided interpretation of data in a dangerously misleading manner. When data is presented, I usually draw the opposite conclusion to the author.
I'll run through a few thoughts, numbered the same as his here:
1-3: gross misuse of statistics. The p values are showing that there is a statistically significant difference between ex-abusers and abusers showing on average some recovery. However, the number of subjects needed to show a difference (15 to 17 in each group) is not sufficient to show side effects which could occur less commonly than about 1 in 16, and for a serious side effect that isn't enough safety information. It also shows a misinterpretation of the average reverting to the normal range but doesn't point out the outliers in the same tables that show persistent abnormalities even in this small sample (look at the range data). If you look at the hormone data in 1 for example, 5 out of the 6 have at least one subject outwith the normal range. This is not remotely reassuring data. For the liver enzymes, 7 out of 9 of them have at least one subject outwith the normal range. For the lipid profies, for the trigylcerides and HDL which were the statistically significant differences, both showed at least one subject outwith the normal range. In such a small sample I draw the conclusion that this is a tendency towards harm.
4. What is the safety of anti-oestrogens used outwith their license?
6. 5% (1.4 to 10.4% for CI 95%) for hypomania or mania is actually seriously worrying. Hypomania or mania are not just psychological effects, they are psychiatric disorders. There is quite a difference.
8. Worringly glossed over. Prove safety rather than assume it.
10. Same, no long term follow up. Suggesting finasteride glosses over the risk, and the safety of finasteride in this situation is unproven.
13. Spurious link with AIDS. It is like the author considers the immune system to be a simple one way switch!
14. I love the advice to use diuretics carefully because of cramp. What about renal failure and hypokalaemia (both of which can be fatal) from diuretic use?
The article is using selective and misguided interpretation of data in a dangerously misleading manner. When data is presented, I usually draw the opposite conclusion to the author.
21 April 2012, 09:56 PM
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pardon my dismission of NSAIDS-the possible side effects are very real but these aare still available OTC.
any im asking - are the serious side effects associated common? if so why are they available OTC?
any im asking - are the serious side effects associated common? if so why are they available OTC?
evidence of the situation youve descrdibed above where youve put patients over levels and the subsequet harm its caused please? evidnece in your terms please.
when you prescribe POM WITH hepatoxic possible effects is that acCompanied by nutritonal advice to combat it? never ever ever in my years of exposure has it. why not?
My yet unanswered question is of the scenarios ive provided who would you consider to be at greater risk of ill health.
and then a link to your medical standard levels of info proving recovery from my suggested protocol are incocrrect/unrecoverable from- and by which means youve measured the results
Last edited by john banks; 21 April 2012 at 09:59 PM.
21 April 2012, 10:06 PM
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like you john i take articles on the internet with a pich of salt
the use of diruetics can be extremely dangerous, and agree renal failure can be causeed if tkaen to extremes
but AGAIN john this is not what im discussing - please answer my question - your coming across like a politician - question dodging to put your point across!!
i posted that link, which i already told you may be positivley biased along with a link to an a site id consider anti-ped use. as a comparison.
we both know diuretic use is the short term killer in competitive bodybuilders eg andreas munzer - but this evel of use is not the norm, im talking abou the joe bloggs in the average gym.
just as you mention the author of the article i posted has jumped hoops, the author of your quote posted has jumped straight into referancng vetinary drug use, the cumulative effects of cocaine, hepatoxicity ect. with even giving real lfe context - what abouth the hepatoxicity of caffine, alcohol ect
theres no referance marker of measurment mentioned.
i think this is drawing to a conclusion whereby niehter party will agree.
we can go on posting articles tit for tat fashion - i will continue to assist people who i feel are really potentially putting themsleves at harm, youll continue to dismiss the issue.
each to there own
and i can leave at that - if your happy to.
on my part its dis heartening to hear your veiw points although i can undertand them to an extent - its really not helping the generation at risk out there just now.
the use of diruetics can be extremely dangerous, and agree renal failure can be causeed if tkaen to extremes
but AGAIN john this is not what im discussing - please answer my question - your coming across like a politician - question dodging to put your point across!!
i posted that link, which i already told you may be positivley biased along with a link to an a site id consider anti-ped use. as a comparison.
we both know diuretic use is the short term killer in competitive bodybuilders eg andreas munzer - but this evel of use is not the norm, im talking abou the joe bloggs in the average gym.
just as you mention the author of the article i posted has jumped hoops, the author of your quote posted has jumped straight into referancng vetinary drug use, the cumulative effects of cocaine, hepatoxicity ect. with even giving real lfe context - what abouth the hepatoxicity of caffine, alcohol ect
theres no referance marker of measurment mentioned.
i think this is drawing to a conclusion whereby niehter party will agree.
we can go on posting articles tit for tat fashion - i will continue to assist people who i feel are really potentially putting themsleves at harm, youll continue to dismiss the issue.
each to there own
and i can leave at that - if your happy to.
on my part its dis heartening to hear your veiw points although i can undertand them to an extent - its really not helping the generation at risk out there just now.
