Sympathy for the Devil
The road to the future is paved in blood my own. Not too long ago, a nurse went a little crazy with my hemoglobin. Somewhere in the middle of the second vial, I got too dizzy to pay attention, but it felt like she took pints, quarts, gallons, whatever comes after gallons, gleefully mining my veins for any secrets they might conceal. The blood was sent to a medical lab that ran a battery of tests and then shipped the results to a doctor named Ron Rothenberg, with whom I would meet to discuss what portents it held. Besides the blood work, getting in to see Rothenberg also required signing a 10-page waiver, filling out a 20-page health-and-lifestyle questionnaire and being profoundly willing to look my medical future square in the eye.
Rothenberg, himself, is a medium-size guy, smooth-skinned and strong-shouldered, with sandy-brown hair, dark eyes and darker eyebrows. He looks a little like a Jewish version of a Latin American soap star, which is to say he looks nothing like his 59 years. He is open about his age, just as he is open about the fact that he feels 25, but unlike most who brag of their youthful virility, because of the way Ron Rothenberg now makes a living, his youthful virility is perhaps no idle claim. Rothenberg runs the California Health Span Institute in Encinitas, California, and to the limited number of people who know of him and understand the world of anti-aging medicine, he is considered something of a pioneer which is saying a lot when you consider that the Western tradition of anti-aging medicine dates back at least to the 1500s, when someone named Juan Ponce de León accidentally discovered Florida while looking for the Fountain of Youth.
Rothenberg was not trained in anti-aging medicine, because, at the time he was trained, anti-aging medicine was not something one got trained in. Instead, he graduated from Columbia Medical School in 1970, moved out West, learned to surf, and completed his residency in 1975 at Los Angeles CountyUSC Medical Center. He received an academic appointment to teach emergency medicine at the University of California, San Diego, in 77, and became a full professor in 89. Throughout, Rothenberg has kept on surfing. Back in 1975, he was one of the first Americans to venture to Bali to try his hand at those now-legendary Indonesian waves. He has a house down deep in Baja, right in front of one of the better breaks in Mexico. Surfboards hang on his office walls, as do pictures of him riding overhead waves with a charging stance akin to that of Greg The Bull Noll. These pictures were taken last year, when Rothenberg was 58, but it was a few years before this, around the time he turned 50, when his interest in surfing pointed him toward the then-emerging field of anti-aging medicine.
Around the half-century mark, I saw all these changes in my body, recalls Rothenberg. I felt fuzzy. I felt like I was losing my edge. My energy was low, my libido was low, things didnt look as good as they used to. When I went surfing, I would get winded on the paddle-out. I wasnt used to getting winded on the paddle-out. I read a Newsweek article about the anti-aging properties of DHEA and started to wonder if there was something I could do about the way I was feeling and the changes my body was undergoing.
Rothenberg got in touch with the nascent American Academy of Anti-Aging and began re-educating himself. Most doctors are frozen in time, he says. They stop learning when they get out of medical school. Unfortunately, one of the first things they teach you in medical school is that nearly half of what youll learn there is wrong only no one is exactly certain which half. One of the main things he learned in medical school was that time marches on and aging is an unstoppable process. For Rothenberg, this turned out to be part of the half that was wrong.
How wrong is still a matter of debate, but few disagree that the version of anti-aging medicine as practiced by Rothenberg and his cohorts represents one of the more radical departures in Western medical thought to surface in centuries. Traditional medicine is reactive, disease-based medicine, says Dr. Robert Goldman, chairman of the American Academy for Anti-Aging Medicine. Anti-aging medicine is the opposite. Its about finding the problem and fixing the problem before it occurs. If sports medicine is about optimizing the body for maximum athletic performance, then anti-aging medicine is about optimizing the body for living in general.
Goldman believes that anti-aging is the future of medicine. And Ron Rothenberg was one of the first to venture into that future. He became the 10th doctor in the world to become board-certified in anti-aging medicine and among the earliest to hang a shingle and open his doors to the public, in 1998. He had been self-medicating for a little while before that, and his earliest patients were fellow doctors who noticed that Rothenberg seemed younger, faster, stronger and who wanted some of that good magic for themselves. His prescription for them was very similar to his prescription for me and this is where the road to the future takes a sharp left turn because the basis for both prescriptions was hormones. Though, as Rothenberg and others like to point out, Theres a joke in the medical community: When someone has something nice to say about the work were doing, they use the word hormones. When they dont have something nice to say, they like to call them steroids.
