Performance pharmacology and doping

Informational content on steroids, hormones and banned substances: what they do, their real risks and why anti-doping control exists. This is not a usage guide.

What 'doping' is and why a banned substance list exists

The World Anti-Doping Agency (WADA) bans a substance when it meets at least two of three criteria: it improves performance, it poses a health risk, or it goes against the 'spirit of sport'. This list is reviewed every year and covers everything from steroids to certain diuretics, and it is the reason competitive sport distinguishes between natural and chemically assisted performance.

How to apply it

• If you compete under a federation, always check the current WADA list before taking any new supplement or medication
• Understanding this list helps you interpret what you see about fitness on social media with more context

Anabolic steroids: what they actually do

Anabolic steroids activate the androgen receptor, the same one testosterone uses, increasing muscle protein synthesis and reducing catabolism. There is no 'purely anabolic steroid without androgenic effects': they all act on the same receptor, so they all carry androgenic effects to a greater or lesser degree (acne, hair loss, virilisation), despite what the historic marketing of some compounds suggested.

How to apply it

• Be suspicious of any compound sold as 'anabolic with no androgenic side effects': no such thing exists
• Understand that the difference between 'natural' and chemically assisted physiques is not only genetics or discipline

The real risks of anabolic steroids

The risk profile affects several systems at once and part of it does not reverse when you stop: cardiovascular (HDL drops, blood pressure rises, greater risk of thrombosis and sudden death in young users), hormonal (your body stops producing its own testosterone, with hypogonadism that can persist for months or years), hepatic (especially oral forms), and psychiatric (irritability, aggression, manic episodes). This is not a theoretical risk: it is well documented in the medical literature.

How to apply it

• If you know someone using them, honest information about these risks is worth more than silence or judgement
• The risk is not only 'long term': some cardiovascular and psychiatric effects appear during use itself

Growth hormone: less miraculous than people think

In healthy adults, controlled trials show that exogenous growth hormone produces modest weight gains, largely from water retention rather than new muscle, with no consistent improvements in strength. In exchange, its risk profile (insulin resistance, carpal tunnel syndrome, abnormal bone growth, cardiac problems with prolonged use) is disproportionately high relative to the real benefit.

How to apply it

• Do not assume growth hormone is a magic shortcut to more muscle: the evidence in healthy adults does not support it
• The perceived benefit in many cases is retained water, not functional muscle tissue

SARMs: the myth of the 'safe and legal' alternative

SARMs are often marketed as 'risk-free steroids' because in theory they act more on muscle and bone than on the prostate or skin. In practice, no SARM is approved for human use in any indication, they suppress your own testosterone production much like steroids, and independent analyses frequently find contamination and dubious purity in products sold as a 'supplement'.

How to apply it

• Do not trust that 'SARM' means 'safe': they have no approval for human use and no established safety profile
• Any product sold as a supplement containing SARMs is in fact an unregulated experimental drug

Blood doping: why it is so dangerous

Artificially increasing red blood cells (with EPO or transfusions) raises oxygen transport and endurance performance, but it also thickens the blood non-linearly, greatly raising the risk of thrombosis, embolism and heart attack, especially combined with the normal dehydration of prolonged exercise. Several documented deaths in endurance cycling in the 1990s are attributed precisely to this combination.

How to apply it

• Understand that the risk from this kind of doping is not abstract: blood viscosity is a real and acute mechanism of harm

If you are already using or considering it: reduce the harm

If someone already uses or is going to use these substances whatever the guidelines say, the worst option is doing it with no medical supervision at all. A reasonable minimum of monitoring includes a lipid profile, liver function, haematocrit and hormonal evaluation (LH, FSH, testosterone, oestradiol) before, during and after, ideally with a doctor who knows the real situation rather than being kept in the dark.

How to apply it

• If this applies to you, prioritise regular blood work with a professional, even if you are embarrassed to give them the full context
• Hiding your actual use from your doctor is the surest way for a serious problem to go unnoticed until it is severe

Why comparing your physique with 'fit' influencers is not fair

A meaningful share of the extreme physiques you see on social media (lots of muscle with very little fat, maintained all year round) is not explained by exceptional genetics, a perfect diet or discipline alone: the use of these substances is widespread in that niche, even though it is almost never declared. Measuring your natural progress against that benchmark is an unfair comparison that only breeds frustration.

How to apply it

• Compare your progress with your own starting point, not with physiques that may have undeclared chemical help
• If a result looks 'too good' for the training and diet being described, it probably is