An investigative series on anti-aging medicine by Brian Alexander of MSNBC is highly critical of the anti-aging industry. Alexander has interviewed a few academics to reinforce the skeptical overview of the industry suggesting the industry is more about financial profiteering than health optimization (”Mainstream docs join anti-aging bandwagon,” April 21).
Dr. Thomas Perls, a Boston University researcher who studies centenarians (people who live at least 100 years), and a vociferous critic of the anti-aging industry, argues that while some anti-aging practitioners “may have their hearts in the right place … in my mind the whole anti-aging practice has so many problems of ethical and professional misconduct. These practices are selling medicines and substances at great profit with very little in the way of clinical studies to support what they are doing.”
The answers to the science questions can be complicated, but the motivations of some doctors to enter the anti-aging world are not. Dr. Arnold Relman, a former editor of The New England Journal of Medicine who is now a professor emeritus of medicine and social medicine at Harvard Medical School, believes “the interest in anti-aging practice is mainly based on economic considerations” by physicians who are looking to boost income.
Alexander is troubled by the extreme commercialization of the anti-aging industry as seen at anti-aging conventions (”Selling longer life - or snake oil?” April 18).
Indeed, there is no better place to witness the truism of the phrase “hope springs eternal” — and perhaps “there’s a sucker born every minute” — than an anti-aging convention, especially on the trade show floor where the latest products and services are hawked.
At the 15th Annual World Congress on Anti-Aging and Regenerative Biomedical Technologies in Las Vegas, held under the auspices of the American Academy of Anti-Aging Medicine (A4M), dozens of businesses set up displays to market everything from horny goat weed dietary supplements to wands containing dirt that supposedly align water molecules so the H2O will get into your cells…
In an interview, Dr. Ronald Klatz, co-founder, with Dr. Bob Goldman, of A4M, said he gets annoyed when reporters wander the booths of an A4M event and use the sketchy claims and flimsy science of fringe products to attack the credibility of A4M or anti-aging in general.
“This exhibit hall is constantly being mistaken for the American Academy of Anti-Aging Medicine,” he said. “But that is just the exhibit hall. That is where advertising, lotions, potions, lasers, X-ray equipment, plastic surgery equipment are being sold. That is an exposition. That is advertising! Then there is the scientific conference. That is where the real science is going on and real clinical medicine is being taught.”
The investigative series reveals that the founders of A4M, Dr. Ronald Klatz and Dr. Bob Goldman, have a conflict of interest with the scientific agenda of A4M since they have financial interests in the very products (e.g. Arasys Perfector) and services (Regenerco) advertised at the associated convention.
But distancing A4M from the kinds of products and services offered at the exposition is somewhat disingenuous. Klatz, Goldman and the company that organizes the meeting itself, Tarsus Group PLC, are deeply involved in some of these same kinds of businesses.
Regenerco, for example, is a Klatz and Goldman company seeking to “offer, at a reasonable cost, high-quality, multi-screened vital pathogen-free stem cells originating from umbilical cords and placentas of healthy, live-births, or autologous [genetically identical] adult stem cells from peripheral blood collection.” It promises to use such cells as an anti-aging therapy and has made a deal with a resort developer in Indonesia, PT Hanno Bali, to be the exclusive stem cell distributor for anti-aging resorts serviced by yet another company called One Life +.
The Arasys Perfector is being funded with up to $500,000 from a firm called CapRegen PLC, a publicly traded regenerative medicine investment company based in the United Kingdom. CapRegen’s founders? Klatz, Goldman and Tarsus Group.
Do the commercial ambitions of the founders of A4M jeopardize the scientific agenda of A4M? What do you think?
A recent ad campaign by Cenegenics Medical Institute seen in various domestic in-flight magazines and on various websites featured the muscular torso of Dr. Jeffry Life, Chief Medical Officer of Cenegenics Las Vegas. One internet banner ad asks the question, “how does this 67-year old doctor have the body of a 30-year old?”
