Bodybuilding Case Study: Discussion

Diet | Pharmaceuticals | Exercise

The purpose of this study was to document a champion bodybuilder's precontest preparation practices and to attempt to study their effects on body composition.


The subject ate a combination of all food components every meal. Thus, the subject was not concerned about the glycemic index of each food. Workouts usually began 1 hour after the completion of a meal. Premature hunger followed by mild hypoglycemia was experienced if the percentage of calories from fat approached or dropped below 20%. It was hypothesized that an adequate amount of dietary fat was needed to slow the emptying of the gut for a sustained release of foodstuffs into the body. Anabolic-androgenic steroid use may alter glucose tolerance, and induce hyperinsulinism (Yesalis, 1989). Powerlifters using anabolic steroids have been shown to develop insulin resistance and diminished glucose tolerance (Cohen, 1987). Although chronic exercise generally decreases serum insulin levels (Viru, et. al. 1992), this is accompanied by an increase in peripheral insulin sensitivity (Richter, 1989).


No relationship was found between dietary intake and body composition. In contrast to previous studies, the subject maintained a relatively high caloric diet while incorporating a long duration walking regimen. The variation of daily activities may have accounted for the fluctuation in body fat. Unfortunately, a detailed record of walking duration and intensity was not included in the training logs. This is a serious deficiency in this study.

Overfeeding has been shown to lead to an increase in lean body mass possibly as a result of increased plasma somatomedin-C, testosterone, and insulin (Forbes, et. al. 1989). Insulin facilitates and increases the transport of glucose and amino acid into muscle cells. Insulin can also stimulate the synthesis and storage of cellular protein and glycogen in muscle cells (Di Pasquale, 1993). Although insulin's effect on amino acid uptake into the cell may not be indicative of increased muscle mass (Florini, 1989), insulin may permit maximum protein synthesis to occur in ideal physiological situations (Di Pasquale, 1993). Insulin and other anabolic compounds may act synergistically to produce significant anticatabolic and anabolic effects (Di Pasquale, 1993). Intercellular amino acid is essential to the action of anabolic steroid's role in protein synthesis.

It must be noted, though, insulin increases lipoprotein lipase action and can enhance the synthesis and storage of triglycerides in fat cells (Di Pasquale, 1993). Anabolic steroids may play a physiological role in the regulation of fatty acid oxidation in the liver and fast twitch muscle mitochondria even in the absence of intense physical training (Guzman, 1991). It has been argued that a high fat diet has a positive effect on muscle growth (Di Pasquale, 1992, B).

The subject took virtually no nutritional supplements for several years. Many claims made for commercially marketed supplements for bodybuilding athletes are not supported by current research (Grunewald, 1993).

The subject attempted to increase muscle mass by a modified carbohydrate load by discontinuing resistive training four days before the show and increasing calories slightly in an effort to restore glycogen in the muscle. Balon, Horowitz, and Fitzimmons conclude that carbohydrate loading has no additional advantage to enhancing muscle girth in bodybuilders over weight-lifting alone (Balon, et. al 1992). The effectiveness of the subjects' carbohydrate loading was not tested in this study. See "Exercise Discussion" below.


The greatest results came from the initial administration of Oxymetholone (Anadrol). As the cycle progressed, a higher dosage was needed to continue progress.

Anadrol seemed to be the most effective single substance in the synthesis of lean body mass. Anadrol combined with Primobolan Depot was the most effective combination later in the cycle. Winstrol-V and Equipoise seemed too weak by themselves. Though, they did seem to increase the effectiveness of Anadrol. The combination of oral and an injectable may be of benefit to those who may have side effects with higher dosages of orals.

Descending dosages seemed to reduced lean body mass. Similarly, dosages significantly lower than the dosages administered in the previous period lowered lean body weight. Although, increases in body weight were apparent in periods 13 and 14 when no drugs or descending dosages were present. The increased Calories after both competitions probably increase body weight substantially. Bodybuilders have been known to rapidly gain weight prior to competition after breaking their pre-contest diet (Hildebrand, 1989; Hickerson, 1990).

The least gains in lean bodyweight occurred during week 5 when 108.3 mg/day of Equipoise (Boldenon Undecyclenate) was administered, significantly more than the previous weeks. One likely explanation of this discrepancy is that Equipoise has a particularly long half-life of 12-14 days. The effects of the higher dosage may have not been observed until the following weeks when much greater lean body weight was gained. However, this theory is difficult to substantiate since the reintroduction of elevated dosages of Anadrol (half-life of 8-9 hours) may have also been responsible for the dramatic increases in lean body weight during this time.

The greatest lean body weight was at period 10. Lean body mass gains (4.8 lbs) surpassed all previous losses in lean body mass (-4.1 lbs) with a lower dosage (157.1 mg/day) than the greatest dosage (178.6 mg/day) at period 7. Four possible explanations exist: 1) The introduction of Primobolan Depot. 2) A synergistic effect between a combination of drugs. 3) An up regulation of androgen receptors from the previous dosage reduction. 4) A relative decrease of Steroid Binding Hormones due to the previous dosage reduction 5) The relative magnitude of increase from the previous dosage is the greatest of all periods. This change was 50 mg/day over period 9.

At week 11, Methenolone enanthate (Primobolan Depot) was not used, but Oxymetholone (Anadrol) and Stanozolol (Winstrol-V) were continued. Lean body mass decreased (-1.6 lbs) despite the similar overall dosage of all drugs (150 mg/day) compared to the period 10 (157.1 mg/day).