My journey to see Dr. Rothenberg did not begin with an inquiry into anti-aging medicine, but it did begin with steroids. It began with a onetime baseball player named Jose Canseco and the stir caused by his memoir of wild times, rampant roids, smash hits and how baseball got big. It was in Juiced that Canseco claimed to be the man who popularized steroids in baseball. It was also in Juiced that Canseco defined road beef as any girl you met on the road and had sex with. For this reason and others, theres very little in the book that gives one faith in its authors opinions. He repeatedly argues that steroids are the wonder drug of tomorrow, but nowhere in the book is a medical paper cited or a scientist quoted. He promises that someday soon everyone will be doing it. Steroid use will be more common than Botox is now. Every baseball player and pro athlete will be using at least low levels of steroids. As a result, baseball and other sports will be more exciting and entertaining. Human life will be improved, too. We will live longer and better. And maybe well love longer and better, too. As it worked out, these rosy prognostications came around the time that pundits and politicians were making plenty of hay saying the exact opposite.
They had been saying the exact opposite for years, but Cansecos book and the BALCO scandal combined to add new fuel to the fire and helped spark this past springs congressional steroid hearings a circus act that saw everyone from Mark McGwire to Sammy Sosa look uncomfortable fudging answers to questions raised by Juiced , while Canseco seemed relaxed and in control, and shameless by comparison. One memorable moment came when former pitcher and current Republican senator from Kentucky, Jim Bunning, decried the nightmare scenario of baseball players actually getting better as they aged: "Mr. Chairman, maybe Im old-fashioned. I remember players didnt get any better as they got older. We all got worse. When I played with Henry Aaron, Willie Mays and Ted Williams, they didnt put on 40 pounds and bulk up in their careers, and they didnt hit more home runs in their late 30s as they did in their late 20s. Whats happening in baseball now is not natural, and it isnt right."
The results of all the hysteria were new drug-testing and steroid-suspension policies in all major sports including baseball, where Commissioner Bud Selig has proposed 50-game suspensions for a first offense, and football, which increased the possible number of random off-season drug tests from two to six. There was also the re-drafting of the 1990 Steroid Control Act into the updated 2005 Steroid Control Act, and this doesnt include the two sports-related anti-steroid bills pending in the House of Representatives.
The experts were nearly unanimous in their Canseco condemnations, but despite all of this, the reason I found myself sitting in Ron Rothenbergs office last June was because I had started to harbor what seemed the most ridiculous of all suspicions: What if Jose Canseco was actually right?
The real reason I started to wonder this had little to do with steroids and plenty to do with another taboo class of chemicals. It is well known that back in the 1960s, when Timothy Leary snuck LSD out of Harvard and into mainstream culture, all sorts of tie-dyed hell broke loose. Our young people were at risk; the very foundation of our society was in jeopardy. Hallucinogens, we were told, were diabolical. They induced insanity. You want proof? Did not the Grateful Dead become the most successful bar band in the history of the world? Perhaps less familiar is the fact that before Captain Cosmonaut came on the scene, psychedelics had been the basis of some really promising science so good that nearly all of modern pharmacological psychology is based on this research. LSD led us to the neurotransmitter serotonin, and serotonin jump-started the entire Prozac nation. Studies dating back almost to the 1920s hint that hallucinogens are uniquely suited to treat some of our more intractable diseases, but most of these studies have been buried so long and so deep that the core component of the Schedule One classification where hallucinogens currently reside states that they contain no beneficial medicinal properties.
There were, however, a few folks who knew what was what, and these folks have been stubbornly lobbying the powers that be for more than three decades. In 1990, a managerial decision to depoliticize the Food and Drug Administration forced the rest of the government to finally reopen this door. There are currently a half-dozen hallucinogen studies under way at major universities, the early results of which are seriously promising. All of which led me to wonder, if psychedelics werent the bogeymen they had been made out to be, maybe everything were hearing about steroids being the devil incarnate is wrong as well.
If you want to know anything about steroids, Mauro Di Pasquale is a pretty good place to start. Hes a two-time world-champion power-lifter, eight-time Canadian champ, two-time Pan-American and two-time North American champion. Along the way, Di Pasquale also went to medical school and became one of our foremost authorities on performance-enhancing drugs. He has since written eight books on the topic, worked as a columnist for half a dozen fitness magazines and as editor in chief for the international quarterly newsletter Drugs in Sports and the bimonthly Anabolic Research Review (both are no longer published). In the early 90s, when World Wrestling Federation founder Vince McMahon decided it was time to get his empire off the juice, Di Pasquale was the one who got the job. He later became the medical director to the World Bodybuilding Federation and the acting medical review officer for NASCAR, helping both sports develop their stringent drug-testing policies.
