While professional athletes and bodybuilders often promote supplements to enhance performance, the industry is unregulated and young adults may be induced to take substances that are not only unnecessary and expensive but potentially dangerous.
Muscle synthesis depends on the synergy between resistance training and fueling with protein.
Complete proteins provide the building block of amino acids for muscle synthesis.
Creatine is an amino acid that is made by the body but can also be supplemented in the diet.
Anabolic steroids are a synthetic version of the body’s natural androgenic hormone—testosterone (T).
T-boosters are widely marketed to young athletes but they carry important health risks.
Before considering a supplement, start with inexpensive and safe performance-enhancing changes to your routine: diet, hydration, and sleep for recovery.
Don’t go overboard on meat — eating a 16 oz steak will not translate to a pound of new muscle.
To build muscle, you need three things: resistance training, protein, and recovery. Resistance training plus protein consumption stimulates muscle growth synergistically, meaning you need to do both to maximize your gains.
The supplement industry has capitalized on this knowledge for years by promoting amino acids and protein powders, but the truth is, we already produce (endogenously) the right amino acids and hormones to build muscle. That said, a good diet focused on boosting protein intake after training can help accelerate the process of muscle development (or “bulking”).
To build muscle, your body needs access to building block amino acids, some of which must be found in the diet because they cannot be made endogenously. Whey protein is an example of a complete protein because it contains all the essential amino acids in a readily available form, and it also contains branched-chain amino acids (BCAAs) which are essential to building muscle mass.
An anabolic steroid, on the other hand, is a synthetic hormone — an artificial version of testosterone — which stimulates muscle protein synthesis. Bulking through a smart diet is safer and less expensive than supplements.
Protein supplements and amino acids can help build power, volume
Protein supplements — like whey — help ensure a sufficient supply of the raw building blocks for muscle synthesis: amino acids. Of the 20 amino acids, 11 are made by the body while nine are considered “essential,” meaning they are not manufactured by the body and must be found in food. Whey is a complete protein able to supply all nine essential amino acids and the BCAAs needed to build muscle. However, you do not need a supplement to get enough complete proteins. Animal proteins found in meat, poultry, fish, eggs, and dairy are sufficient. Plant-based complete proteins include quinoa, buckwheat, hempseed, blue-green algae, and soybeans.
Creatine is an amino acid in red meat and seafood, but it is also made by the liver, kidneys, and pancreas from three amino acids (arginine, glycine, and methionine) and stored in muscle as phosphocreatine. The International Society of Sports Nutrition says that creatine can not only improve exercise performance, but can play a role in preventing and/or reducing the severity of the injury, enhancing rehabilitation from injuries, and helping athletes tolerate heavy training loads. A recent randomized controlled trial in a small group of young athletes found that post-workout creatine supplementation at 0.1 grams/kg each day was effective in building muscle strength and endurance compared to placebo.
One important distinction is that creatine while creatine can help boost strength, does not have a direct effect on muscle mass generation, and is not an anabolic steroid like testosterone.
Testosterone (“T”) is a sex hormone produced within the body by males (and females) which promotes bone density and muscle mass, with peak production late in adolescence (typically 18-19 years). Although women do not produce as much testosterone as men, the American Council on Exercise says that women can still see a 20 to 40% increase in strength with several months of training. Boosting T using anabolics or ‘roids has serious health consequences and can lead to dependency.
If I want to increase my performance with an anabolic compound, what side effects might I expect?
In a recent meta-analysis, anabolic steroid use caused reductions in gonadotropin levels which took 13-24 weeks to return to baseline. Gonadotropins are hormones that regulate testicular and ovarian function. After discontinuing use, testosterone remained lower compared to baseline; a reduction in testicle size, as well as the structure and function of sperm and gynecomastia, were also noted at least four months after discontinuation. Other real-world observations from male bodybuilders include hair loss and fat deposition.
How can I minimize the risk while maximizing the reward?
T-boosters are widely available on the Internet but limited human studies are available to evaluate safety and efficacy. It is hard to come off a T-boosting cycle because you will feel worse while your endogenous production recovers. (In other words, the testicles shrink while taking a T-booster because they do not need to make testosterone. It takes months to resume normal production and size.)
How should I start a cycle?
Testosterone is available orally, via injection, skin patches, and creams. Before starting a cycle, visit a sports medicine clinic and discuss your goals with an endocrinologist or nutritionist, measure your baseline testosterone levels, and take stock of your overall health. Testosterone supplementation has uncertain long-term cardiac health risks, and an over-supply triggers the production of female hormones leading to supplementation with natural or synthetic aromatase inhibitors. In other words, a go-to “newbie” cycle can easily be overkill and lead to unintended physical and mental effects which take months to reverse.
What effects do steroids have on female athletes?
For women, changes in the clitoris, menstruation, and fertility were observed as side effects.
How should I monitor my health while on steroids?
Regular hormone testing should be recommended by the clinic you visit for your intake exam.
What are the warning signs that I should stop?
Depression, insomnia, suicidal ideation, fatigue, mania, liver damage, and unwanted physical effects such as hair loss or reduction in testicular size.
Best ways to build muscle
The safety profiles of whey protein and creatine are good at the right dose, they are well tolerated and may offer a performance boost, but they can put a load on the kidneys at higher than recommended dosages. Approximately half of the college athletes take sports supplements, but they do not have sufficient knowledge about dosing or reputable supply sources.
On the other hand, considering an anabolic steroid is a major leap into a much riskier venture. Get the most out of diet and training because cycling with synthetic hormones is expensive, carries risks, and is extremely complex to optimize.
Before you hit the gym, eat right to give your body the protein it needs to build muscle: about 1-2 grams per kilogram of body weight each day. And instead of going straight to supplements and steroids, improve performance through intentional dietary choices, such as making a post-workout smoothie with complete proteins and getting enough sleep to allow for muscle synthesis. If your diet is already finely tuned and you still want to optimize performance, consider a stepwise progression starting with the safest option — creatine or whey protein — and do your research on anabolics.
- NIH. International Society of Sports Nutrition position stand: safety and efficacy of creatine supplementation in exercise, sport, and medicine.
- NIH. Prevalence, knowledge and attitudes towards using sports supplements among young athletes.
- Children's Hospital Colorado. Creatine, Creatine Supplements and Adolescent Athletes.
- NIH. Effects of Creatine Supplementation during Resistance Training Sessions in Physically Active Young Adults.
- NIH. Common questions and misconceptions about creatine supplementation: what does the scientific evidence really show?
- NIH. What is the history of anabolic steroid use?
- StatPearls. Biochemistry, Essential Amino Acids.
- USDA. Proteins.
- NIH. Effects of Anabolic Androgenic Steroids on the Reproductive System of Athletes and Recreational Users: A Systematic Review and Meta-Analysis.
- Harvard Health Publishing. Is testosterone therapy safe? Take a breath before you take the plunge.
- NIH. Treatments for people who use anabolic androgenic steroids: a scoping review.