Selective androgen receptor modulator use and related adverse events including drug-induced liver injury: Analysis of suspected cases.

PURPOSE: Selective androgen receptor modulators (SARMs) have demonstrated agonist activity on the androgen receptor in various tissues, stimulating muscle mass growth and improving bone reconstruction. Despite being in clinical trials, none has been approved by the Food and Drug Administration (FDA) or European Medicines Agency for pharmacotherapy. Still, SARMs are very popular as performance-enhancing drugs. The FDA has issued warnings about the health risks associated with SARMs, but the long-term exposure and possible adverse events still need to be fully understood. This review aims to evaluate the adverse events associated with using SARMs by humans. METHODS: PubMed database was searched from September 16, 2022, to October 2, 2023. In total, 20 records were included in the final review. Data from preclinical and clinical studies supported the review. RESULTS: Since 2020, 20 reports of adverse events, most described as drug-induced liver injury associated with the use of SARM agonists, have been published. The main symptoms mentioned were cholestatic or hepatocellular liver injury and jaundice. Limited data are related to the dosages and purity of SARM supplements. CONCLUSION: Promoting SARMs as an anabolic agent in combination with other performance-enhancing drugs poses a risk to users not only due to doping controls but also to health safety. The lack of quality control of consumed supplements makes it very difficult to assess the direct impact of SARMs on the liver and their potential hepatotoxic effects. Therefore, more detailed analyses are needed to determine the safety of using SARMs.

Does sodium bicarbonate based extra-cellular buffering support reduce high intensity exercise-induced fatigue and enhance short-term recovery assessed by selected blood biochemical indices?

Exercise-induced metabolic processes induce muscle acidification which contributes to a reduction in the ability to perform repeated efforts. Alkalizing agents such as sodium bicarbonate (NaHCO3) prevent large blood pH changes, however, there is no evidence on whether regulation of acid-base balance may also support whole body homeostasis monitored through heamatological and biochemical blood markers in a dose-dependent manner. Thirty Cross-Fit-trained participants were studied in a randomized, multi cross-over, placebo (PLA)-controlled double-blind manner in which they performed a control session (CTRL, without supplementation), three NaHCO3 visits (three different doses) and PLA (sodium chloride in an equimolar amount of sodium as NaHCO3). Each visit consisted of two 30-s Wingate tests separated by CrossFit-specific benchmarks (Wall Balls and Burpees - both performed for 3 min). Blood samples were collected at rest, immediately post-exercise and after 45 min recovery. Significant differences between visits appeared for blood pH, percentage of lymphocytes and granulocytes, red blood cells count and haemoglobin concentration at post-exercise and 45-min recovery, and for white blood cells count, percentage of monocytes, concentration of magnesium and creatinine at 45-min recovery. Most of the observed differences for heamatological and biochemical markers were significant compared to CTRL, but not different after PLA. NaHCO3 supplementation compared to PLA did not significantly affect exercise or recovery shifts in studied blood indicators. However, the changes in these markers after NaHCO3 and PLA in relation to CTRL indicate a possible role of sodium.

Safety and Impact on Training of the Influenza Vaccines in Elite Athletes Participating in the Rio 2016 Olympics.

OBJECTIVE: The aim of the study was to evaluate the safety and tolerance of influenza vaccines for the northern and southern hemispheres in Polish elite athletes participating in the Rio 2016 Olympics. DESIGN: Prospective, observational, cohort study. SETTING: Institutional level. PARTICIPANTS: Ninety-seven athletes vaccinated only with the northern hemisphere vaccine; 98 athletes received the southern hemisphere vaccine alone, whereas 39 athletes were vaccinated with both vaccines. INTERVENTIONS: The athletes were vaccinated with a trivalent, inactivated influenza vaccine recommended for the northern hemisphere 2015/2016 and then with the vaccine recommended for the southern hemisphere 2016. Athletes kept a diary of adverse events and effects (if any) on training for 6 days after vaccination. MAIN OUTCOME MEASURES: The percentage of general and local adverse events, number of lost or modified training sessions. RESULTS: Significantly more local adverse events (pain and redness) were found in the group immunized with the vaccine for the northern hemisphere. There were no differences in the frequency of general adverse events and influence on training between groups. Of total 273 athletes who had 1911 training days during 6 days after vaccination, 6 athletes (2.2%) lost 13 training days (0.7%) and 16 athletes (5.9%) had to modify 34 (1.7%) training days within first 2 days after vaccination. CONCLUSIONS: Athletes tolerated influenza immunization well. If they are going to travel to the other hemisphere during the influenza season, the use of the second influenza vaccine should be advised. Athletes should anticipate modification of trainings for 2 days after vaccination.

