Monday, November 15, 2010

Your mind as an anabolic steroid

The figure below, taken from Wilmore et al. (2007), is based on a classic 1972 study conducted by Ariel and Saville. The study demonstrated the existence of what is referred to in exercise physiology as the “placebo effect on muscular strength gains”. The study had two stages. In the first stage, fifteen male university athletes completed a 7-week strength training program. Gains in strength occurred during this period, but were generally small as these were trained athletes.


In the second stage the same participants completed a 4-week strength training program, very much like the previous one (in the first stage). The difference was that some of them took placebos they believed to be anabolic steroids. Significantly greater gains in strength occurred during this second stage for those individuals, even though this stage was shorter in duration (4 weeks). The participants in this classic study increased their strength gains due to one main reason. They strongly believed it would happen.

Again, these were trained athletes; see the maximum weights lifted on the left, which are not in pounds but kilograms. For trained athletes, gains in strength are usually associated with gains in muscle mass. The gains may not look like much, and seem to be mostly in movements involving big muscle groups. Still, if you look carefully, you will notice that the bench press gain is of around 10-15 kg. This is a gain of 22-33 lbs, in a little less than one month!

This classic study has several implications. One is that if someone tells you that a useless supplement will lead to gains from strength training, and you believe that, maybe the gains will indeed happen. This study also provides indirect evidence that “psyching yourself up” for each strength training session may indeed be very useful, as many serious bodybuilders do. It is also reasonable to infer from this study that if you believe that you will not achieve gains from strength training, that belief may become reality.

As a side note, androgenic-anabolic steroids, better known as “anabolic steroids” or simply “steroids”, are synthetic derivatives of the hormone testosterone. Testosterone is present in males and females, but it is usually referred to as a male hormone because it is found in much higher concentrations in males than females.

Steroids have many negative side effects, particularly when taken in large quantities and for long periods of time. They tend to work only when taken in doses above a certain threshold (Wilmore et al., 2007); results below that threshold may actually be placebo effects. The effective thresholds for steroids tend to be high enough to lead to negative health side effects for most people. Still, they are used by bodybuilders as an effective aid to muscle gain, because they do lead to significant muscle gain in high doses. Adding to the negative side effects, steroids do not usually prevent fat gain.

References

Ariel, G., & Saville, W. (1972). Anabolic steroids: The physiological effects of placebos. Medicine and Science in Sports and Exercise, 4(2), 124-126.

Wilmore, J.H., Costill, D.L., & Kenney, W.L. (2007). Physiology of sport and exercise. Champaign, IL: Human Kinetics.

41 comments:

Anonymous said...

What are your thoughts on real steroids?

I know everyone has a knee jerk emotional reaction because its against the law, so you rarely see an open and frank discussion about it that looks it from a logical science point of view.

MANY years ago, Bryant Gumbel did this piece:
http://video.google.com/videoplay?docid=1214580768278932315#
but has there been any news since?

I've seen 70 year olds, that take steroids just to replenish the testosterone that they lose naturally.. they can lift and run laps around their peers.. how unhealthy can this be?!

Todd Hargrove said...

Interesting. Perhaps the athletes who thought they received steroids were on the road to overtraining, so that the gains were destined to be only short lived. Or perhaps they had never pushed their limits hard enough before in the gym. Its hard to believe that they actually increased their potential work capacity. You probably know this but there are studies where people improve their strength by just imagining doing some strength training.

Kindke said...

There is certainly a psychological element to resistence exercise.

I often find myself handling heavier weight and pumping more reps when I know or feel someone watching me at the gym.

js290 said...

A good documentary on steriod use in America. Not very deep scientifically, but good commentary on American hypocrisy on use of performance enhancers.

Ned Kock said...
This comment has been removed by the author.
Ned Kock said...

Hi Todd.

One possible mechanism would be a small suppression of autogenic inhibition.

The human body seems to be mechanically able to exert a lot more force than the average person can.

Supposedly this (i.e., suppression of autogenic inhibition) is the phenomenon behind the feats of folks like Dennis Rogers:

http://www.dennisrogers.net/

Ned Kock said...

Hi Kindke.

That is one of the reasons why it may be a good idea to have a personal trainer.

Ned Kock said...

Hi js290, thanks for the link. Right at the beginning is that guy whose "biceps exploded" - surely not the poster child for use of steroids.

Ned Kock said...

Hi Anon.

I think steroids are particularly problematic for young men who are not fully developed (still growing), and certainly are likely to be very problematic for women.

They may also lead to serious problems for those who have mood disorders, intensifying them. They tend to reduce HDL, which may not be a big deal if you are healthy and have no family history of heart disease. But a reduction of HDL usually also means an increase in trigs, which are not very good signs.