The answer, in part, is likely anabolic steroids (testosterone) and human growth hormone which are the cornerstone of anti-aging and age management medicine. The Cenegenics ad campaign seeks to appeal to individuals seeking to improve their physical appearance; benefits may include “improved muscle tone,” “decreased body fat,” “increased energy,” “increased sex drive / libido,” “sharper thinking,” and “improved outlook on life.” These happen to be the same motivations that lead men of all ages to the illicit use anabolic steroids and growth hormone.
When I attended a lecture by Dr. Bob Goldman, American Academy of Anti-Aging Medicine (A4M), at the 2008 Iron Man Expo in Los Angeles, I was surprised that the presentation focused primarily on the obtainability of muscular, athletic physiques through the anti-aging lifestyle with a slideshow featuring several muscular bodybuilders and athletes.
Now that sports doping scandals have made HGH, as well as testosterone and other hormones, front-page news, and some anti-aging clinics and compounding pharmacies have been raided by the U.S. Drug Enforcement Agency for being overly liberal with hormone prescriptions, the anti-aging community has toned down its endorsement of hormones, at least in public.
“Less than 10 percent of patients involved in anti-aging are receiving growth hormone,” Klatz insists.
That seems a dubious assertion. In fact, hormones remain a key ingredient of anti-aging practice. “Most of my anti-aging patients get hormones,” typically growth hormone as well as sex hormones appropriate to each gender, Jurow says.
Given the steroid hysteria and steroid demonization resulting from the steroids in sports scandals, it seems like this would hurt business for anti-aging medicine. But this has not been the case, business is booming in anti-aging medicine.
Back in 1994, the annual Las Vegas meeting of the fledgling American Academy of Anti-Aging Medicine (A4M) was held in a small hotel off the Las Vegas strip. Everyone could fit into a temporary tent-like structure on the pool patio. Last December, at the 15th A4M confab, roughly 2,000 attendees, including business owners, anti-aging promoters and hundreds of doctors — among them obstetricians, ER docs, psychiatrists and internists — filled a cavernous meeting space inside the Venetian Hotel and Resort.
Today, claims Dr. Bob Goldman, A4M’s co-founder, there are about 20,000 A4M-certified doctors around the world. A4M’s tax returns confirm the boom. The income from fees charged to those seeking board certification from A4M more than doubled from $544,845 in 2005 to $1.2 million in 2006.
A rival organization, Age Management Medicine Group, is growing rapidly, too, says co-founder Rick Merner. He claims the group had more than 400 doctors at its last meeting, sponsored by the nation’s single largest “age-management” clinic, Cenegenics. The Cenegenics Foundation also certifies practitioners in age-management medicine (it shuns the term “anti-aging”) and claims to have experienced a 100 percent increase in the number of its physician “affiliates” to more than 800.
Could the steroid hysteria actually be stimulating business for legal prescriptions for testosterone and growth hormone?! The public condemnation of the muscle-building and performance-enhancing effects of steroids and other PEDs may be accompanied by a private celebration of the potential benefits of these hormones.
Eleven members of the Greek Olympic Weightlifting Team tested positive for three banned substances. These have been identified as methyltrienolone (an anabolic steroid), buprenorphine (an opioid antagonist), and an anti-estrogen compound. There has been some speculation as to why, if the Greek athletes intentionally doped, would they use an opioid drug commonly used to overcome heroin and oxycodone addiction?
The managing editor of HellenicAthletes.com suspects that buprenorphine was used to counteract the highly addictive effects of the anabolic steroid methyltrienolone.
The second substance is reported to be an opiate, used to purge the body of the drug-addiction tendencies of methyltrienolone.
Professor Demetrios Kouretas of the University of Thessaly believes buprenorphine was used to counteract the extreme aggressiveness caused by methyltrienolone.
The biochemistry professor suggests that the combination of substances was designed to “improve the athlete’s psychological disposition because the anabolic steroid triggers extreme aggressiveness”.
The Athens News, an English-language newspaper in Greece, has been covering the recent steroid scandal plaguing the Greek Weightlifting Olympic Team. The newspaper discusses the anabolic steroid methyltrienolone, one of the three substances in the failed drug tests for the eleven Greek weightlifters. The newspaper makes the preposterous and irresponsible claim that methyltrienolone killed 200 bodybuilders in the 1960s.
