THE NEW YORK TIMES
Many competitive bodybuilders take anabolic steroids
to achieve their freakishly exaggerated physiques. That is no secret.
But steroids can be only one part of an extreme regimen that can wreak
havoc on the body.
Human growth hormone,
supplements, painkillers and diuretics can also be used to create the
“shrink-wrapped” muscles so prized in the aesthetic. And the high
concentration of muscle mass puts stress on the body, as if the lifter
were obese.
Lifting weights in the gym is “extremely healthy for you,” said Kenneth
Wheeler, a former elite bodybuilder known as Flex. “But if you want to
be a bodybuilder and compete at the highest level, it has nothing to do
with health.” A relatively rare form of kidney disease forced Wheeler to
retire in 2003 at age 37, and he needed a kidney transplant later that year.
Determining the extent of the damage that bodybuilders inflict on
themselves is difficult, in part because there is little interest in
financing studies on such an extreme group, and because bodybuilders
are not always honest about what they take. That is why a case study
published last month by a top kidney journal is generating interest in
the nephrology and bodybuilding communities. It is among the first to
assert a direct link between long-term steroid use and kidney disease.
Patrick Antonecchia, a powerlifter and strong man competitor, ended his steroid use and career about a year ago.
Credit
Joyce Dopkeen for The New York Times
The study began 10 years ago when a kidney pathologist at Columbia
University Medical Center in New York noticed that a bodybuilder had an
advanced form of kidney disease. Curious, she started looking for
similar cases and eventually studied 10 men with serious kidney damage who acknowledged using steroids. Nine were bodybuilders and one was a competitive powerlifter with a similar training routine.
All 10 men in the case series,
published in November by the Journal of the American Society of
Nephrology, showed damage to the filters of the kidney. Nine had an
irreversible disease known as focal segmental glomerulosclerosis
— the same disease contracted by Wheeler — even though the men in the
study did not have other apparent risk factors. Their disease was worse
than in obese patients with a higher body-mass index, suggesting that
steroids — combined with the other practices — might be harming the
kidneys.
Among
the study’s most persuasive details is the story of a man, 30 years old
at the time, who damaged his kidneys after more than a decade of
bodybuilding. The patient’s condition improved after he stopped using
the drugs, discontinued his regimen and lost 80 pounds. But it worsened
after the man, who became depressed, returned to bodybuilding and
steroids.
“These
patients are likely the tip of the iceberg,” said Vivette D. D’Agati,
the lead researcher. “It’s a risk. A significant risk.”
Several experts not affiliated with the study said that while the claims
were intriguing, the study’s value was limited because it focused only
on intensive steroid users and because the bodybuilders’ layered
training practices had to be taken into account. “I think it’s hard to
be certain what’s causing their kidney disease,” said William Bremner,
chairman of the Department of Medicine at the University of Washington
and an endocrinologist who studies steroids.
Antonecchia has lost about 50 pounds
and said he misses the attention his
290-pound frame attracted.
Credit
Joyce Dopkeen for The New York Times
D’Agati
said, “It’s probably multiple factors that are converging in these
patients, but the common entity in all of them is anabolic steroids.”
One
participant in the study, Patrick Antonecchia, 46, competed in
powerlifting and strong man events for more than 25 years and said he
used steroids, supplements and a high-protein diet to attain feats such as pulling a 40,000-pound truck.
He ended his career and stopped using steroids about a year ago, and in
February received a diagnosis of serious kidney damage. His doctors
warned him not to use the drugs again. “They said: ‘Pat. Don’t. Because
it comes back,’ ” he said.
Antonecchia
has lost about 50 pounds and said he misses the attention his 290-pound
frame attracted: “The toughest thing now is it was my identity for 25
years. Now, when people see me, they say, ‘What happened to you?’ ”
Jerry
Brainum writes a column for Iron Man Magazine called Bodybuilding
Pharmacology and said he welcomes more research on the subject. “I found
it very alarming, quite frankly,” Brainum said.
Since the 1990s, at least eight accomplished bodybuilders
have died at a young age, and in addition to Wheeler, another six were
forced to stop competing because of serious illness, often involving
kidney disease.
Kenneth Wheeler, a bodybuilder known as Flex, in 1996. He developed kidney disease and was forced to retire in 2003 at age 37.
Credit
Gary Phillips
The main source of information for bodybuilders is
word of mouth and experimentation, Brainum said. “These guys have no
guidance, they talk among themselves, and they don’t even tell the truth
to each other,” he said.
The risk-taking has been made worse by a trend toward ever larger physiques among the sport’s top competitors, some said. Jay Cutler, who won the 2009 Mr. Olympia contest, weighs almost 40 pounds more than Arnold Schwarzenegger did when he won the title in 1974, even though Cutler is five inches shorter.
“Each
decade you have a guy that comes along that sets new standards and you
say O.K., now I’m going to have to take it to the next level,” said
Shahriar Kamali, a professional bodybuilder known as King.
The
International Federation of Body Building and Fitness reserves the
right to test for steroids and human growth hormone at the professional
level, and testing is done on a random basis, said Bob Cicherillo,
athlete representative for the federation, which is the main governing
body for bodybuilding.
But
several bodybuilders said the testing was nearly nonexistent, and
Cicherillo said he could not provide specific figures on competitors who
tested positive. In addition, the chairman of the organization’s
medical commission, Robert M. Goldman, is a leading champion of the anti-aging effects of human growth hormone, a drug that is banned by most sports governing bodies.
Antonecchia competing in the 2001 New World Strongest Man competition where he was the runner-up.
James Manion, who runs the professional division of the federation, did not return several calls seeking comment.
Some
bodybuilders expressed doubt that their practices were dangerous,
pointing to former competitors who are still healthy in their 70s. They
attributed the deaths of elite bodybuilders to the abuse of
over-the-counter painkillers and diuretics, not steroids. The
bodybuilding federation tests for diuretics at professional events,
although competitors said they are still used.
Bodybuilders
said that they were unfairly singled out as drug abusers when athletes
in most other sports were also using performance-enhancing drugs. “Like
anything else, it’s use and abuse,” Cicherillo said. “We’re the ones who
are visual. We’re the ones who walk around, and you see us with the big
muscles.”
Wheeler said he was convinced steroid use did not cause his kidney disease, although it might have made it worse.
The
patient whose case was the centerpiece of the kidney study said he was
most likely predisposed to develop the condition. “The drugs weren’t the
reason I got sick,” said the man, who declined to be identified because
his steroid use was illegal. After taking a year off from steroids and
bodybuilding because of the kidney disease, the man, age 34, is
returning to competition. His symptoms have worsened, a sacrifice he
said he is willing to accept.
“It’s
just really hard to walk away from it,” he said. “I know I can only do
this until my early 40s, so I really want to give it my all now.”
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