The risks of anabolic steroids - used by some athletes to build muscle mass - are by now well-documented. But it turns out, perhaps not surprisingly, that steroids bought illegally through "underground labs" and over the internet generally aren't what their labels say they are, researchers reported at the American Academy of Addiction Psychiatry's annual meeting in Los Angeles, US.
Steroid users often complain that the drugs they had bought - often at significant expense - don't work, or have serious side effects. "Actual data regarding the composition of steroids obtained on the black market are scarce," however, presenter Dr D. Zach Smith, of Boston Medical Centre, told Reuters Health.
"Many labs in the US refuse to analyse suspected steroids," he continued, "so users are not able to determine with any degree of certainty if the steroids they are using are labelled or dosed correctly."
Smith and his colleagues looked at 217 studies that had analysed the chemical makeup of illegally obtained anabolic steroids.
The researchers found that almost a third - 30% - of samples others had analyzed did not contain any of the drugs listed on their labels.
Even when the samples did include an anabolic steroid, nearly half - 44% - contained the wrong dosages, either much lower or much higher. One sample had less than 1% of the dosage its label claimed, while another had more than five times as much.
Unexpectedly high doses could lead to more severe cases of all the potential harms associated with steroids, Smith said: high blood pressure, high cholesterol, shrinkage of the testicles, enlarged male breasts, and acne.
There is also "more evidence accumulating that the likelihood of having a bad reaction with severe psychiatric symptoms including mania, hostility, or aggression, is linked to higher dosages," he said.
Heavy metal contamination
One in five of the samples was contaminated with heavy metals such as tin, lead, and arsenic. Such metals can have toxic effects on the nervous and digestive systems, as well as the muscles.
Would steroid users "be willing to risk serious legal consequences and prosecution for a steroid either so underdosed as to be worthless, or contaminated with heavy metals?" asked Smith. "These questions deserve to be asked, and as clinicians we owe our patients an informed and fully accurate discussion." - (Karla Gale/Reuters Health, December 2009)