Long-term steroid use damages the heart, research shows

[mayhem]

Long-term use of anabolic steroids damages the heart more than researchers previously believed and could be setting up many users for heart disease and death, researchers reported Tuesday. The drugs, which include testosterone and related hormones, are taken by weight lifters and other athletes to boost muscle mass. Research reported in the journal Circulation: Heart Failure shows that they can severely impair the heart's ability to pump blood throughout the body.

Previously known side effects of the drugs include liver tumors, jaundice, high blood pressure, shrinkage of the testicles, reduced sperm count, development of breasts, paranoid jealousy, extreme irritability and impaired judgment.

Because some studies have also suggested an effect on the heart, Dr. Aaron L. Baggish of Massachusetts General Hospital in Boston and his colleagues decided to study the effects more carefully. They recruited 12 male weight lifters, average age 40, who reported taking about 675 milligrams of steroids per week for nine years. They were compared with seven closely matched weight lifters who had not taken the drugs.

The researchers used echocardiography to measure the so-called ejection fraction, the proportion of blood in the left ventricle forced out of the heart with each contraction. In healthy people, the ejection fraction is normally somewhere between 55% and 70%. In the steroid-taking group, the average ejection fraction was about 50%, compared to 59% in the group that did not take drugs. Such low ejection fractions are associated with an increased risk of heart disease and heart failure. The steroid users also had significantly impaired diastolic function, impeding the ventricle's ability to relax and fill with blood.

Previous studies have not found such clear-cut problems, Baggish said. That may be in part because they were conducted in Europe and athletes may have been taking different drugs. Also, most previous studies have looked at professional athletes, who might be expected to be healthier, while this one focused on recreational athletes.

"What we hope is that people start recognizing steroid use as a potential cause of heart disease and a cause of otherwise unexplained heart dysfunction in young people," Baggish said in a statement.
-- Thomas H. Maugh II

Source: latimesblogs.latimes.com/booster_shots/2010/04/longterm-steroid-use-damages-the-heart-research-shows.html

[White-Tiger]

Very low sample group.
675mg of test for 9 years? No mention of if that's continously or cycling.
LVEF of 50 vs 59% in sample group, I doubt that's statistically significant given the small sample.

And what type of study has less controls than subjects?

[nii]

And most would consider 675mgs/week a reasonable dose.

^^Im assuming its continuous use.

[BenT]

Methods and Results—We performed 2-dimensional, tissue-Doppler, and speckle-tracking echocardiography to assess left ventricular (LV) ejection fraction, LV systolic strain, and conventional indices of diastolic function in long-term AAS users (n=12) and otherwise similar AAS non-users (n=7). AAS users (median [Q1, Q3] cumulative lifetime AAS exposure 468 [169-520] weeks) closely resembled non-users in age, prior duration of weightlifting, and current intensity of weight training. LV structural parameters were similar between the two groups. However, AAS users had significantly lower LV ejection fraction (50.6% [48.4, 53.6] versus 59.1% [58.0, 61.7]; p = 0.003 by Wilcoxon rank sum test, two-tailed); longitudinal strain (16.9% [14.0, 19.0] versus 21.0% [20.2, 22.9]; p = 0.004), and radial strain (38.3 [28.5, 43.7] versus 50.1 [44.3, 61.8]; p = 0.02). Ten of the 12 AAS users showed LV ejection fractions below the accepted limit of normal (55%). AAS users also demonstrated decreased diastolic function compared to non-users, as evidenced by a markedly lower E' velocity (7.4 [6.8, 7.9] versus 9.9 [8.3, 10.5]; p = 0.005) and E/A ratio (0.93 [0.88, 1.39] versus 1.80 [1.48, 2.00]; p = 0.003).

[BenT]

p=0.003 is statistically significant.

however, I agree it is a small sample, and question why if the normal range is 55-70 that the "healthy" controls are at 59%

[L3]

....duh...you think this shit is harmless?!?

[nii]

....duh...you think this shit is harmless?!?

