Inflammation the Other Silent Killer in Bodybuilding

High blood pressure is said to be a silent killer as you don’t “feel” anything wrong when it is elevated.

You could make the same case from for chronic low grade inflammation.

In current and former anabolic androgenic steroid (AAS) users, visceral adipose tissue (VAT) accrual was an independent predictor of lower insulin sensitivity.

Users had lower body fat % than non users, but higher amounts of VAT.

Mechanisms are not known for decreases in insulin sensitivity, but may be through chronic low grade inflammation.

In users, we see elevated pro-inflammtory cytokine production in VAT and increase hepatic production of C-reactive protein levels indicating an inflammatory response.

AAS users have elevated CRP levels compared to non using counter parts

Low-grade systemic inflammation is a risk for:

• Atherosclerosis
• Dyslipidemia
• Hypertension
• Metabolic Syndrome
• Diabetes

Anabolic Steroid users share similar metabolic characteristics of obese/sedentary populations such as Metabolic Syndrome, thereby increasing risk of Cardiovascular disease.

Why Does This Happen?

• Overweight /obesity
• Overproduction of reactive oxygen species
• Advanced glycation end products (elevated blood glucose outcomes)
• Mitochondrial dysfunction
• Renin Angiotensin System (RAS) deregulation
• Visceral fat accumulation
• Defective cell autophagy

All the above are driven from ↑ food,↑ body weight, ↑ gear usage.

Combating inflammation and oxidation is an important aspect to managing long term health in supraphysiological PED usage. So, this brings to question what can we do to work on the mechanisms causing inflammation?

In a meta-analytic review paper, nutritional and pharmaceutical compounds were investigated for their impact on lower CRP levels. Six compounds were included as they met criteria to be promising, safe, tolerable, affordable and acceptable strategies for reducing chronic low grade inflammation.

Compounds Effects on CRP Reduction:

Probiotic -0.43 mg/L reduction
Angiotensin Receptor Blockers -0.2mg/L reduction
Omega 3 -0.17 mg/L reduction
Metformin -0.16mg/L reduction
Resveratrol and Vitamin D showed no reduction

Normal CRP levels is <1.0mg/L

When building health intervention protocols we need to look at the “why” and “how” of PEDs bring about poor health.

Through this we can investigate strategies that can work to mitigate those effects.

REFERENCES

Grace, Fergal & Davies, Bruce. (2004). Raised concentrations of C reactive protein in anabolic steroid using bodybuilders. British journal of sports medicine. 38. 97-8. 10.1136/bjsm.2003.005991.

Altan Onat; Günay Can; Gülay Hergenç (2008). Serum C-reactive protein is an independent risk factor predicting cardiometabolic risk. , 57(2), 207–214.doi:10.1016/j.metabol.2007.09.002

McCullough D, Webb R, Enright KJ, et al. How the love of muscle can break a heart: Impact of anabolic androgenic steroids on skeletal muscle hypertrophy, metabolic and cardiovascular health. Rev Endocr Metab Disord. 2021;22(2):389-405. doi:10.1007/s11154-020-09616-y

Custodero C, Mankowski RT, Lee SA, Chen Z, Wu S, Manini TM, Hincapie Echeverri J, Sabbà C, Beavers DP, Cauley JA, Espeland MA, Fielding RA, Kritchevsky SB, Liu CK, McDermott MM, Miller ME, Tracy RP, Newman AB, Ambrosius WT, Pahor M, Anton SD. Evidence-based nutritional and pharmacological interventions targeting chronic low-grade inflammation in middle-age and older adults: A systematic review and meta-analysis. Ageing Res Rev. 2018 Sep;46:42-59. doi: 10.1016/j.arr.2018.05.004. Epub 2018 May 25. PMID: 29803716; PMCID: PMC6235673.