Is vitamin D status reflected by testosterone concentration in elite athletes?

Vitamin D is a nutrient whose active form affects tissues as a hormone and possibly enhances performance. One plausible mechanism is by increasing testosterone concentration, which is established as an important factor for athletic performance. Therefore the aim of the study was to examine the relationship between plasma concentration of 25(OH)D and testosterone in Polish elite track and field athletes depending on vitamin D status, season, training period, body composition, sex, type of training, sun exposure and vitamin D supplementation. Plasma concentrations of 25(OH)D and testosterone were measured in all seasons within two years in athletes (70 females, 79 males) who represent strength (n = 103) and endurance (n = 46) kinds of sports, in the preparatorycompetitive season and transition period. There were no differences in 25(OH)D concentration between male and female athletes, insufficiency [25(OH)D < 30 ng/ml] was observed in 32.9%, whereas deficiency [25(OH)D < 20 ng/ ml] in 3.2%. Circannual rhythm was noted for vitamin D but not for testosterone concentration; no correlations between them were found either in strength or endurance athletes or between 25(OH)D and body composition. Testosterone concentration was higher in the transition period than in the preparatory-competition period only in male athletes. Higher 25(OH)D was observed in athletes who trained during winter in Africa (higher sun exposure) or used oral supplementation, whereas the respective testosterone levels were unchanged. In athletes, testosterone concentration did not reflect vitamin D status. The widespread of inadequate vitamin D status among athletes, makes it vital to recommend them the regular monitoring of 25(OH)D concentration and use of reasonable supplementation.

Comparison of GC-MS and MEKC methods for caffeine determination in preworkout supplements.

In this study, GC-MS- and MEKC-based methods for determination of caffeine (CAF) in preworkout supplements were developed and validated. The proposed protocols utilized minimal sample preparation (simple dilution and syringe filtration). The developed methods achieved satisfactory validation parameters, i.e. good linearity (R2 > 0.9988 and R2 > 0.9985 for GC-MS- and MEKC-based method, respectively), satisfactory intra- and interaccuracy (within 92.6-100.7% for method utilizing GC-MS and 92.1-110.3% for protocol based on MEKC) and precision (CV < 15.9% and CV < 6.3% for GC-MS- and MEKC-based method, respectively) and recovery (within 100.1-100.8% for method utilizing GC-MS and 101.5-106.2% for protocol based on MEKC). The LOD was 0.03 and 3 µg/mL for method utilizing GC-MS and MEKC, respectively. The CAF concentrations determined by GC-MS- and MEKC-based methods were found to be in the range of 8.53-11.23 and 8.20-11.61 µg/mL, respectively. Taking into consideration information on the labels, the investigated supplements were found to contain from 110.0 to 167.3% of the declared CAF content, which confirmed the literature reports on incompatibility of the declared product compositions with real ones. Nevertheless, the consumption of examined supplements as recommended by producers did not lead to exceeding the CAF safe limit of 400 mg per day. Additionally, the MEKC-based method allowed for detection and identification of vitamin B3 and B6 in all of the investigated supplement samples, which demonstrated that MEKC-based protocols may be an appropriate assays for simultaneous determination of CAF and vitamins.

Upper Respiratory Tract Infection and Mucosal Immunity in Young Ice Hockey Players During the Pretournament Training Period.