No, but studies that help quantify those sides are more informative than posts like, 'this shit is bad for you yo'.

BenT where did you find the actual study? I couldn't find it linked in the article.

I just hope in 40 years, open heart surgery is the norm and i get some pig valves =D

[dku]

It sounds like this study suffers from "correlation is not causation" problem. Just because the weightlifters have worse hearts, it doesn't mean it was caused by steroids. It could have been the weightlifting itself, it could have been that the weightlifters ate more calories, or more fat, etc.

[steve_d]

Very low sample group.
675mg of test for 9 years? No mention of if that's continously or cycling.
LVEF of 50 vs 59% in sample group, I doubt that's statistically significant given the small sample.

And what type of study has less controls than subjects?

It doesn't matter that it is a low sample group. the effect was there, the variance of the outcome measures was very small in both groups, and the results were statistically significant.

Also, you don't need to have an equal number of control than subjects for a study to be valid. While I agree that the description is vague on how they determined "use", there is definitely enough evidence here to be curious about the results.

What I would question is how they selected this sample, and how "similar" the controls actually were. Yes, they were "matched" for age, and weightligting intensity...actually, by the abstract, you can't tell if they were really matched, but they were comparable in age, and duration of weight training and intensity of training...but who knows if they were really similar. as we all know there is much more to it than that. Who knows...the steroid group may be way too hardcore users for the results to be generalized to the average steroid population.

Nonetheless, the results are interesting.

[steve_d]

by the way, the link to the paper:

http://circheartfailure.ahajournals.org/cgi/content/abstract/CIRCHEARTFAILURE.109.931063v1

[tiramisu]

Left Ventricle hypertrophy is a known effect of aas. It is also known to be reversible with the cessastion of aas.

If you combine left ventricle hypertrophy with aas related high blood pressure you've got a double whammy.

Now the argument that either of these are permanent conditions is a little more questionable. They can both result in heart failure, stroke, kidney failures and stuff like that.

[BenT]

Sadly my portal doesn't allow me full access to this article. I would like to see the full data.


It doesn't matter that it is a low sample group. the effect was there, the variance of the outcome measures was very small in both groups, and the results were statistically significant.

Also, you don't need to have an equal number of control than subjects for a study to be valid. While I agree that the description is vague on how they determined "use", there is definitely enough evidence here to be curious about the results.

What I would question is how they selected this sample, and how "similar" the controls actually were. Yes, they were "matched" for age, and weightligting intensity...actually, by the abstract, you can't tell if they were really matched, but they were comparable in age, and duration of weight training and intensity of training...but who knows if they were really similar. as we all know there is much more to it than that. Who knows...the steroid group may be way too hardcore users for the results to be generalized to the average steroid population.

Nonetheless, the results are interesting.

[Solo59]

What's the point of posting something like this and calling it factual? There are so many variables unaccounted for this could indicate any number of things. Yes, "continuous use" is one of the questions? Of course, if you stay "on" over the years you are putting your life in jeopardy.

Solo

[tony_canuck]

i'm of the opinion that if i used anything at a relatively high dose straight for many, many years something bad would probably happen... the body doesn't like change and will react to stress in some way, the changes to the heart seem to have been proven, the question is, since we know that some of the changes can be reversed, if someone were to cycle would there be any negative changes to the heart?

[chan_ho_nam]

The researchers are leaving a lot of holes here.

The users are 40 year olds, whats the typical heaert function for a 40 year old natural weight lighter? We need that as a basis for comparison first of all.

Second, what about diet, race, genetic predisposition? A group of 12 tells me absolutely nothing.

And to say the threshold is 55%-70% and not mention why the natural group was scraping the low end of that range, is just stupid.

Dumbass biased research, thats all it is.

[St]

Left Ventricle hypertrophy is a known effect of aas. It is also known to be reversible with the cessastion of aas.

If you combine left ventricle hypertrophy with aas related high blood pressure you've got a double whammy.

Now the argument that either of these are permanent conditions is a little more questionable. They can both result in heart failure, stroke, kidney failures and stuff like that.

