science on tap

A Small Dose of Toxicology Performance enhancement – 04/01/08

Pushing the Boundaries of “Best”: Sports Performance

Enhancement using Steroids, B12, and Erythropoietin

April 1, 2008

Science on Tap

Steven G. Gilbert, PhD, DABTwww.asmalldoseof.org

www.toxipedia.org

A Small Dose of Toxicology

See: www.asmalldoseof.org -- smdose

Small Dose of Toxicology

Milestones of Toxicology

www.toxipedia.org

A free toxicology encyclopedia and resource center that anyone can edit. Toxipedia provides comprehensive, accurate, and scientifically based information on the hazards and risks of chemical and physical agents, with the goal of advancing human and environmental health. Toxipedia

Healthy World Theater

Healthy World Theater reaches to the heart to promote awareness and understanding through the arts to create a more healthy and peaceful world so that all creatures may reach, maintain, and enjoy their potential.

Coupling art and science to forge a more healthy

and peaceful world

www.healthyworldtheater.org

LDDI Consensus Statement

Scientific Consensus Statement on Environmental Agents Associated with

Neurodevelopmental DisordersDeveloped by the Collaborative on

Health and the Environment’s Learning and Developmental Disabilities

InitiativeNovember 7, 2007

http://www.iceh.org/LDDI.html

LDDI Consensus Statement

http://www.iceh.org/LDDI.html

Given established scientific knowledge, protecting children from neurotoxic exposures from the earliest stages of fetal development is clearly an essential public health measure. By reducing environmental factors that may lead to learning and developmental disorders, we will create a healthier environment in which all children can reach and maintain their full potential.

“Conditions that ensure that all living things have the best opportunity to reach and maintain their full genetic potential.”

Steven G. Gilbert, 1999

Human & Environmental Health

What Is Performance Enhancement?

AthleticsMuscles StrengthEnduranceStimulantMemory / Learning

Baseball = Steroids?Mitchell Report on Major

League Baseball players – did Roger Clemens use performance enhancing substances?

Dose it matter?

"A thing is right when it tends to preserve the integrity, stability, and beauty of the biotic community. It is wrong when it tends otherwise." -

Aldo Leopold, 1949, A Sand County Almanac

The First Bioethicist

---------- 1887 - 1948 ----------

Aldo Leopold

Ethical Issues? Even if anabolic steroid use was legal, is it

ethical to artificially gain a performance advantage over others?

Should there be limits on what people can do to their own bodies and minds?

What about using legal supplements to achieve a similar advantage?

Should high school athletes be subject to random-drug testing?

Ethical Issues?

Fairness?Protecting people?Discouraging drug use?

Doping / Athletic Performance

Doping - “the use of a drug or blood product to improve athletic performance.”

Is This Doping?

Taking Tylenol to relieve muscle aches and pain

Using an asthma inhaler to prevent the constriction of the airway and to allow proper respiration

Ancient Greek Athletes - “The Greek physician, Galen, is reputed to have prescribed ‘the rear hooves of an Abyssinian ass, ground up, boiled in oil, and flavored with rose hips and rose petals’ to improve performance.”

Ancient Awareness

Ancient Olympic athletes Ate sheep testicles to boost testosterone (the base anabolic steroid)

Ancient Awareness

Strychnine, a stimulant used until the 20th century

HashishCola plantsCactus-based stimulantsFungi (Mushrooms)

Ancient Drugs

The Christian era marked the end of the overwhelming popularity of public sporting events.

In 393 A.D., Emperor Theodosius promulgated a ban on all forms of “pagan” sports, including the Olympic Games.