Since low testosterone levels create problems of their own, one could argue that older men may benefit from taking steroids. One thing to bear in mind, however, is that testosterone varies with age in a somewhat nonlinear way, a bit like growth hormone levels:

http://healthcorrelator.blogspot.com/2010/06/growth-hormone-secretion-drops-with-age.html

The Australian aboriginals on the photo in the post below never took steroids. The guy in the middle looks like he is in his 70s.

http://healthcorrelator.blogspot.com/2010/05/intermittent-fasting-as-form-of.html

Those body types seem very strong and healthy. But would not win a Mr. Olympia title. They probably wouldn't even qualify for the tournament.

notrace said...

Great! All we need for athletic success is sleezy doctors giving our athletes placebo steroids with absolute assurance that they will never get caught. But then, maybe it is still an unfair advantage even to think you are taking steroids.

js290 said...

Ned,

Greg Valentino's biceps are fake. Apparently, he injects them with something to make them weird shape like that. It's not due to steriods.

The film points out that the popularized roid rage is a myth. Roid rage can be more easily explained by steriods makes a jackass into a bigger jackass.

There are side effects, of course. If you're body doesn't have to produce it's own testosterone, then the testicles will shrink. But, when you stop the effects are reversible.

There's a lot propaganda against performance enhancing drugs, particularly the ones used in sporting competition, because Americans have this strange notion of fair play and ethics in athletic competition that they don't have in other aspects of their lives.

Ned Kock said...

I've watched the Bryant Gumbel documentary (thanks Anon). One thing that seems to be clear from that documentary, and some of the articles I read, is that steroids don't have a particular signature that allows a death to be traced back to them.

Another interesting thing in that documentary is that it doesn't consider a couple of major confounders - the protective effects of strength training and low body fat percentage (due to the high lean body mass).

The folks shown in the documentary were clearly serious about strength training. The 70 yo gentleman was a former bodybuilding champion, and a lifelong strength training athlete.

Anonymous said...

Hi Ned,

Are there ANY studies that have looked at the effects of steroids?

Steroids have been around a long, long time, with tons of users, so even though there may not be a smoking gun showing it's a killer, how about any studies showing disease after prolonged use?

David Isaak said...

As to strength training through visualization, these folks found a 13.5% average strength increase from purely mental work:

http://www.newscientist.com/article/dn1591-mental-gymnastics-increase-bicep-strength.html

As you say, it's probably a matter of increased enervation of the target muscles.

Apart from steroids per se, however, how do you feel about DHEA, 7-keto-DHEA, and their kin?

Ned Kock said...

Hi Anon.

This article has quite a few citations to it on Google Scholar:

http://eurheartj.oxfordjournals.org/content/17/10/1576.abstract

Not a large study, but the reported effects are a bit scary.

Ned Kock said...

There is also this article, which addresses long-term effects:

http://www.ingentaconnect.com/content/adis/smd/2002/00000032/00000002/art00001

They note that there seems to be "... an increased incidence of premature mortality among power lifters."

They also point out that: "Anabolic steroids and other concomitantly used drugs are the probable cause of this increased mortality, as power training itself does not increase health risks and all types of physical activity promote health."

Ned Kock said...

Hi David.

As with many substances that are produced by our body, isolated DHEA and metabolites don't seem to have the same effects as the "real stuff".

See this study, which looked at the effects of both DHEA and androstenedione, compared to a placebo:

http://www.ncbi.nlm.nih.gov/pubmed/10613429

By the way, when one looks at steroid synthesis in the human body, a case can be made that low cholesterol levels are detrimental.

Ned Kock said...

Just to clarify my point made earlier regarding the placebo effect described in the post.

I mentioned that a "possible mechanism would be a small suppression of autogenic inhibition."

By this I meant that the suppression would allow the participants to increase their strength training load.

The outcome was, I believe, an actual increase in strength AND muscle, caused by muscle hypertrophy (and/or hyperplasia).

I am not referring to neural adaptation here. Major gains due to neural adaptation usually occur in beginners, and the participants were not beginners.

The more you increase your load, as a trained athlete, the higher should be your strength and muscle gains, as long as you are eating properly.

It seems that your mind may help you increase the load your can handle in a strength training session.

js290 said...

"...all types of physical activity promote health."

I guess that would depend on how health is defined.

Ned Kock said...

One thing that is quite problematic, at least in my mind, is the fact that anabolic steroids tend to consistently decrease HDL cholesterol levels. This was mentioned in the Nieminen et al. article and others.

This is problematic because strength training in the absence of anabolic steroids seems to have the opposite effect, an increase in HDL, as long as body fat is not significantly increased.

Based on this, we could reasonable conclude that anabolic steroids have a doubly negative effect on HDL cholesterol.

Again, having an HDL that is high is particularly protective when other conditions are present (FH, diabetes), and not as much in the absence of any health problems.

But still, a clear reduction in HDL in response to taking anabolic steroids seems like a sign that something is not right.

LeonRover said...

May I put in a plea here for clarity on two things when writing

1) is it natural (bioidentical) T (tesosterone) vs analogues or those with added side-chains being referenced?

2) physiological vs infra- or supra-physiological doses.

Wang et al J Clin Endocrinol Metab 89; 2936-2941, 2004
has a nice discussion on production rates.

Ned Kock said...

Hi Leon.