I have a close friend with this problem.He goes the the Ottawa heart institute for regular checks,and also after 1 year off his left ventricle is still enlarge,it only went down about 30% but the doctor is happy that it want down a bit.His doctor said he has studied gear for 30 year and what effect it has on the heart.

[steve_d]

The researchers are leaving a lot of holes here.

The users are 40 year olds, whats the typical heaert function for a 40 year old natural weight lighter? We need that as a basis for comparison first of all.

Second, what about diet, race, genetic predisposition? A group of 12 tells me absolutely nothing.

And to say the threshold is 55%-70% and not mention why the natural group was scraping the low end of that range, is just stupid.

Dumbass biased research, thats all it is.

they answered that question with the controls. its about 59%, and the IQR was pretty tight around that number. The natural group wasn't really scraping the low end especially if you consider most people at that age probably do scrape the low end.

I am not saying there is no flaw in the research. All research needs to be taken with a grain of salt, but what they showed is all they are showing - that's it that's all.

To me, the only true flaw that people have brought up was the fact that this could be reversible (though its not a flaw in the study design since it wasn't the point of the study). Follow both these groups for another 10 years and see what happens if BOTH stay clean from now on. But like that is going to happen. The conclusion is that if you take steroids long term, it effects your heart worse than previously thought. They aren't trying to say this isn't reversible, just that it is what it is.

Not really biased research from what I read. The bias is when the media takes it out of context, and re-words it a little to make the general public think what they want them to think.

[brawler32]

However if testosterone replacement is used wisely and not abused then it can be beneficial to your heart. See Study below.


Low Testosterone (http://www.mesomorphosis.com/steroid-profiles/testosterone.htm), ED Linked to Cardiac Death Risk
http://www.medpagetoday.com/Cardiolo...Syndrome/19800 (http://www.medpagetoday.com/Cardiology/AcuteCoronarySyndrome/19800)


PRAGUE -- Men with erectile dysfunction and low testosterone (http://www.mesomorphosis.com/steroid-profiles/testosterone.htm) have an increased risk of dying from cardiovascular disease, an Italian researcher reported.

In a prospective cohort study of men with erectile dysfunction, those whose serum testosterone (http://www.mesomorphosis.com/steroid-profiles/testosterone.htm) was below a threshold of 230 nanograms per deciliter and who suffered a major adverse cardiovascular event were seven times more likely to die as a result than those with the highest testosterone levels, according to Giovanni Corona, MD, PhD, of the University of Florence.

But low testosterone itself did not increase the risk of any cardiac event, Corona said in a poster presentation at the 2010 European Congress of Endocrinology in Prague.

It's the first time that low testosterone has been associated with higher death rates from heart disease in men with erectile dysfunction, Corona said in a statement.

The finding "shows that screening for testosterone deficiency in men with erectile dysfunction may help clinicians identify those at higher risk from cardiovascular events," he said.

It might be that testosterone replacement therapy could prevent some unnecessary deaths, Corona said, but it's still not clear whether low testosterone levels are the cause or the consequence of the higher cardiac risk. The work needs to be confirmed in larger studies, he said.

Corona and colleagues studied testosterone levels of 1,687 patients with erectile dysfunction who attended the andrology clinic at the University of Florence.

Patients were interviewed using the structured interview on erectile dysfunction (SIEDY) as well as the ANDROTEST structured interview to measure aspects of erectile dysfunction and hypogonadal symptoms.

Total testosterone was evaluated at baseline and information on major adverse cardiovascular events came from the City of Florence Registry Office. On average, patients were followed for 4.3 years, Corona reported.

The baseline analysis showed that 5.2%, 13.8%, and 22.4% were hypogonadal according to different thresholds: meaning serum testosterone less than 230, 300, and 350 nanograms per deciliter, respectively.

During follow-up, the researchers observed 139 major adverse cardiovascular events, 15 of which were fatal, but the unadjusted incidence of those events was not associated with testosterone levels.

