Performance-Enhancing Drugs May Put Teenagers At Future Health Risk

An athletic boost in the short term may mean health problems in the long term for teens who use performance-enhancing drugs, warns a youth sports medicine specialist from the University of Michigan Health System.

In fact, the same substances that athletes take as teens to have more muscles, power and endurance may cause them to grow into shorter adults – and may even make them take on some secondary physical characteristics of the opposite sex.

The consequences may turn out to be dire, says David Marshall, M.D., a clinical instructor in the U-M Department of Pediatrics and a physician at the U-M Brighton Health Center. But still, he says, more and younger athletes than ever before are imitating their professional sports heroes by using outlawed drugs and unproven supplements to pump up their bodies and their game.

What’s most frightening, Marshall says, is that doctors just don’t know exactly what performance enhancers will do to teens later in life: Research on side effects from banned substances such as anabolic steroids, and over-the-counter products such as creatine and androstenedione, has only been done on adults.

That’s because until a few years ago, doctors didn’t need to worry much about teens taking steroids and other substances, he adds.

“We used to be concerned that the athletes were using them at the elite level, the professionals, the aspiring Olympians,” he says. “But now we are starting to find that these types of performance-enhancing substances are coming down more to the high school levels, and recent studies show that the junior high kids are also starting to get involved in banned, illegal performance enhancing substances, and that is concerning us.”

That’s because teen bodies, including tissues, bones, kidneys and livers, are still developing. So are teen muscles, though not at the pace that some would like. As a result, up to 4 percent of boys and 2 percent of girls turn to the same performance-enhancing legal and illegal drugs that their pro idols use, according to studies by scientists at the U-M Institute for Social Research.

With competitive pressure mounting to make the team, beat the competition, keep their weight down, win the medal or snag the college athletic scholarship, teens may even double or triple the suggested doses to get more results, Marshall says. “This ‘more is better’ attitude that they have for performance-enhancing drugs and everyday life can lead to problems or hazards as the body is flooded with extra levels of the biologically active substances.”

They may think that the over-the-counter products are safe because they see professional ballplayers, wrestlers and others wearing their logos, and because they are often easily available at vitamin, drug and grocery stores. Even regulated substances such as anabolic steroids may take on an appearance of safety when fellow athletes offer them at the gym.

Instead, steroid performance enhancers can cause teens’ growth plates, the flexible stretching regions in bones, to fuse solid at an accelerated pace – stunting their height prematurely. They can cause boys’ breasts to enlarge and ache, a condition called gynecomastia and nicknamed “gyno” by athletes. They can cause girls’ voices to become lower-pitched or whispery, and keep their normal hip and breast curves from developing.

While Marshall reserves his largest concerns for drugs that have been banned by professional sports organizations, he also warns about protein supplements and other nutrient aids.

“I think one of the biggest concerns we have about those is the purity of the compound, because they are not regulated by the Food and Drug Administration,” he says. “They don’t have to go through clinical trials, and so we are not sure about their purity when they’re sold, or even whether they work.” Teens who eat a balanced diet will get plenty of protein, he says.

So what should parents look for, to tell if their teen may be using performance enhancers? Boys who take anabolic steroids may gain weight and muscle rapidly, far faster than normal, changing their pre-puberty boyish body into a man’s physique. Girls who use the banned substances may be easier to spot, because their bodies will lose or not develop the normal curves of a woman’s body.

Still, many of the signs – acne on the face and back, mood swings – are easily mistaken for normal teenage developments. Many of the newer performance enhancers may cause no visible side effects or are so new that physicians don’t yet know what they will do. And while some side effects will reverse if teens go off the drugs, Marshall stresses that too much is unknown about other effects.

Facts about kids, sports and performance enhancers:

According to the Monitoring the Future study conducted by the University of Michigan’s Institute for Social Research, 2.7 percent of 50,000 students in the high school class of 1998 who were surveyed had used steroids sometime in their life, a slight increase from previous years. About 0.3 percent had used steroids in the past 30 days.
Similarly, the 1997 Steroid Use Youth Risk Behavior Surveillance by the National Center for Chronic Disease Prevention and Health Promotion (part of the Centers for Disease Control) found that nationwide, 3.1 percent of students had used illegal steroids (i.e., without a doctor’s prescription) during their lifetime.
Another U-M survey found that 44.5 percent of high school seniors said it would be fairly easy or very easy for them to get hold of steroids if they wanted them.

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