Orysiak, J, Witek, K, Malczewska-Lenczowska, J, Zembron-Lacny, A, Pokrywka, A, and Sitkowski, D. Upper respiratory tract infection and mucosal immunity in young ice hockey players during the pretournament training period. J Strength Cond Res 33(11): 3129-3135, 2019-The aim of this study was to determine the effects of 17 days of training during preparation for the Ice Hockey Under 18 World Championship of the Polish ice hockey national team on the mucosal immune function and monitor upper respiratory tract infection (URTI) incidence before, during, and after the competition. Twelve male ice hockey players (age, 17.7 ± 0.5 years) were recruited for this study. The first saliva and blood collection took place at the beginning of the training camp (without training at the training camp), the second one was collected on the 9th day of the training camp immediately after the intensification of training, and the third collection was performed on the 13th day of training (4 days before leaving for the World Championship) in the tapering phase. To assess the mucosal immune function, concentrations of secretory immunoglobulin A (sIgA), sIgA1, and sIgA2 were analyzed in saliva. Cortisol concentration and creatine kinase activity were determined in blood, as indicators of stress and muscle damage, respectively. The Wisconsin Upper Respiratory Symptom Survey-21 questionnaire was used to assess URTI symptoms. A significant increase in the sIgA1 and sIgA2 concentrations was observed in the third collection compared with the second time point (114.45 ± 33.00 vs. 77.49 ± 27.29 and 88.97 ± 25.33 vs. 71.65 ± 32.44 U, respectively). There were no statistically significant correlations between the URTI incidence and saliva variables. In conclusion, the tapering period positively affects the mucosal immune function, especially sIgA1 and sIgA2 concentrations, with no significant change in the frequency of URTI in young ice hockey players.

Hematological status and endurance performance predictors after low altitude training supported by normobaric hypoxia: a double-blind, placebo controlled study.

The benefits of altitude/hypoxic training for sea level performance are still under debate. This study examined the effects of low altitude training supported by normobaric hypoxia on hematological status and endurance performance predictors in elite female cyclists. Twenty-two female cyclists trained for 3 weeks at low altitude (<1100 m) and 2 weeks near sea level. During the first 3 weeks, 15 subjects stayed in hypoxic rooms simulating an altitude of 2200 m (+NH group, n = 8) or 1000 m (placebo group, n = 7), and 7 (control group) stayed in regular rooms. Significant increases in total hemoglobin mass (tHb-mass: p = 0.008, p = 0.025), power at 4 mmol·l-1 lactate (PAT4: p = 0.004, p = 0.005) (in absolute and relative values, respectively) and maximal power (PF: p = 0.034) (in absolute values) were observed. However, these effects were not associated with normobaric hypoxia. Changes in tHb-mass were not associated with initial concentrations of ferritin or transferrin receptor, whereas changes in relative tHb-mass (r = -0.53, p = 0.012), PF (r = -0.53, p = 0.01) and PAT4 (r = -0.65, p = 0.001) were inversely correlated with initial values. Changes in tHb-mass and PAT4 were positively correlated (r = 0.50, p = 0.017; r = 0.47, p = 0.028). Regardless of normobaric hypoxia application, low altitude training followed by sea-level training might improve hematological status in elite female cyclists, especially with relatively low initial values of tHb-mass, which could translate into enhanced endurance performance.

Asthma and exercise-induced respiratory disorders in athletes. The position paper of the Polish Society of Allergology and Polish Society of Sports Medicine.

Exercise-induced respiratory symptoms describe acute airway narrowing that occurs as a result of exercise. It includes exercise-induced bronchoconstriction (EIB) and exercise-induced asthma (EIA) issues. To provide clinicians with practical guidelines, a multidisciplinary panel of stakeholders was convened to review the pathogenesis of EIB/EIA and to develop evidence-based guidelines for the diagnosis and treatment. Recommendations for the diagnosis and treatment of EIB were developed. High-intensity exercise in polluted environment (cold air, humidity, contamination, allergens) may increase the risk of EIB and asthma symptoms in athletes. Diagnostic procedures should include history taking, physical examination, atopy assessment and functional tests of the respiratory system. A strong recommendation was made for regular use of inhaled glucocorticosteroids and avoidance of short-acting ß2-agonists as the only treatment. The treatment of asthma in athletes should always take into account current anti-doping regulations. This position paper reflects the currently available evidence.

