History of Anabolic Steroids

The history of anabolic steroids dates its beginnings farther back than most people would expect to think. Contrary to popular belief, anabolic steroids are not a modern discovery, nor are they an ‘invention’. The fact of the matter is that anabolic steroids are very natural products of the human body, and the use of anabolic steroids for any purpose is simply the act of inserting more of what our bodies already produce inside of us. With this being said, the origins of anabolic steroids (and their use for the purposes of performance enhancement) date back into antiquity. The major mainstream and widespread use of anabolic steroids – including the development of countless variants and analogues – has only existed since approximately 70-100 years ago, at the beginning of the 20th century. Although the actual use of anabolic steroids can be traced back several thousand years ago in antiquity, it was not until the modern period of the 19th and 20th centuries that anabolic steroids begun to be fully understood, slowly but surely over this 150-200 year period.

Anabolic Steroid’s Beginnings In Antiquity

Testosterone is the absolute number one primary anabolic steroid that is naturally produced by the human body, as well as nearly all other animal species. It is the anabolic steroid by which all other anabolic steroids are based upon and/or derived from. It has been understood since the beginnings of civilization that the testicles are a crucial component which plays a role in the maintenance and development of male masculinity, virility, androgenicity, male characteristics, strength, and the general overall ‘machismo’ and high driven assertive/aggressive behavior typically found in the male population of not only humans, but in the characteristics of almost all animal species. However, it was not understood how or why this was exactly the case until the modern period around the 19th century. Prior to this period, it was simply understood that the testicles were a crucial component for these factors.

There exists a semi-popular photo on the internet depicting a statue of an ancient Greek or Roman (it is unclear which) who is of a large muscular stature, and the caption on this picture states something along the lines of “do you think this guy was on steroids when he posed for this sculpture? Think again! This sculpture was drawn in 1742 long before anyone heard of steroids! Back then, guys like this got big and lean naturally!”. This photo along with this caption could not be any further from the truth! The use of the anabolic steroid Testosterone, which is produced by the testes, can be dated back as far as 1700 BC (and perhaps thousands of years prior) where the ancient Greek Olympic athletes and competitors would consume the testes of sheep and bulls in large quantities. Unbeknownst to these athletes, they were actually orally ingesting large amounts of the anabolic steroid Testosterone contained within – of course, this was not understood by those athletes consuming the testicles, and the athletes simply recognized there was a correlation between the consumption of animal testicles and an increase in strength and performance. Ancient athletes indeed did consume anabolic steroids – it was just not properly understood as to what exactly they were doing or why it resulted in the changes experienced. Therefore, the truth is that ‘doping’ in sports has actually been occurring for thousands upon thousands of years, and in 1700 BC this was a widely accepted and common practice with no laws or repercussions against it.

Because it has been known that the testicles play a key role in the maintenance and development of everything related to male masculine characteristics, in the mid-late 16th century it was understood that castration resulted in the disappearance of these male characteristics including muscle and strength. Therefore, castration became a practice beginning in 16th century Italy where young boys prior to puberty (or in the early stages of puberty) would undergo castration in order to achieve a high pitched soprano singing voice in the opera.  These castrated individuals who performed in the opera were known as Castrati (plural for Castrato). Once again, the function of the testicles in the development of the male secondary sex characteristic of a deepened voice was unknown to these people during this time period, but it was understood that the testicles played a key role here and that the removal of them prevented male development.

The Modern Period and The First Discoveries Surrounding Testosterone and Androgens

Enter the 19th century. It was during this time period that the first major discoveries concerning Testosterone and its other related androgens (such as Dihydrotestosterone, etc.) occurred. Various animal experiments at this time were conducted and published that could be described in simple terms as trial and error experiments. These experiments involved the removal of testicles from various animal test subjects and the re-application of them, and the various changes that resulted from these experiments were observed. These experiments allowed scientists and the medical establishment to finally garner a more complete understanding of the role that the testicles play in the development and maintenance of the male species of animals. This is essentially where the origins of the study of hormones began, which is known in the medical field as Endocrinology. One key doctor who conducted many of these experiments was a doctor and zoologist by the name of Arnold Adolph Berthold in Germany, who conducted these experiments on birds and chickens.[1][2] These experiments and discoveries were groundbreaking and although they did not even cover 1/100th of what would later on be discovered concerning anabolic steroids, these experiments overcame the first hurdle towards the understanding of Testosterone and anabolic steroids. Without these experiments, it may not have been possible for the further discovery and development of anabolic steroids to have occurred.