End of Ancient Sports

19th century, sporting events returned with the onset of the Industrial Revolution

Recreation and entertainmentAnd BusinessAnd Doping

Modern Sports

European cyclists Used caffeine, ether-coated

sugar cubes, cocaine-laced wine 1886 a Dutch cyclist died from an

overdose of cocaine and heroin 1896 a Welsh cyclist died after

taking strychnine

Endurance Sports - Cycling

1896 - Summer Olympics were held and doping was prevalent

1904 – 3rd Olympic Games in St. Louis - Thomas Hicks took brandy laced with strychnine – almost died, but kept the gold metal

Olympics

1930s, Nazi doctors created anabolic steroids – testosterone that could be administered through a syringe – goal of increasing aggression in troops

Germany 89 medals - won the overall medal count

United States came in second with 56 medals

Massive doping

Olympics - 1936

Cold war – new weaponsNuclear Arms Race Competition at Olympic sportsAnabolic Steroid Race

Post WWII - Olympics

1928 – first bans but no tests 1950s - the International Cycling

Union (UCI) introduced drug testing programs

1960 - Olympic Games, Danish cyclist, Knut Jensen, died from amphetamines

Banning Doping

1967 - Tom Simpson, a British cyclist, died in the Tour de France. He collapse during a climb and three tubes of amphetamines were found in the back pocket of his racing jersey.

Event widely publicized (see youtube videos)

Increased Awareness

Cycling Football Baseball Basketball Hokey Running Olympic sports Wrestling

Wide Spread Use

Toxicology - the study of poisons orthe adverse effects of chemical and

physical agents on living organisms.

Toxicology Definition

Key Words

Risk =Hazard X Exposure

Dose / Response

Individual Sensitivity

What Is This Drug?

Wired – X344

Warning:If you can’ t handle massive Caffeine, then stay away from this one! We jacked up the caffeine to 344 mg per 16 oz. Can! Ever wonder why some so called energy drinks don’t list their caffeine content? How about their Taurine? Guarana? B Vitamins? What’s up with the “energy blends”? Here’s what’s in your X-344 Extreme Energy Supplement.

Ingredients per 16 oz. can include: 344 mg Caffeine250 mg Guarana Seed Extract3000 mg Taurine100 mg Inositol60 mg White Tea Extract500% RDI Vitamin B12200% RDI Vitamin B6160% RDI Vitamin B3100% RDI Vitamin B5

http://www.wiredenergydrink.com/x344.htm

Wired – XXX

Extreme Energy Supplement Arouse your senses with this stimulating herbal combination. Wired Triple X is specially formulated with the benefits of Horny Goat Weed, L-Arginine, Maca, and Tribulus terrestris to help enhance your sexual prowess. Get Wired, Stay Wired!

Ingredients per 16 oz. can include: 3000% RDI Vitamin B12500% RDI Vitamin B6200% RDI Vitamin B3100% RDI Vitamin B51000 mg Taurine1000 mg L-Arginine150 mg Caffeine100 mg Inositol100 mgEpimedium (Horny Goat Weed)10 mg Maca4 mg Tribulus terrestris

http://www.wiredenergydrink.com/xxx.htm

My Neighborhood

Blood Doping

Blood doping originally meant literally doping with blood, i.e. the transfusion of RBCs.

Extract blood, harvest RBCs re-inject Increases oxygen to muscles Used by endurance athletics, cycling,

marathon runners Hazard – blood clotting, stoke, death See also EPO

What is This?

Erythropoietin

Erythropoietin (EPO) Stimulates the production of red

cells in bone marrow and a treatment for anemia in humans. (kidney disease, cancer, (chemotherapy & radiation)

Amgen made a fortune Endurance sports (cycling) –

Increases number of RBC Clotting - death

What is This?

Testosterone

Used for 1000s of years1930’s modern chemistryNatural Anabolic SteroidsSynthesis and now 100s

Testosterone’s Desired Effects

increase protein synthesis within cells, which results in the buildup of cellular tissue (anabolism), especially in muscles

muscle mass and physical strength stimulates bone growth and appetite, induce male puberty treat chronic wasting conditions such

as cancer and AIDS

Testosterone’s Hazards

growth of the vocal cords body hair harmful changes in cholesterol levels acne high blood pressure liver damage changes in the structure of the left

ventricle of the heart testicular atrophy

What is This?