21 April 2012, 10:20 PM
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Sorry I'm not clear which of your questions is still awaiting a reply? I thought I'd been quite careful to respond to them all where I have something to say.
The article I quoted a small part of has 66 references to back up its points and uses them well. If you want the full text, PM me an email address and I will send it.
I am not dismissing the issue, otherwise I wouldn't have spent considerable time trying (to no avail which I find disheartening also) to influence your views, but as you will not agree to scientific methods to prove the efficacy and safety of interventions I haven't got any where. I've challenged many points and they seem not to strike home with any impact yet logically I'm pretty sure I have very robust ground.
I find my interaction with you and the literature I have reviewed in doing so has strengthened my anti-AAS views. I will file it in my learning plan for this year's appraisal.
However, when I took 40 minutes with a young man a few years ago (in a 10 minutes appointment) that planned to use steroids, it was like banging my head against a brick wall.
Can I say in my learning plan that anything I have learned from our interaction will actually change my practice? Sadly I don't think I can, it has just backed up previous opinions.
The article I quoted a small part of has 66 references to back up its points and uses them well. If you want the full text, PM me an email address and I will send it.
I am not dismissing the issue, otherwise I wouldn't have spent considerable time trying (to no avail which I find disheartening also) to influence your views, but as you will not agree to scientific methods to prove the efficacy and safety of interventions I haven't got any where. I've challenged many points and they seem not to strike home with any impact yet logically I'm pretty sure I have very robust ground.
I find my interaction with you and the literature I have reviewed in doing so has strengthened my anti-AAS views. I will file it in my learning plan for this year's appraisal.
However, when I took 40 minutes with a young man a few years ago (in a 10 minutes appointment) that planned to use steroids, it was like banging my head against a brick wall.
Can I say in my learning plan that anything I have learned from our interaction will actually change my practice? Sadly I don't think I can, it has just backed up previous opinions.
Last edited by john banks; 21 April 2012 at 10:24 PM.
21 April 2012, 10:33 PM
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BTW, why the alarm at the mention of veterinary drug use? Winstrol-V appears to be veterinary (not a UK human drug trade name) and when you google it you get pages related to bodybuilding. Is mentioning this some sort of taboo?
21 April 2012, 10:41 PM
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john , we are human beings
conflict in opinions due to differing lifestyles is part of our nature. our lifes expeiriences lead us to draw coclusions that may differ from others.
thats life.
i fully accpet your weiw pointand i hope you extend me the same courtesy.
people i know could seriosly shorten there life through ridiculous advice, they receive - ill until the day i day do what i can to pass on information thats relevant and can possibly help,
iv been open in the levels of my posts, youve tried to dupe me with outlandish article staemetns, which were never of any any relevance to my discussion
and finally from our discussion it re-inforces my opinion that gp,s are unwilling to help people and use disnissive techniques to enforce there opinion
its been interesting
thanks
conflict in opinions due to differing lifestyles is part of our nature. our lifes expeiriences lead us to draw coclusions that may differ from others.
thats life.
i fully accpet your weiw pointand i hope you extend me the same courtesy.
people i know could seriosly shorten there life through ridiculous advice, they receive - ill until the day i day do what i can to pass on information thats relevant and can possibly help,
iv been open in the levels of my posts, youve tried to dupe me with outlandish article staemetns, which were never of any any relevance to my discussion
and finally from our discussion it re-inforces my opinion that gp,s are unwilling to help people and use disnissive techniques to enforce there opinion
its been interesting
thanks
21 April 2012, 10:48 PM
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Here is the BNF (our prescribing bible) section on testosterone and esters if useful, maybe you have it already. This is what I turned to in the long consultation, and the patient didn't refute the risks, just said that it was so important to him that they didn't matter. Anyway, the list is based on information from the summary of product characteristics for drugs that can be prescribed in the UK.