I reached him at his home in Toronto after a frustrating morning spent trying to find a clear-cut definition of steroids. You wont find one, said Di Pasquale. When people use the word, they are usually talking about one of two things. Doctors use it to mean corticosteroids, which are catabolic hormones that break tissue down. Corticosteroids are the bodys natural anti-inflammatories, produced as part of our normal reaction to stress. When the general public talks about steroids, they sometimes mean our actual sex hormones, but mostly they mean testosterone or substances designed to mimic testosterone.
Testosterone is both an anabolic and an androgenic steroid. Anabolic means the exact opposite of catabolic; its a hormone that builds up tissue rather than breaking it down. Androgens are any hormone that controls the development and maintenance of male sexual characteristics, just as estrogens are any hormone that controls the development and maintenance of female sexual characteristics. Testosterone is the upstream precursor of estrogen, meaning testosterone breaks down into estrogen. Quite literally, if there were no such thing as testosterone, there would be no such thing as women.
Our earliest known research into the effects of tampering with testosterone date back to 1767, when Scottish scientist John Hunter failed to learn much of anything by transplanting the testicles of a rooster into the abdomen of a hen. A hundred years later, a German zookeeper and professor named Arnold Berthold picked up Hunters thread and performed one of our first recorded experiments in endocrinology. He castrated a series of cockerels and afterward reported that his animals most definitive male sexual characteristics vanished right alongside their testicles. Gone were the flamboyant comb, the aggressive behavior and any interest in the opposite sex, but and this was the finding that first paved the road into the future Berthold also found that these changes could be reversed by injecting the castrated rooster with the as-of-yet-unnamed substance extracted from its testicles.
Two decades after Bertholds breakthrough, our first steroid controversy arrived when noted British neurologist Charles Edward Brown-Sequard began injecting himself with an extract of animal testes. No one really knows which species he preferred, but he sampled guinea pigs, dogs and sheep and so enjoyed the experience that he spent the later years of his life tarnishing his illustrious career in the eyes of the medical community by touting his potions rejuvenating qualities and advocating injections as a means of prolonging human life. It was hard to persuade the general public to go this extract route, but in the 1930s a Dutch pharmacologist named Ernst Laqueur managed to isolate 10 milligrams of crystalline testosterone from 100 kilograms of bull testicles, and that changed everything. Suddenly, we could pick apart testosterones chemical structure; suddenly, we could experiment. Synthetic versions were soon to follow, as were the Swedish athletes taking Rejuven, a performance enhancer that worked its magic with a small amount of testosterone. Other shenanigans ensued. In the 1936 Olympics there were rumors that German competitors fueled by Hitlers dreams of Aryan perfection were taking even larger doses.
A few years after that, as John Hoberman writes in his book Testosterone Dreams: Testosterone became a charismatic drug because it promised sexual stimulation and renewed energy for individuals and greater productivity in society. Physicians described the optimal effects of testosterone as a feeling of well-being, a term that has been used many times over the past half-century to characterize its positive effect on mood. In the early 1940s, testosterone was hailed as a mood-altering drug whose primary purpose was the sexual restoration and reenergizing of aging males.
But the real dam broke in 1945, when science writer Paul de Kruif published The Male Hormone. When the book came out, it was big news. Newsweek wrote a full-page review, and Readers Digest excerpted the work. Reviewers cited both de Kruifs bioethical fearlessness and his scientific excellence. The book was about testosterone and the impact it would have on our economy and our health. De Kruif foresaw riches for its manufacturers; however, he didn't predict that steroids would become a huge black-market business. He foretold increased vigor and extended life for its consumers. About health, de Kruif was downright prescient, though very few people know this, and the reason very few people know this is because its quite possible Paul de Kruifs was the last unbiased opinion on the subject.
So strong are those biases and so fervently have they been promoted that calling the worlds top steroid experts and asking them questions especially in light of the presidents inclusion of steroids as public enemy No. 2 in his most recent State of the Union address was having a hall-of-mirrors effect.
As used by most people, including athletes, the adverse effects of anabolic steroids appear to be minimal, says Di Pasquale. Steroids do not cause cancer. They dont cause kidney failure. There have been thousands of steroid studies and about a hundred of those point out bad side effects. But if you look at those studies carefully, theres no one-to-one correlation, and a one-to-one correlation is the hallmark of good science. Do anabolics produce roid rage? They produce an incredible amount of energy, but you need to think about the kind of people taking steroids. If really competitive and aggressive people start taking drugs that give them more energy, then common sense says that sooner or later youre going to have some problems, but are steroids the problem or the fact that this person didnt know how to control their anger long before the steroids came along?
