Testosterone-Proprianate with a Russian label.

Gary Wolf

February 26, 2009

Not long ago I asked somebody I know with deep knowledge of athletes,
athletic training, and performance enhancing drugs to talk to me about
what I suspected was a “dark net” of self-monitoring and
self-experimentation. Athletes track their performance in many ways.
They measure speed, strength, weight, recovery time, and dozens of
other variables. Those who are using performance enhancing drugs must
also have well developed monitoring routines. What can we learn from
them?

My interest was sparked by last week’s news about Alex Rodriguez, the great Yankee third baseman. I haven’t been able to work up much interest in baseball since Barry Bonds broke the season home run record. I watched a few of those home runs from the ballpark and enjoyed them a lot, but the stupidity and mendacity of the steroid scandal that followed more or less ruined the fun. I can see both sides of the pro- and anti-steroid argument. Why shouldn’t we seek peak performance using every technological means at our disposal? And although gladiatorial contests that reward self-mutilation will seem disgusting if you look too closely at the costs (cf., professional football), the risk to self is not necessarily lower in other sports that are shielded from moralism by a nominally more civilized aesthetic (cf., horse racing). Still, there is a difference between a little guy risking his neck careening around a dirt track on a mammalian rocket and a tall, well-built infielder calling down the wrath of an early stroke through injections of testosterone. The difference is that the jockey’s risk is in the open, and the infielder’s risk is in the shadows. What got to me about the steroids scandal was not the steroids, but the lying. Wrapped in layers of righteous accusation and defensive prevarication were the answers that any reasonable observer would want. What are athletes taking? What are the true effects? What are the physiological changes? Some of this is obvious, but some of it is unknowable, at least under current conditions. These professionals are performing experiments on themselves, and the details won’t be known until there is a critical mass of data. With everybody lying as fast as they can, the data will never arrive. In my parochial interest in the increase of knowledge about making better humans, I find this distressing. We have questions. The athletes have answers. But instead, we get this:

 

Alex Rodriguez: I didn’t think they were steroids. That’s again the part of being
young and stupid. It was over the counter, it was pretty basic. And you
know, it was really amateur hour. I mean, it was two guys, we couldn’t
go outside, we couldn’t ask anyone, we didn’t want to ask anyone. We
went outside team doctors, team trainers. It was two guys doing a very
amateur and very immature thing. We probably didn’t even take it right;
like I said in my statement, we used to do it about two times a month.
I don’t even know if that’s proper. So when this gentleman asked about
how it affected us, I’m not sure if we even did it right to affect us
in the right way. So all these years, I never thought I did anything
that was wrong. Perhaps. But not wrong. But come to figure out that
boli triggered a positive test in ’03.

Reporter: As someone who monitors
everything that they put in their body, how could you not have done
more research or been more conscientious about what you were taking?

Alex Rodriguez: I wish I knew. I was 24. I was 25. I was pretty naïve and pretty young
and initially I was curious because he mentioned it a few times and I
just gave it a try. (See the full transcript here).

Since Alex is unwilling to tell us anything, I took my questions elsewhere.

My source asked to be quoted under a pseudonym, for now. Let’s call him Phineus. Phineus is an experienced, well connected trainer, with wide interests and knowledge. He has access to media, and his research includes both his own direct experience and extensive contacts. He will be talking about these topics under his own name in the future, but he’s not ready to go public yet. I asked him to share just a few things that might be of interest to the broader community of people seeking self-knowledge through numbers.

GW: How do athletes using performance enhancing substances track their regimen?

Phineus:
Athletes generally track performance-enhancing drug cycles, including
anabolic-androgenic steroids (AAS) with a dosing schedule. For
most people, depending on the drugs, cycles will last from 8 -12 weeks,
between which you allow your endogenous hormone production to restart
and normalize.
In my particular case post-reconstructive surgery, I had a schedule of
3 pages, printed out, one
month on each page, a separate highlighter for each drug to show start
and stop dates and dosages.  One of the biggest challenges for
measuring effects is
that very few athletes use a single anabolic steroid in isolation.
Combining drugs is the rule rather than the exception,
because there are synergistic effects that allows you to get the same
or greater
effects with lower doses of each.  One standard “stack” is dianabol and deca-durabolin,
and oral and injectable, respectively, plus human growth hormone
(HGH).  The oral steroid is taken daily, the Deca-Durabolin is injected
once weekly, and the HGH might be injected 2x/daily if a
low-dose/high-frequency dosing protocol is followed to minimize
side-effects.

GW: Do they do this on a spreadsheet?

Phineus: Most
people will track with paper and pen, simply because the potential
legal side effects of using illegal steroids are so severe. Possession
of a Schedule III controlled substance is punishable by up to seven
years in prison, more if you are using enough that it
could be misinterpreted as intent to distribute.  The data tends to
live offline and off of hard disks.

GW: You don’t take all the drugs all at the same time?

Phineus:  The more astute self-experimentalists stagger dosing.
From a blood-level standpoint, you might well be “on” all of the drugs
at the same time, but you introduce them — and remove them — one at a
time.  This is very important if you want to correctly correlate the
positive effects and side-effects to specific drugs.  Understanding the
varied pharmacokinetics and having a written schedule is critical.
Suppose you are
taking a testosterone suspension
daily that reaches peak concentration in 4 hours, an oil-based
testosterone blend like Sustanon 250 that might produce a cumulative
peak at approximately day 25, and Deca-Durabolin, which is injected
weekly and achieves maximal blood-nandrolone levels 48 hours after each
injection.  It is prudent and beneficial to know when those peaks will
overlap, both for scheduling training and avoiding other situations
(negotiating a business deal with the testosterone level of a bull
shark is not recommended).