Here is the list of UK prescribable male sex agonists:
TESTOSTERONE AND ESTERS
Oral
Restandol® Testocaps
Buccal
Striant® SR
Intramuscular
Testosterone Enantate
Nebido®
Sustanon 250®
Virormone®
Implant
Testosterone
Transdermal preparations
Intrinsa®
Testim®
Testogel®
Tostran®
MESTEROLONE
Pro-Viron®
Androgens cause masculinisation; they may be used as replacement therapy in castrated adults and in those who are hypogonadal due to either pituitary or testicular disease. In the normal male they inhibit pituitary gonadotrophin secretion and depress spermatogenesis. Androgens also have an anabolic action which led to the development of anabolic steroids (section 6.4.3).
Androgens are useless as a treatment of impotence and impaired spermatogenesis unless there is associated hypogonadism; they should not be given until the hypogonadism has been properly investigated. Treatment should be under expert supervision.
When given to patients with hypopituitarism they can lead to normal sexual development and potency but not to fertility. If fertility is desired, the usual treatment is with gonadotrophins or pulsatile gonadotrophin-releasing hormone (section 6.5.1) which will stimulate spermatogenesis as well as androgen production.
Caution should be used when androgens or chorionic gonadotrophin are used in treating boys with delayed puberty since the fusion of epiphyses is hastened and may result in short stature; skeletal maturation should be monitored.
Intramuscular depot preparations of testosterone esters are preferred for replacement therapy. Testosterone enantate, propionate or undecanoate, or alternatively Sustanon®, which consists of a mixture of testosterone esters and has a longer duration of action, may be used. Satisfactory replacement therapy can sometimes be obtained with 1 mL of Sustanon 250®, given by intramuscular injection once a month, although more frequent dose intervals are often necessary. Implants of testosterone can be used for hypogonadism; the implants are replaced every 4 to 5 months.
Testosterone implants can be used in postmenopausal women as an adjunct to hormone replacement therapy. A testosterone patch is also licensed to improve libido in surgically induced menopausal women (receiving concomitant oestrogen therapy).
TESTOSTERONE AND ESTERS
Additional information interactions (Testosterone).
Indications
see under preparations
Cautions
cardiac impairment, elderly, ischaemic heart disease, hypertension, epilepsy, migraine, diabetes mellitus, skeletal metastases (risk of hypercalcaemia), undertake regular examination of the prostate and breast during treatment; monitor full blood count, lipid profile and liver function; pre-pubertal boys (see notes above and under Side-effects); interactions: Appendix 1 (testosterone)
Women
Regularly assess for androgenic side-effects; women should be advised to report any signs of virilisation e.g. deepening of the voice or hirsutism
Contra-indications
breast cancer in men, prostate cancer, history of primary liver tumours, hypercalcaemia, nephrotic syndrome
Hepatic impairment
avoid if possible—fluid retention and dose-related toxicity
Renal impairment
caution—potential for fluid retention
Pregnancy
avoid; causes masculinisation of female fetus
Breast-feeding
avoid; may cause masculinisation in the female infant or precocious development in the male infant; high doses suppress lactation
Side-effects
prostate abnormalities and prostate cancer, headache, depression, gastro-intestinal bleeding, nausea, vomiting, cholestatic jaundice, changes in libido, gynaecomastia, polycythaemia, anxiety, irritability, nervousness, asthenia, paraesthesia, hypertension, electrolyte disturbances including sodium retention with oedema and hypercalcaemia, weight gain; increased bone growth, muscle cramps, arthralgia; androgenic effects such as hirsutism, male-pattern baldness, seborrhoea, acne, pruritus, excessive frequency and duration of penile erection, precocious sexual development and premature closure of epiphyses in pre-pubertal males, suppression of spermatogenesis in men and virilism in women; rarely liver tumours; sleep apnoea also reported; with patches, buccal tablets, and gel, local irritation and allergic reactions (including burn-like lesions with patches), and taste disturbances
Additional information interactions (Testosterone).