Toward the beginning of the 20th century in the late 1880s and 1890s, the very first discovery and isolations of androgens had occurred through the filtration of urine samples to locate and isolate hormones, or from extraction directly from the testicles. It was from this that the very first (although extremely basic) hormonal injection preparations were developed, but it would not be until a short time later that the real full-scale research and development of anabolic steroids would be underway.

It is important to note, however, that the body contains several different androgenic hormones in addition to the commonly known Testosterone and Dihydrotestosterone. Because of the wide array of hormones where the testes are concerned, the discovery and isolation of androgens does not necessarily refer to the discovery and isolation of Testosterone itself. It may refer to a precursor hormone or a very androgenic hormone extremely similar to Testosterone but used for a different function, such as Androstenone, which was discovered and isolated before Testosterone had been.

The Beginning of the Modern Age of Anabolic Steroids

It was during the early portion of the 20th century during the 1930s where some of the most major discoveries concerning Testosterone and various anabolic steroids took place. In 1931, a chemist in Marburg, Germany by the name of Adolf Butenandt isolated 15 milligrams of the androgen Androstenone from massive amounts of urine samples. It was then synthesized in 1934 by a chemist by the name of Leopold Ruzicka, also a German scientist. However, at this time it was known that there contained a far stronger (and primary) androgen within the testes than Androstenone – but it had not yet been identified or discovered. The race to discover what exactly this androgen was was now underway. Three scientific teams that were lead and funded by some major pharmaceutical companies located in the Switzerland, the Netherlands, and Germany took upon the task to discover and isolate this androgen.[3][4] In May of 1935, this hormone known as Testosterone was finally discovered by scientists Karoly Gyula David, E. Dingemanse, J. Freud and Ernst Laqueur and published in a paper On Crystalline Male Hormones from Testicles (Testosterone).[5] The name for the hormone Testosterone finds its etymology in the two words testicle and sterol (a ‘sterol’ is the name for the general sterol chemical skeleton structure), which determine the prefix, and the suffix of the word Testosterone is derived from the prefix of the word ketone. In August of that same year, Butenandt and G. Hanisch then successfully discovered a method of synthesizing Testosterone from Cholesterol.[6] With Testosterone itself now having been synthesized and a method for synthesizing it discovered, this now opened the doors for the way into the widespread development and use of Testosterone for a multitude of applications. It is important to understand that at this point, it was the discovery, isolation, and synthesis of Testosterone that had been completed. Its effects, benefits, and use in an almost infinite amount of applications were at this time unknown and yet to be discovered at that point. Ruzicka and Butenandt were awarded the Nobel Prize in Chemistry in 1939 for their efforts in these discoveries. However, Butendandt was refused the Nobel Prize by the Nazi German government at the time. After World War II, however, he then accepted the Nobel Prize.

Following the discovery and synthesis of Testosterone in 1935, the applications of Testosterone were now making headway at full steam. In 1937, synthetic preparations of Testosterone in the form of Testosterone Propionate were administered to test subject in human clinical trials. During this same time in 1937, an orally bioavailable form of Testosterone, Methyltestosterone, was also being administered orally to test subjects in clinical trials.7 In 1938 the very first known reference to anabolic steroids in a bodybuilding magazine, Strength and Health, had appeared in a letter addressed to the editor of Strength and Health.[7]During the Second World War, it had been reported many times that a certain amount of German soldiers were administered Testosterone by German military scientists and doctors in an effort to enhance the physical abilities of the soldiers in the areas of strength and endurance, including aggression. It was even reported by Adolf Hitler’s own personal physician that Hitler was administered injections of Testosterone to treat a myriad of various disorders.[8] Nazi doctors and scientists had also documented their use of anabolic steroids in experiments on concentration camp prisoners during the war8, and anabolic steroids were also reportedly used on concentration camp prisoners by the Allies after liberating the prisoners in an effort to improve feed efficiency and restore body weight and mass to the malnourished concentration camp survivors.8

The use of Testosterone on German soldiers during the Nazi government in retrospect was seen as an extension of Adolf Hitler’s undying dream to create a soldier that could withstand the burdens and hurdles that no normal man could, and Hitler’s idea was to accomplish this at any cost. The anticipated result would be an army that could not be challenged by any other country. Hitler had driven the Nazi scientific industry to venture into developing a useable drug that could allow a soldier to withstand arduous physical exertion and at the same time a state of malnourishment with the added benefits of accelerated wound recovery and healing – all factors that Testosterone can be said to provide. Unfortunately the extent of the research into anabolic steroid use in Nazi Germany at the time occurred far too late, travelled in a direction far too distant from the goal, and general research into Testosterone applications was in its infancy. This is where the Soviet Union would pick up where Nazi Germany had left off at the war’s end.

