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- Jason J. Koch, MD*
- *Southdale Pediatrics, Edina, MN
Objectives
After completing this article, readers should be able to:
List the names and actions of performance-enhancing substances.
Describe the signs and symptoms of anabolic steroid use.
Describe the signs and symptoms of growth hormone use.
Characterize the adverse effects of anabolic steroids and other performance-enhancing substances.
Describe the clinical changes seen in patients using anabolic steroids and growth hormone.
Introduction
Pediatricians see many adolescent patients who present for sports physical examinations, camp physical examinations, or immunizations. One area of concern in the health of these patients should be the use of performance-enhancing substances (PES), which may be better known as ergogenic aids or performance-enhancing drugs. The use of these agents has grown significantly among athletes to help performance and among nonathletes to improve appearance. Use of substances such as anabolic steroids, creatine, and dietary supplements is widespread among adolescents and is related to numerous pressures to excel in academics, at home, and on the athletic field.
To be prepared to discuss PES with our patients, we should know the names of the substances, how they are believed to work, and problems associated with their use. We should be aware of the current epidemiology, prevalence, and popular attitudes. We also should know the clinical aspects of PES, including symptoms and signs of use and abuse as well as the science behind the chemicals and the studies that have been published. Finally, we should understand our role in the management of patients using these substances and how we can act as educators, spokespersons, and advocates for child athletes.
History and Definitions
PES have been present as long as there has been human competition. Aztec athletes and warriors ate human hearts to give them strength in battle and competition. Ancient Greek Olympians used special mushrooms they believed gave them added power. In the 1800s, European cyclists used …
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