Antibody Response to Trivalent Influenza Vaccine in the Northern and the Southern Hemisphere in Elite Athletes.

Being frequent travelers, the elite athletes are advised to undergo an influenza vaccination. The aim of the study was to describe the antibody response to repeated trivalent, inactivated, split influenza vaccine, of different antigenic content, recommended for the Northern and the Southern Hemisphere, administered to sportsmen before the Olympic Games in Brasil in 2016. Fourteen athletes were included in the study. For both A/California/7/209/pdm09 A/H1N1/ antigen and A/Switzerland/971593/2013/A/H3N2/ antigen, higher seroconversion rates were obtained after the first than the second vaccination (10.2 vs. 1.5 and 10.6 vs. 3.0, respectively; p < 0.05 both). Conversion rates for B/Phuket/3073/2013, B/Brisbane/60/2008, and A/HongKong/4801/2014/A/H3N2/ antigens were lower. Nonetheless, the protection rate was greater than 70% for all antigens contained in both vaccines. The proportion of individuals demonstrating a high level of both protection rate and response rate was greater after the first than the second vaccination. We conclude that the immunological response after influenza vaccination is good in elite athletes and remains so after a second influenza vaccination required due to a different vaccine composition recommended for different hemispheres.

Interrelationships between changes in erythropoietin, plasma volume, haemoglobin concentration, and total haemoglobin mass in endurance athletes.

Interrelationships between physiological changes (Δ) in erythropoietin (EPO), plasma volume (PV), haemoglobin concentration ([Hb]), and total haemoglobin mass (tHb-mass) were examined in cyclists who trained in different altitudes. Regardless of differences in pattern of changes observed in three training locations, ΔEPO was correlated positively with ΔPV, negatively with Δ[Hb], and trivially with ΔtHb-mass. Δ[Hb] was negatively correlated with ΔPV. In the pooled data the Spearman's rank correlation coefficients were as follows: r = 0.783, P < 0.001; r = -0.704, P < 0.001; r = 0.136, P > 0.05; r = -0.813, P < 0.001, respectively. The obtained results have shown that EPO does not only regulate [Hb] by erythropoiesis stimulation but also by PV modulation, which probably aims at keeping proper level of arterial oxygen content for oxygen delivery to tissues.

Pertussis outbreak in Polish shooters with adverse event analysis.

In addition to different injuries, infections are the most common reason for giving up training altogether or reducing its volume and intensity, as well as a lack of opportunities to participate in sports competitions. Nowadays, a slow but constant re-emergence of pertussis, especially among teenagers and young adults, including athletes, can be observed. This paper describes an outbreak of pertussis among professional Polish shooters, focusing on the transmission of Bordetella pertussis infection between members of the national team, its influence on performance capacity and adverse event analysis. From 9 June, 2015 to 31 July, 2015, a total of 4 confirmed and suspected cases of pertussis were reported among members of the Polish Sport Shooting National Team, their relatives and acquaintances. Pertussis significantly decreased exercise performance of the first athlete, a 35-year-old woman, interrupted her training, and finally resulted in failure to win a medal or quota place. Pertussis also significantly decreased performance of the second athlete, a 25-year-old shooter. The other cases emerged in their families. Whooping cough is a real threat to athletes and should be prevented. Preventive measures include appropriate immunization, constant medical supervision, as well as early isolation, diagnostic tests and treatment of all infected sport team members. Regular administration of booster doses of the acellular pertussis vaccine (Tdpa) every 5 years seems reasonable.

Total Hemoglobin Mass, Aerobic Capacity, and HBB Gene in Polish Road Cyclists.