The Development of Synthetic Anabolic Steroid Analogues and Performance Enhancement

Research continued through the late 1930s and the 1940s surrounding Testosterone and its benefits and applications. Following World War II, the Soviet Union was the first nation to place a firm grasp on Testosterone and anabolic steroid use, and carry its research farther before any other country had caught on to the benefits of Testosterone use and its various applications. By grasping this head start, the Soviet Union could maintain a clear advantage in many different areas and did so for the most part during the late 1940s and 1950s. The primary and most popularly known area where this could be seen was that of the Olympics, where the Eastern Bloc and the Soviet Union were the first to use Testosterone to enhance the strength and performance of their Olympic athletes. The Cold War had been well underway by 1950, and it has been said that the struggle between the East and West during the Cold War for superiority in every arena was one of the primary driving factors for the development and application of anabolic steroids. The Soviet Union had dominated completely through the 1950s Olympic Games, especially in activities where strength had been a primary determining factor. American Olympic athletes were losing by an extreme margin to the Soviet athletes. It was during this time that the American government had intervened in an attempt to question the United States weight lifting team’s physicians as to why the Soviet athletes had such a gross advantage over the Americans. One doctor working for the US Olympic weight lifting team at this time was a doctor by the name of John Ziegler.

Ziegler and a team of scientists and doctors investigated and conducted various studies on the Soviet athletes (those that had defected to the United States). It was discovered through this research and study that the Soviet athletes had been administered exogenous Testosterone. In response to this, John Ziegler and his team had set out to develop an anabolic steroid that would exhibit reduced androgenic effects and possibly provide even greater anabolic effects.[9] This would be the United States’ response to the Soviet athletes. The resulting anabolic steroid developed was the anabolic steroid known as Methandrostenolone, which was then marketed by the pharmaceutical company Ciba as Dianabol (also known in short form as ‘D-bol or ‘Dbol’’). Shortly after discovery and development, the Food and Drug Administration (FDA) approved Dianabol for use in 1958. In addition to its use as a performance enhancing drug, its other applications included common administration to burn victims for enhanced healing, and elderly patients for assistance with a multitude of medical issues. It was during this time period of anabolic steroid development that Nandrolone and Dihydrotestosterone (which are two naturally occurring compounds as opposed to modified compounds that are not produced by the human body, such as Dianabol) were discovered and synthesized. This was the time period where scientists and doctors realized that the various effecting properties of Testosterone (anabolic, estrogenic, and androgenic) could be modified and augmented by adjusting and altering the chemical structure. The ‘boom’ of anabolic steroid development during this time created the focused goal of scientists to attempt to create an anabolic steroid that could garner some very strong anabolic effects while exhibiting little to zero estrogenic and androgenic effects. The idea with this effort was to create an anabolic steroid that could provide only 100% of the beneficial desirable effects (such as muscle growth) and none of the undesirable effects. This is where the many different anabolic steroids were developed, which have varying anabolic/estrogenic/androgenic effects. By the 1960s, literally thousands of different anabolic steroid analogues of Testosterone, Nandrolone, and Dihydrotestosterone were created. They are all simply augmented and modified variants (known as ‘analogues’) of the original anabolic steroid: Testosterone. The other two anabolic steroids that occur naturally that analogues are also derived from are Nandrolone and Dihydrotestosterone.