Hurley attempts to dramatize the dosages of pharmaceuticals used by the athletes by drawing reference to the dose usually administered for androgenic deficiency. This is a misleading reference to judge athletic dosages since anabolic-androgenic steroids are often used in greater dosages for purposes other than androgen deficiency. For example, Hurley illustrates Oxymetholone (Anadrol) was used by one subject in an average dosage of 87.5 mg/day, 5.8 times that usually administered for androgen deficiency. The subject's dosage was approximately only 1 mg/kg body weight per day (Hurley, 1984). The actual recommended dosage for children and adults is 1-5 mg/kg body weight per day for a minimum of 3 to 6 months (Physicians Desk Reference, 1993).

Early in period 4, the subject claimed he did not feel the sensations he has experienced when on Testosterone cypianate. A counterfeit drug may contain either no anabolic steroid or a substitute commercial anabolic steroid (Di Pasquale, 1992 (A); Walters, 1990). After Stanozolol (Winstrol-V) was used later in the cycle, small gains were found. Although, the gains seen during period 4 may be due to contamination of the unusually long lag time of equipoise in period 5.

Case studies have been used to study drug detection techniques on athletes who self-administered anabolic-androgenic steroids (30).

One of the most common methods of escaping detection when using anabolic steroids is simply discontinuing the use of oral anabolic steroid(s) several days prior to a drug test. Anavar, Winstrol (tablets), and Dianabol are usually undetectable 3 to 4 days of after cessation. Injectable steroids usually have a much longer detection interval. Metabolites of nandrolone have been found in the urine of some athletes after 2 years it was reportedly last used. Stanozolol (Winstrol-V) has been detected in the urine of an athlete 4 months after cessation of its injection (Di Pasquale, 1992, A).

Many oral anabolic steroids are more highly associated with liver abnormalities. Their metabolites can be cleared from the body in only fourteen days after discontinuing use and are therefore more commonly used when drug testing is a concern (Yesalis, 1989).

Athletes have used various methods before drug testing to either decrease the excretion of banned drugs or prevent the detection of these drugs in the urine. Compounds that have been used to decrease the excretion of unblocking steroids and their metabolites include uricosuric agents (e.g., probenecid, carinamide, sulfinpyrazone, phenylbutazone, benzbromarone), corticosteroids, estrogens, oral contraceptives (containing norethindrone), Depo-Provera, phenytoin, pyrazinamide, dexamethasone, and apple cider vinegar. Compounds used to prevent the detection of banned drugs in the urine include various diuretics, Defend, and chemical contaminants such as sodium hypochlorite, and bacteria. Defend acts by both decreasing the excretion of the drug and by diluting the urine (Di Pasquale, 1992, A).

Bilateral gynecomastia developed during the steroid treatment but disappeared a few months after cessation of the pharmaceuticals. The severity was described as "hardly noticeable." Men have been shown to be more susceptible to gynecomastia as a result of anabolic-androgenic steroid use (Yesalis, 1989). Gynecomastia in athletes has been associated with the increase of serum estradiol concentrations during the use of anabolic-androgenic steroids (Alen, 1985).

When athletes discontinue the use of anabolic steroids, they experience a refractory period where they do not produce physiological amounts of endogenous testosterone (Di Pasquale, 1992, A). Anabolic-androgenic steroid can reduce endogeneous testosterone, gonadotrophic hormones, and sex hormone-binding globulin (Yesalis, 1989). Weight-trained athletes have been shown to have low serum testosterone concentrations immediately after cessation of an anabolic-androgenic steroid cycle but return to normal within weeks (Alen, 1985).

It should be noted, the effects of anabolic steroids vary significantly depending upon the type and dose of steroid as well as for different individuals and situations (Yesalis, 1989).

It may be a serious error to overgeneralize the effects and potential side effects of specific anabolic-androgenic steroids to all other anabolic-androgenic steroids. Likewise, it may be also erroneous to assume the effects and potential side effects of certain steroid use in relatively large dosage and/or long duration will have the same effects and potential side effects at a relatively lower and/or shorter duration. Furthermore, it is not correct to assume the effects and potential side effects of certain steroid therapy on medical patients, or even individuals within the "normal" population for that matter, will have the same effects or potential side effects on a given athlete.

All of the effects of anabolic steroids have been demonstrated to be fully reversible within several months following cessation of use; except changes in myocardium which has not been followed (Yesalis, 1989).


The subject engaged in brisk walking to utilize fat and to avoid overtraining. Lower intense submaximal exercise utilizes proportionally less carbohydrates. Intense or prolonged exercise can rapidly deplete muscle glycogen (Di Pasquale, 1993). Protein can supply up to 10% of total energy substrate utilization during prolonged intense exercise if glycogen stores and energy intake is inadequate (Di Pasquale, 1992, C; Brooks, 1987).

Cortisol is a catabolic hormone that induces the breakdown of cellular proteins. Cortisol increases as intense exercise is prolonged (Di Pasquale, 1992, C). Submaximal exercise at lower intensities (ie: 63% maximum oxygen consumption) stimulates lower cortisol response than higher intensities (ie: 86% maximum oxygen consumption) (Farrell, 1983; Naveri, 1985). Significant elevations in cortisol seem to reduce endogenous testosterone by acting directly upon the testis to impair the biosynthesis of testosterone (Di Pasquale, 1992, C).

Resistive training was ceased four days before the show in an effort to restore glycogen in the muscle. In light of studies that do not support the premise that carbohydrate loading increases muscle girth (Balon, et. al 1992), it is suspected that muscle girth could have been enhanced by continued weight training up until the day before the show. The subject later noted that various muscle girths decreased approximately 0.5 inch (1.27 cm) after a layoff as little as 4 days. It seems localized muscle edema diminishes days after weight training.

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