Malczewska-Lenczowska, J, Orysiak, J, Majorczyk, E, Zdanowicz, R, Szczepanska, B, Starczewski, M, Kaczmarski, J, Dybek, T, Pokrywka, A, Ahmetov, II, and Sitkowski, D. Total hemoglobin mass, aerobic capacity, and the HBB gene in polish road cyclists. J Strength Cond Res 30(12): 3512-3519, 2016-The relationship between genes, amount of hemoglobin, and physical performance are still not clearly defined. The aim of this study was to examine the association between-551C/T and intron 2, +16 C/G polymorphisms in the beta hemoglobin (HBB) gene and total hemoglobin mass (tHbmass) and aerobic capacity in endurance athletes. Total hemoglobin mass and aerobic capacity indices, i.e.,V[Combining Dot Above]O2max, oxygen uptake at anaerobic threshold (V[Combining Dot Above]O2AT), maximal power output (Pmax), and power at anaerobic threshold (PAT) were determined in 89 young road cyclists, female (n = 39) and male (n = 50), who were genotyped for 2 polymorphisms in the HBB gene. The relative values of aerobic capacity indices differed significantly among intron 2, +16 C/G polymorphisms of the HBB gene only in female cyclists; athletes with GG genotype had significantly higher values of V[Combining Dot Above]O2max (p = 0.003), V[Combining Dot Above]O2AT (p = 0.007), PAT (p = 0.015), and Pmax (p = 0.004) than C carriers. No relationships were found between the C-carrier model (CC + CG vs. GG in the case of intron 2, +16 C/G and CC + CT vs. TT for -551 C/T polymorphisms of the HBB gene) and relative values of tHbmass. Our results demonstrated that the HBB gene could be related to aerobic capacity, but it seems that it does not result from an increase in the amount of hemoglobin in the blood.

BUDESONIDE TREATMENT OF PROFESSIONAL ATHLETES AND ANTI-DOPING TESTING--CASE STUDIES.

According to the World Anti-Doping Agency (WADA) Prohibited List, glucocorticosteroids are prohibited in competition and only when administered by oral, intravenous, intramuscular or rectal routes. Up to now, in order to differentiate whether glucocorticosteroids were administered by one of the prohibited routes or not, a specific reporting limit for urinary concentrations of parent compounds and their metabolites was established at 30 ng/mL. Additionally, the new specific regulation starting from 1 September 2014 for budesonide have been introduced that the 6ß-hydroxybudesonide shall be targeted. Budesonide is a glucocorticosteroid used mainly by inhalation for asthma management. Interestingly, anti-doping laboratory statistics show that budesonide adverse analytical findings (AAF) constitute almost 50% of all reported glucocorticosteroid AAFs, even though budesonide possesses a very low systemic activity which may cause performance enhance effects. This work presents the results of five studies of controlled budesonide administration carried out on professional athletes. The samples were analyzed by using a quantitative HPLC/MS/MS method for 16α-hydroxy-prednisolone, the most abundant budesonide metabolite in urine. Our data clearly show that inhalation of budesonide at least 12 h before a competition at therapeutic doses leads to appearance of the main budesonide metabolite in concentrations exceeding prior reporting limit for this compound. Therefore, our work strongly supports recent WADA decision not to target the main budesonide metabolite using the same reporting limit as for other glucocorticosteroids.

Overrepresentation of the ACTN3 XX genotype in elite canoe and kayak paddlers.

The aim of the study was to examine the association between the ACTN3 R577X polymorphism in canoe sprint athletes (canoe and kayak paddlers) and their results at 200- or 1000-m distance. Eighty-six European white male athletes divided into 2 groups-successful, who were outstanding at national championships, and nonsuccessful in these competitions-and 354 nonathletic controls were included in this study. The R577X polymorphism of ACTN3 was typed using PCR-RFLP. ACTN3 genotype distribution among all tested athletes and controls was in Hardy-Weinberg equilibrium. The odds ratio (OR) for successful 1000-m athletes harboring the XX genotype compared with sedentary controls was 2.95 (95% confidence interval [CI]: 1.37-6.35), but the OR for nonsuccessful 200-m athletes having the XX genotype compared with controls was 2.64 (95% CI: 1.30-5.36). These results suggest that factors associated with the ACTN3 XX genotype in canoe and kayak paddlers might provide some competitive advantage in performance at 1000 m, but it seems to limit at 200 m. Further studies aimed at development of training strategies based on genetic factors are needed.

