The Big Lie about steroids

If I had a dime for every time i heard a juicehead proclaim that it was not his gear growing muscle on him, it was just facilitating his own efforts to do so (“it’s just giving me the ability to work out harder, you see”), I’d have been if not rich, then just a little less poor than I am. This is one of the biggest lies surrounding the use of anabolic steroids.

The purpose of this post is not at all to discredit the results of people on juice, just to discredit their claims of it being all themselves. Fact is, if they hadn’t juiced they wouldn’t be as big (while also being lean) or as strong and as this is part of what they are being judged by, it is not fair to blame all of their muscle mass or strength on their own efforts. Face it, when was the last time your heard “well, it wasn’t ALL me. I did use three cycles of test and tren to get here” when replying to a compliment on their size or strength?

Pre-Bhasin

In the 80′es and 90′es it was actually controversial whether or not anabolic steroids had any performance-enhancing or macroscopically significant anabolic effects. The reason behind this was of course that no-one had done studies with supraphysiological doses of anabolic steroids yet and in the light of this absence there was actually no real evidence to support the notion that anabolic steroids was the game changers that some people claimed.

“The magic bullet” about steroids aka Bhasin et al, 1996

But lo and behold, in 1996 Shalender Bhasin had a paper published in one of the most prestigious medical journals, the New England Journal of Medicine, describing a study that would forever change the view on anabolic steroids (Bhasin et al, 1996). Essentially the study was a double cross-over study in which 43 young healthy normal weight men, were put on standardized diets and then into one of four intervention groups:

  1. No exercise, placebo
  2. No exercise, 600 mg Testosterone Enanthate weekly
  3. Resistance exercise 3 times/week, placebo
  4. Resistance exercise 3 times/week, 600 mg Testosterone Enanthate weekly

for 10 weeks. Bhasin reported that the changes in fat-free mass were as follows:

  1. +0.8 kg
  2. +3.2 kg
  3. +2.0 kg
  4. +6.1 kg

Thereby proving beyond any reasonable doubt that 600 mgs of Testosterone Enanthate per week does indeed cause skeletal muscle hypertrophy and increases in strength (strength data not shown in this blog post).

figure from Bhasin et al, 1996, NEJM, detalining muscle mass results with graded doses of steroids

figure from Bhasin et al, 1996, NEJM, detalining muscle mass results

But besides showing that testosterone actually works, it also shows that testosterone causes skeletal muscle hypertrophy and strength improvements even in the absence of training! 3.2 kgs of muscle in 10 weeks with no exercise… That’s not too shabby, if you ask me.

But wait, there’s more

Bhasin did another study in which he recruited young men, knocked their endogenous testosterone production down pharmacologically, effectively making them hypogonadial and randomised them to graded doses of testosterone (25, 50, 125, 300 or 600 mg testosterone enanthate/week) for 20 weeks (Bhasin et al, 2001). Note that in this study, no one did any exercise. It should be noted that the normal dosage used for replacement therapy in hypogonadism is 250 mg of Test E every two to three weeks (more frequently 3 than two), i.e. 80-120 mg/week, indicating that the two lower groups are probably somewhat hypogonadic even with the adminstered testosterone, which shows clearly from the graph below. The real interesting stuff is that with 600 mg/week the subjects grew 7-9 kgs of muscle (!) and lost 1-2 kgs of fat (check the table below)!

tabulated results of changes in muscle mass and fat mass with hydrostatic weighing and DXA

tabulated results of changes in muscle mass and fat mass with hydrostatic weighing and DXA

Also, please note that the graph for changes in muscle mass by no means seem to indicate any degree of saturation. This indicates that much larger doses would be even more effective.

Also, note that the amount of muscle grown with the same dosages in 10 weeks was about 3 kgs. Considering that it takes some time for Testosterone Enanthate to increase blood levels of testosterone, it means that testosterone-driven hypertrophy didn’t start until 2, maybe even 3 or 4 weeks into the study. So if we subtract the first 3 weeks from each study and compare 3 kgs in 7 weeks vs. 8 kgs in 17 weeks, it looks like the rate of muscle gain is about the same in both studies, indicating that the muscle mass at the end of the 20 week study had not reached steady state for the given level of testosterone. Thus, if the testosterone therapy had been maintained, the subjects would likely have had even more dramatic results!

Changes in muscle and fat mass in groups adminstered 25, 50, 125, 300 or 600 mg of Test E/week

Changes in muscle and fat mass in groups adminstered 25, 50, 125, 300 or 600 mg of Test E/week

In a later study, in which they used the same protocol, they demonstrated essentially the same results, but in a larger cohort (and that conversion to dihydrotestosterone is not neccessary for testosterone to exert it’s effects) (Bhasin et al, 2012).

Discussion

Anabolic steroids grow muscle all on their own. It is indeed possible to sit on one’s ass, watching netflix, playing GTA, and masturbating, while getting jacked. To put the numbers into context, a normal adult man of 80 kgs will have about 25-30 kgs of muscle mass and 10-15 kgs of fat mass. Going from 27 kgs of muscle and 12 kgs of fat to 35 kgs of muscle and 10 kgs of fat would be, ahem, a quite visible change. Those are approximately the changes that would be expected with 12 months of really serious resistance training and decent nutrition.

So when gearheads claim that the steroids are just enabling them to work harder, they are if not lying then just wrong. Naturally, it’s just a case of them trying to reduce cognitive dissonance as they’d like to think that it is their own effort that builds those muscles. Sadly, they are wrong about that. In the lower dose ranges it may actually have an effect where it reinforces training adaptations, but the hypertrophy seen with higher doses is purely driven by chemistry.

Of course, after a steroid cycle, most of the muscle gained will be lost, but the period of having chemically hypertrophic muscle most likely provides a degree of size consolidation (i.e., muscle memory) that makes it possible to maintain some of it, just like people that have previously had muscle hypertrophy from lifting weights will also have an easier time regaining that muscle mass.

Conclusion

I do not mean to take anything away from people training hard that happen also to be taking steroids, but their cognitive dissonance should not get in the way of fact, and the fact is that the majority of gains to be had from anabolic steroids are from the steroids themselves and not an exercise/testosterone interaction. So when you see that guy preparing for a natural bodybuilding show and the other one preparing for an “unnatural” one, it’s not because the “unnatural” dude is training harder that he’s much bigger. Actually, it’s probably somewhat easier for him, because he doesn’t have to be just as careful about overtraining and losing too much precious muscle with his fat as the “natty”. I do not intend to say that the natural athletes do “more”, but that the “un-nattys” get a lot more with the same level of effort. At least that’s what I’m told by the people I know that have tried preparing for both natural and unnatural bodybuilding or fitness shows ;o).

References

Bhasin, S., Storer, T. W., Berman, N., Callegari, C., Clevenger, B., Phillips, J., et al. (1996). The effects of supraphysiologic doses of testosterone on muscle size and strength in normal men. The New England Journal of Medicine, 335(1), 1–7. doi:10.1056/NEJM199607043350101

Bhasin, S., Woodhouse, L., Casaburi, R., Singh, A. B., Bhasin, D., Berman, N., et al. (2001). Testosterone dose-response relationships in healthy young men. American Journal of Physiology Endocrinology and Metabolism, 281(6), E1172–81.

Bhasin, S., Travison, T. G., Storer, T. W., Lakshman, K., Kaushik, M., Mazer, N. A., et al. (2012). Effect of testosterone supplementation with and without a dual 5α-reductase inhibitor on fat-free mass in men with suppressed testosterone production: a randomized controlled trial. Jama, 307(9), 931–939. doi:10.1001/jama.2012.227

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