Di Pasquale says the same thing is true about all the scary steroid stories hanging around cautionary-tale cases like Lyle Alzado and Steve Courson. Alzado was the All-Pro-defensive-lineman-turned-actor who died of inoperable brain cancer in 1992 at the age of 43. Alzado blamed longtime steroid use for his condition. Steve Courson, who once lined up opposite Alzado, wrote the tell-all book False Glory: Steelers and Steroids about the juiced-up ways of the 70s Steelers. Courson was recently on the heart-transplant list before correcting his gravely enlarged heart with diet and exercise. Both were known for living large as well as being large.
As Di Pasquale and many others have pointed out, people with a proclivity for risk take steroids; people with a proclivity for risk also play professional sports, drink too much, take recreational drugs and have unprotected sex. For almost every famous steroid-related tragedy, there are a host of underreported extenuating circumstances, but sports are big business, and pill-popping booze hounds with a penchant for unprotected sex dont sell tickets like they used to.
Which is not to say anabolics arent without complications. When teenagers use steroids, the results can be disastrous. When weightlifters ingest 10 times the normal amount of anabolics for years at a time, theres excessive hair growth in unwanted places, premature baldness and gynecomastia (the development of so-called bitch tits?) in men, and clitoral hypertrophy (the development of so-called big clit) in women. Men also face testicular atrophy, which may or may not go away once they stop using steroids. As for the long-term effects, until very recently, almost nobody had studied them.
One of the first such investigations was undertaken a few years ago by UCLA orthopedic surgeon and sports-medicine specialist Nick Evans, who writes the Ask the Doctor column for MuscleMag International. When I asked Evans why it had taken so long for anyone to do such a long-term study, he reminded me that while steroids have been increasing body mass and strength in athletes for nearly 75 years, it wasnt until 1996 that medical science got around to admitting that steroids actually could increase muscle mass and strength. Its the craziest thing youve ever seen, said Evans. It was like scientists bought into all the negative hype and propaganda and never bothered to walk into a gym and talk to a bodybuilder.
Evans, on the other hand, had no problem with bodybuilders. In the early 90s he started talking to plenty of them and in 1996 published his first paper, Gym and Tonic: A Profile of 100 Steroid Users, in the British Journal of Sports Medicine. That was followed by an even more rigorous look at 500 long-time juicers that was presented this year at the American College of Sports Medicines annual meeting. Like Di Pasquale, Evans found no concrete links between steroids and the deadly panoply with which they are often associated, though at the extreme-bodybuilding end of the spectrum, he has some serious concerns about the heart. The heart is a muscle and steroids increase muscle size. If the heart starts getting bigger, it becomes less efficient at doing its job, and over time that can cause big problems.
Evans also feels that if users had access to proper medical advice, many of these problems could be avoided. He finds Americas current steroid policy slightly ridiculous, not because he believes that people should be taking steroids, but because of the reasons most people are taking steroids. Theres this idea out there that the only people who use these drugs are professional athletes that regulating steroids will clean up professional sports and make the problems go away, but that couldnt be farther from the truth. There are 3 million steroid users in the United States. In both of my studies I found that 80 percent of them were using them for cosmetic purposes.
What I found interesting about this is that when steroid-related complications are compared to complications from other radical cosmetic practices like liposuction or breast augmentation, the statistics show across the board that elective surgeries produce far more problems, and far more serious ones at that. What I found more interesting was that unlike these cosmetic practices, steroids hold real promise. Plastic surgery may hide wrinkles by cutting them out, but steroids might actually make you feel younger from the inside out. All of which raises the question: If steroids are not nearly as bad for us as weve been led to believe, and if they show far more potential as anti-aging medicine than anything else currently available, then what the hell is the problem?
NHL hockey teams are worth about $150 million each. NFL teams are worth about $530 million each. The New York Yankees are valued at about a billion dollars. But it is not just the teams themselves that appear at risk from the steroid menace, but also all the downstream profits generated by these teams. The range of such profits is immense, with everything from television contracts to the added value stadiums bring to urban areas to Nike shoe sales to the salary of the baseball reporter at the Kansas City Star included in the assessment. The general feeling is that steroids threaten all of these enterprises because steroids threaten the level playing field that many people think is the very foundation of sport. In other words, juicing is considered cheating.