Detection of ß-methylphenethylamine, a novel doping substance, by means of UPLC/MS/MS.

Novel substances of expected doping activity are constantly introduced to the market. ß-Methylphenethylamine (BMPEA) is classified as a doping agent by the World Anti-Doping Agency as it is a positional isomer of amphetamine. In this work, the development and application of a simple and rapid analytical procedure that enables discrimination between both isomers is described. The analytes of interest were extracted from urine by a two-step liquid-liquid extraction and then analyzed by UPLC/MS/MS under isocratic conditions. The entire analytical procedure was validated by evaluating its selectivity, discrimination capabilities, carry-over, sensitivity, and influence of matrix effects on its performance. Application of the method resulted in detection of BMPEA in eight anti-doping samples, including the first report of adverse analytical finding regarding its use. Further analysis showed that BMPEA may be eliminated unchanged along with its phase II conjugates, the hydrolysis of which may considerably improve detection capabilities of the method. Omission of the hydrolysis step may therefore, produce false-negative results. Testing laboratories should also carefully examine their LC/MS/MS-based amphetamine and BMPEA findings as both isomers fragment yielding comparable collision-induced dissociation spectra and their insufficient chromatographic separation may result in misidentification. This is of great importance in case of forensic analyses as BMPEA is not controlled by the public law, and its manufacturing, distribution, and use are legal.

Relationship between ACTN3 R577X polymorphism and maximal power output in elite Polish athletes.

BACKGROUND AND OBJECTIVE: The main purpose of this study was to examine the association between ACTN3 R577X polymorphism and the ability to produce peak power in young male athletes from various sports. Our hypothesis was that the ACTN3 R577X polymorphism is associated with jumping performance and athletes with RR genotype have better scores in tests than athletes with XX or RX genotype independently of the sport discipline. MATERIALS AND METHODS: Two hundred young Polish male participants representing different disciplines were recruited for this study. Genotyping for ACTN3 gene was performed using polymerase chain reaction. The power output of lower extremities and the height of rise of the body mass center during vertical jumps were measured on a force plate. RESULTS: The genotype distribution of the ACTN3 gene did not differ significantly between groups of athletes. The significant difference in height of counter-movement jump was found between athletes with RR and XX genotype (0.446±0.049m vs. 0.421±0.036m, respectively, P=0.026). The ACTN3 RR genotype was associated with greater muscle power and height of jump in young male athletes. CONCLUSIONS: These results suggest that the ACTN3 gene may play a significant role in determining muscle phenotypes. However, this gene is only one of many factors which could contribute to athletes' performance and muscle phenotypes.

Withania somnifera and Trigonella foenum-graecum as ingredients of testosterone-boosting supplements: Possible clinical implications.

This narrative review provides an overview of scientific studies on dietary supplements that may affect circulating testosterone (T) levels to explore which substances are scientifically proven to increase T concentration. We also review the scientific literature for their potential mechanisms and laboratory test changes triggered by their use. Based on the analysis of existing data on substances used to increase endogenous T levels, especially double-blind placebo-controlled randomized clinical trials, we selected 2 herbal extracts with the best documented positive effects on T levels, Withania somnifera root and root extracts/leaves and seed extracts of Trigonella foenum-graecum. Although these substances have different postulated mechanisms of action, both significantly increase T levels in men. Withania somnifera may inhibit the effects of cortisol and prolactin on the hypothalamic-pituitary-gonadal axis and directly affect the hypothalamus. Trigonella foenum-graecum seeds contain the active substance diosgenin, which is a precursor for sex hormone synthesis in gonads.

Predicting Future Athletic Performance in Young Female Road Cyclists Based on Aerobic Fitness and Hematological Variables.