While new anabolic steroid analogues were being created daily throughout the mid-1950s to the 1980s, the International Olympic Committee (IOC) had grown increasing concern over the use of anabolic steroids by Olympic athletes, which were now being used by the athletes of nearly all countries participating. What is interesting to note, however, is that it was during this time (and all the way up until the early 1990s) that the overwhelming majority of the medical establishment had consistently stated that anabolic steroids provided no benefit to athletes or improvements for athletic performance. Despite these claims by the medical establishment, the IOC in 1976 placed anabolic steroids on the list of banned substances and introduced drug testing during competition season, and approximately 10 years later random drug testing for anabolic steroids during the ‘off season’ or ‘out of competition’ period was implemented.[10] It was after the 1976 ban on anabolic steroids in the Olympics that other sports leagues would follow in the footsteps of the IOC and introduce anabolic steroid bans in their respective sports as well. Following these bans in sports and regulations, athletes would now seek methods to avoid, skirt, and fool the drug testing programs. Some of these methods included simple practices such as utilizing anabolic steroids that do not result in metabolites that linger for extended periods of time, or anabolic steroids that are basic and clear the body within a matter of days. Testosterone is one such example, as the IOC testing procedures for detecting Testosterone simply test what is known as the Testosterone:Epitestosterone ratio. Epitestosterone is an epimer of Testosterone, and the levels of Epitestosterone do not change in the body in relation to Testosterone. If testing displays that Testosterone levels are drastically higher than Epitestosterone levels in the body, then it is a strong indication that the athlete in question has been administering Testosterone. However, anabolic steroids such as Testosterone suspension or Testosterone Propionate clear the body in as little as a matter of days – thus allowing the athlete to skirt possible drug tests in a short time frame. This is in contrast with other anabolic steroids such as Nandrolone, where the metabolites of Nandrolone are tested for during drug tests, and the metabolites of a compound will linger in the body for a time after administration of the substance. In the case of Nandrolone, for example, its detectable metabolites are known to remain for far longer periods of time than other anabolic steroids. Other methods of ‘tricking’ the testing system is to simply utilize a brand newly created anabolic steroid compound that has been kept secret or has not been released on the market yet. One must understand that in order for a lab to find a compound, they must know what they are already looking for. If an athlete is utilizing a compound that is a custom made compound and is yet to be discovered, and there is no knowledge of this compound has reached chemists, doctors, or the IOC testing lab, then there will be zero chance of detecting the anabolic steroid or its metabolites. East Germany was well known as being one such country where their athletes utilized this method to skirt drug testing.

These cat-and-mouse games of drug testing in sports and the Olympics continued all throughout the 1970s and 1980s until 1988 when Canadian Olympic sprinter Ben Johnson won the 100 meter dash and tested positive for the anabolic steroid Winstrol following the games.

The Legal Hammer Coming Down on Anabolic Steroids

Anabolic steroids enjoyed a free period of flourishing use and research and development until the 1988 summer Olympic Games when Canadian Olympic sprinter Ben Johnson tested positive after his victory at the 100 meter dash. This would be the swan song for the freedom and legality of anabolic steroids in the United States and the first part of the control placed on anabolic steroids. The 1988 Olympic steroid scandal sparked a congressional hearing on the issue of anabolic steroid use, and it was during this year that anabolic steroids were placed under the Controlled Substances Act in the United States. Although this did not make possession and use a criminal illegal act, it removed the freedom to openly purchase anabolic steroids without a prescription. It is very important to note that during the congressional hearings and investigations prior to this decision to place anabolic steroids into the Controlled Substances act, the American Medical Association (AMA), Drug Enforcement Administration (DEA), Food and Drug Administration (FDA) as well as the National Institute on Drug Abuse (NIDA) all opposed the idea of placing anabolic steroids under the Controlled Substances act and denied support to congress in such an act. All of these agencies made it specifically clear to congress and the United States government that there existed no reasonable or valid medical or legal reason for placing such a control measure on anabolic steroids. Blatantly disregarding and ignoring the recommendations from these professional institutions and bodies, United States congress still made the decision to place anabolic steroids under the controlled substances act.

However, it was not until two years later in 1990 when congress then passed the 1990 Steroid Control Act, and placed anabolic steroids into the Schedule III category of the Controlled Substances act, which classified anabolic steroids along with Opiates, Ketamine, and Barbiturates. This now made it an illegal criminal offense in the United States to possess, use, buy, and sell anabolic steroids without a valid prescription.

It is very important to understand that anabolic steroids are legal in most countries in the world, and that in many countries it is not illegal. The United States of America is one of the only countries in the world to implement strict and stringent draconian laws concerning anabolic steroids. For example, in Canada anabolic steroids are placed under Schedule IV in the Canadian Controlled Drugs and Substances act where personal possession and use is legal and not an offense. As well, anabolic steroids were not actually legislated in Canada until 1996. Prior to 1996 in Canada, anabolic steroids were freely available for use and consumption.

