Avoid nonmedical anabolic steroid use for muscle gain
In a Danish study, men with positive gym doping tests for anabolic androgenic steroids had three times the mortality of matched controls and more than twice the median annual hospital-contact rate. Acne, male breast enlargement, and erectile dysfunction each affected more than one in ten users. In China these substances are prescription-regulated; informal sales without the required controls are unlawful.
What it takes
Nothing, and it saves drug costs. Accepting slower muscle growth may require patience.
What you may gain
Danish researchers used records for 545 men who tested positive for androgenic steroids at gyms between January 3, 2006, and March 1, 2018, with 5,450 age-matched controls. They checked the pattern in another 644 men who refused testing and 6,440 controls. Steroid users had HR 3.0 for mortality, 95% CI 1.3–7.0. Median annual hospital-contact rates were 0.81 versus 0.36, P<0.0001; the median divides the observations in half. Acne, gynecomastia (enlarged male breasts), and erectile dysfunction each affected over 10% of users and were substantially more common than in controls, P<0.0001. The second cohort showed consistent results. Article 7 of China's Anti-Doping Regulations strictly regulates prohibited substances on the doping list and prohibits unlawful manufacture, sale, import, or export. Article 9 places anabolic agents and peptide hormones under prescription-drug management.
Context & considerations
Disputed causal interpretation: this was an observational study, not a randomized trial. Users may differ in other risk-taking behavior, so the entire threefold association cannot be attributed to the drugs. The confidence interval is wide, from 1.3 to 7.0. The source regards the conspicuous adverse effects—each affecting over 10%—as less vulnerable to this confounding, though the observational design still matters. Ordinary protein powder and creatine are outside this entry's scope. Products promising exceptionally fast muscle gain may contain undeclared substances. As with slimming products, check legitimate drug authorization and prescribing; claims of quick results are a reason for scrutiny, not proof by themselves that a nutritional product is adulterated.
Research & references
Horwitz H et al. (2019). Health consequences of androgenic anabolic steroid use. Journal of Internal Medicine. https://doi.org/10.1111/joim.12850; State Council (2004). Anti-Doping Regulations, Order No. 398, Articles 7 and 9. http://www.gov.cn/gongbao/content/2004/content_63129.htm