PURPOSE: This study aimed to determine whether the initial levels of aerobic fitness and hematological variables in young female road cyclists are related to their athletic performance development during their careers. METHODS: Results of graded exercise tests on a cycle ergometer and total hemoglobin mass (tHb-mass) measurements were analyzed in 34 female road cyclists (age 18.6 [1.9] y). Among them, 2 groups were distinguished based on their competitive performance (Union Cycliste Internationale world ranking) over the following 8 years. Areas under the curve in receiver-operating-characteristic curves were calculated as indicators of elite-performance prediction. RESULTS: Initial graded exercise test variables (peak power, peak oxygen uptake, and power at 4 mmol/L blood lactate) were not significantly different in elite (n = 13) versus nonelite (n = 21) riders. In contrast, elite riders had higher tHb-mass expressed either in absolute measures (664 [75] vs 596 [59] g, P = .006) or normalized to body mass (11.2 [0.8] vs 10.3 [0.7] g/kg, P = .001) and fat-free mass (14.4 [0.9] vs 13.1 [0.9] g/kg, P < .001). Absolute and relative erythrocyte volumes were significantly higher in elite subjects (P ranged from < .001 to .006). Of all the variables analyzed, the relative tHb-mass had the highest predictive ability to reach the elite level (area under the curve ranged from .82 to .85). CONCLUSION: Measurement of tHb-mass can be a helpful tool in talent detection to identify young female road cyclists with the potential to reach the elite level in the future.

Illegal Use of Testosterone and Other Anabolic-Androgenic Steroids in the Population of Amateur Athletes in Wroclaw, Poland-An Unfavorable Lifestyle Trend in the Population of Men of Reproductive Age.

Background: One factor that may negatively impact male reproductive health is the illegal use of testosterone and anabolic-androgenic steroids. This study aimed to evaluate the prevalence of testosterone use in recreational athletes, as well as factors associated with its use, and to determine the profile of a person using testosterone. Methods: A cross-sectional analysis of data from an anonymous, online questionnaire of men recruited from gyms, randomly selected in Wroclaw, Poland, has been performed. The minimal sample size was evaluated with the univariate logistic regression model. The association between testosterone use and other factors was also evaluated with the univariate logistic regression model. Results: A total of 35% of respondents used testosterone. The main purposes of testosterone use were the improvement of training effects and the improvement of body shape. The respondents most likely to use testosterone and other anabolic-androgenic steroids were men aged 26-35, whose earnings were at the level of the middle class or higher, who were married, had children, had training experience of at least 6 months, exercised at least once a week, took part in weightlifting competitions, were managers in a corporation or enterprise, or were self-employed. Most of the people using testosterone had self-treated side effects. Conclusions: The profile of the person most likely to use testosterone corresponds to the characteristics of men in optimal socio-demographic conditions for reproduction. These results indicate that this is a significant social problem that may impact male reproductive health.

Relationships between Changes in Hematological Adaptations and Exercise Capacity in Olympic Rowers after a Period of Reduced Training Loads.

Endurance performance is positively associated with hematological adaptations; therefore, high total hemoglobin mass and intravascular volumes are commonly observed in high-level endurance athletes. However, it is still unclear whether the fluctuations in exercise capacity that typically occur in endurance athletes during the annual training cycle are directly associated with changes in hematological adaptations, which appear to be relatively stable during this time. To better understand this issue, a study was conducted with 10 Olympic rowers, who followed the same training program. Athletes underwent laboratory testing in the competitive and the general preparation phase of an annual training cycle (a 34% reduction in training volume). This included a graded exercise test on a rowing ergometer (GXT) and blood measurements of hemoglobin concentration (Hb), total hemoglobin mass (tHb-mass), plasma volume (PV), and blood volume (BV). Decreases in maximal values of power relative to body mass (p = 0.028), lactate concentration (p = 0.005), and heart rate (p = 0.017) in the GXT were registered. At the same time, absolute (p = 0.017) and relative (p = 0.005) PV decreased. Changes in PV (rS = 0.842, p = 0.002) and BV (rS = 0.818, p = 0.004), but not in tHb-mass (rS = 0.588, p = 0.074) and Hb (rS = -0.188, p = 0.602), were significantly correlated with changes in maximal power in the GXT. Our results indicate a close relationship between changes in intravascular volumes and maximal exercise capacity after a period of reduced training loads in elite endurance athletes.