After adjusting for age and chronic diseases score, using a Cox regression model, fatal events were significantly associated with a testosterone level below 230 nanograms per deciliter. The hazard ratio was 7.1, with a 95% confidence interval from 1.8 to 28.6, which was significant at P<0.001.

The researchers also analyzed links between obesity, blood flow to the penis, and the risk of a fatal cardiac event, using the same cohort of patients.

The researchers found that 39.8% were of normal weight -- defined as a body mass index of between 18.5 and 24.9 kg/m2. Another 44.1% were overweight (BMI 25 through 29.9) while 16.1% were obese (BMI 30 or more).

Cox regression analysis, adjusted for age and chronic disease, showed that obesity classes and the presence of arteriogenic erectile dysfunction were significantly and independently associated with incident major adverse cardiovascular events, at P<0.05 and P<0.001, respectively.

Within obesity classes, arteriogenic erectile dysfunction -- defined as peak systolic velocity of less than 25 centimeters per second on a penile flow at color Doppler ultrasound -- was associated with increased risk of a cardiac event only among the obese, Corona and colleagues found.


Primary source: European Congress of Endocrinology
Source reference:
Corona G, et al "Low testosterone is associated with an increased risk of MACE lethality in subjects with erectile dysfunction" ECE 2010; Poster 149.

Additional source: European Congress of Endocrinology
Source reference:
Corona G, et al "Is obesity a further cardiovascular risk factor in patients with erectile dysfunction?"ECE 2010; Poster 151.

[Kilburn]

ya well i pretty much already knew this.

my boss at my last job used to wrestle (like wwf style wrestling) was on juice for like 15 years and he almost died of a heart attack in his late 30s. he could tell just by looking at me that i was on it and he said to me "eventually that sht will kill you". obv genetics play a large part too but juice def doesnt help the situation.

[chan_ho_nam]

Fair enough, so the control group was also 40 year olds?

I wonder then, if 59% is the standard for natural 40 year olds, and the steroid group was 50% after 9 years.

Thats aboout 1% drop a year with continued use on average. That could actually be very useful information. Although I still wonder how accurate it is with only a sample of 12.


they answered that question with the controls. its about 59%, and the IQR was pretty tight around that number. The natural group wasn't really scraping the low end especially if you consider most people at that age probably do scrape the low end.

I am not saying there is no flaw in the research. All research needs to be taken with a grain of salt, but what they showed is all they are showing - that's it that's all.

To me, the only true flaw that people have brought up was the fact that this could be reversible (though its not a flaw in the study design since it wasn't the point of the study). Follow both these groups for another 10 years and see what happens if BOTH stay clean from now on. But like that is going to happen. The conclusion is that if you take steroids long term, it effects your heart worse than previously thought. They aren't trying to say this isn't reversible, just that it is what it is.

Not really biased research from what I read. The bias is when the media takes it out of context, and re-words it a little to make the general public think what they want them to think.

[steve_d]

Thats aboout 1% drop a year with continued use on average. That could actually be very useful information. Although I still wonder how accurate it is with only a sample of 12.

judging by the interquartile range, it is fairly accurate. I am not an expert on this measure of cardiac function, but it seems to me the variablility was quite small. They also mention 10 of 12 with lower than 55%, so again, when the signal:noise ratio is that good, even just 12 was enough to show what they wanted to show.

[j-dub]

meh. whats lurking in the deli will kill you quicker than the nectar of the gods:D

seriously though, if i took over 600mg of test a week for a decade i reckon my heart would resemble canned ham too. people should do real studies on healthy people. tell us the benefits that are real, not possible effects that are seemingly limited to the more fool hardy. hrt is the fountain of youth but keeping people healthy is not good for business if you are the government run health care system.

now i'm hungry :ht

http://i271.photobucket.com/albums/jj123/jonwaite/funnies/threads%20owned/jason65ftbk8.gif

[juced_porkchop]

It sounds like this study suffers from "correlation is not causation" problem. Just because the weightlifters have worse hearts, it doesn't mean it was caused by steroids. It could have been the weightlifting itself, it could have been that the weightlifters ate more calories, or more fat, etc.

yes!!!!!!!!!!!!!!!!! somany factores!
shit just heavy lifting all the time will enlarge left V of heart!

they will grow em liek a farm soon .lol

[JonnyO]

Blood pressure is a major factor that many should be concerned with, continous high blood pressure will lead to a lot of issues down the road if it isnt kept in check.