Strychnine

Stimulant at low doseWidely used as medicinePesticide at higher dosesMuscle convulsions Effects glycine receptor

What is This?

Vitamin B12

Vitamin B-12, factor in normal functioning of the brain and nervous system and for the formation of blood

Stress relief Purported to increase energy and

is largely anecdotal Can have deficient – little tox

What is This?

Growth hormone

Growth hormone 191-amino acid, single chain

polypeptide hormone somatotrophin the recombinant DNA -

"rhGH“ Body builders inject growth hormone

to decrease body fat and increase muscle mass.

Fat burning is increased and glucose burning is decreased.

Result is muscle bulk and strength.

Growth Hormone Hazards

high levels of blood fats glucose intolerance gigantism in pre-adolescents diabetes enlarged heart high blood pressure heart disease nerve disease lung disease

What is This?

Gamma-hydroxybutyrate (GHB)

More of a social drug – related to growth hormones

Naturally occurring Intoxicant or as a date rape drug Athletes and bodybuilders use GHB,

to elevate human growth hormone Hazards - unconsciousness,

convulsions, vomiting, suppression of the gag reflex, respiratory depression and death

What is This?

Insulin

Hormone which causes liver and muscle cells to take in glucose and store it in the form of glycogen

way of 'energizing' the body - increase muscle mass

widespread amongst the body building community

hypoglycemic coma and death type 2 diabetes

What is This?

Viagra

Viagra Performance issue? Pfizer - Billion $$ plus drug Treat male erectile dysfunction

(impotence) Pulmonary arterial hypertension

(PAH) causes release of nitric oxide (NO) Hazards - hypotension, myocardial

infarction, ventricular arrhythmias, stroke,

Memory Enhancement

Hydergine Vincamine, Nimodipine and

Vinpocetine (from periwinkle) Ginko biloba L-Deprenyl Rasagiline ……….

Ethical Issues? Even if anabolic steroid use was legal, is it

ethical to artificially gain a performance advantage over others?

Should there be limits on what people can do to their own bodies and minds?

What about using legal supplements to achieve a similar advantage?

Should high school athletes be subject to random-drug testing?

Ethical Issues? Should society respect a person’s choices about

his or her own body, even if the behavior is risky? Are enhancements harmful or beneficial to

individuals who use them? Are enhancements harmful or beneficial to society

when individuals use them? Is it fair for an individual to use an enhancement? Does fairness require that everyone in society

have equal access to enhancements? Does using enhancements in performance violate

the integrity of the performance? Is the achievement of an individual who uses an

enhancement less authentic?

Principles of Toxicology

Additional Information

• Taking performance-enhancing drugs: Are you risking your health? http://www.mayoclinic.com/health/performance-enhancing-drugs/HQ01105

• National Institute on Drug Abuse: NIDA, NIH, DHHS Steroid-related resources geared towards the general public

• US Anti-Doping Agency: dedicated to eliminating the practice of doping in sport, and to preserving the well being of sport and ensuring the health of athletes through research initiatives and educational programs

• What's wrong with enhancement? The President's Council on Bioethics

Authorship Information

For Additional Information ContactSteven G. Gilbert, PhD, DABT

E-mail: smdose@asmalldoseof.orgWeb: www.asmalldoseof.org

www.toxipedia.org

This presentation is supplement to “A Small Dose of Toxicology”

NW Public Health

See: http://healthlinks.washington.edu/nwcphp/nph/ nwph

Public Health and the Precautionary

PrincipleBy Steven G. Gilbert

Precautionary Principle

“When an activity raises threats of harm to human health or the environment,

precautionary measures should be take even if some cause and effect relationships are not

fully established scientifically.”

Wingspread Conference, 1998.

• Setting goals (Health indicators)• Taking preventive action in the face of

uncertainty• Shifting the burden of responsibility to the

proponents of an activity (Who benefits?)• Exploring a wide range of alternatives to

possibly harmful actions (Is it necessary?)• Increasing public participation in decision

making (transparency of information & environmental justice)

Central components

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