Steven Kotler |
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 County–USC 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 didn’t look as good as they used to. When I went surfing,
I would get winded on the paddle-out. I wasn’t 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 you’ll
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. It’s 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, “There’s a
joke in the medical community: When someone has something nice to say about
the work we’re doing, they use the word hormones. When they don’t 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, there’s very little in the book
that gives one faith in its author’s 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 we’ll 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.
  Lifebegins at 59: Dr. Ron Rothenberg seems to have found the fountain of youth, and it's not in Baja. 
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They had been saying the exact opposite for years, but Canseco’s book
and the BALCO scandal combined to add new fuel to the fire and helped spark
this past spring’s 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 I’m old-fashioned.
I remember players didn’t get any better as they got ‘older.’ We all got worse.
When I played with Henry Aaron, Willie Mays and Ted Williams, they didn’t put
on 40 pounds and bulk up in their careers, and they didn’t hit more home runs
in their late 30s as they did in their late 20s. What’s happening in baseball
now is not natural, and it isn’t 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 doesn’t 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 Rothenberg’s 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 weren’t the bogeymen they had been made out to be, maybe everything
we’re hearing about steroids being the devil incarnate is wrong as well.
[
 Strongmedicine: Approaching 60, Dr. Mauro Di Pasquale (right), a former champion weightlifter, says don't believe the negative hype about steroids. 
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If you want to know anything about steroids, Mauro Di Pasquale is a
pretty good place to start. He’s 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 won’t 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 body’s 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; it’s 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 Hunter’s 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 Berthold’s 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 potion’s 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 testosterone’s 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 Hitler’s
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 Reader’s Digest excerpted the work.
Reviewers cited both de Kruif’s 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 it’s quite possible Paul de Kruif’s was the
last unbiased opinion on the subject.
So strong are those biases and so fervently have they been promoted that calling
the world’s top steroid experts and asking them questions — especially in light
of the president’s 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 don’t 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, there’s 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 you’re going to have some problems, but are steroids the problem or
the fact that this person didn’t 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 don’t sell tickets like they used
to.
Which is not to say anabolics aren’t 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, there’s 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 wasn’t until 1996 that medical science got around to
admitting that steroids actually could increase muscle mass and strength. “It’s
the craziest thing you’ve 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
Medicine’s 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 America’s 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. “There’s 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 couldn’t 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 we’ve 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 wasn’t just that using steroids was cheating — other factors came into play.
“There’s a whole subset of the industry that’s 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 can’t argue about who’s the best batter ever if some of the
best batters were on steroids. They’re a subset, but they’re 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 Nixon’s 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
don’t 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 Orwell’s classic book about a totalitarian
future, 1984.”
This wasn’t 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 couldn’t 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 world’s 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 didn’t matter. Senator Herbert Kohl spoke for many when he said, “Steroid
users set an intolerable example for our nation’s 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 controversy’s 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 Jekot’s 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 weren’t 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 ex–football 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 Jekot’s 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 didn’t
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 someone’s
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
Dullnig’s 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. Jekot’s
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, there’d be a few million HIV-positive people who’d 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 government’s 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 they’ll pass another bill,” says Rick Collins, the author
of Legal Muscle. “But it doesn’t 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, it’s a brave new world. There’s still no reliable
test for human growth hormone (a pituitary extract that promotes lean muscle
mass), and nobody is close to finding one. There’s blood doping, some people
say there’s already gene doping. The government is spending a lot of time and
money chasing after an almost-obsolete technology that’s 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 government’s numbers and most drug-reform advocacy groups put the price
tag at close to $50 billion a year, roughly the equivalent of our country’s
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, “It’s 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 that’s 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 isn’t 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 aren’t the wonder
drug of tomorrow,” says Mark Gordon, a Los Angeles–based 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 there’s a muscle surrounding
the eye that wears out as we age and steroids can keep it healthy?” And his
list doesn’t include many of the current or coming wonders of anti-aging medicine
of which steroids — or, now that we’re being nice, let’s call them hormones
— will be a part.
But to understand what’s 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 body’s 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 organism’s 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 Harman’s
free-radical theory among them. Another is that the accumulation of excess glucose
in our tissues screws up the cells’ ability to function normally. There’s also
the end segments of a DNA strand known as telomeres. These are naturally lost
in normal cell division, but, over time, when we’ve lost too many telomeres,
then our cells lose their ability to divide into new cells. Without these new
cells we can’t rebuild body tissue, and when we can’t 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 Alzheimer’s, 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 that’s 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 Alzheimer’s disease. “My advice here is really pretty simple,” says Rothenberg.
“Fruits, vegetables, meats, fish are all fine. Frozen foods and canned goods
— that’s the danger zone. Avoid the center aisles at the grocery stores — you’ll
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 there’s a need for some DHEA, and that’s when
we land squarely in the midst of today’s 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 it’s
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, isn’t about what I need
now; it’s about what I might want then. “If you can hold on for five more years,”
says Rothenberg, “you won’t believe what’s coming.”
Stem cells are, of course, the biggest promise. “We’re talking about cloning
your exact DNA to repair your DNA. And this stuff isn’t in the future — it’s
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 don’t know what we’ll have access to in America and what we won’t. You may
have to go to Switzerland to avoid having to go to chemotherapy, but it’s coming.”
And then there’s 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. “We’re talking about
DNA repair at an incredible level,” says Rothenberg. “If your body has stopped
producing the desired amount of testosterone, pretty soon we’re 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 we’re looking at a life span of 120 years. And all those
later years won’t be spent in a wheelchair and a nursing home. Thanks to the
wonders of hormones, what’s 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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