I am considering getting an ECG done at least annually to see how my heart health is as well.

[steve_d]

It sounds like this study suffers from "correlation is not causation" problem. Just because the weightlifters have worse hearts, it doesn't mean it was caused by steroids. It could have been the weightlifting itself, it could have been that the weightlifters ate more calories, or more fat, etc.

sounds to me you didn't understand the study correctly then. Both groups were weightlifters, the difference was one was on steroids, the other wasn't.

If it was weightlifting itself than why didn't both groups have it. Unless you are implying the steroid users ate more and were generally more unhealthy than the controls - (which could have been the case - but I would hope the reviewers looking over this study before publishing it would have at least mentioned the fact that the two groups would be similar in things more than just age and weightlifting intensity).

Looks like I am going to have to see if I can get the full article for myself.

[steve_d]

like I said before, the only thing potentially flawed about this study is the steroid group might have been biased compared to the controls. For these guys to be on steroids for that long, and potentially high doses compared to a natural athlete who perhaps does cardio or what not.

I can sort of agree with what DKU said, in that it is not necessarily causation...but it is pretty close to a potential causation. It would be REALLY tough to get a group of controls similar to the steroids users in all aspects except steroid use. the fact that they have used for years and years potentially "abusing" makes them a different type of group...


But at the same time, its likely that using and abusing causes the heart problems, which everyone here would agree with. What I see all the time is media blowing things out of proportion or context...but at the same time, you'll always get people around here saying "nah, its biased, its crap, its meaningless...."

Anyone who thinks steroid use has NO negative effects is ignorant.

[chan_ho_nam]

Yeah I can definitely agree with that. I guess what I'm hoping for although i know its near impossible, is to have the media and general public look at it in the view as alchohol. Deadly with abuse but not so in moderation. The old arguement that if cigarettes which honestly is just poison in a box, if those are legal, how can the politicians take the high road on steroids?

I would be for legalizing steroid use under the supervision of a GP. Wouldnt that solve a lot of issues, instead of driving it underground?

Can only hope.


like I said before, the only thing potentially flawed about this study is the steroid group might have been biased compared to the controls. For these guys to be on steroids for that long, and potentially high doses compared to a natural athlete who perhaps does cardio or what not.

I can sort of agree with what DKU said, in that it is not necessarily causation...but it is pretty close to a potential causation. It would be REALLY tough to get a group of controls similar to the steroids users in all aspects except steroid use. the fact that they have used for years and years potentially "abusing" makes them a different type of group...


But at the same time, its likely that using and abusing causes the heart problems, which everyone here would agree with. What I see all the time is media blowing things out of proportion or context...but at the same time, you'll always get people around here saying "nah, its biased, its crap, its meaningless...."

Anyone who thinks steroid use has NO negative effects is ignorant.

[natenator]

Yeah I can definitely agree with that. I guess what I'm hoping for although i know its near impossible, is to have the media and general public look at it in the view as alchohol. Deadly with abuse but not so in moderation. The old arguement that if cigarettes which honestly is just poison in a box, if those are legal, how can the politicians take the high road on steroids?

I would be for legalizing steroid use under the supervision of a GP. Wouldnt that solve a lot of issues, instead of driving it underground?

Can only hope.
steroid use is legalized under the guidance of a GP. It's called HRT.

What more do you want?

[j-dub]

Anyone who thinks steroid use has NO negative effects is ignorant.

with a broad stroke like that. the same can be said for dairy products, red meat etc etc.

imo. the benefits of hrt far outweigh the perceived and unsubstantiated dangers of logical administration. using elite bodybuilders as a guide is not in any way related to logical therapy.

