1. Anabolic steroids. These drugs, most often ending in an -one and -iol (testosterone, androstenediol, for example), build lean muscle mass and reduce fat. Bye bye potbelly, hello biceps. Not only do they masculinize the users (including women--who'll drop their voices and start growing hair in unfeminine places) they can also make you aggressive, depressed, shrink your testicles, and cause acne and liver damage. Fun times!
2. Peptide hormones and growth factors.
- erythropoetin-like agent (such as EPO, or Epogen) stimulate the bone marrow to grow more red blood cells. Red cells carry oxygen to your body. The more you have, the more oxygen you can deliver to your exercising body. The real Lance Armstrong is dealing with this one.
- insulin. Apparently it's used along with steroids to boost energy storage in muscles and continue the anabolic effect of steroids.
- growth factors (growth hormone, insulin-like growth factor, etc) also used to increase muscle mass.
- hormones like corticotropin, leutinizing hormone, also used to add mass and optimize muscle growth
4. Hormone modulators. These are things like aromatase inhibitors (commonly used to treat breast cancer or osteoporosis). This one had me scratching my head. Apparently, when using anabolic steroids, the balance between natural estrogens and androgens (female and male hormones--both of which are found naturally in men and women) goes off kilter. Men using steroids can sometimes paradoxically grow breasts (called gynecomastia) because of this imbalance. Using anti-estrogens like aromatase inhibitors can prevent a bodybuilder from needing to buy a bra at Victoria's Secret. Secret indeed!
5. Diuretics and masking substance. Diuretics, such as thiazides, are meds that make you pee like a racehorse, which may help you pass your urine drug test. Other substances, like dextran, albumin, and mannitol, can mask the actual illegal chemicals.
6. Blood enhancers. This includes blood transfusions (your own banked blood, or someone else's) an chemicals that help your blood carry more oxygen, like perflurochemicals or blood substitutes.
7. Gene doping. Yes! This is not sci-fi, this is real. You are not allowed to have genetically modified cells injected into yourself.
8. Stimulants. Caffeine? Okay! Sudafed (pseudoephedrine)? Only in tiny amounts. Crystal meth? Adrenaline? No.
9. Narcotics. I know that work out hurt, but no, you cannot pop prescription pain pills.
10. Cannabis, or pot. Or weed. (I wonder if this will change with the legalities of cannabis changing right now.)
11. Glucocorticoids. These are super powerful anti-inflammatory meds, also helpful in recovering from that tough work out. Good for asthma exacerbations, bad for pro athletes.
For more info, check out the comprehensive list by the World Anti-Doping Agency.
The CBC gives a nice description of how and why these substances are used.
And the U.S. Anti-Doping Agency also has a nice overview.
If you've got a fictional medical question, let me know! Post below or email me at