As what would be typical during such times, the media entered into a frenzy of anabolic steroid demonization, exaggerations, sensationalizing, and mass hysteria amounting to what is basically modern witch-hunts, stake-burnings, and necktie parties over a substance that at one time during the 1950s was looked upon by doctors and the medical establishment as a miracle drug, and a proverbial ‘fountain of youth’. What is interesting is that during this time during the early 1990s, the medical applications of anabolic steroids for the treatment of various diseases, ailments, and medical conditions saw a large boom and expansion while the detriment of the legislation and hysteria surrounding anabolic steroids continued to spike.

Unfortunately, however, it is because of the sensationalizing of anabolic steroids and the stigma stapled to it that has held back the potential developments and research that could have benefited many people. It is because of this that so many individuals have unfortunately suffered a great deal and/or have died from disabilities and conditions that anabolic steroids could have been used as treatment. Shortly after the Anabolic Steroid Control Act of 1990, many pharmaceutical companies halted the production and marketing of anabolic steroids in the United States, serving to further hold back any potential positive medical research and development. These companies included Ciba, Searle, Syntex, as well as many others. The legislation of anabolic steroids in the early 1990s and the negative stigma that has followed ever since has also raised the common question that if steroids are so deadly, why are they are manufactured by US pharmaceutical companies and prescribed as medicine to help people, but if one utilizes it for the purpose of physique and performance enhancement they suddenly supposedly become deadly?

The Second Major Assault on Anabolic Steroids

As time passed since the 1990 Anabolic Steroid Control Act, the use of anabolic steroids among the population only increased, and the legislation of anabolic steroids created a massive new lucrative spot in the black market for the buying and selling of anabolic steroids. The attempts by politicians and the governing bodies of sports to continually pummel anabolic steroids into the ground would not end, however. In the early 2000s, anabolic steroid hysteria saw resurgence when Patrick Arnold, an organic chemist in the United States, did some digging back into Syntex’s research and development archives from the 1950s and re-introduced a couple of compounds known as prohormones. Prohormones are what are known as precursors to anabolic steroids, and have little to no hormonal activity on its own. However, when it is ingested (or administered in any other route) into the body, the liver through a series of biochemical reactions will convert these prohormones into active anabolic steroid hormones in the human body. The development of these substances effectively avoids the legislation placed on anabolic steroids and at the time allowed the sale of these prohormones in supplement shops. The particular prohormones introduced into the market by Patrick Arnold were Androstenedione and 1-Androstenediol.

At this same point in time, professional baseball saw a large surge in anabolic steroid use among its players. Barry Bonds, Mark McGwire, Jose Canseco, Jason Giambi, Sammy Sosa, and Roger Clemens are a few of the most well-known professional baseball players that at the time that were placed in the media and congressional spotlight for anabolic steroid use in baseball, with accusations flying left, right and center. A reporter had claimed to have seen a bottle of Androstenedione in Mark McGwire’s locker. It was at this time that congress decided to step in and hold investigations and hearings into the issue of anabolic steroids in baseball. Once again, anabolic steroids were in the full spotlight by the mid-2000s.

Following the congressional hearings and investigations, it was decided upon by congress to amend the Anabolic Steroid Control Act of 1990 with a new and updated Anabolic Steroid Control Act of 2004. The amendment added prohormones to the list of controlled substances, effectively banning and pulling all prohormone products from the shelves of stores, as well as making it a criminal offense to possess, use, buy, or sell them. To this date, the Controlled Substances act under (41)(A) defines anabolic steroids as: “any drug or hormonal substance, chemically and pharmacologically related to Testosterone (other than Estrogens, Progestins, corticosteroids, and Dehydroepiandrosterone.[11] This definition effectively placed a much tighter stranglehold on the legality of substances and creates a much broader range of potential bans on substances. Following the Anabolic Steroid Control Act of 2004, the largest anabolic steroid drug raid by the DEA in the history of the United States occurred in September 2007 known as Operation Raw Deal. This operation was the result of an 18 month investigation and resulted in the arrest of 124 people and the bust of 56 underground labs, making it the largest anabolic steroid investigation in American history.