[Voltaire]

^ Correct.

And anyone who thinks staying on for over a decade will have no ill side effects at dosages of those proportions is quite naive... the question is more so how much of a relative danger does it pose vs the thousands of other disgusting toxins ingested daily that are known to cause numerous health issues... as brought up earlier in this thread.

At any rate, it can be said with conviction there's plenty of other factors about bodybuilding which place stress on your heart (rapid weight gain and loss, the fact you're sitting with 100lbs plus of weight your body was never supposed to have for years...) which make it very hard to determine the 'actual' risk factor(s).

If you think taking this shit for years won't effect at those dosages, you're dillusional however.

[faller]

steroid use is legalized under the guidance of a GP. It's called HRT.

What more do you want?

I guess if you're happy with a three months supply of that gel shit which'll run you about a grand.

Most GP's won't even talk about HRT let alone prescribe it.

[juced_porkchop]

my doc gave me deca a bunch of times and this was in canada.

too much $ thow. and now there isnt even deca being sold in pharms. they pulled it

[cog]

I guess if you're happy with a three months supply of that gel shit which'll run you about a grand.

Most GP's won't even talk about HRT let alone prescribe it.

Can you help me hold Nate down while I put this tag in his ear?:)

[nisser]

Fair enough, so the control group was also 40 year olds?

I wonder then, if 59% is the standard for natural 40 year olds, and the steroid group was 50% after 9 years.

Thats aboout 1% drop a year with continued use on average. That could actually be very useful information. Although I still wonder how accurate it is with only a sample of 12.

You didn't understand the study at all.

TEST GROUP:
12 individuals at 40 years who weightlifted and had used test for the past 9 years around 600mg/mL

CONTROL GROUP:
7 individuals at 40 years who weighlifted and had not used test for the past
9 years

The effect is real but the remaining questions remain:

1. Is a drop of 9% a significant health risk factor (i.e. how much will it contribute to disease)

2. Is there anything else that's fundamentally different between the two groups that may be the cause - examples may include:

a) ancillary drugs that the test group may be taking (SERMS, AIs, etc)
b) Other drugs such as clen, ephedra, etc
c) whatever else


Having said that, you can't complain that the results don't mean much; they DO and are clear. That's the one thing I hate about steroid users - many turn a blind eye to things that are right in front of them. Look at the risks and decide for yourself if they're worth it but don't look away.

[faller]

I don't think anyone can argue that 600mg for nine years is going to have a neg. impact... A glass or two of wine a night is fine, a bottle or two a night and you're going to have problems down the road.

[chan_ho_nam]

You really think a sample of 12 is enough?

What if they only used white males from north america? What type of diet were they eating? How about African Americans? Asian? Mexicans? East Asians? Different genetics will repond to the the same drugs differently. Those are all variables that need to be taken into account if you want an accurate study.

This study is incredibly narrow and lacking important details, although with interesting results. How can I honestly be expected to take it with anything but a grain of salt without being more detailed and run with a far larger sample, across different races, family histories, diet etc...

What if the researches fluked a steroid group that responded well to long term use, does that then prove that LT steroid us is not harmful? NO. It only means that it wasn't for those 12 individuals. I'm going to say it again, small samples are horrible relfections on real world results.


You didn't understand the study at all.

TEST GROUP:
12 individuals at 40 years who weightlifted and had used test for the past 9 years around 600mg/mL

CONTROL GROUP:
7 individuals at 40 years who weighlifted and had not used test for the past
9 years

The effect is real but the remaining questions remain:

1. Is a drop of 9% a significant health risk factor (i.e. how much will it contribute to disease)

2. Is there anything else that's fundamentally different between the two groups that may be the cause - examples may include:

a) ancillary drugs that the test group may be taking (SERMS, AIs, etc)
b) Other drugs such as clen, ephedra, etc
c) whatever else


Having said that, you can't complain that the results don't mean much; they DO and are clear. That's the one thing I hate about steroid users - many turn a blind eye to things that are right in front of them. Look at the risks and decide for yourself if they're worth it but don't look away.

