What Causes Abdominal Distension in Anabolic Steroid and HGH Users? – Dr. George Touliatos


It is quite common the  repulsive look  of  the late IFBB pros, showing  protrusion of their abdominal area.

There are several mechanisms that cause this phenomenon and its multifactorial.

1)  It is known  that HGH via somatomedin  (IGF-1) causes   hypertrophy/hyperplasia  of   skeletal muscles and  rest of the tissues  (lips, ears, tongue, gums).This actually takes place under high doses of somatropin (>8IU/day). Viscera (stomach, heart,lungs,liver,small and large intestines, kidneys) have a large number of receptors IGF-1, which will lead to them inflating. This effect is not immediate, it depends on the dose and time. Therefore the abuse ofr-HGH for an extended period of time creates the extrusion of the abdomen. In other words, organomegaly occur, the enlargement of each organ as a whole.

2)  Accumulation of visceral fat occurs between the organs of the abdomen and the omentum. Greater and lesser omentumare layers of peritoneum surrounding the viscera and their vessels, nerves. Omentum creates bends and sinuses between the abdominal organs (peritoneal cavity).

The accumulation of fat happens mainly because of the lipogenesis (fat storage) induced by the use of insulin that is administrated synergistically with the HGH. Both act synergistically and the regulate glucose metabolism. Since somatropin raises serum glucose (through gluconeogenesis in liver) and insulin lowers serum glucose (and activate glycogen synthase enzyme in liver), they apparently have opposite effects on the metabolism of carbohydrates. Therefore, HGH causes hyperglycemia and the release of hepatic glycogen in blood.

On the other hand, insulin leads to hypoglycemia and enhances formation of liver and muscle glycogen. Insulin resistance is the decrease in body’s ability to respond properly to the metabolism of insulin and glucose, leading to a vicious circle of hyperglycemia, hyperinsulinemia  and eventually the establishment of DM2 (non-insulin dependent).

As it is known, the chronic use of r-HGH decreases insulin sensitivity, resulting in a growing need of insulin that eventually will exceed the body’s ability to properly regulate it. On that case, drugs reducing insulin resistance are required (metformin). Alternatively berberine, Chromium picolinate, alpha lipoic acid and vanadyl sulphate are among the supplements that improve insulin sensitivity. While the lipolytic action of growth hormone is generally strong enough to counteract the negative effects of insulin resistance in the fatty subcutaneous cells, it does not have the same positive effect on the visceral fat depots.

The extent, to which the combination of HGH and insulin will lead to abdominal distension, differs from person to person. Factors such as the type of diet (trans fat, refined sugars create insulin  spikes),  cardiovascular exercise, the frequency of weight lifting, the type of insulin used and the supplements can affect the sensitivity and therefore the likelihood of developing visceral fat.

3) Exogenous  insulin interferes with the electrolyte balance increasing the retention of water and sodium, therefore leading to edema and swelling of tissues. This water retention occurs not only in the subcutaneous, but on the whole body as well, which is why many people hold water in the abdomen after the injection, especially with the regular use of insulin.

4)   The consumption of large portions of food is another factor of stomach distention. Therefore, the larger amounts of food consumed, the more difficult the digestion is, resulting in the distention of the intestine.

5)   The chronic use of anabolic steroids (AAS) in tablet form (17 alkylated) lowers and modifies the operation of the normal intestinal flora. This change disrupts the normal bowel function and causes constipation, overproduction of gas and distension of the intestine. The use of lactobacillus acidophilus probiotic bacteria as a supplement, or the consumption of kefir and organic yogurt  could be of great value. Moreover candida albicans is useful as well .

6)   Digestive disorders such gluten sensitivity and lactose intolerance thatlead to the overproduction of gas in the intestine. Therefore dairy products and wheat should be avoided.

7)   The excessive intake of red meat and the inadequate fiber intake burdens the colon, which inflames because of the toxins. Gus based on nitrogen is produced, giving the feeling of bloated  bowel. In order to facilitate the digestion and assimilation of the gastrointestinal tract, it is necessary to consume vegetables and fruits  that are rich in fiber , in order to  facilitate  intestinal peristalsis, thus  preventing  constipation and bowel distension.

8)   The weakening of the transverse abdominal muscle plays also an essential role. Transverse abdominal muscle  forms a tube like cavity,that ori ginates from the lumbar fascia, the last six  ribs, the iliac crest, the inguinal ligament ;while it ends  in linea alba  with its denervation. It is located beneath the  external  oblique and rectus abdominis muscles. The action of the transverse abdominis helps to control the body’s stability, the cornering and bending of the trunk, the support of the abdominal wall and the production of intra-abdominal pressure. The transverse abdominal muscle twitches before the other muscles of the body do, and creates the base of the body movement. Its contraction creates a rigid cylinder because of its location and its crown shape mobilizes the thoracolumbar fascia; thus creating the conditions for the increase of the intra-abdominal pressure. It acts basically like a belt around your waist, holding the truck. Relaxation of the transverse abdominis could be the result of the technique of many exercises with a large increase of intra-abdominal pressure   (squats, deadlifts, leg press, and lunges), leading to abdominal distension.

It seems necessary and obligatory to drop on weight in order for the tissues to diminish. This is something accomplished by fasting and caloric deficit, following smaller meals and minimizing insulin spikes. There are top athletes who managed to reverse this and have a more aesthetic appearance on stage. Bubble gut can ruin the V taper of the physique and particularly the front three poses (relax,lats spread,double biceps) that reveal it.

Performing  respiratory exercises of vacuum, by sucking the air  through diaphragmatic breathing, can control the midsection during relaxing condition. It would be wiser to perform abdominal exercises focusing on the rectus abdominis, rather than hitting the external obliques. In this way we minimize distention of waist circumference.

Mr.Olympians known for their excellent V taper were Sergio Oliva and Lee Haney.


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