That steroids threatened the level playing field became readily apparent in the 1960s, when androgynous Eastern Bloc female athletes started doing a little too well at the Olympics. By 1975, steroids were added to the Olympics list of banned substances. College and professional football followed, with other sports eventually following suit. But it was already too late. The word had gotten out: Steroids built muscle, shortened muscle recovery times, helped speed the healing of injuries and made you feel good along the way. And the word was bad for business.
It wasnt just that using steroids was cheating other factors came into play. Theres a whole subset of the industry thats very devoted to the record books, says Rodney Fort, Washington State University professor of economics and author of Pay Dirt: The Business of Professional Team Sports. These are everyone from the people who make baseball cards to the journalists who cover baseball. They believe you cant argue about whos the best batter ever if some of the best batters were on steroids. Theyre a subset, but theyre an impactful and vocal subset, and when it came to steroids, they were almost unanimously against.
This entire fracas meant that something had to be done, though what was actually done seems asinine until you remember the history of hallucinogens and exactly what became of Nixons war on drugs. The organized-sports establishment decided they would solve the whole problem by educating the athletes, wrote Rick Collins, one of our foremost authorities on performance-enhancing drugs and the law, in his book Legal Muscle: Anabolics in America. They would present the facts to discourage competitive athletes from using steroids. The establishment devised a strategy: to convince competitive athletes that anabolic steroids dont build muscle. But they needed a credible source through which to sell the message. It was decided that the American College of Sports Medicine would be the entity to spread the news, a bit like the Ministry of Truth had the job of spreading false propaganda in George Orwells classic book about a totalitarian future, 1984.
This wasnt yet 1984, this was 1977, and the College of Sports Medicine took to issuing proclamations: Steroids had no effect on lean muscle mass; the effects athletes were seeing were water retention; the effects athletes were seeing were the placebo effect. These claims were propped up by what many consider to have been flawed studies. Nonetheless, they held sway until the real 1984, when there was so much anecdotal evidence to the contrary that the college finally had to admit that, yes, those 300-pound beasts playing left tackle could only have gotten to be 300-pound beasts with the help of anabolic steroids.
So they came up with a different approach tell the athletes that steroids are bad for them. Make them sound horrible. As these things can go, they made them sound horrible enough that the media picked up the story (and ran with it and are running with it still). Then another fact came to light high school kids were starting to use steroids. Saving our children fills war chests, and Congress couldnt resist. In 1988, Ronald Reagan signed the Anti-Drug Abuse Act of 1988, which made trafficking in steroids illegal, and a variety of subcommittees were formed to hear testimony about whether or not steroids should become a controlled substance. Among those who testified was Charles Yesalis, a professor of health and human development at Penn State and the worlds leading steroid authority at the time. Steroids do have a medical use, Yesalis testified. From an epidemiologic point of view of the health dangers, I am much more concerned about heroin; I am much more concerned about cocaine; I am much more concerned about cigarettes than anabolic steroids.
The American Medical Association, the Drug Enforcement Agency, the Department of Health and Human Services, and the Food and Drug Administration the four regulatory agencies that are supposed to have control of the drug-scheduling process all testified against turning steroids into a controlled substance. It didnt matter. Senator Herbert Kohl spoke for many when he said, Steroid users set an intolerable example for our nations youth. At the time he was speaking, Senator Kohl also owned the Milwaukee Bucks.
In 1990, Congress passed the Anabolic Steroids Control Act. Five years later, a Los Angeles doctor named Walter Jekot was arrested for procuring and prescribing steroids for bodybuilders. His case went all the way to the Supreme Court, where he eventually pleaded guilty and served five years in federal prison. At the time much of this was front-page news; what was significantly less publicized was that because of his imprisonment, Walter Jekot is widely considered the steroid controversys first AIDS martyr.
Before 1990, steroids were a prescription drug available to anyone with a note from their doctor. Since the 1960s, Jekot had been writing such notes for some of his patients, primarily athletes and bodybuilders. He was still writing these notes in 1982, when Dr. Michael Gottlieb identified a strange virus that seemed to be plaguing the gay community. A number of Jekots patients turned out to be HIV-positive, and a few of those patients were the same athletes and bodybuilders who had been using steroids. By 1984, Jekot noticed that his HIV-positive patients who had been taking steroids were still alive, while everyone else seemed to be dropping like flies. They werent succumbing to AIDS wasting syndrome, and many of them looked downright healthy. In 1984, Walter Jekot became the first doctor to begin prescribing anabolic steroids as a treatment for AIDS.