[Thorgrim]

I agree with Chan. Sample groups are too small. Especially the clean group with only 7.

Also like was mentioned by nisser there could have been a lot of other factors at play that could have led to the differences. I would think that the geared group would be significantly larger then the clean group. The extra weight they were carrying could have been the difference alone. Walking around with 40-50 more pounds for 9 years wether fat or muscle is going to have some affect. It might not be the drugs themselves having a negative impact on the heart.

[nisser]

You really think a sample of 12 is enough?

What if they only used white males from north america? What type of diet were they eating? How about African Americans? Asian? Mexicans? East Asians? Different genetics will repond to the the same drugs differently. Those are all variables that need to be taken into account if you want an accurate study.

This study is incredibly narrow and lacking important details, although with interesting results. How can I honestly be expected to take it with anything but a grain of salt without being more detailed and run with a far larger sample, across different races, family histories, diet etc...

What if the researches fluked a steroid group that responded well to long term use, does that then prove that LT steroid us is not harmful? NO. It only means that it wasn't for those 12 individuals. I'm going to say it again, small samples are horrible relfections on real world results.

Again, your questions all stem from your ignorance.

The control group of test subjects have all been matched for those factors. They wouldn't pick Asians in one group and then Caucasians in the other; that's an absurd concept that the scientific community learned..oh I dunno whenever people started doing science.

Fluked? Now you're pulling at straws and being thick-headed but if ignorance makes you feel better, then feel free.

[steve_d]

You didn't understand the study at all.

TEST GROUP:
12 individuals at 40 years who weightlifted and had used test for the past 9 years around 600mg/mL

CONTROL GROUP:
7 individuals at 40 years who weighlifted and had not used test for the past
9 years

The effect is real but the remaining questions remain:

1. Is a drop of 9% a significant health risk factor (i.e. how much will it contribute to disease)

2. Is there anything else that's fundamentally different between the two groups that may be the cause - examples may include:

a) ancillary drugs that the test group may be taking (SERMS, AIs, etc)
b) Other drugs such as clen, ephedra, etc
c) whatever else


Having said that, you can't complain that the results don't mean much; they DO and are clear. That's the one thing I hate about steroid users - many turn a blind eye to things that are right in front of them. Look at the risks and decide for yourself if they're worth it but don't look away.
Well said. Finally someone who understand a study for what it is.

You really think a sample of 12 is enough?

What if they only used white males from north america? What type of diet were they eating? How about African Americans? Asian? Mexicans? East Asians? Different genetics will repond to the the same drugs differently. Those are all variables that need to be taken into account if you want an accurate study.

This study is incredibly narrow and lacking important details, although with interesting results. How can I honestly be expected to take it with anything but a grain of salt without being more detailed and run with a far larger sample, across different races, family histories, diet etc...

What if the researches fluked a steroid group that responded well to long term use, does that then prove that LT steroid us is not harmful? NO. It only means that it wasn't for those 12 individuals. I'm going to say it again, small samples are horrible relfections on real world results.

You don't understand statistics, nor research, so even though your points could make sense, they really don't apply here. Do you think your the only one that would understand what "bias" is? Don't you think the study would be published in even a shitty journal if the steroid group were selected in such a way to ensure the study results would show up?

Small sample are all that are needed when effects are large. It's not a fluke. That's the whole point of statistics. 12 + 7 flukes in a row that were this different? Nope.



I agree with Chan. Sample groups are too small. Especially the clean group with only 7.

Also like was mentioned by nisser there could have been a lot of other factors at play that could have led to the differences. I would think that the geared group would be significantly larger then the clean group. The extra weight they were carrying could have been the difference alone. Walking around with 40-50 more pounds for 9 years wether fat or muscle is going to have some affect. It might not be the drugs themselves having a negative impact on the heart.