On August 29, 2012 the designer anabolic steroids Methasterone (AKA Superdrol) and Prostanozol were banned and added to the Schedule III list of drugs under the Controlled Substances Act. ‘Designer steroids’ are one of two things; first, they are either brand new anabolic steroid compounds that are developed, effectively circumventing the Anabolic Steroid Control Act due to the fact that these newly created substances are not on the list of scheduled substances. Or, they are compounds that were once created in the 1950s and 1960s boom of steroid development that were never officially passed for production and never left the initial laboratory for various reasons, usually because the compound was found to be too harsh or undesirable in some aspect to the point where it was not deemed worthy of marketing. Some chemists have brought these compounds ‘back from the dead’ in an attempt to circumvent anabolic steroid legislation. For example, Patrick Arnold was not just known for his re-introduction onto the market of various prohormones but also his development of the designer steroid Tetrahydrogestrinone (THG, AKA “the clear”).

Where Anabolic Steroids Currently Stand and The Potential Future

Following the 1990 Anabolic Steroid Control Act, a collaboration of individuals formed a small movement which criticized the laws pertaining to anabolic steroids. This movement still exists to this day, but the numbers are believed to be far too small to make any appreciable influence or changes to the current political and legal climate of anabolic steroids in the United States. In 2005, Real Sports featured a small report discussing and questioning the validity and efficacy of the prohibition of anabolic steroids in America. July 2005 saw Philip Sweitzer, who is an attorney and author come forth to the United States government and mailed a letter addressed to the Members of the House Committee on Government Reform, as well as the Senate Committee on Commerce. The letter made strong criticism of the course of action of the lawmakers in scheduling anabolic steroids, and pointed out the ‘disregard of scientific reality for symbolic effect’. Mr. Sweitzer also put forth the proposition of decriminalization and the request for a new policy direction concerning anabolic steroids. Rick Collins, a lawyer who specializes in the law where anabolic steroids are concerned (and is also the author of the book Legal Muscle), has also criticized the legislation that has been passed upon anabolic steroids. In 2006 at a seminar, Rick Collins stated that the media is extremely biased and misinformed in regards to the risks associated with anabolic steroids. He added that the criminalization of anabolic steroids only serves to amplify the risks concerning impurities in anabolic steroid preparations on the black market. In 2009, the documentary Bigger, Stronger, Faster was released, which shed a more neutral and in some areas a positive light on the subject of anabolic steroids. Despite these various movements for the decriminalization of anabolic steroids, the United States government has remained rock steady in its position since 1988 in its belief that it is far too great of a risk to allow anabolic steroids to become unregulated or decriminalized.

The history of anabolic steroids is an ongoing process, and as the days and hours continue to tick by history is constantly being made. It is not something that is solidified and in permanent stone. The history of the modern use of anabolic steroids is a very recent and young one, and is by no means ‘over’.

 

Medical References:

[1] Maisel AQ. The Hormone Quest (1965) Random House

[2] Kochakian CD. J Nutr (1935) 23 135

[3] Hoberman JM, Yesalis CE (1995). “The history of synthetic testosterone”. Scientific American 272 (2): 76–81. doi:10.1038/scientificamerican0295-76. PMID 7817189.

[4] Freeman ER, Bloom DA, McGuire EJ (2001). “A brief history of testosterone”. Journal of Urology 165 (2): 371–373. doi:10.1097/00005392-200102000-00004. PMID 11176375.

[5] David K, Dingemanse E, Freud J, Laqueur L (1935). “Uber krystallinisches mannliches Hormon aus Hoden (Testosteron) wirksamer als aus harn oder aus Cholesterin bereitetes Androsteron”. Hoppe Seylers Z Physiol Chem 233 (5–6): 281. doi:10.1515/bchm2.1935.233.5-6.281.

[6] Butenandt A, Hanisch G. (1935). “A Method for Preparing Testosterone from Cholesterol”. Chemische Berichte 68: 1859.

[7] Hoberman JM, Yesalis CE (1995). “The history of synthetic testosterone”. Scientific American 272 (2): 76–81. doi:10.1038/scientificamerican0295-76. PMID 7817189.

[8] Taylor, William N (January 1, 2002). Anabolic Steroids and the Athlete. McFarland & Company. p. 181. ISBN 0-7864-1128-7.

[9] Calfee R, Fadale P (2006). “Popular ergogenic drugs and supplements in young athletes”. Pediatrics 117 (3): e577–89. doi:10.1542/peds.2005-1429. PMID 16510635.

[10] Hartgens and Kuipers (2004), p. 515

[11] United States Congressional records.