A couple of years later, Barry Chadsey, a charismatic exfootball star who had since gone to medical school and built a thriving general practice in L.A.s gay community, was diagnosed as HIV-positive. Inspired by Jekots work, he began self-medicating, got immediate results and started experimenting to try to better those results. It was the late Chadsey who confirmed that the liver damage often associated with steroids was actually caused by a molecular change in oral steroids that allowed them to get past stomach acids and into the bloodstream and not by the steroids themselves. It was also Chadsey who helped develop a proper protocol for AIDS patients. Word spread quickly around the West Coast but didnt get national attention until 1995, when another HIV-positive doctor, Michael Dullnig, published an article in Muscle Media magazine talking about his own experiences with steroids.
In the early days of HIV research, doctors used the immune cell CD4 as a marker. Healthy, HIV-negative people have a 1,000-to-1,500 CD4 count. When doctors talk about AIDS early intervention, they usually mean beginning treatment when someones CD4 count hovers between 400 and 600, while the syndrome itself is defined by a CD4 count below 200. Dullnig had a CD4 count of four. He should have been dead within weeks. Instead, he started taking steroids, regained 40 pounds and lived. That was the story published in Muscle Media for a limited audience, this information started saving lives. Unfortunately there were a lot of lives to save.
Dullnig was trying to reach a larger audience but had been too sick when he started taking steroids and only lasted another year. Before he died, he got to know an HIV-positive chemical engineer named Nelson Vergel. Because of Dullnigs advice, Vergel began taking steroids. I put on 35 pounds during the next year or so. My immune response also improved, especially my CD8 T-cells, which went from 900 to 2,500 cells per mm³ (as it turns out, CD8 cells which are the immune cells boosted by steroids are a much better indicator of health in HIV positives). My symptoms basically disappeared. I never looked or felt better in my life, even when I was HIV negative.
This testimony appears in Built To Survive: HIV Wellness Guide, which Vergel co-authored with Los Angeles nutrition-expert-turned-AIDS-researcher Michael Mooney. The book is a step-by-step guide to beating back AIDS with nutrition and exercise and steroids, and it soon became the basis for both good medicine and an epic struggle. It was a crusade of sorts, Mooney said. Everyone we knew was dying, and we had come to realize that a lot of these people were dying because we were crusading against 30 years of anti-steroid propaganda.
Walter Jekot got caught in the middle. Nowhere in the transcript of Dr. Jekots court case does it mention that he was prescribing steroids illegally in order to continue his treatment of HIV-positive patients. The government, though, claimed he was distributing the drugs to athletes and bodybuilders, and that was enough for the court. The government wanted to make an example out of someone, says Mooney. They chose Jekot. Was it a bad choice? Well, they scared the shit out of a lot of good doctors, and they spread a lot of bullshit about steroids that bad doctors believed as truth. It almost goes without saying that if things had gone differently, thered be a few million HIV-positive people whod still be alive today.
Those numbers are still rising. Today, steroids are part of the standard treatment protocol for HIV. Today, steroids are just good medicine and common sense in the high-risk world of autoimmune diseases. Despite all of this, because of the effectiveness of the governments propaganda push, there are still swatches of the country especially, according to Mooney, more-rural areas where health care is already strained and HIV care already far below average where one can find doctors who believe that prescribing steroids to AIDS patients is akin to signing their death warrants. Unfortunately, the recent Steroid Control Act of 2004 did nothing to change their minds which, as I was rapidly coming to understand, was pretty much par for the course when it came to all things anabolic.
The Steroid Control Act of 2004 was essentially an update of the 1990 version. Twenty-six new substances were added to the list, and slightly less clunky and slightly less confusing language in the new bill replaced some clunky and confusing language from the old bill. The point, according to politicians, like California Congressman Henry Waxman, who were championing the bill, was to save our children and protect our sports. All of which raises some peculiar questions, since the point of the 1990 act was also to save our children and our sports, and that first bill did such a good job that we needed a new version some 15 years later.
And in 15 more years theyll pass another bill, says Rick Collins, the author of Legal Muscle. But it doesnt matter. You can keep adding more steroids to the list, but since there are a near-infinite number of possible steroids, what good does it do? Anyway, its a brave new world. Theres still no reliable test for human growth hormone (a pituitary extract that promotes lean muscle mass), and nobody is close to finding one. Theres blood doping, some people say theres already gene doping. The government is spending a lot of time and money chasing after an almost-obsolete technology thats not going to solve their problems anyhow.
