Doping, Performance-Enhancing Drugs, and Hormones in Sport

1. Overview: Doping in Sport
History and Current State of the Problem
Prevalence by Sport, Country, Level of Competition
World Anti-Doping Agency and Legal Problems
Ethical Issues of Usage, Sportsmanship, Character
Are There Situations in Which Athletes Can Use PEDs?—Therapeutic Use Exemption
Close-Up: Sports Doping in Ancient Civilization—Nothing New Under the Sun
References
2. Anabolic Androgenic Steroids
Treatment of Endocrine Disruptions
The Athletic Drive to Increase Muscle Mass
Intracellular Biochemical and Nuclear Actions
Early Paradoxes and Later Confirmations in Research Findings
Effects of Abuse, Reversible and Nonreversible
Other Anabolic Substances
Close-Up: The Victims of the East German Medal Machine 1970s to 1990s
References
3. Stimulants
Losing Weight, Staying Awake, Gaining Focus
Staying Athletically Lean and on Task
Neurochemistry
Performance Enhancement Evidence
Speeding and Crashing
Conclusion
Close-Up: Weight Loss and Body Composition—What’s the Difference Between Lean Body Mass, Fat-Free Mass, and Muscle Mass, and Why Do Athletes Care?
4. Glucocorticoids
Anti-Inflammatory and Pulmonary Actions
Helping Athletes Recover Faster, Breathe Better, and Burn More Fat
Endocrine and Immune Actions
Do They work? Yes, No, and Maybe
Pseudo-Cushing’s Syndrome and Mineralocorticoid Actions?
Conclusion
Close-Up: Primum non nocere—Glucocorticoids and an Ethical Dilemma in Sports Medicine
References
5. Peptide-Protein Hormones
Offsetting Endocrine Defects and Dysfunctions
Increasing Muscle Mass and Enhancing Oxygen Delivery
Ramping Up Hormone Actions Within Cells
It Works, Within Limits
Acromegaly, Blood Hyperviscosity, and Death
Conclusion
Close-Up: Can Altitude Training Alone Have the Same Effects as Taking EPO?
References
6. Beta-2 Agonists
Asthma Prevention and Treatment
Breathing More and Easier Building Muscle in Sport
Bronchodilation Adrenergic Actions and Reactions
Asthmatics, Yes. ! Everyone Else?
Tachycardia, Arrhythmias, Syncope
Conclusion
Close-Up: Use of Inhalers by Asthmatic Athletes—Is This Really Doping?If My Child Uses an Inhaler for Asthma, Is That Doping?
References
7. Hormone and Metabolic Modulators
Estrogen and Androgen Modulation in Health and Disease
The Balance Between Gender-Based Hormones
Selective Receptor Modulation Drugs
Contradictions and Ambiguous Evidence
Thrombosis, Embolisms, Hot Flashes, and Hyperandrogenism
Conclusion
Close-Up: Selective Estrogen Receptor Modulators and Exercise as Treatments for Breast Cancer Survivors
References
8. Narcotics
In the arms of Morpheus
The Athletic Need to Push Through the Pain
The Opioid System and Pain
Substances that Work too Well
Addiction, Addiction, and Addiction
Close-Up: Pain Management in Athletes—How do Physicians Deal with this Issue when Narcotics are WADA Banned Substances?
References
9. Beta Blockers
Cardiovascular Modulation and Health
Staying Calm, Cool, and Collected on the Battlefield of Sport
Blocking the Actions of Neurotransmitters and Hormones
Strong Evidence of Performance Enhancement
From Lethargy to Impotence: Undesirable Effects
Close-Up: Sometimes the Consequences of Doping Can Be Quite Severe
References
10. Athlete Testing, Analytical Procedures, and Adverse Analytical Findings
WADA Testing Procedures
Biospecimen Analysis Techniques
Strengths and Weaknesses of the Bioanalytical Procedures
Ways in Which Athletes Avoid Detection
What Happens When an Athlete Gets a Positive Test Result?
Close-Up: Fox Guarding the Henhouse
References
11. The Future of Performance Enhancement in Sport
Can Prevention and Detection Deter Doping?
Education of Athletes: Is That Enough?
Staying Ahead of the Doping Athlete: Is it Possible?
Genetic Doping: Is it the Future?
Should Doping be Legalized and Regulated?
Binary Gender Constructs and the Future
What’s Next?
Close-Up: Women Athletes—Taller, Faster, Stronger, and Hyperandrogenism
References

Doping, Performance-Enhancing Drugs, and Hormones in Sport: Mechanisms of Action and Methods of Detection examines the biochemistry and bioanalytical aspects of performance-enhancing drugs (PEDs) and other questionable procedures used by athletes to enhance performance. The book informs the specialist of emerging knowledge and techniques and allows the non-specialist to grasp the underlying science and current practice of the discipline.

With clear and compelling language appropriate for a broad spectrum of readers, this book provides background on prevalence, types of agents, their actual or supposed benefits, and their negative effects on health. The technical aspects of detection are discussed, followed by a discussion of why detection is a problematic and still-evolving science. To facilitate comprehension, each chapter is organized in a uniform way with six sections: (1) standard medical uses, (2) why the drugs are used by athletes, (3) biological mechanism of action, (4) what research says about efficacy in improving performance, (5) major health side effects from use and abuse in sport, and 6) concluding key points.

• Presents the scientific concepts of how performance enhancers work, how they are used, and how they are detected and masked from detection
• Features language that is neither simplistic to scientists nor too sophisticated for a large, diverse global audience
• Provides a short “close-up” in each chapter to illustrate key topics that engage, entertain, and create a novel synthesis of thought
  

Biochemists, pharmacologists, medical doctors, nurses, clinical trials specialists, specialty foods processors and distributors, legislators and their staffs, regulatory scientists and administrators, public health officials, kinesiologists, physical educators, and members of the general public with an interest in exercise and physical training