Ummm...so steroids make you big which puts strain on your heart is what your saying...So steroids aren't the problem, its being big...C'mon.


Again, your questions all stem from your ignorance.

The control group of test subjects have all been matched for those factors. They wouldn't pick Asians in one group and then Caucasians in the other; that's an absurd concept that the scientific community learned..oh I dunno whenever people started doing science.

Fluked? Now you're pulling at straws and being thick-headed but if ignorance makes you feel better, then feel free.
Again, agreed 100%.

[chan_ho_nam]

Again, your questions all stem from your ignorance.

The control group of test subjects have all been matched for those factors. They wouldn't pick Asians in one group and then Caucasians in the other; that's an absurd concept that the scientific community learned..oh I dunno whenever people started doing science.

Fluked? Now you're pulling at straws and being thick-headed but if ignorance makes you feel better, then feel free.


What I'm saying is yes I agree, in that group of 12 those were the effects that took place. Now my question is would the same effects have taken place if it were a different group of 12, from another race, with some who are genetically predisposed to heart conditions, or maybe a race that isnt? Would we get the same results? We can speculate, but what I'm asking for is a larger group to answer those questions. Whats wrong with that?

Maybe I'm coming off like I'm trying to discredit the studies findings but I'm not, I'm just saying it can be more accurate. If you are honestly telling me had they taken a group of say 10,000 steriod users, accounting for different races, diets, family histories of heart conditions, even age groups. If you are telling me that I wouldn't get a more accurate study in that case, than YOU are the one blinded and ignorant.

[steve_d]

the results are only generalizable to the population they took yes. So, if all 12 (AND THE 7) were white regular normal weighlifters without any predisposed conditions, then the results would basically only apply to that population. But basically this is what happens in all studies...Say I did a clinical trial at the ottawa hospital, and I say drug X is great compared to placebo...Then somebody out in halifax says: oh, well I don't think it is a good study, because I don't think it will work at hospitals out east. Well...they have a point, its possible that something about ottawa could totally change the effect of the drug compared to halifax. but how likely is that? If a drug works here, it should work there.

Say you took 12 (AND 7) who are predisposed, then the likely effects would be both groups would have lower values, and you'd still find the effect of steroids by itself to remain. In reality, sometimes a larger group will make it harder to show effects when you start mixing the groups up with different races, pre-existing conditions, etc. Yes, the above is speculating on my part, since there is always a chance, that you find something like:

"In mexicans weightlifters, with predisposed heart conditions, both steroid users and non users have shitty hearts and the hearts were no shittier in the steroid group". So, there is the potential for race or pre-disposed conditioned to modify the effect of steroids. but the purpose of the paper was not to look for those interactions. It was to get 2 similar groups in all aspects except steroid use, and to look at outcome.

And I think the thing about having 10000 users giving more acurate results is a given...But whats the point from a financial standpoint of having 10000 people in a study, when all they needed was 12 to show the results were there. If they showed it in 12, they would show it in 10000. The only thing more they could show in 10000 is specific subgroups that this may or may not apply to.

[nisser]

Yeah, good luck finding 10,000 people in one region who have been avid weightlifters and used steroids continually for 9 years, 600mg/week+. They used as many as they could. Even the highest value in the steroid group is lower than the the lowest value in the control group.

12 is more than enough if you're objective and open-minded.

[steve_d]

Yeah, good luck finding 10,000 people in one region who have been avid weightlifters and used steroids continually for 9 years, 600mg/week+. They used as many as they could. Even the highest value in the steroid group is lower than the the lowest value in the control group.

12 is more than enough if you're objective and open-minded.

1 region or all regions on earth..yeah, I think the only way to convince them would be if they followed everyone on earth, and divided them into every possible category of "use" vs. non-use...Actually, come to think of it, they still wouldn't believe the results would apply to themselves as they must be in the rare group with invincible hearts.

I won't disagree, there is probably people that have perfectly values in the perfectly healthy range who could have been in the steroid user group. But on average, the values are much much lower.