Another comparison may be helpful. In 1980, the U.S. government spent $1.5 million fighting the war on drugs. By 2003, that number had become $19 billion, roughly $600 a second, while about 1.6 million Americans were arrested in the process. That budget increased by a billion dollars in 2004 and will increase again this year, quite possibly by another billion. It is worth pointing out that these are the governments numbers and most drug-reform advocacy groups put the price tag at close to $50 billion a year, roughly the equivalent of our countrys agriculture, energy and veterans programs combined, and perhaps coincidentally, equal to the amount of money Americans spend each year on illegal drugs.
By 2000, the Department of Justice released a report showing that state prisons were operating between capacity and 15 percent above capacity, with drug offenders responsible for 61 percent of those imprisoned. That same year, the Substance Abuse and Mental Health Services Administration (SAMHSA) reported that 47 percent of the eighth-graders surveyed and 88.5 percent of high school seniors reported marijuana was easy to obtain, and 24 percent of eighth-graders and 48 percent of seniors said the same thing about cocaine. In 2001, the Pew Research Center released a report stating that three out of four Americans believe the war on drugs is an absolute failure. Thirty-five years had passed since President Richard Nixon started the war on drugs by hyping a heroin problem into a national hysteria, and nearly all experts everywhere now agree that drugs are now more available, less expensive and more potent than ever before in history.
Which might lead one to wonder who benefits from all this fighting. Well, according to George W. Bush, Its so important for Americans to know that the traffic in drugs finances the work of terror, sustaining terrorists, that terrorists use drug profits to fund their cells to commit acts of murder. Current figures show that 1 million Americans use more than $400 million worth of black-market steroids a year, roughly 80 percent of anabolics used. Since the majority of black-market steroids come from Mexico and Australia, these profits are most likely not ending up in al Qaeda coffers, but thats merely a reflection of the current state of affairs and not a glimpse at the future of those affairs.
Which is not to say that all this tough talk isnt having any effect. While hard numbers are difficult to come by, most experts now concur that the majority of these black-market steroids are fakes. The Atlanta Journal and Constitution recently looked into this issue, concluding that tougher laws and heightened enforcement . . . have fueled thriving counterfeit operations that pose even more severe health risks. Di Pasquale points out that most counterfeits are manufactured under unsupervised and potentially unsanitary conditions, and may contain no real androgens at all. They may also be contaminated with bacteria or other dangerous substances. One thing is clear: Across America, doctors are continuously reporting treating far more athletes for the side effects of bogus steroids than they ever did with reliable pharmacy-purchased steroids.
As it turns out, Jose Canseco was wrong. Steroids arent the wonder drug of tomorrow, says Mark Gordon, a Los Angelesbased anti-aging doctor with more than 3,700 patients, including movie stars, studio heads and network executives. Steroids are the wonder drug of right now. Just look at the diseases they treat. Patients with MS on steroids exhibit no symptoms [according to several studies done in Europe, where research is more advanced]. A full turnaround in AIDS wasting syndrome. I know athletes who had injuries that normally take nine months to heal after surgery with an anabolic-steroid protocol, that time shrinks to two months. Do you wear glasses? Do you know theres a muscle surrounding the eye that wears out as we age and steroids can keep it healthy? And his list doesnt include many of the current or coming wonders of anti-aging medicine of which steroids or, now that were being nice, lets call them hormones will be a part.
But to understand whats coming, I first had to understand a bit about the aging process and that meant I had to understand a bit about metabolism. Loosely defined as our bodys way of burning food to produce the energy that runs out of cells, metabolism was linked to aging over a century ago. In 1908, physiologist Max Rubner noticed a relationship between body size, longevity and metabolism. Two decades later, American biostatistician Raymond Pearl expanded this into his rate-of-living theory, which states that the faster an organism lives, the shorter that organisms life span. Then, in 1935, veterinary nutritionist Clive McCay found that limiting the caloric intake of lab animals thus limiting their metabolic rate decreased and delayed the onset of age-related diseases and significantly extended life span. Denham Harman provided a little molecular respectability to this notion in 1954, postulating that oxygen radicals now known as free radicals caused the damages associated with aging and death.
There are now a number of big theories as to the causes of aging, with Harmans free-radical theory among them. Another is that the accumulation of excess glucose in our tissues screws up the cells ability to function normally. Theres also the end segments of a DNA strand known as telomeres. These are naturally lost in normal cell division, but, over time, when weve lost too many telomeres, then our cells lose their ability to divide into new cells. Without these new cells we cant rebuild body tissue, and when we cant rebuild body tissue, we age. But the theory that has provided the most interesting and perhaps the most controversial results, especially in light of the current anti-steroid ethos, has to do with hormones.