Steroid expert Patrick Arnold (Ergopharm) has told me he doesn’t believe methyltrienolone was ever formally introduced commercially; therefore it is extremely unlikely that any bodybuilders were even aware of its existence in the 1960s. It is “completely inconceivable” that 200 bodybuilders died from using methyltrienolone, according to Arnold.
“This [methyltrienolone] is a very old drug and no one has tested positive for it in the [recent] past. It is on the banned drugs list. But because it is extremely toxic, especially for the liver, it is not used,” Kouretas said. “Those that tested positive are in a sense very lucky because if they continued, they could have died.”
Of the three banned substances for which the Greek athletes tested positive, methyltrienolone is the most dangerous. The drug was held responsible for the death of about 200 people, mainly bodybuilders, in the 1960s.
“After three or four weeks of taking it, you get severe liver problems, and if you don’t stop, it could lead to death in a few months,” Kouretas.
“For the last 25 years, methyltrienolone has been used in hundreds of laboratory experiments on killing cancer cells. It is commercially called R-1881. But it is not used as an anabolic steroid,” Kouretas said.
The newspaper article quotes Professor Demetrios Kouretas extensively. Dr. Kouretas received a postdoctoral degree from Harvard Medical School and has had over 40 articles published in scientific journals.
Nowhere is Dr. Kouretas directly quoted with the absurd and blatantly false propagandistic statement that the anabolic steroid methyltrienolone killed 200 bodybuilders?! Unfortunately, the author of the Athens News article interjected the statement giving the impression that it may be attributable to Dr. Kouretas.
Greek journalists apparently have no qualms about (mis)using university experts when publishing their steroid misinformation. Dr. Kouretas’ fearmongering about Greek weightlifters (being on the verge of death only to be saved by a positive doping result) was not enough for the author of the report.
Anabolic steroid users represent the largest client at needle exchange programs in the United Kingdom according to the weekly current affairs magazine, the New Statesman (”Shape of the future: observations on bodybuilding,” April 17).
The New Statesman magazine also identifies some disturbing trends in steroid use in the U.K.
But rates of steroid use aren’t the only thing that’s changing: so is the type of person who uses the drugs.
According to Martin Chandler, a specialist in steroid use at Liverpool John Moores University, the rise is caused by people “younger and less knowledgeable” than their previous counterparts. “What scares me is their limited research and understanding,” he says.
According to Martin Chandler, the increasing number of young people using steroids is due to aesthetic (body image) concerns and not performance enhancement concerns.
If the demographic of steroid users is changing, so too are their motivations. Among older users, the drugs were often taken as a means to open up non-academic job opportunities. This was particularly true in former manufacturing towns. When manual workers found themselves unable to make a living in the old industries, they often trained as security staff, bouncers or police officers to continue making a living through their bodies.
But, unlike mining and manufacturing work, for instance, these new careers did not develop appropriate physiques “on the job”. Being a doorman might require a big build, but the job itself is more likely to cultivate guts than shoulders. Hence the rise of gym culture, and steroids.
Now, according to Chandler, it is fashion rather than function that motivates the younger generation to pump up: “Ultimately, what new users are concerned with is body image. It’s got nothing to do with performance gain - it’s about aesthetic.” The trend is not surprising. Men’s magazines are booming; there are also flourishing industries in male health, diet and supplements. Meanwhile, multimillion-dollar advertising budgets are pulling in actors and sportsmen to sponsor the “male ideal”.
Fortunately, the harm reduction programs offer an additional opportunity at steroid education hopefully improving the health of steroid users.
Dr. Jay Hoffman is a Professor of Health and Exercise Science at the College of New Jersey and a member of the board of directors for the National Strength and Conditioning Association (NSCA). Dr. Hoffman recently shared his views of steroid use in professional sports with Express (a free daily published by the Washington Post).