Indications
see under preparations
Cautions
cardiac impairment, elderly, ischaemic heart disease, hypertension, epilepsy, migraine, diabetes mellitus, skeletal metastases (risk of hypercalcaemia), undertake regular examination of the prostate and breast during treatment; monitor full blood count, lipid profile and liver function; pre-pubertal boys (see notes above and under Side-effects); interactions: Appendix 1 (testosterone)
Women
Regularly assess for androgenic side-effects; women should be advised to report any signs of virilisation e.g. deepening of the voice or hirsutism
Contra-indications
breast cancer in men, prostate cancer, history of primary liver tumours, hypercalcaemia, nephrotic syndrome
Hepatic impairment
avoid if possible—fluid retention and dose-related toxicity
Renal impairment
caution—potential for fluid retention
Pregnancy
avoid; causes masculinisation of female fetus
Breast-feeding
avoid; may cause masculinisation in the female infant or precocious development in the male infant; high doses suppress lactation
Side-effects
prostate abnormalities and prostate cancer, headache, depression, gastro-intestinal bleeding, nausea, vomiting, cholestatic jaundice, changes in libido, gynaecomastia, polycythaemia, anxiety, irritability, nervousness, asthenia, paraesthesia, hypertension, electrolyte disturbances including sodium retention with oedema and hypercalcaemia, weight gain; increased bone growth, muscle cramps, arthralgia; androgenic effects such as hirsutism, male-pattern baldness, seborrhoea, acne, pruritus, excessive frequency and duration of penile erection, precocious sexual development and premature closure of epiphyses in pre-pubertal males, suppression of spermatogenesis in men and virilism in women; rarely liver tumours; sleep apnoea also reported; with patches, buccal tablets, and gel, local irritation and allergic reactions (including burn-like lesions with patches), and taste disturbances
TESTOSTERONE AND ESTERS
Oral
Restandol® Testocaps
Buccal
Striant® SR
Intramuscular
Testosterone Enantate
Nebido®
Sustanon 250®
Virormone®
Implant
Testosterone
Transdermal preparations
Intrinsa®
Testim®
Testogel®
Tostran®
MESTEROLONE
Pro-Viron®
Androgens cause masculinisation; they may be used as replacement therapy in castrated adults and in those who are hypogonadal due to either pituitary or testicular disease. In the normal male they inhibit pituitary gonadotrophin secretion and depress spermatogenesis. Androgens also have an anabolic action which led to the development of anabolic steroids (section 6.4.3).
Androgens are useless as a treatment of impotence and impaired spermatogenesis unless there is associated hypogonadism; they should not be given until the hypogonadism has been properly investigated. Treatment should be under expert supervision.
When given to patients with hypopituitarism they can lead to normal sexual development and potency but not to fertility. If fertility is desired, the usual treatment is with gonadotrophins or pulsatile gonadotrophin-releasing hormone (section 6.5.1) which will stimulate spermatogenesis as well as androgen production.
Caution should be used when androgens or chorionic gonadotrophin are used in treating boys with delayed puberty since the fusion of epiphyses is hastened and may result in short stature; skeletal maturation should be monitored.
Intramuscular depot preparations of testosterone esters are preferred for replacement therapy. Testosterone enantate, propionate or undecanoate, or alternatively Sustanon®, which consists of a mixture of testosterone esters and has a longer duration of action, may be used. Satisfactory replacement therapy can sometimes be obtained with 1 mL of Sustanon 250®, given by intramuscular injection once a month, although more frequent dose intervals are often necessary. Implants of testosterone can be used for hypogonadism; the implants are replaced every 4 to 5 months.
Testosterone implants can be used in postmenopausal women as an adjunct to hormone replacement therapy. A testosterone patch is also licensed to improve libido in surgically induced menopausal women (receiving concomitant oestrogen therapy).
21 April 2012, 10:56 PM
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john im happy to leave our discusssion as it is.
your evidence desnt corrleate with my experience or many of theusers i know,
we both realise were not going to agree.
im not talking about post menopaulsal women - and ever have been
as someone activley involved in this "scene" your a decade behind in ped use. sex hormones are old old news.
your evidence desnt corrleate with my experience or many of theusers i know,
we both realise were not going to agree.
im not talking about post menopaulsal women - and ever have been
as someone activley involved in this "scene" your a decade behind in ped use. sex hormones are old old news.
21 April 2012, 11:03 PM
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The use in women is at least legal.
Can you provide information on what is presently used in the "scene" so that I can give evidence based information to a user that will be willing to listen? This way they won't come away from a consultation where I'm only talking about the use of drugs which are 10 years out of date in the present scene.
I am aware of class A, B and C, respectively the 17 beta hydroxy esters, 17 alpha hydroxy alkylations, and alkylation of the A, B or C rings of the steroid backbone.
The UK prescribable variants are primarily class A.
Can you provide information on what is presently used in the "scene" so that I can give evidence based information to a user that will be willing to listen? This way they won't come away from a consultation where I'm only talking about the use of drugs which are 10 years out of date in the present scene.
I am aware of class A, B and C, respectively the 17 beta hydroxy esters, 17 alpha hydroxy alkylations, and alkylation of the A, B or C rings of the steroid backbone.
The UK prescribable variants are primarily class A.
Last edited by john banks; 21 April 2012 at 11:08 PM.