The thinking goes that all animals are extremely efficient machines throughout their reproductive years, but afterward those machines start to break down. Scientists now believe this breakdown is triggered by a loss in hormones. The old idea, says Rothenberg, was that our hormones decline because we age. The new idea is that we age because our hormones decline. Loss of hormones has been directly linked to everything from mental fuzziness and low libido to a variety of age-related disease like Alzheimers, arthritis, osteoporosis, Type II diabetes and cardiovascular disease. So the anti-aging world hit upon an obvious solution: Replace the missing hormones.
When I went to meet Dr. Rothenberg to discuss the results of my blood work, his job was to examine that picture of my hormonal health and make suggestions. We started out looking at my cholesterol and my triglycerides, and I got a short lesson on the dangers of trans fats a kind of saturated fat thats been fortified with zinc and copper and then widely used as a preservative. In recent studies, trans fat has been linked to the same kind of neurological decline often associated with Alzheimers disease. My advice here is really pretty simple, says Rothenberg. Fruits, vegetables, meats, fish are all fine. Frozen foods and canned goods thats the danger zone. Avoid the center aisles at the grocery stores youll live longer.
We work our way to C-reactive proteins, which are a great measure of inflammation in the body. Chronic inflammation is both the cause and the effect of most of the diseases of aging. While acute inflammation may save your life (by cutting off blood flow to a wound), silent inflammation is what kills you. My C-reactive proteins seem to be okay, but theres a need for some DHEA, and thats when we land squarely in the midst of todays controversy.
DHEA, a steroid hormone, is a cousin of testosterone and estrogen and has been called everything from the mother of all hormones to the fountain-of-youth hormone to the snake oil of the modern world. It is the most abundant steroid in the body, but the body stops producing copious amounts in our 20s. By age 70, we make roughly 20 percent of the DHEA we had in our youth. DHEA is also a precursor to all our major sex hormones, so its decline is partially responsible for a sluggish sex drive. Research has also shown that DHEA is useful in combating inflammation, depression, cognitive decline, Type II diabetes complications, cancer, arthritis, osteoporosis and heart disease, but naysayers claim its either worthless or dangerous or both. And while DHEA is currently available in most health-food stores, those naysayers many of whom are reputable doctors and researchers also caution that not enough is known about how the hormone works over time and that it should be classified as an investigational drug at best. Some go as far as saying its wide availability is a disaster in the making, and those DHEA detractors worked very hard unsuccessfully to add it to the list of substances banned by the 2004 Steroid Control Act.
Another substance that sits squarely on that list is human growth hormone (HGH), and Rothenberg does suggest that I could benefit from a little extra HGH. Long used to stimulate growth in children, in adults HGH has been shown to be great for immune function, well-being, hormone repair and though this has never been directly proved increased athletic performance. A little HGH means a self-administered daily shot, at a cost somewhere between $3,000 and $10,000 per year, though almost all of this money goes not to the doctors prescribing the drug, but to the companies making the drug, and it does so despite the fact that the real cost of HGH is pennies on the dollar.
As it turns out, my testosterone levels are fine. In a few years, maybe a boost would be in order, but that boost is a far cry from the megadoses that bodybuilders are putting in their body. The real eye opener, though, isnt about what I need now; its about what I might want then. If you can hold on for five more years, says Rothenberg, you wont believe whats coming.
Stem cells are, of course, the biggest promise. Were talking about cloning your exact DNA to repair your DNA. And this stuff isnt in the future its just about ready for prime time in Korea. He tells me that right now, vaccines for almost all of the major cancers are working their way through the drug pipeline. I dont know what well have access to in America and what we wont. You may have to go to Switzerland to avoid having to go to chemotherapy, but its coming.
And then theres the future of hormones. Not only are other methods of delivery soon to be available making the syringe stigma a thing of the past but there are also all kinds of gene technologies in development. Were talking about DNA repair at an incredible level, says Rothenberg. If your body has stopped producing the desired amount of testosterone, pretty soon were going to be able to insert genes that double testosterone production. How effective these technologies will be or how controversial the hubbub they will produce remains to be seen, but anti-aging doctors figure that if we can hold on for five or 10 more years, then were looking at a life span of 120 years. And all those later years wont be spent in a wheelchair and a nursing home. Thanks to the wonders of hormones, whats on the table here is a geriatric second childhood. Unless, of course, Congress decides that anti-aging medicine is a threat to the seniors golf tour and then, well, all bets are off.
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