Because, one, it wasn’t illegal. I did it with a physician. I had constant blood and liver function tests. I did it with someone who cared about me as a patient, making sure it was done the right way. I never did anything black market. I did it in specific time frames, that would maximize my ability as an athlete used it for a specific purpose: to be a better football player. And people have to understand there is a difference between a strength power athlete that uses it to get ready for a season versus a body builder that uses it on a consistent basis. Most individuals who use it, use it in a cyclic fashion and stacking several different drugs for certain period of time, and then come off it. There are side effects that are associated with that and the side effects are greater with the amount of anabolic steroid being used. But it’s transient. And unless there’s an underlying disease — and that’s why it’s important to go with a physician — unless there’s an underlying disease, the risks associated with it are not as great as people make it out to be. But for those individuals who never come off a cycle, the risks are very real. Many of the athletes who have died, are generally those body builders or wrestlers who never come off it.
I think Dr. Hoffman touches on some very interesting points.
(1) The patterns of steroid use by most professional athletes and competitive bodybuilders are substantially different. The implication is that it is unfair to extrapolate the side effects from extreme users of anabolic steroids to all athletes (and individuals) who use anabolic steroids for non-medical purposes.
(2) The side effects of anabolic steroids are transient in nature for the most part.
(3) The side effects of anabolic steroids have been overstated if there is no underlying disease in the individual using steroids for non-medical purposes.
(3) Steroid use can be done the “right way” with proper medical monitoring by a physician with necessary lab work.
I have previously written about how the current climate of steroid hysteria has limited the availability of anabolic steroids for medically indicated purposes. I’ve also posted lists of compounding pharmacies that, in the face of limited availability and increased federal pressure, continue to sell anabolic steroids to patients who have a genuine medical need for them.
Today MESO-Rx has learned that at least one compounding pharmacy has contacted bodybuilding, steroid, and health websites requesting the removal of all references to the company, their website and the (anabolic steroid) product(s) they sell.
I spoke with the chief marketing officer for the compounding pharmacy to find out more information. I was told that the company was concerned about receiving adverse attention from publicity of anabolic steroid sales. The company was adamantly dedicated to only serving the populations (e.g. HIV, wasting) that truly needed steroids for medical purposes. The publication of steroid information in connection with their company could possibly compromise that goal, especially on a bodybuilding and/or steroid-related website.
It seems highly unusual for the chief marketing officer to try and stifle publicity for one of their products. But it is understandable. If they publicize that they sell nandrolone decanoate (for example), then they are likely to attract adverse attention from (1) bodybuilders and athletes seeking steroids for performance enhancement or (2) federal and/or state authorities who may suspect they are selling steroids in a manner similar to what has been alleged in other publicized compounding pharmacy steroid scandal cases.
But if a steroid like Deca Durabolin (nandrolone decanoate) is so difficult to find from a legitimate (compounding) pharmacy AND the (compounding) pharmacies that do sell it do not publicize (and actually prohibit promotion of the) fact, then how will patients (e.g. HIV/AIDS) who really need it for medical reasons be able to find it? And as of this writing, this information is not readily available on Google; the steroid sources for Deca Durabolin are practically all outside the United States (thereby making it illegal for U.S. citizens to purchase even with a valid medical prescription.)
This is not good for patients who need steroids for their health and well-being.
When the researchers looked at the subjects’ muscles through a microscope, they made a surprising discovery: Rather than returning to their original proportions, the muscles of the steroid users who’d stopped taking the drug looked remarkably similar to those of the subjects who were still using. They also had larger muscle fibers and more growth-inducing “myonuclei” in their muscle cells than the nonsteroid users.
The main findings were that: a) Muscle fiber hypertrophy by strength training is further increased by anabolic steroids. b) The number of nuclei per muscle fiber is higher in power lifters using anabolic steroids compared to non-steroids using lifters. c) Among power lifters who have withdrawn from anabolic steroid usage and training for several years, the number of myonuclei, both subsarcolemmal and internal, remains high. d) In active power lifters, anabolic steroids have no further effect on the number of satellite cells per fiber. e) Power lifters have a high proportion of split fibers.
High intensity resistance training increases muscle strength and banned substances such as testosterone and anabolic steroids can enhance the training effects. The studies on muscle cell morphology presented in this thesis reveals that anabolic steroids and testosterone increases muscle fiber size and adds more nuclei to the muscle cell.