Anabolic steroids are really only mentioned in passing in the post.

Not the main focus of it, but it appears to be the one leading to the most discussion here.

What is your take on anabolic steroids?

LeonRover said...

Hi Ned

One is well aware that the synthesis of the feedstock from which human sex hormones can be made was given freely to the world by its inventor in 1935.

Natural (bioidentical) T has a half life of about 4 hours in the male body. So this fact led to the manufacture of PATENTABLE unnatural Ts, which had half-lives of days or weeks and could be INJECTED. With PATENTS a very high premium is chargeable.

The same premium charging was adopted in the construction of the birth control pill in that UNNATURAL hormones were administered. Premium prices were also seen in the use of hormones for menopausal women.

So what is my take on anabolics? If by anabolics is meant UNNATURALS, I am against them on the grounds that our evolution did not lead there!

As far as natural T is concerned any administration which leaves salivary or blood levels of T within physiological levels is allowable. My own research leads me to suggest that up to 15 mg of exogenous natural T could be used (the exact dose to be titrated, of course).

The above considerations apply both to athletes looking for improvement or to aging males. In fact, there is anecdotal evidence that some aging males on TRT (replacement therapy) compete quite hard!

Glenn said...

Hi Ned,
You write:
"The outcome was, I believe, an actual increase in strength AND muscle, caused by muscle hypertrophy (and/or hyperplasia).

I am not referring to neural adaptation here. Major gains due to neural adaptation usually occur in beginners, and the participants were not beginners.

The more you increase your load, as a trained athlete, the higher should be your strength and muscle gains, as long as you are eating properly.

It seems that your mind may help you increase the load your can handle in a strength training session."

The techniques of visualization, instigating the fight-or-flight sympathic nervous system response, and developing a strong "mind-muscle connection" are all well-known in the bodybuilding and athletic world, so I think there is little doubt about this.

Btw, I thought that hyperplasia was pretty conclusively believed not to occur in humans (certainly not after puberty)?

Ned Kock said...
This comment has been removed by the author.
Ned Kock said...

Hi Glenn.

Wilmore et al. (2007) review evidence of hyperplasia in animals and humans. They conclude that hyperplasia very likely happens in both under certain conditions. What is not yet very clear is what those conditions are.

There is evidence in favor and against, but the evidence in favor is hard to ignore. They describe a study in which bodybuilders were compared with controls. The results suggest that the larger muscle cross-sectional areas in the bodybuilders could not be explained based on muscle fiber hypertrophy alone. There was actually an increase in number of muscle fibers, strongly suggesting hyperplasia.

Glenn said...

Thanks Ned!
Any chance you have a more specific citation? I put "wilmore 2007 hyperplasia" into google scholar, but couldn't find the article.

Ned Kock said...

The full citation is at the end of the post, under "References".

Damndirtyape said...

FYI, the oil that guy injected into his arms is called Synthol. A few other desperate people do the same thing based on the fact that the average person cannot people can tell the difference between ridiculous fake oiled swelling and real muscle development replete with veins and striations etc.
(similar to breast implants - seemingly few men seem to discern or care about the difference)

As for the placebo effect of steroids, if anything it's very minor. There is no substitute for the real thing. After 6 months of training side by side, a person on a decent amount of real gear will far outshine anyone natural, ceteris paribus.

Ned Kock said...

Posting here from spam folder, by js290. Google has been blocking comments with embedded links.

-------------

In this interview,Greg Valentino admits to using Propionate and Equipoise, not Synthol.

http://www.t-nation.com/free_online_article/sports_body_training_performance_interviews/the_most_hated_man_in_bodybuilding

damndirtyape said...

>> In this interview,Greg Valentino admits to using Propionate and Equipoise, not Synthol.

LOL he is lying. Everyone in pro bodybuilding knows what Synthol is and many pros use it to varying degrees to enhance weak bodyparts. The clueless mainstream media believes Valentino because they have no clue about bodybuilding in general ("muscle turns to fat" etc)

Just google the word Synthol and check out the images - tons of pics of other synthol users that look the same as Valentino (nicknamed "Valvolino" for the oil in his arms.) Then google "Ronnie Coleman" and compare that to actual (albeit steroid enhanced) muscle development.

Injecting anabolics does not cause massive localized growth like that. If it did, every pro bodybuilder would have enormous glutes since that's the standard site for IM injections.

Not saying he didn't ALSO foolishly inject right into his arms (called "site injections"), but the reason his arms were so obscenely huge and unnatural is because Synthol is not real tissue.

FYI Propionate is a common ester of testosterone and the Equipoise is a veterinary steroid.

PS: Love the blog! Didn't want to get too off topic with the Valentino thing, but I figured since I'm intimately familiar with that world I would chime in.

Anonymous said...

testosterone as cancer prevention!

http://www.healthiertalk.com/anti-cancer-must-men-2909

Anonymous said...

testosterone as cancer prevention!

http://www.healthiertalk.com/anti-cancer-must-men-2909

Ned Kock said...

Interesting article, thanks.

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