GW: What is the cutting edge, what can people doing other kinds of self-monitoring learn from these athletes?

Phineus:
The biggest mistake people make in self-monitoring is that they do not
get an accurate baseline. This is a subtle point, because once is not
enough. In other words, I am not interested in a single snapshot, but
in the trend. Let’s say you think you are getting a baseline, and you
do a complete metabolic panel* and lipid profile.*^ You have an HDL of
60, you take the anabolic steroids, and four weeks later it is 50.
There you seemingly have evidence that the steroids caused your decrease in
HDL. But if you had done a lipid profile four weeks prior to your
cycle, and then immediately prior, you might have seen 65 for the first
test, then 60 on the second, showing that there was already a downward trend.
That would have helped you avoid misattributing the total decrease to
the effect of the drugs.

GW: What have you learned from your experiences working with doctors?

Phineus:
Even if you find a doctor who will supervise your use of the drugs –
and it is very difficult to find somebody who is both qualified and
willing – a proper pre-use baseline is almost never established.
They seldom look for trending in estradiol, for instance, and often neglect to look at pre-AAS levels of Luteinizing Hormone (LH) or Follicle-Stimulating Hormone
(FSH), which are influenced by a negative-feedback loop. Not looking at
trends is the biggest medical error by far.  There is a good chance
your system is somewhat off-kilter before the self-experimentation, so
gather gather more control data earlier, on at least two occasions.

GW: How did you learn this?

Phineus: I’ve been self-tracking through blood tests for at
least six years. Before I used AAS, I had blood tests drawn every 2
months to measure eosinophil levels, among dozens of other variables, and my levels did not fall outside
normal range until the third or fourth tests.  But the doctors never
looked at more than one test, they never analyzed them in succession.
They said, normal, normal, normal – oh, you have a problem!  It could have been addressed months earlier. You will
also find baseline problems in the case of mood tracking. People using
anabolic steroids don’t track mood much because there is no real
performance benefit to doing so. But if you do, you develop a hyperawareness of emotional states
that you did not have before, and you interpret mood swings that you
had before as new. For that reason, you have to track the variables
before you begin. You should begin self monitoring at least four weeks
in advance.

GW: How common is this sort of self-experimentation among athletes?

Phineus:
Among athletes that perform in any strength-, speed-, or endurance-dependent sport
at the highest levels, at least 80 percent use “drugs” of some type. I use
this term very broadly, because from a training perspective a drug is a
drug is a drug. The usual distinction between a nutritional supplement
and a drug is not a biological distinction, but a legal distinction.

GW: The ones who get caught using banned drugs always say “I didn’t know what I was taking!”

Phineus:
Pro athletes who claim ignorance are using the only
defense they can.  “I thought I was injecting flaxseed oil to get
bigger.”  Right.  That would be like a NASCAR driver claiming he knows
nothing about fuel or tires.  His job requires he know the vehicle, and
being a top professional athlete requires understanding exactly what
you put in your body to get performance out of your organic machine.
It could make the difference between a 7-figure or 8-figure income.
Carl Lewis tested positive for performance enhancers – stimulants – the
same year that Ben Johnson tested positive for anabolic steroids and
had his gold medal revoked.  How did Carl Lewis then inherit the gold by default?
Lewis had a more developed defense – herbal tea consumption – and the
term “inadvertent use” was used to dismiss the charges.  Athletes know
exactly what’s banned — the lists are beaten over their heads ad
nauseum because sports franchises and amateur federations dislike the
labor costs, PR headache, and revenue loss that scandals can produce.

GW: Any last advice you might want to deliver to the broader world of self-trackers and self-experimenters?

Phineus:
Yes, you need to develop an ability to interpret data for yourself. I
have seen legitimate medical doctors in life extension facilities gloss
over serious side effects of the substances they recommend. Remember
that private clinics are in business, and — in this case — drugs are
a profit center.  Don’t expect unbiased feedback. For example, aromatase inhibitors
such as Arimidex (anastrozole), often used to minimize the estrogenic
side-effects of AAS, can cause near instantaneous problems with your
lipid profile, particularly related to decreased HDL “good
cholesterol”.  To track this, you should have your blood tests
drawn every two weeks. Certain adverse side effects are reversible
following short-term use of AAS.
Testicular atrophy and HTPA disruption
are two typical examples. But
certain side effects are irreversible, and you are the one who has to
determine what risk/benefit ratio is acceptable. There is a reason you
see certain athletes with bigger heads and bigger hands than they had
five years ago, as well as bodybuilders with distended abdomens due to
enlarged visceral organs.  In fact, there are two reasons: HGH and,
less common, IGF-1. Guess what: when they stop using these drugs, their heads
are not going to shrink.  Do your homework, as you will have to live with the results.  Caveat emptor.
—
*Here is a list of what Private MD Labs, an online lab-test ordering service, provides in their complete metabolic profile for $64.49: A:G ratio; Albumin, serum; Alkaline phosphatase, serum: ALT (SGPT); AST (SGOT); Bilirubin, total; BUN; BUN:creatinine ratio; Calcium, serum; Carbon dioxide, total; Chloride, serum; Creatinine, serum; Globulin, total; Glucose, serum; Potassium, serum; Protein, total, serum; Sodium, serum; Creatine Kinase (CK), total, serum
*^Here’s what the $47.99 lipid profile contains: Cholesterol, total; high-density lipoprotein (HDL) cholesterol; low-density lipoprotein (LDL) cholesterol (calculation); triglycerides; very low-density lipoprotein (VLDL) cholesterol (calculation).