Based on the morphological appearance of muscle sections from doped and nondoped power lifters, we conclude that testosterone and anabolic steroids enhances the hypertrophic effects of training without adding new features. The addition of myonuclei by training and doping appears to be longer lasting in some muscles than in others. The high proportion of split fibers in power lifter is probably due to high mechanical stress. The findings and conclusions in this thesis raise questions regarding relevant suspension times for athletes caught with banned substances in the body.
The thesis confirms what many bodybuilders have long suspected based on anecdotal evidence. Even noted steroid researcher Charles Yesalis is convinced of the permanent muscle-enhancing effects of anabolic steroids based on his assessment of 30 years of anecdotal evidence.
Charles Yesalis, a former strength coach and professor emeritus of health policy and administration at Pennsylvania State University, says athletes who continue to train can retain as much as 85% of their gains from using drugs. This isn’t based on muscle biopsies or peer-reviewed research, he says, but on 30 years of experience with athletes. He says he has talked privately with hundreds of dopers, some of them champions, and has seen the permanent benefits of performance-enhancing drugs. “These things are like rocket fuel,” he says.
The little known doctoral thesis has already influenced doping penalties even though it was not peer-reviewed and not published in any medical or scientific journal.
At a meeting in Madrid in November, WADA’s Foundation Board voted to change its code to allow for a maximum four-year ban for first-time offenders caught using performance-enhancing drugs. The new ban, which goes into effect in all sanctioned Olympic events in 2009, is a severe penalty for athletes — whose careers tend to be short. Bengt Eriksson, the vice-chairman of the Swedish Sport Confederation’s doping commission, who attended the Madrid conference, says he thinks the study was “one of the main reasons” WADA raised the maximum penalty. David Howman, WADA’s director general, says the Swedish study played only a minor role in the decision.
Scientific support for the notion that three or four cycles of anabolic steroids could lead to permanent muscle enhancement is big news in bodybuilding circles.
But if true, this could lead to lifetime bans for first time doping offenses by WADA and other anti-doping agencies. This is also big news in the doping world too.
WADA’s [director general] Mr. Howman says that if science continues to confirm the findings of the Swedish study, a lifetime ban is not out of the question. “Never say never,” he says.
The defense team of NPC bodybuilder Thomas Vigliatura used the “steroids made me crazy” defense in Vigliatura’s GHB/GBL distribution trial. (”Vigliatura says he’s changed,” March 30)
At the same time. Mr. Vigliatura’s life “was a merry-go-round of alcohol abuse, substance abuse and, most horrifically, the conduct detailed in the indictment,” Mr. Sinnis said. Mr. Vigliatura suffered from physical and psychiatric symptoms as a result of androgenic-anabolic steroids he began using in 1990 in connection with body building, Mr. Sinnis said.
And the steroid money quote…
The steroids left him with permanent severe cognitive deficits, according to excerpts of a neuropsychology report commissioned by the defense. But it noted that he has greatly recovered, perhaps fully, from the psychological and mood effects of the steroids and it predicted an ability “to return to a fulfilling and gainful life in society.”
The steroid insanity defense. Damn those steroids. Damn those steroids!!
Since nandrolone decanoate is no longer manufacturer by any U.S. pharmaceutical company, it is difficult to find in the United States with availability limited to compounding pharmacies. Members of Vergel’s Yahoo Group PozHealth have researched and identified only five compounding pharmacies nationwide that still offer nandrolone decanoate with a valid medical prescription (and in some cases, additional requirements) ["Nandrolone Prices at Compounding Pharmacies," March 28).
Prices of a 10mL vial Nandrolone Decanoate (200 mg/ml) at Compounding Pharmacies
[NOTE: Pricing and compounding pharmacy has been removed per request. The publication of such information has regrettably caused adverse attention for at least one compounding pharmacy.]
Two other compounding pharmacies have ceased production of nandrolone decanoate due to federal pressure and/or limited availability of the raw materials (Applied Pharmacy Services and Leiter’s Pharmacy, respectively).
We desperately need a rational discussion on anabolics steroids to replace the steroid demonization and steroid hysteria sweeping our country. Legislation and federal actions involving anabolic steroids over the past several years have arguably done nothing to decrease steroid use among professional athletes or high school athletes; the war on steroids has indisputably compromised the available of anabolic steroids for medical purposes in affected populations. This is the real crime.