21 April 2012, 11:14 PM
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Mayo clinic (a source I trust) list other performance enhancing drugs:
http://www.mayoclinic.com/health/per...-drugs/hq01105
Are you talking about another class entirely? The trouble is often that "scene" language needs translation! Not just in this scene either.
http://www.mayoclinic.com/health/per...-drugs/hq01105
Are you talking about another class entirely? The trouble is often that "scene" language needs translation! Not just in this scene either.
21 April 2012, 11:38 PM
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The challenge is the difference between a science and non science background.
Science will only accept the most rigorous proof for anything even if that proof may raise new questions and be inconvenient to current practice.
None science is more accepting of the new and unusual, is welcoming of anecdotal evidence especially if having seen or experienced something similar along with the resulting bias and most likely feels that good science is just making things "too difficult"
Science will only accept the most rigorous proof for anything even if that proof may raise new questions and be inconvenient to current practice.
None science is more accepting of the new and unusual, is welcoming of anecdotal evidence especially if having seen or experienced something similar along with the resulting bias and most likely feels that good science is just making things "too difficult"
21 April 2012, 11:44 PM
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Another huge can of worms, and for insulin like growth factors there is far less safety information than for steroids.
I can't see how there will be data to support their use outwith very narrow and rare licensed indications though and for that reason would have to resume my default position as I would with any drug without data, even if it was to treat a serious illness, unless it was in the context of a trial.
What proportion of "users" are on growth factors compared with steroids in your experience? You think that it is likely there will be any users on our small list of 4400 patients?
thesyn, I think that is a good summary, but I know what side of the fence I want to be on.
I can't see how there will be data to support their use outwith very narrow and rare licensed indications though and for that reason would have to resume my default position as I would with any drug without data, even if it was to treat a serious illness, unless it was in the context of a trial.
What proportion of "users" are on growth factors compared with steroids in your experience? You think that it is likely there will be any users on our small list of 4400 patients?
thesyn, I think that is a good summary, but I know what side of the fence I want to be on.
Last edited by john banks; 21 April 2012 at 11:46 PM.
22 April 2012, 01:28 AM
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from a quick look that ;ink covers some articles from testing on veal to rats amd soem human results in non scientofoc gold standard testing of growth hormone/insulin and igf1-lr3
what about the rest i mention?
theve all been around for decades what about the rest?
let me guess something youve no experiece of, no exposure to, no knowlgdege of and therfore adop the opinion of, its not safe.
well done for educating people john.
i think ill continue to take persoanl experience over your unavailable data all day long tbh
you want a list of some more researchc chemicals available and in use today?
i dont think theres any point really tbh
this discussion has just about concluded from my point of view , thanks again.
what about the rest i mention?
theve all been around for decades what about the rest?
let me guess something youve no experiece of, no exposure to, no knowlgdege of and therfore adop the opinion of, its not safe.
well done for educating people john.
i think ill continue to take persoanl experience over your unavailable data all day long tbh
you want a list of some more researchc chemicals available and in use today?
i dont think theres any point really tbh
this discussion has just about concluded from my point of view , thanks again.
22 April 2012, 09:47 AM
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I think that sums it up well. Until a substance is licensed in the UK for human indications I would recommend not using them. If licensed for one indication and there was a compelling reason to use them for another where the literature showed benefit over the alternatives then that could be considered.
Even a drug closely related to another well known and already in use drug cannot legally be used until proven by scientific method. Even when it is an early human trial for a disease with 100% mortality you cannot wade in without the necessary checks.
This is unashamedly my approach and that backed by law for good reason. The best educational message is not to use quackery to supervise the taking of these substances, as that gives the illusion that they are safe and well understood. "First do no harm."
Oddly we don't see much opposition amonst scientists to the safety mechanisms in place to regulate medicine. Even if it produces delays, most drugs fall by the wayside before they reach human use. Short circuiting that delay and process leaves the user wide open to unknown dangers. Good luck with that, I hope the results really are worth it.
Even a drug closely related to another well known and already in use drug cannot legally be used until proven by scientific method. Even when it is an early human trial for a disease with 100% mortality you cannot wade in without the necessary checks.
This is unashamedly my approach and that backed by law for good reason. The best educational message is not to use quackery to supervise the taking of these substances, as that gives the illusion that they are safe and well understood. "First do no harm."
Oddly we don't see much opposition amonst scientists to the safety mechanisms in place to regulate medicine. Even if it produces delays, most drugs fall by the wayside before they reach human use. Short circuiting that delay and process leaves the user wide open to unknown dangers. Good luck with that, I hope the results really are worth it.
Last edited by john banks; 22 April 2012 at 09:53 AM.